bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in the clinical features of amyotrophic lateral sclerosis: A 14‐year Chinese cohort study
Authors: Chen Lu , Xu Lu , Tang Lu , Xia Kailin , Tian Danyang , Zhang Gan , Wang Yajun , Yu Zhou , Ma Jingyue , Zhang Yixuan , Wang Fan , Sun Can , Zhang Gaoqi , Fu Jiayu , Jiao Lin , Yilihamu Mubalake , Wang Shengfeng , Zhan Siyan , Fan Dongsheng 
Published: May 2021

AbstractBackground and purposeThe aim was to determine the transitional patterns in the clinical characteristics, treatments and comorbidities in amyotrophic lateral sclerosis (ALS) patients over the past 14 years using data from a large clinical cohort in mainland China.MethodsSporadic ALS patients who visited the Peking University Third Hospital from January 2005 to December 2018 were included in this study. The 14 years were divided into three periods, and changes in the baseline characteristics of the participants were analyzed at 5‐year intervals.ResultsIn total, 3410 patients with sporadic ALS were recruited: 2181 were men and 1229 were women. The proportion of patients with bulbar‐onset ALS increased from 13.0% in 2005–2009 to 19.5% in 2015–2018 (p < 0.001). The mean (standard deviation) age at onset increased from 49.5 (11.4) years in 2005–2009 to 53.0 (11.0) years in 2015–2018 (p < 0.001). ALS patients with diabetes or hypertension showed a delay in ALS onset, and the delay was even more apparent when the patients had both comorbidities. The proportion of riluzole users in 2015–2018 was approximately 2.5‐fold of that in 2005–2009 (p < 0.001).ConclusionsIn the context of a lack of clinical data on ALS in mainland China, this study evaluated a large cohort of patients diagnosed over a 14‐year period. The age at onset and percentage of patients who used riluzole both increased over the study period. Additionally, it was found that patients with comorbidities such as diabetes and hypertension had a delayed age of ALS onset.
Evaluation of 3D design lower limb exoskeleton on human musculoskeletal with various loads
Authors: Sohane Anurag , Agarwal Ravinder 
Published: May 2021

AbstractThe surface electromyography (SEMG) based exoskeleton presents a new opportunity for human augmentation and rehabilitation. Developing an efficient exoskeleton in real‐time is challenging as each individual's muscles and joint forces are unique. The aim of this research article is to analyze and evaluate the design of the lower limb exoskeleton during the squatting movement in a simulated environment to address problems concerning the development of a functional exoskeleton for an individual. An exoskeleton was designed in SolidWorks CAD software and imported into AnyBody Modelling Software (AMS). Thereafter, the performance of 3D designed exoskeleton was evaluated by placing various loads (0:5:25 kg) on both the shoulders of the human musculoskeletal. The results show the force in the knee muscles with the assistance of the exoskeleton were reduced significantly by 65.18–97.20% in the biceps femoris, 50.01–33.16% in the rectus femoris, 41.87–28.31% in the vastus lateralis, 42.25–28.78% in the vastus medialis, 7.28–22.91% in gluteus medius, and 22.54–13.13% in semitendinosus. The force in the knee joint was reduced by 44.04–31.43% as the load increases. Individual muscle force estimated from the SEMG signal and AMS during squatting was also compared for validation. The developed model helps in understanding the load effects on different muscles and provides useful information for the construction of an individual's optimized exoskeleton.
Number of teeth, denture wearing and cognitive function in relation to nutritional status in residents of nursing homes
Authors: Suma Shino , Furuta Michiko , Takeuchi Kenji , Tomioka Mikiko , Iwasa Yasuyuki , Yamashita Yoshihisa 
Published: May 2021

BackgroundAlthough statistical associations between tooth loss and cognitive decline have been reported, there are few previous studies on denture wearing. Additionally, it remains unclear whether nutritional status mediates this association.ObjectiveOur purpose was to test for the hypothesis that the association between the number of teeth and denture wearing with cognitive function is mediated by nutritional status in residents of nursing homes.Materials and MethodsWe enrolled 162 participants who required long‐term care (mean age: 87.7 ± 7.5 years, 26 men and 136 women) and were admitted to eight nursing homes in Fukuoka city, from September 2013 to March 2014. A trained dentist conducted dental and swallowing examinations, and the care‐staff assessed nutritional status, comorbid conditions and cognitive function using the Clinical Dementia Rating (CDR).ResultsPoisson regression analysis showed that 0‐19 teeth without dentures were associated with severe cognitive impairment (CDR 3) (prevalence ratio = 2.00; 95% confidence interval: 1.13‐3.55) after adjustment for sex, age, suspected swallowing dysfunction and comorbid conditions. Mediation analysis confirmed that the nutritional status as a mediator of this association (the percentage mediated effect through nutritional status was 23.1%).ConclusionThere is an association between dental status and cognitive impairment in elder individuals, and dentures and poor nutrition are involved in this association. However, due to the cross‐sectional design of this study, there is a possibility that this association is bidirectional.
Integrase strand transfer inhibitor treatment does not increase the incidence of immune reconstitution inflammatory syndrome in HIV‐infected Koreans
Authors: Kim J , Nam H‐J , Kang S‐J , Jung S‐I , Hwang CH , Kim Y‐S , Chang H‐H , Kim S‐W , Park K‐Hwa 
Published: May 2021

ObjectivesImmune reconstitution inflammatory syndrome (IRIS) is a major concern when starting antiretroviral therapy (ART) in patients with advanced HIV infection. The aim of this study was to determine the incidence and risk factors of IRIS in HIV‐infected Koreans initiating ART, and whether integrase strand transfer inhibitor (INSTI) treatment increases the risk of IRIS.MethodsThis retrospective analysis included adults living with HIV, seen at four university‐affiliated hospitals in South Korea, who were naïve to ART and had a CD4 T‐cell count < 200 cells/μL between January 2004 and May 2019. IRIS was determined through a medical record review within 6 months of ART initiation. Propensity score‐matched case–control study between the non‐INSTI and INSTI groups was performed.ResultsThe study included 501 patients; 192 were assigned to the INSTI group, who started ART based on INSTIs as the initial treatment. There were opportunistic infections (OIs) in 253 (50.5%) cases before ART initiation. The three most common OIs were Pneumocystis jirovecii pneumonia, candidiasis and tuberculosis (TB). We identified 47 cases of IRIS; TB‐IRIS was the most common type. The incidence of IRIS within 6 months of ART initiation was 9.4%, and there were no significant differences in baseline characteristics and incidence of IRIS between the matched groups. The risk factors for IRIS were pre‐ART CD4 T‐cell count (< 30 cells/μL), higher pre‐ART viral load (≥ 75 000 copies/mL), and TB‐OI.ConclusionsThe incidence of IRIS was 9.4% in Korean HIV patients. The INSTI regimen was not related to IRIS occurrence.
Online engagement during COVID‐19: Role of agency on collaborative learning orientation and learning expectations
Authors: Almusharraf Norah Mansour , Bailey Daniel 
Published: May 2021

AbstractDuring the COVID‐19 outbreak, students had to cope with succeeding in video‐conferencing classes susceptible to technical problems like choppy audio, frozen screens and poor Internet connection, leading to interrupted delivery of facial expressions and eye‐contact. For these reasons, agentic engagement during video‐conferencing became critical for successful learning outcomes. This study explores the mediating effect agentic engagement has on collaborative language learning orientations (CLLO) within an EFL video‐conferencing course to understand better how interactions influence academic learning expectations. A total of 329 (Male = 132, Female = 197) students were recruited from four South Korean universities to participate in this questionnaire study. Data analysis was carried out using the statistical software packages SPSS, and a series of data screening procedures were carried out. Findings revealed that collaborative language learning orientations were a statistically significant predictor of academic learning expectations, but this relationship was fully mediated when agentic engagement was added to the model. Students with a propensity for social language learning strategies believe they will succeed; however, this relationship is explained by their propensity to interact with the instructor when video‐conferencing. An assortment of learning activities should be provided to support both collaborative and individual learning orientations for academic success. Students with collaborative learning tendencies and a propensity to actively engage the instructor during video conference classes are active participants in the eLearning context, possibly leading to positive course expectations.
Social efficiency of entry: Implications of network externalities
Authors: Basak Debasmita , Petrakis Emmanuel 
Published: May 2021

AbstractWe examine the welfare effects of entry in the presence of network externalities. We show that if network goods are fully incompatible, entry is socially insufficient as long as the entry cost is high, the goods are sufficiently differentiated, and the degree of network externality is low. Further, we show that as the degree of compatibility between the network goods increases, insufficient entry becomes more likely. Our findings provide policy guidelines for anticompetitive and procompetitive entry regulations.
Association of frailty with outcomes in individuals with COVID‐19: A living review and meta‐analysis
Authors: Dumitrascu Flavia , Branje Karina E. , Hladkowicz Emily S. , Lalu Manoj , McIsaac Daniel I. 
Published: May 2021

AbstractBackground and ObjectivesFrailty leaves older adults vulnerable to adverse health outcomes. Frailty assessment is recommended by multiple COVID‐19 guidelines to inform care and resource allocation. We aimed to identify, describe, and synthesize studies reporting the association of frailty with outcomes (informed by the Institute for Healthcare Improvement's Triple Aim [health, resource use, and experience]) in individuals with COVID‐19.DesignSystematic review and meta‐analysis.SettingStudies reporting associations between frailty and outcomes in the setting of COVID‐19 diagnosis.ParticipantsAdults with COVID‐19.MeasurementsFollowing review of titles, abstracts and full text, we included 52 studies that contained 118,373 participants with COVID‐19. Risk of bias was assessed using the Quality in Prognostic studies tool. Our primary outcome was mortality, secondary outcomes included delirium, intensive care unit admission, need for ventilation and discharge location. Where appropriate, random‐effects meta‐analysis was used to pool adjusted and unadjusted effect measures by frailty instrument.ResultsThe Clinical Frailty Scale (CFS) was the most used frailty instrument. Mortality was reported in 37 studies. After confounder adjustment, frailty identified using the CFS was significantly associated with mortality in COVID‐19 positive patients (odds ratio 1.79, 95% confidence interval [CI] 1.49–2.14; hazard ratio 1.87, 95% CI 1.33–2.61). On an unadjusted basis, frailty identified using the CFS was significantly associated with increased odds of delirium and reduced odds of intensive care unit admission. Results were generally consistent using other frailty instruments. Patient‐reported, cost and experience outcomes were rarely reported.ConclusionFrailty is associated with a substantial increase in mortality risk in COVID‐19 patients, even after adjustment. Delirium risk is also increased. Frailty assessment may help to guide prognosis and individualized care planning, but data relating frailty status to patient‐reported outcomes are urgently needed to provide a more comprehensive overview of outcomes relevant to older adults.
Structural Breaks in U.S. Macroeconomic Time Series: A Bayesian Model Averaging Approach
Authors: CHECK ADAM , PIGER JEREMY 
Published: May 2021

AbstractWe investigate the evidence for structural breaks in autoregressive models of U.S. macroeconomic time series. There is substantial model uncertainty associated with such models, including uncertainty related to lag selection, the number of structural breaks, and the specific parameters that break. We develop a feasible approach to Bayesian model averaging, where the model space encompasses these sources of uncertainty. We find pervasive evidence for breaks in variance parameters, and for price inflation series, we find strong evidence of changes in persistence. We also find evidence for reductions in trend growth rates of production series. For most series, there is substantial model uncertainty, calling into question the common practice of basing inference on one selected structural break model.
Primary culture of adult cortical neurons from reptile Gekko japonicus
Authors: He Bingqiang , Sun Chunshuai , Li Hui , Yang Ting , Song Honghua , Wang Yongjun , Wang Yingjie 
Published: May 2021

AbstractAdult neurons of several reptiles still retain the ability of axonal regeneration in contrast to the low intrinsic regenerative capacity of those in the central nervous system (CNS) in mammals. This feature of the reptilian neurons has provided a perfect model for elucidating the regenerative mechanism lost in the mammalian counterparts. However, little information is available on the primary culture method of adult reptilian neurons, which greatly limits their valuable applications. In the present study, we introduced a simple and easy method for the isolation, culture, and identification of neurons from the cerebral cortex using the adult geckos. The cultured cells were further identified by immunofluorescence using antibodies against neuron‐specific markers β‐Ⅲ‐tubulin and NeuN. The cortical neurons from adult gecko displayed spindle‐shaped, bipolar, or multipolar morphology with a plump soma. This primary culture method for adult reptilian neurons will be beneficial for comparative studies of neuronal biology in various vertebrates.
Non‐shivering thermogenesis in four species of African mole‐rats differing in their sociality
Authors: Luna F. , Okrouhlík J. , McKechnie A. E. , Bennett N. C. , Šumbera R. 
Published: May 2021

AbstractMany mammalian species are adapted to living in burrows for most of their lives. Inhabiting such thermally stable environments may influence the variation on the species thermogenic capacity, particularly non‐shivering thermogenesis (NST). African mole‐rats (Bathyergidae) are subterranean rodents occurring in fynbos, grassland and wooded savannas across sub‐Saharan Africa that vary in the complexity of their social systems, ranging from strictly solitary to highly social species. The presence and magnitude of NST are well known in social bathyergids, but no such data exist for their solitary counterparts. In this study, we quantified NST in three solitary mole‐rat species represented by three distinct genera together with one social species. Our results showed that NST in all species is functional. Maximum metabolic rate after norepinephrine injection was equivalent to 269% of resting values in the social giant mole‐ratFukomys mechowiiand 166%, 282% and 157% in the three solitary species: the silvery mole‐ratHeliophobius argenteocinereus, the Cape mole‐ratGeorychus capensisand the Cape dune mole‐ratBathyergus suillus, respectively. To test our prediction that NST capacity is higher in solitary bathyergids, we combined our data with those available for other members of this family. In contrast to our prediction, NST did not differ between social and solitary bathyergids. Body mass, as the main factor, and minimum air temperature (Tmin), accounts for more than 80% of NST variation in bathyergid mole‐rats.
ALK‐rearranged histiocytosis: Report of two cases with involvement of the central nervous system
Authors: Rossi Sabrina , Gessi Marco , Barresi Sabina , Tamburrini Gianpiero , Giovannoni Isabella , Ruggiero Antonio , Colafati Giovanna Stefania , Frassanito Paolo , Carboni Alessia , Alexandre Andrea , Cacchione Antonella , Trombatore Pietro , Diomedi‐Camassei Francesca , Gaspari Stefania , Gianno Francesca , Marras Carlo Efisio , Cecinati Valerio , Carai Andrea , Mastronuzzi Angela , Alaggio Rita 
Published: May 2021

AbstractAimsHistiocytoses are a heterogeneous group of localized or disseminated diseases. Clinical presentation and patients' outcome vary greatly, ranging from mild to life‐threatening disorders. Rare cases of systemic or localized histiocytosis harboring ALK rearrangement have been reported.MethodsTwo cases of CNS histiocytosis were thoroughly investigated by implementing multiple molecular tests, i.e. FISH, RT‐qPCR, NGS analysis.ResultsIn a 10‐month old girl (patient #1), MRI showed two left hemispheric lesions and a right fronto‐mesial lesion histologically consisting of a moderately cellular infiltrative proliferation, composed by CD68(PGM1)+/CD163+ spindle cells. ALK 5’/3’‐imbalance and a KIF5B(exon 24)‐ALK(exon 20) fusion were documented by RT‐qPCR and NGS analysis, respectively. A subsequent CT scan showed multiple hepatic and pulmonary lesions. The patient was started on chemotherapy (vinblastine) associated to an ALK‐inhibitor (Alectinib) with remarkable response. In a 11‐year‐old girl (patient #2), MRI showed a right frontal 1.5 cm lesion. Neuropathological examination revealed a histiocytic proliferation composed by medium sized CD68(PGM1)+/HLA‐DR+ cells, showing moderate ALK1 positivity. ALK rearrangement and a KIF5B(exon 24)‐ALK(exon 20) fusion were demonstrated also in this case. Subsequent CT, 18F‐FDG‐PET and MRI scans showed the presence of a single right femoral lesion, proved to be a fibrous cortical defect.ConclusionsIn ALK‐histiocytoses, CNS involvement may occur as part of a systemic disease or, rarely, as its only primary disease localization, which could remain otherwise asymptomatic. The diagnosis often relies on neuropathological examination of brain biopsy, which may pose a diagnostic challenge due to the variable histopathological features. An integrated histological and molecular approach in such cases is recommended.
The left dorsal stream causally mediates the tone labeling in absolute pitch
Authors: Rogenmoser Lars , Arnicane Andra , Jäncke Lutz , Elmer Stefan 
Published: May 2021

AbstractAbsolute pitch (AP) refers to the ability to effortlessly identify given pitches without any reference. Correlative evidence suggests that the left posterior dorsolateral prefrontal cortex (DLPFC) is responsible for the process underlying pitch labeling in AP. Here, we measured the sight‐reading performance of right‐handed AP possessors and matched controls under cathodal and sham transcranial direct current stimulation of the left DLPFC. The participants were instructed to report notations as accurately and as fast as possible by playing with their right hand on a piano. The notations were simultaneously presented with distracting auditory stimuli that either matched or mismatched them in different semitone degrees. Unlike the controls, AP possessors revealed an interference effect in that they responded slower in mismatching conditions than in the matching one. Under cathodal stimulation, this interference effect disappeared. These findings confirm that the pitch‐labeling process underlying AP occurs automatically and is largely nonsuppressible when triggered by tone exposure. The improvement of the AP possessors’ sight‐reading performances in response to the suppression of the left DLPFC using cathodal stimulation confirms a causal relationship between this brain structure and pitch labeling.
Multi‐modal Neuroelectrophysiological Monitoring in the Treatment of Thoracic Tuberculosis with Debridement and Bone Grafting and Posterior Pedicle Screw Fixation via Costal Transverse Process Approach
Authors: Zhang Chen‐wei , Shi Shi‐yuan , Tao Xiao , Hu Jin‐ping , Cao Tian‐yi , Fei Jun 
Published: May 2021

ObjectiveTo explore the value of multi‐mode neuroelectrophysiological monitoring (MIOM) in evaluating spinal cord and nerve root function in the treatment of thoracic tuberculosis via costal transverse process approach.MethodsFrom December 2017 to September 2019, a retrospective study of thoracic tuberculosis patients in our hospital was conducted. This study included 25 patients (14 men and 11 women). The average age of patients at the time of surgery was 63.3 years (range, 20–83 years). All patients (three cases with the destruction of a single vertebral body, 13 cases with the destruction of two vertebral bodies, and nine cases with the destruction of three or more vertebral bodies) underwent costal transverse process approach with debridement and bone grafting and internal fixation combined with intraoperative multimodal neuroelectrophysiological monitoring. During the operation, somatosensory evoked potential (SEP), transcranial electrical stimulation motor evoked potential (TES‐MEP), and spontaneous electromyography (EMG) were used to monitor progress. ESR, visual analogue scale (VAS), Cobb angle, and Oswestry disability index (ODI) were statistically analyzed to evaluate the treatment effects and patient satisfaction.ResultsAll 25 patients were successfully monitored. The follow‐up time ranged from 12 to 21 months, with an average of 15.3 months. SEP waveform abnormalities occurred in five patients during the operation, the incidence rate was 28%. Of these five patients, three patients changed their instruments and postures, and adjusted the flushing water flow in time; one patient received pressure therapy in time; the operation was suspended for 10 min for one patient. There were seven cases with abnormal TES‐MEP waveform, the incidence rate was 28%. Among these seven cases, five cases adjusted the nail path during the operation and adjusted the nail position in time. One case adjusted the inclination angle of the operating table in time; one case completed the contralateral nail stick correction in time; five of them had abnormal TES‐MEP waveforms, and EMG burst potential was also detected, the incidence rate was 20%. After prompt treatment, the abnormal waveforms of all patients returned to normal; no abnormal waveforms, recurrence of tuberculosis, loosening of internal fixation, nerve and spinal cord dysfunction, etc. The VAS score, erythrocyte sedimentation rate (ESR), Cobb angle, and ODI scores of the patients 1 year after operation were significantly improved compared with 1 week after operation (P < 0.05).ConclusionMulti‐mode intraoperative electrophysiological detection combined with costal transverse process approach for the treatment of thoracic tuberculosis could avoid intraoperative nerve and blood vessel damage, reduce surgical risk, improve surgical efficiency, and ensure curative effect.
Language‐centered approach to care improvement in a pediatric dermatology clinic
Authors: Blundell Andrew R. , Moustafa Danna , Bartenstein Diana W. , Smith Gideon P. , Hawryluk Elena B. 
Published: May 2021

AbstractLanguage‐congruent care can improve clinical outcomes. As a quality improvement initiative supported by the Department of Dermatology at Massachusetts General Hospital, the American Academy of Dermatology, and the Society for Pediatric Dermatology, our group established monthly pediatric dermatology “Spanish clinics” that scheduled Spanish‐speaking patients on the same day and utilized a dedicated, live interpreter who stayed with the clinical team throughout the clinic. Patients reported high satisfaction scores, averaging 9.8 out of 10, and 90.5% of patients preferred this model to traditional appointments. Our participating physician found “Spanish clinics” allowed for more efficient care not only in the monthly pilot clinics, but in all clinics occurring during the time period.