bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes and associated predictors of early intervention in autism spectrum disorder: a study protocol
Authors: Masi Anne , Dissanayake Cheryl , Alach Tasha , Cameron Kate , Fordyce Kathryn , Frost Grace , Grove Rachel , Heussler Helen , Silove Natalie , Sulek Rhylee , Tucker Madonna , Williams Katrina , Eapen Valsamma 
Published: August 2021

IntroductionResearch highlights the importance of early intervention for children with autism spectrum disorder with better outcomes associated with earlier access to early intensive intervention (EII) programmes. However, there is significant variability in response to EII despite children receiving the same programmes.Methods and analysisA prospective, multisite cohort study using a pre–post design assesses the predictors of early intervention outcomes for children who receive EII through six early intervention services (Autism Specific Early Learning and Care Centres, ASELCCs) across Australia. Child and family characteristics at entry to and exit from ASELCCs are ascertained using measures of autism symptoms (Autism Diagnostic Observation Schedule-2; Social Communication Questionnaire); cognitive, language and developmental skills (Mullen Scale of Early Learning); adaptive function (Vineland Adaptive Behaviour Scale—second Edition); behaviours (Child Behaviour Checklist—1.5 to 5 years; Restricted Repetitive Behaviour Scale); parental stress (Parent Stress Index-4 Short Form); quality of life (Quality of Life in Autism Scale) and a semistructured family history questionnaire for sociodemographic, family and psychosocial characteristics. Characteristics at entry are used as predictors of outcome at exit following EII approximately 12 months later. The change in score from baseline to exit will be the primary outcome of interest. The mediating role of family and psychosocial factors will also be considered.Ethics approvalUniversity of New South Wales Human Research Ethics Committee (HC14267).Dissemination of resultsFindings will be published in peer-reviewed journals and presented at conferences. A report summarising data and the interpretation of data will be published.
Emotional, informational and instrumental support needs in patients with breast cancer who have undergone surgery: a cross-sectional study
Authors: Cai Tingting , Huang Qingmei , Yuan Changrong 
Published: August 2021

ObjectivesThis study evaluated emotional, informational and instrumental support needs in patients with breast cancer who had undergone surgery, then identified the variables associated with those needs.DesignThis was a cross-sectional survey study.SettingQuestionnaires were distributed in tertiary hospitals in China between January 2018 and July 2020.ParticipantsWe recruited 477 eligible patients with breast cancer via convenience sampling. Due to exclusions for response errors, the final analysed sample included 461 participants (mean age of 50.9 years). Each completed a questionnaire consisting of a sociodemographic information component and three short forms from the Patient-Reported Outcome Measurement Information System (social relationships short forms, anxiety short form and depression short form). Subsequent analyses included the χ2test, Pearson correlation and multivariate regression.ResultsThe T scores for informational support were lower than those for the reference group (general population), while those for emotional and informational support were average. Marital status, childbearing history, lifestyle, employment status, anxiety and depression levels were related to the scores for emotional, informational and instrumental support in this population. The regression analysis revealed that emotional support levels, instrumental support levels, marital status, employment status, anxiety and depression outcomes were predictors for informational support levels.ConclusionsInformational support should be specifically assessed and promoted among patients with breast cancer in general, while marital status, childbearing history, lifestyle, employment status, anxiety and depression levels should be evaluated when conducting interventions to promote emotional, informational and instrumental support for those who have undergone surgery. Early and regular screenings for high-risk patients will help nurses identify those who are likely to benefit from targeted preventive interventions aimed at emotional, informational and instrumental support issues.Trial registration numberChiCTR2000035439; ClinicalTrials.gov registry.
Allogeneic adipose tissue-derived mesenchymal stem cells in ischaemic stroke (AMASCIS-02): a phase IIb, multicentre, double-blind, placebo-controlled clinical trial protocol
Authors: de Celis-Ruiz Elena , Fuentes Blanca , Moniche Francisco , Montaner Joan , Borobia Alberto M , Gutiérrez-Fernández Maria , Díez-Tejedor Exuperio 
Published: August 2021

IntroductionStroke is a serious public health problem, given it is a major cause of disability worldwide despite the spread of recanalisation therapies. Enhancement of brain plasticity with stem cell administration is a promising innovative therapy to reduce sequelae in these patients.Methods and analysisWe have developed a phase IIb, multicentre, randomised, double-blind, placebo-controlled clinical trial protocol to evaluate the safety and efficacy of intravenous administration of allogeneic adipose tissue-derived mesenchymal stem cells (AD-MSCs) in patients with acute ischaemic stroke, concurrently with conventional stroke treatment. Thirty patients will be randomised on a 1:1 basis to receive either intravenous placebo or allogeneic AD-MSCs as soon as possible within the first 4 days from stroke symptom onset. Patients will be followed up to 24 months after randomisation. The primary objective is the safety assessment of early intravenous administration of allogeneic AD-MSCs by reporting all adverse events and neurological or systemic complications in both treatment groups. Secondary objectives assess efficacy of early intravenous AD-MSC treatment in acute ischaemic stroke by evaluating changes in the modified Rankin Scale and the National Institutes of Health Stroke Scale throughout the follow-up period. In addition, brain repair biomarkers will be measured at various visits.Ethics and disseminationThis clinical trial has been approved by the Clinical Research Ethics Committee of La Paz University Hospital (Madrid, Spain) and by the Spanish Agency of Medication and Health Products and has been registered in Eudra CT (2019-001724-35) and ClinicalTrials.gov (NCT04280003). Study results will be disseminated through peer-reviewed publications in Open Access format and at conference presentations.
Prehospital risk stratification in patients with chest pain
Authors: Sagel Dennis , Vlaar Pieter Jan , van Roosmalen Radboud , Waardenburg Ingmar , Nieuwland Wybe , Lettinga Roelof , van Barneveld Robert , Jorna Edward , Kijlstra Roelof , van Well Carien , Oomen Antoon , Bartels Louis , Anthonio Rutger , Hagens Vincent , Hofma Sjoerd , Gu Youlan , Drenth Derk , Addink Ryanne , van Asselt Thea , van der Meer Peter , Lipsic Eric , Juarez Orozco Luis , van der Harst Pim 
Published: August 2021

ObjectivesThe History, ECG, Age, Risk Factors and Troponin (HEART) Score is a decision support tool applied by physicians in the emergency department developed to risk stratify low-risk patients presenting with chest pain. We assessed the potential value of this tool in prehospital setting, when applied by emergency medical services (EMS), and derived and validated a tool adapted to the prehospital setting in order to determine if it could assist with decisions regarding conveyance to a hospital.MethodsIn 2017,EMS personnel prospectively determined the HEART Score, including point-of-care (POC) troponin measurements, in patients presenting with chest pain, in the north of the Netherlands. The primary endpoint was a major adverse cardiac event (MACE), consisting of acute myocardial infarction or death, within 3 days. The components of the HEART Score were evaluated for their discriminatory value, cut-offs were calibrated for the prehospital setting and sex was substituted for cardiac risk factors to develop a prehospital HEART (preHEART) Score. This score was validated in an independent prospective cohort of 435 patients in 2018.ResultsAmong 1208 patients prospectively recruited in the first cohort, 123 patients (10.2%) developed a MACE. The HEART Score had a negative predictive value (NPV) of 98.4% (96.4–99.3), a positive predictive value (PPV) of 35.5% (31.8–39.3) and an area under the receiver operating characteristic curve (AUC) of 0.81 (0.78–0.85). The preHEART Score had an NPV of 99.3% (98.1–99.8), a PPV of 49.4% (42.0–56.9) and an AUC of 0.85 (0.82–0.88), outperforming the HEART Score or POC troponin measurements on their own. Similar results were found in a validation cohort.ConclusionsThe HEART Score can be used in the prehospital setting to assist with conveyance decisions and choice of hospitals; however, the preHEART Score outperforms both the HEART Score and single POC troponin measurements when applied by EMS personnel in the prehospital setting.
Can fibromyalgia be considered a characteristic symptom of climacterium?
Authors: Ozcivit Ipek Betul , Erel Cemal Tamer , Durmusoglu Fatih 
Published: August 2021

Abstract
Fibromyalgia syndrome (FMS) is a chronic pain syndrome, characterised by diffuse pain in musculoskeletal system and accompanied by stiffness, fatigue, tender points, sleep disturbances and cognitive and gastrointestinal symptoms. It affects middle-aged women (between 40 and 65) predominantly. Climacteric syndrome, which is characterised by vasomotor, somatic (headache, sleep disorders, myalgia and arthralgia) and psychical (mood changes) symptoms, results from the change in brain neurotransmitter concentrations due to gradual decline of ovarian hormone levels. Currently, studies focus on the similarities of FMS and climacteric syndrome in terms of age of occurrence, epidemiology, etiopathogenesis, symptomatology and treatment. Hormonal fluctuation during menopausal transition is likely the triggering factor for both syndromes. Therefore, hormone replacement therapy is a favourable approach in the treatment of FMS due to the antiallodynic, anti-inflammatory and neuroprotective effect of oestrogen. In this review, we emphasise the similarity of FMS and climacteric syndrome and suggested that FMS could be considered as a characteristic symptom of climacterium.
Trends of core versus subspecialty operative procedures completed in general surgery residency training programs
Authors: Tuma Faiz , Malgor Rafael D , Kapila Nikit , Kamel Mohamed K 
Published: August 2021

AbstractIntroductionGeneral surgery residency involves performing subspecialty procedures in addition to the core general procedures. However, the proportion of core general surgery versus subspecialty procedures during training is variable and its temporal changes are unknown. The goal of our study was to assess the current trends in core general surgery and subspecialty procedure distributions during general surgery residency training.MethodsData were collected from the ACGME core general surgery national resident available report case logs from 2007 to 2019. Descriptive and time series analyses were used to compare proportions of average procedures performed per resident in the core general surgery category versus the subspecialty category. F-tests were conducted to show whether the slopes of the trend lines were significantly non-zero.ResultsThe mean of total procedures completed for major credit by the average general surgery resident increased from 910.1 (SD=30.31) in 2007 to 1070.5 (SD=37.59) in 2019. Over that same period, the number of general, cardiothoracic, plastic and urology surgery procedures increased by 24.9%, 9.8%, 76.6% and 19.3%, respectively. Conversely, vascular and paediatric surgery procedures decreased by 7.6% and 30.7%, respectively. The neurological surgery procedures remain stable at 1.1 procedures per resident per year. A significant positive correlation in the trend reflecting total (p&lt;0.0001), general (p&lt;0.0001) and plastic (p&lt;0.0016) surgery procedures and the negative correlation in the trend lines for vascular (p&lt;0.0006) and paediatric (p&lt;0.0001) surgery procedures were also noted.ConclusionsTrends in overall surgical case volume performed by general surgery residents over the last 12 years have shown a steady increase in operative training opportunity despite the increasing number of subspecialty training programmes and fellowships. Further research to identify areas for improvement and to study the diversity of operative procedures, and their outcomes is warranted in the years to come.
Quasi-local photon surfaces in general spherically symmetric spacetimes
Authors: Cao Li-Ming , Song Yong 
Published: August 2021

AbstractBased on the geometry of the codimension-2 surface in general spherically symmetric spacetime, we give a quasi-local definition of a photon sphere as well as a photon surface. This new definition is the generalization of the one provided by Claudel, Virbhadra, and Ellis but without referencing any umbilical hypersurface in the spacetime. The new definition effectively excludes the photon surface in spacetime without gravity. The application of the definition to the Lemaître–Tolman–Bondi (LTB) model of gravitational collapse reduces to a second order differential equation problem. We find that the energy balance on the boundary of the dust ball can provide one of the appropriate boundary conditions to this equation. Based on this crucial investigation, we find an analytic photon surface solution in the Oppenheimer–Snyder (OS) model and reasonable numerical solutions for the marginally bounded collapse in the LTB model. Interestingly, in the OS model, we find that the time difference between the occurrence of the photon surface and the event horizon is mainly determined by the total mass of the system but not the size or the strength of the gravitational field of the system.
Radial Radio Number of Hexagonal and Its Derived Networks
Authors: Yenoke Kins , Kaabar Mohammed K. A. , Al-Shamiri Mohammed M. Ali , Thivyarathi R. C. 
Published: August 2021

A mapping

ℸ
:

V

G

⟶
N

∪

0

for a connected graph

G
=

V
,
E

is called a radial radio labelling if it satisfies the inequality

ℸ

x

−

ℸ

y

+
d

x
,
y

≥
rad

G

+
1

∀
x
,
y
∈
V

G

, where

rad

G

is the radius of the graph

G

. The radial radio number of

ℸ

denoted by

r
r

ℸ

is the maximum number mapped under

ℸ

. The radial radio number of

G

denoted by

r
r

G

is equal to min {

r
r

ℸ

/

ℸ

is a radial radio labelling of

G

}.
Variation of Radar-Observed Precipitation Characteristics in Relation to the Simultaneous Passages of a Madden–Julian Oscillation Event and Convectively Coupled Equatorial Waves during the Years of the Maritime Continent Pilot Study
Authors: Geng Biao , Katsumata Masaki 
Published: August 2021

AbstractIn this study, we examined the variations of precipitation morphology and rainfall in relation to the simultaneous passages of a Madden–Julian oscillation (MJO) event and convectively coupled equatorial waves (CCEWs) observed during the Years of the Maritime Continent pilot study. We utilized globally merged infrared brightness temperature data and the radiosonde and radar data observed aboard the Research Vessel Mirai at 4°4′S, 101°54′E. As well as the observed MJO event, equatorial Rossby waves (ERWs), Kelvin waves (KWs), and mixed Rossby–gravity waves (MRGWs) were identified. The radar data exhibited high-frequency variation, mainly caused by KWs and MRGWs, and low-frequency variation, mainly caused by the MJO and ERWs. The MRGWs predominantly modulated convective echo areas and both convective and stratiform volumetric rainfall. In contrast, the MJO event had little influence on the variance of convective echoes. Moreover, stratiform echo areas and volumetric rainfall were more strongly modulated by the combined effects of the MJO, ERWs, KWs, and MRGWs than their convective counterparts. The intense development of stratiform echo areas and volumetric rainfall was coherent with the superimposition of the active phases of the MJO event and all the analyzed CCEWs. The strongest development and a significant reduction of convective echo-top heights before and after the peak MJO date, respectively, were coherent with the passages of ERWs and MRGWs, which were the dominant wave types in modulating echo-top heights. Thus, it appears that the superimposition of the CCEWs on the MJO event exerted complex modulations on the convective activities within the MJO event.
Phosphaturic Mesenchymal Tumors of the Sinonasal Area and Skull Base: Experience at a Single Institution
Authors: Argersinger Davis P. , Haring Catherine T. , Hanks John E. , Kovatch Kevin J. , Ali S. Ahmed , McHugh Jonathan B. , Pynnonen Melissa A. , McKean Erin L. 
Published: August 2021

Objectives: Phosphaturic mesenchymal tumor (PMT) is a rare, polymorphous neoplasm with a highly variable presentation and natural history and unpredictable clinical course. The primary objective was to describe our clinical experience with and management of 4 markedly different cases of sinonasal and skull base PMT. Methods: A retrospective case series with chart review, and relevant literature review, was performed at a tertiary academic medical center between 1998 and 2020. Adult patients treated for PMTs of the sinonasal area and skull base were included. Our main outcome measures included postoperative laboratory findings and radiological evidence of disease remission. Results: Four patients (2 Males, 2 Females; Mean Age: 63.5 years) with PMTs of the skull base have been managed at our institution since 1998. Patient presentations varied, ranging from severe phosphorus wasting and osteoporosis to symptoms secondary to mass effect, including nasal obstruction and rhinorrhea. All 4 patients were eventually found to have elevated levels of fibroblast growth factor 23. Tumors were located in the sinonasal area (right frontal sinus, right ethmoid sinus, and right nasal cavity, respectively) in 3 patients and in the lateral skull base (right jugular foramen) in 1 patient. All 4 patients underwent complete surgical resection of their tumors. PMT tissue pathology was confirmed in all cases. Gross total resection was achieved in all patients. There was no chemical or radiological evidence of disease recurrence in any patients at follow-up. Conclusions: The presentation of skull base PMT is variable, and it may mimic other mass pathologies of the head and neck. Complete surgical resection with negative margins is potentially curative.
Plexiform fibromyxoma: a clinicopathological and immunohistochemical analysis of two cases with a literature review
Authors: Ma Shaofei , Wang Jing , Lu Zhanjun , Shi Chaoying , Yang Daohua , Lin Jun 
Published: August 2021

Objective This article aimed to study the clinicopathological features, immunophenotypes, and differential diagnoses of plexiform fibromyxoma (PF). Methods We searched clinical and pathology databases of our hospital for patients with histologically confirmed PF from 2007 to 2020 and reviewed the relevant English and Chinese language literature. Results Two cases of PF were identified, a 67-year-old woman and a 23-year-old man. Both patients presented with melena and anemia and underwent partial gastrectomy. Histologically, the tumors exhibited a plexiform growth pattern in the gastric submucosa and the presence of bland-looking spindle cells in the fibromyxoid stroma with the formation of small blood vessels. Immunohistochemically, the two cases were strongly positive for vimentin, smooth muscle actin, and muscle-specific actin and negative for CD117, discovered on gastrointestinal stromal tumors protein 1, CD34, CD10, S100, desmin, H-caldesmon, estrogen receptor, progesterone receptor, β-catenin, and cytokeratin. Conclusions PF is a rare mesenchymal tumor of the stomach that can be distinguished from other gastrointestinal mesenchymal tumors based on its distinctive morphology and immunophenotype.
Incremental peritoneal dialysis in incident end-stage kidney disease patients
Authors: Yan Hao , Abreu Zita , Bargman Joanne M 
Published: August 2021

Background: This retrospective cohort study investigated the characteristics and outcomes of the end-stage kidney disease (ESKD) patients treated with incremental peritoneal dialysis (PD) at a large academic centre. Methods: ESKD patients initiating PD with a dialysate volume ≤6 L/day were analysed. Results: One hundred and seventy-five patients were included and were followed up for 352.6 patient-years. The baseline residual kidney function (RKF) was 8.3 ± 3.4 mL/min/1.73 m2. The unadjusted 1- to 5-year patient survival rate was 89.6%, 80.4%, 65.4%, 62.7% and 48.8%, respectively, and the corresponding time on PD therapy rate was 95.1%, 89.1%, 89.1%, 82.4% and 77.6%. Greater initial PD dose (hazard ratio = 1.608, 95% confidence interval 1.089–2.375) was associated with death after adjusting for age, Charlson comorbidity index (CCI), haemodialysis prior to PD, assisted PD and baseline RKF, likely as a result of residual confounding. There was no association with PD discontinuation. The average peritonitis rate and hospitalisation rate were 0.122 and 0.645 episodes per patient-year, respectively. The dialysate volume increased from 4.5 (4.3–5.7) L/day to 8.0 (6.0–9.8) L/day at 5 years. Fifty-seven (32.6%) patients graduated to full-dose PD at a median time of 10.3 (6.2, 15.7) months. Male sex, greater body mass index and lower baseline serum albumin were risk factors for increasing PD dose to over 6 L/day within 1 year. Conclusions: Incremental PD is a safe approach to initiate dialysis, and it offers satisfactory outcomes. Close monitoring, comprehensive evaluation of clinical responses and prompt adjustment of the prescription as needed play a crucial role in this patient-centred treatment.
Parameters and properties for the preparation of Cu nanocolloids containing polyvinyl alcohol using the electrical spark discharge method
Authors: Tseng Kuo-Hsiung , Ke Han-Chiao , Ku Hsueh-Chien 
Published: August 2021

Through the use of an electric discharge machine, this study performed the electrical spark discharge method in deionised water under normal temperature and pressure for Cu nanocolloid (CuNC) preparation. The CuNCs had a zeta potential of 12.3 mV, indicating poor suspension stability. The suspension stability was effectively increased (zeta potential 32.5 mV) through the addition of polyvinyl alcohol (PVA) to form PVA-containing CuNCs PVA/CuNCs. Next, the following pulse-width modulation (Ton:Toff) parameters were tested to determine the optimal setting for PVA/CuNC preparation: 10:10, 30:30, 50:50, 70:70 and 90:90 µs. The optimal preparation parameter was then determined according to the absorbance, zeta potential and size distribution results. Finally, the surface properties and crystal structure of the PVA/CuNCs were characterised through transmission electron microscopy (TEM) and X-ray diffraction (XRD). When the Ton:Toff was set to 30:30 µs, preparation efficiency was optimal, as was suspension stability, as indicated by the absorbance value (0.534), zeta potential (32.5 mV) and size distribution (85.47 nm). Transmission electron microscopy revealed that Cu nanoparticles that were more dispersed in the PVA/CuNCs had a diameter smaller than 10 nm and a crystal line width of 0.2028 nm. X-ray diffraction showed that the PVA/CuNCs contained intact Cu crystal structures.