bluuebunny/crossref_metadata_2025_split huggingface dataset:
How does carer management style influence the performance of activities of daily living in people with dementia?
Authors: Camino Julieta , Kishita Naoko , Bregola Allan , Rubinsztein Judy , Khondoker Mizanur , Mioshi Eneida 
Published: August 2021

AbstractIntroductionPeople with Dementia (PwD)'s performance of activities of daily living (ADLs) has been associated with apathy, cognitive deficits, carers' depression and burden. However, it is not known if the carers' management style affects ADL performance, particularly alongside PwD's cognitive deficits and apathy. Thus, the aim of this study was to explore the contribution of intrinsic (cognition, apathy) and extrinsic (carer management styles) dementia factors to ADL performance.MethodsPwD (n = 143) were assessed on global cognition (ACE‐III); apathy (CBI‐R); ADLs (Disability Assessment for Dementia‐DAD). Carers' (n = 143) criticism, encouragement and active‐management styles were assessed with the Dementia Management Strategy Scale (DMSS). Multiple linear regression analysis investigated contributions of carer styles, cognition, apathy (independent variables) on ADLs (dependent variable).ResultsThe best model explaining the variance of the DAD scores included cognition (β = 0.413, t(142) = 4.463, p = 0.001), apathy (β = –0.365, t(142) = –5.556, p = 0.001), carer criticism (β = –0.326, t(142) = –2.479, p = 0.014) and carer encouragement styles (β = 0.402, t(142) = 2.941, p = 0.004) accounting for 40% of the variance of the DAD scores.ConclusionsThis novel study demonstrated that PwD's level of apathy and the carer's use of criticism negatively affected ADL performance while PwD's cognitive abilities and carer encouragement style improved ADL performance. These findings have critical implications for the development of novel multi‐component non‐pharmacological interventions to maintain function and delay disease progression in dementia, as well as direct relevance to current carers and families.
The challenges of achieving timely diagnosis and culturally appropriate care of people with dementia from minority ethnic groups in Europe
Authors: Gove Dianne , Nielsen Thomas Rune , Smits Carolien , Plejert Charlotta , Rauf Mohammed Akhlak , Parveen Sahdia , Jaakson Siiri , Golan‐Shemesh Daphna , Lahav Debi , Kaur Ripaljeet , Herz Michal Karen , Monsees Jessica , Thyrian Jochen René , Georges Jean 
Published: August 2021

AbstractIn a just society, everyone should have equal access to healthcare in terms of prevention, assessment, diagnosis, treatment and care. Europe is a multicultural society made up of people who identify with a wide range of ethnic groups. Many older people from minority ethnic groups also have a direct migration background. Several studies have shown that there is a lack of equity in relation to dementia diagnoses and care because equal opportunities do not necessarily translate into equal outcomes. An expert ethics working group led by Alzheimer Europe has produced an extensive report on this issue, a policy brief and a guide for health and social care workers. In this brief summary, the authors/members of the expert working group present some of the key challenges and recommendations for healthcare clinicians striving to provide timely diagnosis and good quality care and treatment to people with dementia from all ethnic groups.
The structure of hippocampal circuitry relates to rapid category learning in humans
Authors: Schlichting Margaret L. , Gumus Melisa , Zhu Teresa , Mack Michael L. 
Published: August 2021

AbstractPrior work suggests that complementary white matter pathways within the hippocampus (HPC) differentially support the learning of specific versus general information. In particular, while the trisynaptic pathway (TSP) rapidly forms memories for specific experiences, the monosynaptic pathway (MSP) slowly learns generalities. However, despite the theorized significance of such circuitry, characterizing how information flows within the HPC to support learning in humans remains a challenge. We leveraged diffusion‐weighted imaging as a proxy for individual differences in white matter structure linking key regions along with TSP (HPC subfields CA3 and CA1) and MSP (entorhinal cortex and CA1) and related these differences in hippocampal structure to category learning ability. We hypothesized that learning to categorize the “exception” items that deviated from category rules would benefit from TSP‐supported mnemonic specificity. Participant‐level estimates of TSP‐ and MSP‐related integrity were constructed from HPC subfield connectomes of white matter streamline density. Consistent with theories of TSP‐supported learning mechanisms, we found a specific association between the integrity of CA3–CA1 white matter connections and exception learning. These results highlight the significant role of HPC circuitry in complex human learning.
Fluid flow characteristics and convective heat transfer improvement on a gas turbine blade
Authors: Farooq Arshad , Hussain Shafqat , Li Xiang‐sheng , Khan Maham A. 
Published: August 2021

AbstractThe flow field features and heat transfer enhancement are investigated on a gas turbine blade by applying the jet impingement cooling method. The distribution of the flow field and the Nusselt number (Nu) was determined on the targeted surface in the cooling channel. The injection holes of different shapes, such as circular, square, and rectangular were considered. The Reynolds numbers (Re) of the airflow in the range of 2000–5000 and aspect ratios of 0.5–2 were particularly focused. The flow vortices and recirculation in the cooling channel and their influence on the heat transfer enhancement were analyzed in detail under different airflow and geometric conditions. Decreasing the ratio of the distance between jet‐to‐target plate to the diameter of the jet orifice (H/d) increased the heat transfer rate and produced high‐intensity vortices and recirculation zones. It was noticed that the formation and generation of vortices and recirculation have important effects on the convective heat transfer rate at the impingement surface. Local Nusselt number, formation of complex vortices, and airflow recirculation in the cooling channel decreased with the increase in the distance between the jet hole and the targeted surface. It was found that with the increase in the Reynolds number of the jet, heat transfer between cold airflow and the targeted surface increased. Moreover, it was observed that the cooling performance of the round and square jet holes was better than the rectangular holes.
Liver tumor segmentation from computed tomography images using multiscale residual dilated encoder‐decoder network
Authors: Tummala Bindu Madhavi , Barpanda Soubhagya Sankar 
Published: August 2021

AbstractIn this paper, an encoder‐decoder‐based architecture, which segments liver tumors with a two‐step training process is proposed. Accurate liver tumor segmentation from CT images is still a major problem that impacts the diagnosis process. Heterogeneous densities, shapes, and unclear boundaries make tumor extraction challenging. First, the proposed network segments the liver, and then tumors are extracted from the liver ROIs. We have scaled down the images into different resolutions at each scale and applied normal convolutions along with the dilations and residual connections to capture broad conceptual information without data loss. MDICE, a combined loss function is used to enhance the learning capability and the 3D‐IRCADb1 dataset is considered for training and testing because of its tumor complexities. The segmentation quality metrics DICE, MDICE are analyzed on the 3D‐IRCADb1 dataset and obtained 0.98 and 0.65 accuracies per case for liver and tumor segmentation respectively, and found improvement over U‐Net and other variants.
Evaluation of synthetic canal lining materials in South Texas over 18 years—Final results and conclusions*
Authors: Bonaiti Gabriele , Fipps Guy 
Published: August 2021

AbstractSince 1999, irrigation districts in Hidalgo, Cameron, Willacy, and Maverick Counties in South Texas have been experimenting with an assortment of canal lining materials installed in about 40 km of earthen and concrete canals. In 2005, the Texas A&M AgriLife Extension Service initiated a programme to track the long‐term effectiveness and durability of these materials and to document installation and maintenance procedures which will help ensure good performance. Each lining project was periodically inspected to document the effects of such factors as weather, animals, intentional and unintentional vandalism, farm machinery traffic, and normal irrigation district operational and maintenance activities. Evaluation forms were developed to document observations during inspections. The forms consisted of three elements: a general project description, a district operations questionnaire, and a field observation and rating survey. During inspection, the size and locations of holes and tares in the lining materials were identified, along with the most probable causes of the problems found. In this paper, we summarize results and provide recommendations on liner installation and maintenance obtained from evaluations which span about 18 years of material age. The lining systems which performed the best were synthetic liners overlaid with concrete.
Population characteristics, use, and spending on sole‐source, off‐patent drugs among commercial insurance members in the United States—An analysis of outpatient claims data at a single health plan
Authors: Alpern Jonathan D. , Vazquez‐Benitez Gabriela , DeFor Terese A. , Stauffer William M. , Shahriar Arman A. , Kodet Amy J. , Pawloski Pamala A. , Dehmer Steven P. 
Published: August 2021

AbstractIntroductionLarge price increases of off‐patent drugs with one manufacturer are common in the US due to the monopoly power afforded to single manufacturers. Little is known about the patients using these drugs, including the prevalence of use or the cost to patients and health systems.ObjectiveTo analyze patient characteristics, prevalence of use, and spending on sole‐source off‐patent drugs among a commercially‐insured population in 2017.MethodsWe evaluated the prevalence of use of sole‐source off‐patent drugs overall and use of sole‐source off‐patent drugs with large price increases according to member demographic characteristics and medical conditions. We calculated total and out‐of‐pocket spending per member and total and out‐of‐pocket spending on all sole‐source off‐patent drug fills. We evaluated by insurance status, a drug's history of a large price increase, and drug classification. We determined the top ten sole‐source off‐patent drugs by highest overall spending.ResultsUse of sole‐source off‐patent drugs was observed in 9% of patients. Use was more common among adults with chronic medical conditions, whereas use of drugs with large price increases was rare. Out‐of‐pocket spending was highest among Medicare‐insured patient. Insulin accounted for a disproportionate share of total spending.ConclusionSole‐source off‐patent drug use among patients with chronic medical conditions was common, suggesting these populations are vulnerable to future price increases. Policies that promote manufacturer competition and limit out‐of‐pocket spending for these drugs, particularly insulin, are likely to benefit patients.
The murburn precepts for cellular ionic homeostasis and electrophysiology
Authors: Manoj Kelath Murali , Bazhin Nikolai , Tamagawa Hirohisa 
Published: August 2021

AbstractStarting from the basic molecular structure and redox properties of its components, we build a macroscopic cellular electrophysiological model. We first present a murburn purview that could explain ion distribution in bulk‐milieu/membrane‐interface and support the origin of trans‐membrane potential (TMP) in cells. In particular, the discussion focuses on how cells achieve disparity in the distribution of monovalent and divalent cations within (K+ > Na+ > Mg2+ > Ca2+) and outside (Na+ > K+ > Ca2+ > Mg2+). We explore how TMP could vary for resting/graded/action potentials generation and project a model for impulse conduction in neurons. Outcomes based on murburn bioenergetic equilibriums leading to solubilization of ion‐pairs, membrane's permittivity, protein channels' fluxes, and proteins’ innate ability to bind/adsorb ions selectively are projected as the integral rationale. We also provide experimental modalities to ratify the projections.
Merlin functions as a critical regulator in Staphylococcus aureus‐induced osteomyelitis
Authors: Zhou Zubin , Chen Yuanliang , Min Hong Sung , Wan Yongbai , Shan Haojie , Lin Yiwei , Xia Wenyang , Yin Fuli , Jiang Chaolai , Yu Xiaowei 
Published: August 2021

AbstractMerlin is known as a tumor suppressor, while its role in osteomyelitis remains unclear. This study aimed to investigate the role of Merlin in Staphylococcus aureus‐induced osteomyelitis and its underlying mechanisms. S. aureus‐induced osteomyelitis mouse model was established in Merlinfl/flLyz2cre/+ and Merlinfl/flLyz2+/+ mice. Bone marrow–derived macrophages (BMDMs) were isolated and stimulated by lipopolysaccharide (LPS). Bioassays, including quantitative reverse transcription polymerase chain reaction (qRT‐PCR), Western blot analysis, and enzyme‐linked immunosorbent assays, were conducted to determine the levels of target genes or proteins. Immunoprecipitation was applied to determine the interactions between proteins. DCAF1fl/fl mice were further crossed with Lyz2‐Cre mice to establish myeloid cell conditional knockout mice (DCAF1fl/flLyz2cre/+). It was found that the level of Merlin was elevated in patients with osteomyelitis and S. aureus‐infected BMDMs. Merlin deficiency in macrophages suppressed the production of inflammatory cytokines and ameliorated the symptoms of osteomyelitis induced by S. aureus. Merlin deficiency in macrophages also suppressed the production of proinflammatory cytokines in BMDMs induced by LPS. The inhibitory effects of Merlin deficiency on the inflammatory response were associated with DDB1‐Cul4‐associated factor 1 (DCAF1). In summary, Merlin deficiency ameliorates S. aureus‐induced osteomyelitis through the regulation of DCAF1.
Evaluation of in vivo reflectance confocal microscopy in the diagnosis of extramammary Paget's disease
Authors: Tan Lina , Huang Jian , Zhang Yuezhong , Zeng Liyue , Tong Xiaoliang , Gao Lihua , Zeng Jinrong 
Published: August 2021

AbstractExtramammary Paget's disease (EMPD) is a rare cutaneous malignancy that most commonly affects the apocrine glands of older men and women. Because it is associated with other cancers, early diagnosis and evaluation are needed. This study is to evaluate the value of reflectance confocal microscopy (RCM) in diagnosing EMPD. A total of 73 patients with clinically suspicious diagnosis of EMPD were enrolled in this study, and the RCM device imaged their lesions. Moreover, 67 patients underwent skin biopsies to confirm the diagnosis. We retrospectively analyzed the results of RCM and histological diagnosis and then evaluated the RCM value of biopsy‐confirmed lesions. Based on the RCM image analysis, 54 of 73 (74.0%) patients were diagnosed with EMPD. Of all 67 biopsied lesions, 52 (77.6%) were EMPD. Then, we analyzed the RCM characteristics of 52 cases of biopsy‐confirmed EMPD, compared their RCM image characteristics of three different lesions of EMPD, and further concluded the key points of EMPD under RCM microscopy based on the 52 EMPD cases. Finally, we focused on the differential diagnosis of EMPD from other skin diseases. RCM showed great diagnostic value in diagnosing EMPD.
Influence of environmental temperature on mouth‐form plasticity in Pristionchus pacificus acts through daf‐11‐dependent cGMP signaling
Authors: Lenuzzi Maša , Witte Hanh , Riebesell Metta , Rödelsperger Christian , Hong Ray L. , Sommer Ralf J. 
Published: August 2021

AbstractMouth‐form plasticity in the nematode Pristionchus pacificus has become a powerful system to identify the genetic and molecular mechanisms associated with developmental (phenotypic) plasticity. In particular, the identification of developmental switch genes that can sense environmental stimuli and reprogram developmental processes has confirmed long‐standing evolutionary theory. However, how these genes are involved in the direct sensing of the environment, or if the switch genes act downstream of another, primary environmental sensing mechanism, remains currently unknown. Here, we study the influence of environmental temperature on mouth‐form plasticity. We find that environmental temperature does influence mouth‐form plasticity in most of the 10 wild isolates of P. pacificus tested in this study. We used one of these strains, P. pacificus RSA635, for detailed molecular analysis. Using forward and reverse genetic technology including CRISPR/Cas9, we show that mutations in the guanylyl cyclase Ppa‐daf‐11, the Ppa‐daf‐25/AnkMy2, and the cyclic nucleotide‐gated channel Ppa‐tax‐2 eliminate the response to elevated temperatures. Together, our study indicates that DAF‐11, DAF‐25, and TAX‐2 have been co‐opted for environmental sensing during mouth‐form plasticity regulation in P. pacificus.
Relationship between the presence of primary care physicians and health‐related quality of life
Authors: Yokokawa Daiki , Ohira Yoshiyuki , Ikegami Akiko , Shikino Kiyoshi , Tsukamoto Tomoko , Noda Kazutaka , Uehara Takanori , Ikusaka Masatomi 
Published: August 2021

AbstractBackgroundThe supply of primary care physicians is associated with better health outcomes and a lower total cost of health services. However, the effect of the presence or absence of primary care physicians on health‐related quality of life (QOL) is unknown. We comparatively investigated the health‐related QOL of ordinary citizens according to the presence or absence of a primary care physician.MethodsWe conducted an observational cross‐sectional study using a propensity score analysis. A questionnaire on health‐related QOL (SF‐36v2, age, gender, presence or absence of a primary care physician, and chronic disease status) was mailed to 2200 individuals identified through stratified random sampling. We used propensity scores to compensate for covariates and analyzed three component SF‐36 summary scores and subscale scores of the “primary care physician” and “no primary care physician” groups.ResultsValid responses were received from 1095 individuals (49.8%). The “primary care physician group” comprised 653 individuals (59.6%). The physical health component scores of the “primary care physician group” were significantly lower than those of the “no primary care physician group,” and the “mental health component” scores were significantly higher (p = 0.032, p = 0.009). For the subscales, scores for “vitality” and “mental health” were significantly higher in the “primary care physician group” (p = 0.014, p = 0.018).ConclusionsPatients who had a primary care physician with whom they could comfortably consult at any time had a high mental health component score, and low physical health component score in the health‐related QOL.
Output convergence at sector level across Indian states: Evidence from weak sigma and club convergence analysis
Authors: Akram Vaseem , Ali Jabir 
Published: August 2021

AbstractThe study assesses the per capita output (PCO) convergence hypothesis across 33 Indian states/Union‐Territories at the aggregate and sectoral level by using weak‐sigma and clustering‐algorithm convergence tests for the period of 2011–2012 to 2018–2019. Results from the weak‐sigma convergence test show mixed evidence. This suggests that Indian states are not converging to single steady‐state. Further, results revealed the existence of multiple club‐convergence at aggregate and sectoral level after applying the clustering‐algorithm test. Results also show that the service sector is converging faster than the industry and agriculture sectors. Our findings recommend that sector‐specific policies need to be adopted to boost the aggregate PCO at club level.
One‐year Follow‐up Results of the Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry
Authors: Guo Yutao , Wang Hao , Kotalczyk Agnieszka , Wang Yutang , Lip Gregory Y.H. ,   the ChiOTEAF Registry Investigators
Published: August 2021

AbstractBackgroundThe high prevalence of atrial fibrillation (AF) in the very elderly population (aged >80 years) might be underestimated. The elderly are at increased risk of both fatal stroke and bleeding. The Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry provides contemporary management strategies among the elderly Chinese patients in the new era of non‐vitamin K antagonists.ObjectiveTo present the 1‐year follow‐up data from the ChiOTEAF registry, focusing on the use of antithrombotic therapy, rate vs. rhythm control strategies, and determinants of mortality and stroke.MethodsThe ChiOTEAF registry analyzed consecutive AF patients presenting in 44 centers from 20 Chinese provinces from October 2014 to December 2018. Endpoints of interest were mortality, thromboembolism, major bleedings, cardiovascular comorbidities, and hospital re‐admissions.ResultsOf the 7077 patients enrolled at baseline, 657 patients (9.3%) were lost to the follow‐up and 435 deaths (6.8%) occurred. The overall use of anticoagulants remains low, approximately 38% of the entire cohort at follow‐up, with similar proportions of vitamin K antagonists (VKA) and non‐vitamin K antagonists (NOACs). Antiplatelet therapy was used in 38% of the entire cohort at follow‐up, and more commonly among high‐risk patients (41%). Among those on a NOAC at baseline, 22.4% switched to antiplatelet therapy alone after one year.Independent predictors of stroke/transient ischemic attack/peripheral embolism and/or mortality were age, heart failure, chronic kidney disease, prior ischemic stroke, dementia, and chronic obstructive pulmonary disease.ConclusionsThe ChiOTEAF registry provides contemporary data on AF management, including stroke prevention. The poor adherence of NOACs and common use of antiplatelet in these high‐risk elderly population calls for multiple comorbidities management.
Acute and severe trabecular bone loss in a rat model of critical illness myopathy
Authors: Gugala Zbigniew , Cacciani Nicola , Klein Gordon L. , Larsson Lars 
Published: August 2021

AbstractProlonged mechanical ventilation for critically ill patients with respiratory distress can result in severe muscle wasting with preferential loss of myosin. Systemic inflammation triggered by lung mechanical injury likely contributes to this myopathy, although the exact mechanisms are unknown. In this study, we hypothesized that muscle wasting following mechanical ventilation is accompanied by bone loss. The objective was to determine the rate, nature, and extent of bone loss in the femora of rats ventilated up to 10 days and to relate the bone changes to muscle deterioration. We have developed a rat model of ventilator‐induced muscle wasting and established its feasibility and clinical validity. This model involves pharmacologic paralysis, parenteral nutrition, and continuous mechanical ventilation. We assessed the hindlimb muscle and bone of rats ventilated for 0, 2, 5, 8, and 10 days. Routine histology, microCT, and biomechanical evaluations were performed. Hindlimb muscles developed changes consistent with myopathy, whereas the femurs demonstrated a progressive decline in trabecular bone volume, mineral density, and microarchitecture beginning Day 8 of mechanical ventilation. Biomechanical testing showed a reduction in flexural strength and stiffness on Day 10. The bone changes correlated with the loss of muscle mass and myosin. These results demonstrate that mechanical ventilation leads to progressive trabecular bone loss parallel to muscle deterioration. The results of our study suggest that mechanically ventilated patients may be at risk of compromised bone integrity and muscle weakness, predisposing to post‐ventilator falls and fractures, thereby warranting interventions to prevent progressive bone and muscle decline.