bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered Cerebellar Resting-State Functional Connectivity in Early-Stage Parkinson's Disease Patients With Cognitive Impairment
Authors: Dan Xiaojuan , Hu Yang , Sun Junyan , Gao Linlin , Zhou Yongtao , Ma Jinghong , Doyon Julien , Wu Tao , Chan Piu 
Published: August 2021

Background: Cognitive impairment is one of the most prominent non-motor symptoms in Parkinson's disease (PD), due in part to known cerebellar dysfunctions. Furthermore, previous studies have reported altered cerebellar functional connectivity (FC) in PD patients. Yet whether these changes are also due to the cognitive deficits in PD remain unclear.Methods: A total of 122 non-dementia participants, including 64 patients with early PD and 58 age- and gender-matched elderly controls were stratified into four groups based on their cognitive status (normal cognition vs. cognitive impairment). Cerebellar volumetry and FC were investigated by analyzing, respectively, structural and resting-state functional MRI data among groups using quality control and quantitative measures. Correlation analysis between MRI metrics and clinical features (motor and cognitive scores) were performed.Results: Compared to healthy control subjects with no cognitive deficits, altered cerebellar FC were observed in early PD participants with both motor and cognitive deficits, but not in PD patients with normal cognition, nor elderly subjects showing signs of a cognitive impairment. Moreover, connectivity between the “motor” cerebellum and SMA was positively correlated with motor scores, while intracerebellar connectivity was positively correlated with cognitive scores in PD patients with cognitive impairment. No cerebellar volumetric difference was observed between groups.Conclusions: These findings show that altered cerebellar FC during resting state in early PD patients may be driven not solely by the motor deficits, but by cognitive deficits as well, hence highlighting the interplay between motor and cognitive functioning, and possibly reflecting compensatory mechanisms, in the early PD.
Childhood Intra-Thoracic Tuberculosis Clinical Presentation Determines Yield of Laboratory Diagnostic Assays
Authors: Singh Urvashi B. , Verma Yogita , Jain Rakhi , Mukherjee Aparna , Gautam Hitender , Lodha Rakesh , Kabra Sushil K. 
Published: August 2021

Diagnosis of intra-thoracic tuberculosis (ITTB) in children is difficult due to the paucibacillary nature of the disease, the challenge in collecting appropriate specimens, and the low sensitivity of smear microscopy and culture. Culture and Xpert MTB/RIF provide higher diagnostic yield in presumptive TB in adults than in children. Current study was designed to understand poor yield of diagnostic assays in children. Children with presumptive ITTB were subjected to gastric aspirates and induced sputum twice. Samples were tested by Ziehl-Neelsen stain, Xpert MTB/RIF-assay, and MGIT-960 culture. Subjects were grouped as Confirmed, Unconfirmed, and Unlikely TB, and classified as progressive primary disease (PPD, lung parenchymal lesion), and primary pulmonary complex (PPC, hilar lymphadenopathy) on chest X-ray. Of children with culture-positive TB 51/394 (12.9%), culture-negative TB 305 (77.4%), and unlikely TB 38 (9.6%), 9 (2.3%) were smear positive, while 95 (24.1%) were Xpert-MTB/RIF positive. Xpert-MTB/RIF detected 40/51 culture confirmed cases (sensitivity 78.4% and NPV 96.3%). Culture was positive in more children presenting as PPD (p &lt; 0.04). In culture-negative TB group, Xpert positivity was seen in 31% of those with PPD and 11.9% in those with PPC (p &lt; 0.001).Conclusion: Xpert-MTB/RIF improved diagnosis by 2-fold and increased detection of MDR-TB. Both liquid culture and Xpert-MTB/RIF gave higher yield in children with lung parenchymal lesions. Children with hilar lymphadenopathy without active lung parenchymal lesions had poor diagnostic yield even with sensitive nucleic acid amplification tests, due to paucibacillary/localized disease, suggesting possible utility of invasively collected samples in early diagnosis and treatment.
Burned-Out Testicular Tumors in Adolescents: Clinical Aspects and Outcome
Authors: Persano Giorgio , Crocoli Alessandro , De Pasquale Maria Debora , Cozza Raffaele , Alaggio Rita , Diomedi Camassei Francesca , Beati Federico , Di Paolo Pierluigi , Martucci Cristina , Inserra Alessandro 
Published: August 2021

Purpose: Testicular germ cell tumors are the fourth most common neoplasm in adolescents, accounting for 8% of all tumors in the age group 15–19 years. On rare instances, the primary testicular lesion is not clinically or radiologically evident while nodal or visceral metastases represent the clinical manifestations of the disease. This phenomenon is described as “burned-out testicular tumor.” In this paper, the authors report a single-institution experience with burned-out testicular tumors in adolescents and discuss their clinical implications.Patients and Methods: All the patients diagnosed with metastatic testicular germ cell tumors at Bambino Gesù Children Hospital between January 1, 2010, and June 30, 2020, were included in the study. Patients were categorized into two groups: “primary testicular” and “burned out.” All the patients were staged and treated according to the AIEOP–TCGM 2004 protocol.Results: Eleven patients were classified as “primary testicular,” and five patients were classified as “burned out.” “Burned-out” tumors were associated with the presence of systemic symptoms compared to “primary testicular” tumors (80 vs. 0%; p = 0.0027) and higher aFP, hCG, and LDH levels (p &lt; 0.00001). The “burned-out” population had a statistically significant higher incidence of relevant toxicity than the “primary testicular” population (80 vs. 18%; p = 0.0357) and a worse outcome in terms of both mean overall survival (15 vs. 43 months; p = 0.0299) and mean event-free survival (12 vs. 38 months; p = 0.0164).Conclusion: “Burned-out” testicular tumors seem to be a well-distinct clinical entity with a high treatment-related toxicity and poor prognosis. Further studies are needed to clarify the “burned-out phenomenon” and to identify more effective therapeutic strategies for these patients.
EUS in Pediatrics: A Multicenter Experience and Review
Authors: Piester Travis L. , Liu Quin Y. 
Published: August 2021

Background/Aim: Endoscopic ultrasound (EUS) is a well-established tool used in the evaluation and treatment of a wide range of pathologies in adult medicine. EUS in pediatrics has been shown to be safe and technically effective, and its use continues to evolve. This article aims to describe the EUS experience at our tertiary-care centers with regard to safety, technical success, and its impact in clinical management. We also discuss the current and developing diagnostic and therapeutic uses for EUS in pediatrics such as in pancreaticobiliary disease, congenital anomalies, eosinophilic esophagitis, inflammatory bowel disease, and liver disease.Methods: This is a retrospective review of EUS performed by two pediatric gastroenterologists trained as endosonographers between April 2017 and November 2020. Patient demographics, procedure indication, procedure characteristics, technical success, and complications were collected. Literature review was performed to describe current and future uses of EUS in pediatrics.Results: Ninety-eight EUS were performed with 15 (15.3%) including fine needle aspiration/biopsy and 9 (9.2%) cases being therapeutic. Most common indications include choledocholithiasis (n = 31, 31.6%), pancreatic fluid collections (n = 18, 18.4%), chronic and acute recurrent pancreatitis (n = 14, 14.3%), and acute pancreatitis characterization (n = 13, 13.3%). Notable indications of pancreatic mass (n = 6, 6.1%) and luminal lesions/strictures (n = 6, 6.1%) were less common. Complications were limited with one instance of questionable GI bleeding after cystgastrostomy creation. Ninety-eight of 98 (100%) cases were technically successful.Conclusion/Discussion: EUS has been shown to be performed safely and successfully in the pediatric population by pediatric endosonographers. This study and review support its use in pediatric practice and demonstrate the wide variety of indications for EUS such as pancreatic cystgastrostomy, celiac plexus neurolysis, and evaluation of chronic pancreatitis. This literature review also demonstrates areas of potential development for EUS within the practice of pediatric gastroenterology.
Seroprevalence of Cytomegalovirus and Associated Factors Among Preconception Women: A Cross-Sectional Nationwide Study in China
Authors: Zhou Qiongjie , Wang Qiaomei , Shen Haiping , Zhang Yiping , Zhang Shikun , Li Xiaotian , Acharya Ganesh 
Published: August 2021

Background: Cytomegalovirus seroconversion during pregnancy is common and has a substantial risk of congenital infection with longterm sequale. Screening during pregnancy or vaccination have not been shown to be effective for eliminating congenital infections. Preconception screening policy has not been evaluated adequately in a large scale. This nationwide study aimed to investigate epidemiological features of cytomegalovirus seropositivity and its geographic variation among Chinese women planning a pregnancy to gather epidemiological evidence as an essential for developing novel prevention strategies.Method: This cross-sectional sero-epidemiological survey enrolled women intending to become pregnant within 6 months in mainland China during 2010–2012. The primary outcomes in this study were cytomegalovirus Immunoglobulin G and M seropositivity. Secondary outcomes were the associations between Immunoglobulin G and Immunoglobulin M, with socio-demographic characteristics, including age, occupation, education level, place of residence, and ethnicity. The overall seropositivity and regional disparity was analyzed on the individual and regional level, respectively.Results: This study included data from 1,564,649 women from 31 provinces in mainland China. Among participants, 38.6% (n = 603,511) were cytomegalovirus immunoglobulin G+, 0.4% (n = 6,747) were immunoglobulin M+, and 0.2% (n = 2,879) were immunoglobulin M+ and immunoglobulin G+. On individual level, participant's age, ethnicity, and residing region were significantly associated with IgG+, IgM+, and IgM+IgG+ (P &lt; 0.001), while occupation, education level, and place of residence were not statistically significant (P &gt; 0.05). On regional level, cytomegalovirus immunoglobulin G and immunoglobulin M seropositivity was highest in the eastern region (49.5 and 0.5%, respectively), and lowest in the western region (26.9 and 0.4%, respectively). This geographic variation was also noted at the provincial level, characterized by higher provincial immunoglobulin M+ and immunoglobulin G+ rates associated with higher immunoglobulin G seropositivity. In the subgroup analysis of immunoglobulin G seropositivity, areas of higher immunoglobulin G positivity had a higher rate of immunoglobulin M+, indicating an expected increased risk of reinfection and primary infection.Conclusions: A substantial proportion of women (&gt;60%) were susceptible to cytomegalovirus in preconception period in China, and immunoglobulin G seropositivity was seen at a low-medium level with substantial geographic variation. Integration of cytomegalovirus antibody testing in preconception screening program based on regional immunoglobulin G seropositivity, should be considered to promote strategies directed toward preventing sero-conversion during pregnancy to reduce the risk of this congenital infection.
Cost-Effectiveness of Aprepitant in Preventing Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Published Articles
Authors: Qiu Tingting , Men Peng , Sun Tong , Zhai Suodi 
Published: August 2021

Objectives: The aim of this systematic review is to assess the published cost-effectiveness analyses of aprepitant for patients with chemotherapy-induced nausea and vomiting (CINV).Methods: A systematic literature search was performed on PubMed, EMbase, the Cochrane Library, CNKI, WANFANG DATA, and CBM database. The date of publication is up to January 2019. Two reviewers independently reviewed titles, abstracts, and articles sequentially to select studies for data abstraction based on the inclusion and exclusion criteria. Disagreements were resolved and reviewers reached a consensus. The quality of the included studies was assessed according to the 24-item checklist of the consolidated health economic evaluation reporting standards (CHEERS). The costs reported by the included studies were converted to US dollars via purchasing power parities (PPP) in the year 2019 using the CCEMG–EPPI–Certer Cost Converter.Results: Thirteen articles were included based on the inclusion criteria for cost-effectiveness analysis and cost-utility analysis. Twelve studies were rated as good quality and one as a moderate quality based on the CHEERS checklist. Eight studies compared aprepitant plus 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and dexamethasone with the standard regimen (5-HT3RA and dexamethasone). It was concluded that aprepitant plus standard regimen was a cost-effective strategy for preventing CINV. Only one study that compared aprepitant plus 5-HT3RA with 5-HT3RA, concluded that the addition of aprepitant reduced the incidence of severe nausea, and it might also provide an economic benefit in the overall management. Four studies that compared aprepitant with other antiemetic drugs concluded that aprepitant is a cost-effective strategy for preventing CINV compared with metoclopramide. However, netupitan + palonosetron and olanzapine are cost-effective compared with aprepitant.Conclusion: This study is the first systematic evaluation of adding aprepitant to standard regimens for patients with CINV. Most economic evaluations of antiemetic medications are reported to be of good quality. Adding aprepitant to standard regimens is found to be a cost-effective strategy for preventing CINV.
Photobioreactor Limnospira indica Growth Model: Application From the MELiSSA Plant Pilot Scale to ISS Flight Experiment
Authors: Poughon Laurent , Creuly Catherine , Godia Francesc , Leys Natalie , Dussap Claude-Gilles 
Published: August 2021

Bioregenerative life support systems (BLSS) are the foundation stone to self-sustainable manned space missions. The MELiSSA is a BLSS concept that has evolved through a mechanistic engineering approach designed to acquire both theoretical and technical knowledge on each subsystem independently and, therefore, produces the necessary knowledge and experience needed to co-integrate all the subsystems together with a high level of control. One of the subsystems is a photobioreactor colonized by an axenic culture of the cyanobacterium Limnospira indica PCC8005 for revitalizing the air for the crew. This subsystem was extensively studied, and a mass balanced mechanistic model was developed to describe, predict, and control the photobioreactor. The model was based on a light transfer limitation model coupled to a kinetic model for the cyanobacteria growth through a Linear Thermodynamics of Irreversible Processes (LTIP) approach, including substrate limitation. The model was integrated into several hydrodynamic models adapted to several photobioreactors design and experiments, from a 100 L airlift pilot scale ground photobioreactor to a 50 ml membrane photobioreactor for ISS flight. Through this article we detail the principles of this mechanistic model and their application to different photobioreactor scales for predictive and descriptive simulations.
Mesoscale Structure in the Solar Wind
Authors: Viall N. M. , DeForest C. E. , Kepko L. 
Published: August 2021

Structures in the solar wind result from two basic mechanisms: structures injected or imposed directly by the Sun, and structures formed through processing en route as the solar wind advects outward and fills the heliosphere. On the largest scales, solar structures directly impose heliospheric structures, such as coronal holes imposing high speed streams of solar wind. Transient solar processes can inject large-scale structure directly into the heliosphere as well, such as coronal mass ejections. At the smallest, kinetic scales, the solar wind plasma continually evolves, converting energy into heat, and all structure at these scales is formed en route. “Mesoscale” structures, with scales at 1 AU in the approximate spatial range of 5–10,000 Mm and temporal range of 10 s–7 h, lie in the orders of magnitude gap between the two size-scale extremes. Structures of this size regime are created through both mechanisms. Competition between the imposed and injected structures with turbulent and other evolution leads to complex structuring and dynamics. The goal is to understand this interplay and to determine which type of mesoscale structures dominate the solar wind under which conditions. However, the mesoscale regime is also the region of observation space that is grossly under-sampled. The sparse in situ measurements that currently exist are only able to measure individual instances of discrete structures, and are not capable of following their evolution or spatial extent. Remote imaging has captured global and large scale features and their evolution, but does not yet have the sensitivity to measure most mesoscale structures and their evolution. Similarly, simulations cannot model the global system while simultaneously resolving kinetic effects. It is important to understand the source and evolution of solar wind mesoscale structures because they contain information on how the Sun forms the solar wind, and constrains the physics of turbulent processes. Mesoscale structures also comprise the ground state of space weather, continually buffeting planetary magnetospheres. In this paper we describe the current understanding of the formation and evolution mechanisms of mesoscale structures in the solar wind, their characteristics, implications, and future steps for research progress on this topic.
YETİŞKİN BİREYLERDE DİJİTAL OKURYAZARLIK VE SAĞLIK OKURYAZARLIĞI ARASINDAKİ İLİŞKİ: KONYA ÖRNEĞİ
Authors: YEŞİLDAL Müjdat , KAYA Ş. Didem 
Published: August 2021

Günümüz dünyası, iletişim kurarken kullandığımız yazı sembolleriyle birlikte binlerce sembolik anlatımı da kapsamaktadır. Okuryazarlık kavramı, yaşam boyu öğrenim “sürekli eğitim” bilincini oluşturma, bu bilinci geliştirme, daha etkin öğrenme için bireylerin yeni beceriler kazanmalarını sağlamaktır. Bu çalışmada Konya ilinde (Meram, Karatay, Selçuklu ilçelerinde) ikamet eden yetişkin bireylerin sağlık okuryazarlık ve dijital okuryazarlık düzeyini tespit etmek ve sağlık okuryazarlığı ve dijital okuryazarlık arasındaki ilişkiyi tespit etmek amaçlanmıştır. Araştırmada nicel araştırma deseni kullanılmış olup, örneklem büyüklüğü 500 kişiden oluşmaktadır. Veri toplama formunda Ng (2012) tarafından geliştirilen, Hamutoğlu ve arkadaşları (2017) tarafından Türkçeye geçerlilik ve güvenilirlik çalışması yapılan Dijital Okuryazarlık Ölçeği ile Toçi ve arkadaşları (2013) tarafından geliştirilen, Aras ve Temel (2017) tarafından Türkçeye geçerlilik ve güvenilirlik çalışması yapılan Sağlık Okuryazarlığı Ölçeği kullanılmıştır. Araştırmaya katılan bireylerin %57.4’ü erkek ve %42.6’sı kadındır. Sağlık Okuryazarlığı Ölçeği ile Dijital Okuryazarlık ölçeği arasında yapılan korelasyon analizine göre pozitif yönde zayıf düzeyde ilişki bulunmaktadır(r=0.270). Sağlık Okuryazarlığı seviyesi; cinsiyet, yaş, gelir durumu ve öğrenim durumuna bağlı olarak değişmektedir. Dijital okuryazarlık seviyesi ise cinsiyet, yaş, gelir durumu, öğrenim durumuna göre değişiklik göstermektedir.
AYAKTAN HASTA MEMNUNİYET ÖLÇEĞİ: ÖLÇEK GELİŞTİRME, GÜVENİRLİK VE GEÇERLİK ÇALIŞMASI
Authors: KEVENK Ahmet Uğur , KANTAS YİLMAZ Fatma , ÖZTÜRK Meltem 
Published: August 2021

Bu araştırmada, ayaktan sağlık hizmeti almak amacıyla sağlık kuruluşlarına başvuran hastaların memnuniyet düzeylerini belirleyecek bir ölçek geliştirmek ve bu ölçeğin geçerlik ve güvenirlik düzeyini tespit etmek amaçlanmıştır. Metodolojik tipte tasarlanan çalışmada sekiz adımdan oluşan "ölçek geliştirme ilkeleri” takip edilmiştir. Araştırmanın evreni İstanbul, örneklem sayısı ise 645’dir. Ayaktan hasta memnuniyeti ölçeği için açıklayıcı ve doğrulayıcı faktör analizi uygulanmıştır. Ölçekten elde edilen alt boyutların güvenirlik değerleri, Cronbach’s Alfa ve bileşik güvenirlik değerleri ile hesaplanmıştır. Ölçek alt boyutlarının demografik özelliklere göre değişimi bağımsız örneklem t testi ve tek yönlü varyans analizi ile karşılaştırılmıştır. Tek yönlü varyans analizinde farklılık bulunan boyutlarda farklılığın kaynağı Bonferroni testi ile araştırılmıştır. Ayaktan Hasta Memnuniyet Ölçeği oluşturmak amacıyla hazırlanan 33 maddelik ölçeğin sonuçlarının faktör analizi uygunluğu için yapılan testlerde Bartlet’s testi için olasılık değeri p&lt;0.05 ve KMO değeri 0.944 olduğundan veri seti faktör analizinde “mükemmel” seviyede uygun çıkmıştır. Faktör analizinde toplam kavram açıklayıcılığı %72.34 bulunduğundan ölçeğin ayaktan hasta memnuniyeti kavramını açıklayabildiği tespit edilmiştir. Açıklayıcı faktör analizi sonucunda madde sayısı 26 olarak belirlenen ölçekte maddelerin faktör yükleri (0.52;0.97) aralığında yer almaktadır. Ayaktan Hasta Memnuniyeti Ölçeği, Cronbach’s Alfa güvenirlik puanı katsayısı (0.943) bulunmuştur. Bu araştırmada ayaktan hastaların memnuniyetini ölçmek için güvenirlik ve geçerlik düzeyi yüksek ve uygulanması kolay kapsamlı bir ölçek literatüre kazandırılmıştır.
ORTAOKUL ÖĞRENCİLERİNDE BESLENME ÖZYETERLİK VE BESLENME DAVRANIŞLARININ İNCELENMESİ VE AİLESEL OBEZİTENİN BELİRLENMESİ
Authors: ARUSOGLU Gulcan 
Published: August 2021

Bu çalışmanın amacı, ortaokul çağındaki çocukların beslenme davranışları ile beslenme özyeterliklerini saptamak ve ailesel obeziteyi belirlemektir.
Bunun yanısıra ölçekleri, ailenin ekonomik durumu, öğrencinin ve ailenin algılanan sağlık durumu, öğrencinin yaşı, cinsiyeti, sınıfı ve aile tipi gibi etkileyen değişkenlere göre incelemektir. Araştırmanın verileri, Şubat-Haziran 2019 tarihleri arasında, ortaokula devam eden, 11-13 yaş arası çocuğunun çalışmaya katılmasını kabul eden 630 ebeveyn ve çocuğundan elde edilmiştir. Çok merkezli yürütülen bu çalışmada bilgiler aile formu, Çocuk Beslenme Öz-yeterlik (ÇBÖÖ) ile Beslenme Davranışı Ölçeği (BDÖ) kullanılarak değerlendirilmiştir. Çalışmaya katılan öğrencilerin velileri konu hakkında bilgilendirilerek onayları alınmıştır. Çalışma grubunu oluşturanların 339‘u kız (%53.8), 291‘i (%46.2) ise erkektir. Kız öğrencilerin vücut kitle indeksi (BKİ) ortalamaları 19.13±3.17 kg/m2 ve erkek öğrencilerin BKI ortalamaları 20.26±3.36 kg/m2’dir. Çocukların ÇBÖÖ puanı ortanca değeri 1.0 puan olarak bulunmuştur. Bu skor zayıf düzeyde ancak kısmen olumlu bir öz-yeterliği gösterirken beslenme davranışı ise -2.0 puan ortanca değeri ile negatif davranışı göstermiştir. Öz-yeterlik ölçeği ile davranış ölçeği arasında pozitif yönde orta düzeyde istatistiksel olarak önemli bir ilişki bulunmuştur (rho=0.471). Ailenin BKİ ile çocukların BKİ birbirleri ile ilişkili bulunmuştur. Ailesinde kiloluluk öyküsü olanlarda kilolu çocukların daha sık olduğu belirlenmiştir. Bu çalışmada öğrencilerin sağlıksız beslenme davranışlarında oldukları bulunmuştur. Başta okul öncesi eğitim olmakla birlikte tüm eğitim düzeylerinde beslenme eğitiminin önemi anlaşılmalı ve ders olarak müfredata eklenmesi sağlanmalıdır.