bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relation between physical activity and cerebral small vessel disease: A nine-year prospective cohort study
Authors: Landman Thijs RJ , Thijssen Dick HJ , Tuladhar Anil M , de Leeuw Frank-Erik 
Published: January 2021

Background and aims Given the unexplored potential of physical activity to reduce the progression of cerebral small vessel disease (cSVD, the purpose of this study was to prospectively (across nine-year follow-up) examine the relation between (baseline) physical activity and the (clinical and imaging) consequences of the whole spectrum of cerebral small vessel disease. Methods Five hundred and three patients with cerebral small vessel disease from the RUNDMC study were followed for nine years. Physical activity was assessed using a questionnaire in 2006, 2011, and 2015. Clinical events (i.e. all-cause mortality, cerebrovascular events (by stroke subtype)) were collected with a structured questionnaire. Patients underwent magnetic resonance imaging scanning for the assessment of magnetic resonance imaging markers of cerebral small vessel disease (i.e. white matter hyperintensities, lacunes, and microbleeds) and microstructural integrity of the white matter at three timepoints. Results The mean age at baseline was 66 (SD 9.0) years; 44% were women. A higher baseline physical activity level was independently associated with a lower all-cause mortality (HR: 0.69, 95%CI: 0.49–0.98, p = 0.03) and incidence of cerebrovascular disease (HR: 0.58, 95%CI: 0.36–0.96, p = 0.03). However, we found no relation between physical activity and incident lacunar stroke or progression of magnetic resonance imaging markers of cerebral small vessel disease. Conclusions Whilst regular physical activity was not related to the progression of magnetic resonance imaging markers of cerebral small vessel disease across a nine-year follow-up, results from our study prove that high levels of physical activity in patients with cerebral small vessel disease are associated with a lower all-cause mortality and lower incidence of cerebrovascular events.
External validation of two prediction tools for patients at risk for recurrent Clostridioides difficile infection
Authors: van Rossen Tessel M. , van Dijk Laura J. , Heymans Martijn W. , Dekkers Olaf M. , Vandenbroucke-Grauls Christina M. J. E. , van Beurden Yvette H. 
Published: January 2021

Background: One in four patients with primary Clostridioides difficile infection (CDI) develops recurrent CDI (rCDI). With every recurrence, the chance of a subsequent CDI episode increases. Early identification of patients at risk for rCDI might help doctors to guide treatment. The aim of this study was to externally validate published clinical prediction tools for rCDI. Methods: The validation cohort consisted of 129 patients, diagnosed with CDI between 2018 and 2020. rCDI risk scores were calculated for each individual patient in the validation cohort using the scoring tools described in the derivation studies. Per score value, we compared the average predicted risk of rCDI with the observed number of rCDI cases. Discrimination was assessed by calculating the area under the receiver operating characteristic curve (AUC). Results: Two prediction tools were selected for validation (Cobo 2018 and Larrainzar-Coghen 2016). The two derivation studies used different definitions for rCDI. Using Cobo’s definition, rCDI occurred in 34 patients (26%) of the validation cohort: using the definition of Larrainzar-Coghen, we observed 19 recurrences (15%). The performance of both prediction tools was poor when applied to our validation cohort. The estimated AUC was 0.43 [95% confidence interval (CI); 0.32–0.54] for Cobo’s tool and 0.42 (95% CI; 0.28–0.56) for Larrainzar-Coghen’s tool. Conclusion: Performance of both prediction tools was disappointing in the external validation cohort. Currently identified clinical risk factors may not be sufficient for accurate prediction of rCDI.
Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years
Authors: Kokame Gregg T. , Tanji Tarin T. , Omizo Jase N. 
Published: January 2021

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.
Nudging in Singapore: Current Implementation in Three Key Areas
Authors: Detenber Benjamin H. 
Published: January 2021

The city state of Singapore has a long history of social engineering efforts, yet only recently have social scientists and civil servants started to use behavioural insights (BI) to create ‘nudges’ and integrate them into the daily lives of citizens. Colloquially known as a nanny state for its extensive social programmes and sometimes heavy-handed approach to guiding social behaviour, Singapore is often regarded favourably by its neighbours in terms of its cleanliness, efficiency, and productivity. Yet how it manages its populace and the restrictions it imposes on unwanted behaviours are sometimes viewed sceptically by others in Asia and the West. Thus, many in the Singapore Civil Service have come to see nudging as a less coercive way to promote social welfare and well-being. This article reviews some of the latest actions in three areas: finance, health, and the environment. In discussing the range of nudging practices, their effectiveness will be assessed and some of the implications for society and individuals will be addressed. To the extent that Singapore can be considered a bellwether or harbinger, its use of nudges may offer a glimpse of what lies ahead for other countries in the region. JEL codes: E70, O35
Continuity in general practice and hospitalization patterns: an observational study
Authors: Wensing Michel , Szecsenyi Joachim , Laux Gunter 
Published: January 2021

Abstract
Background
High continuity of care is a key feature of strong general practice. This study aimed to assess the effect of a programme for enhancing strong general practice care on the continuity of care in Germany. The second aim was to assess the effect of continuity of care on hospitalization patterns.

Methods
We performed an observational study in Germany, involving patients who received a strong general practice care programme (n=1.037.075) and patients who did not receive this programme (n=723.127) in the year 2017. We extracted data from a health insurance database. The cohorts were compared with respect to three measures of continuity of care (Usual Provider Index, Herfindahl Index, and the Sequential Continuity Index), adjusted for patient characteristics. The effects of continuity in general practice on the rates of hospitalization, rehospitalization, and avoidable hospitalization were examined in multiple regression analyses.

Results
Compared to the control cohort, continuity in general practice was higher in patients who received the programme (continuity measures were 12.47 to 23.76% higher, P< 0.0001). Higher continuity of care was independently associated with lowered risk of hospitalization, rehospitalization, and avoidable hospitalization (relative risk reductions between 2.45 and 9.74%, P< 0.0001). Higher age, female sex, higher morbidity (Charlson-index), and home-dwelling status (not nursing home) were associated with higher rates of hospitalization.

Conclusion
Higher continuity of care may be one of the mechanisms underlying lower hospitalization rates in patients who received strong general practice care, but further research is needed to examine the causality underlying the associations.
Effect of a sports mouthguard on the functional range of motion of the spine and the upper body posture in taekwondo
Authors: Ohlendorf Daniela , Romdhane Mara , Lehmann Christoph , Lehmann Sebastian , Kopp Stefan , Maurer-Grubinger Christian , Oremek Gerhard , Groneberg David A. , Wanke Eileen M. 
Published: January 2021

Abstract
Background
The aim is to investigate to what extent the different oral protections compared to the habitual occlusion affect the upper body posture in statics and during taekwondo-specific movement.

Methods
12 Taekwondoka (5 f/7 m) of German national team were measured by using a 3d back scanner and an ultrasonic distance measuring (upright stand, taekwondo attack and defense movement, two taekwondo specific combinations) in habitual occlusion, with a custom-made and ready-made mouth protection

Results
There are no significant changes in the upper body posture (p ≥ 0.05). Depending on the dynamic measurements, different significant reactions of the spinal position were found while wearing the custom made mouthguard or the ready-made mouthguard according to the conducted movement.

Conclusion
The measured changes in dynamic movements are not clinical relevant. Based on the positive responses from the participants, the custom-made mouth protection can be recommended combined with an individual analysis.
Exome sequencing enables diagnosis of X-linked hypohidrotic ectodermal dysplasia in patient with eosinophilic esophagitis and severe atopy
Authors: Modi Bhavi P. , Del Bel Kate L. , Lin Susan , Sharma Mehul , Richmond Phillip A. , van Karnebeek Clara D. M. , Chan Edmond S. , Avinashi Vishal , Rehmus Wingfield E. , Biggs Catherine M. , Wasserman Wyeth W. , Turvey Stuart E. 
Published: January 2021

AbstractX-linked hypohidrotic ectodermal dysplasia (XLHED) is the most common form of ectodermal dysplasia. Clinical and genetic heterogeneity between different ectodermal dysplasia types and evidence of incomplete penetrance and variable expressivity increase the potential for misdiagnosis. We describe a family with X-linked hypohidrotic ectodermal dysplasia (XLHED) presenting with variable expressivity of symptoms between affected siblings. In addition to the classical signs of hypohidrosis, hypotrichosis and hypodontia, the index patient—a 5 year old boy, also presented with a severe atopy phenotype that was not observed in the other two affected brothers. Exome sequencing in the index and the mother identified a pathogenic nonsense variant in EDA (NM_001399.4: c.766 C>T; p. Gln256Ter). This study highlights how exome sequencing was crucial in establishing a precise molecular diagnosis of XLHED by enabling us to rule out other differential diagnoses including NEMO deficiency syndrome, that was initially presented as a clinical diagnosis to the family.
Clinical and immunologic characteristics of Japanese patients with anti-glomerular basement membrane disease: case reports and literature review
Authors: Shimamura Yoshinosuke , Maeda Takuto , Abe Koki , Ogawa Yayoi , Takizawa Hideki 
Published: January 2021

Abstract
Background
Clinical studies of anti-glomerular basement membrane (GBM) disease were limited because of the low incidence. We aimed to report the characteristics, treatments, and outcomes of patients with anti-GBM disease at a tertiary reference medical center in Japan and review the literature of mortality in patients with anti-GBM disease.

Case presentation
Case 1 was a 72-year-old Japanese man that was referred with worsening of the serum creatinine (from 1.1 to 27.3 mg/dL). Anti-GBM disease was confirmed by renal biopsy, and treatments with oral prednisolone and plasmapheresis were initiated. Although his anti-GBM antibody decreased (from 476 to 18 units/mL) after the treatments, the patient died from lung abscess. Case 2 was a 32-year-old Japanese man that presented with fever and macroscopic hematuria. At presentation, his serum creatinine was 4.2 mg/dL, and anti-GBM antibody was 265 units/mL. Renal biopsy confirmed the diagnosis of anti-GBM disease, and intensive treatments with plasmapheresis and methyl prednisolone were started, followed by oral prednisolone. Living-donor kidney transplantation was performed because his anti-GBM antibody had remained undetectable for 1 year after diagnosis. In the main text, clinicopathological characteristics of 12 patients with anti-GBM disease at our institution were summarized.

Conclusions
We found that the 1-year survival rate of patients with anti-GBM disease was 88% in our cohort, which was comparable to previous studies. Multicenter, nationwide studies are expected to evaluate prognosis of Japanese patients with this rare entity.
Temporary central venous catheter at hemodialysis initiation and reasons for use: a cross-sectional study
Authors: Nakaya Izaya , Goto Taijiro , Nakamura Yuki , Yoshikawa Kazuhiro , Oyama Junji , Tamayama Yoshihiko , Morooka Mizuho , Ito Sadatoshi , Ishioka Hirotaka , Matsuura Yuki , Soma Jun 
Published: January 2021

Abstract
Background
Creating permanent vascular access (VA) is recommended before hemodialysis initiation in patients with end-stage renal disease (ESRD). Although many patients are still introduced to hemodialysis with temporary central venous catheters (CVCs), the reasons for their use remain unclear. We aimed to clarify the characteristics of Japanese patients introduced to hemodialysis using temporary CVCs, the reasons for their use, and whether this rate can be reduced in the future.

Methods
We conducted this cross-sectional study in an acute care general hospital in Japan. We enrolled 393 patients aged ≥ 18 years who received a permanent VA creation for initiating hemodialysis. We classified participants into the temporary CVC group or the permanent VA group according to the VA type at hemodialysis initiation and compared their backgrounds. We identified why permanent VA could not be used at hemodialysis initiation for patients in the temporary CVC group.

Results
Of the 393 patients, 137 (35%) initiated hemodialysis with a temporary CVC, and arteriovenous fistulas (AVFs) were created as the first VA in all patients during hospitalization following hemodialysis initiation. The remaining 256 patients (65%) initiated hemodialysis via AVF cannulation. The duration of predialysis nephrology care was significantly shorter in the temporary CVC group than that in the permanent VA group. The median time from AVF creation to the first successful cannulation was also shorter in the temporary CVC group (8 vs. 66 days, P < 0.001), but the estimated glomerular filtration rate values at hemodialysis initiation did not differ. Reasons for temporary CVC use were varied and complex. Problems on the part of healthcare providers, patient behavioral issues, and characteristics of causative kidney disease itself were underlying reasons. Delayed referral to a nephrologist was less frequent than expected (16%) and the most commonly reported reason (20%) was that a nephrologist was unable to predict the timing of hemodialysis initiation.

Conclusions
Patients with ESRD should be referred to a nephrologist earlier for AVF creation. However, given the already relatively high rate of hemodialysis initiation with permanent VA in Japan, we considered it surprisingly difficult to further reduce the temporary CVC usage rate in Japan.
The efficacy of ultrasound-guided multifidus cervicis plane block versus greater occipital nerve block for cervicogenic headache
Authors: Mohamed Zenat Eldadamony , Zarad Carmen Ali , Flifel Mohamed E. , Abou Elmaaty Ali A. 
Published: January 2021

AbstractIntroductionTraditionally, non-invasive and invasive techniques were used for the treatment of cervicogenic headache (CH). Greater occipital nerve block is the most frequent peripheral nerve block invasive technique used for the management of cervicogenic headache. The purpose of this prospective, double-blinded study was to compare the efficacy of two different techniques: multifidus cervicis plane block and greater occipital nerve block in the treatment of refractory cervicogenic headache by using ultrasound.MethodsSixty patients with cervicogenic headache were recruited and diagnosed according to the ICHD-III beta version. The patients were divided into two groups, one group was for greater occipital nerve block and the other group was for multifidus cervicis plane block with ultrasound-guided.ResultsVisual analog scale (VAS) was 2.09% in the multifidus cervicis plane block (MCPB) group and was 2.22% in the greater occipital nerve block (GONB) group with a median reduction of − 4.33 and − 3.048, respectively, at 2-week visits with a statistically significant difference better in the MCPB group (P< 0.001). At 4 weeks visits, VAS scale was better in the MCPB group than in the GONB group (3.79 and 4.44, respectively) with a median reduction in VAS scale (− 3.27 and − 3.095, respectively) and statistically significant differences between both groups (P= 0.020).ConclusionBoth the ultrasound-guided multifidus cervicis plane block and greater occipital nerve block are effective as intervention techniques in the treatment of refractory cervicogenic headache. These techniques are simple, safe, more reliable with less side effects, and often reduce the requirements of analgesic drugs.
The periodic rotary motions of a rigid body in a new domain of angular velocity
Authors: Ismail A. I. 
Published: January 2021

AbstractIn the previous works, the limiting case for the motion of a rigid body about a fixed point in a Newtonian force field, which comes from a gravity center lies on Z-axis, is solved. The authors apply the small parameter technique which is achieved giving the body a sufficiently large angular velocity component ro about the fixed z-axis of the body. The periodic solutions of motion are obtained in neighborhood ro tends to $$\infty$$
∞
. In our work, we aim to find periodic solutions to the problem of motion in the neighborhood of r0 tends to $$0$$

0

. So, we give a new assumption that: ro is sufficiently small. Under this assumption, we must achieve a large parameter and search for another technique for solving this problem. This technique is named; a large parameter technique instead of the small one well known previously. We see the advantage of the new technique which appears in saving high energy used to begin the motion and give the solution of the problem in another domain. The obtained solutions by the new technique depend on ro. We consider that the center of mass of this body does not necessarily coincide with the fixed point O. We reduce the six nonlinear differential equations of the body and their three first integrals to a quasilinear autonomous system of two degrees of freedom and one first integral. We solve the rational case when the frequencies of the generating system are rational except $$(\,\omega = \,1,\,2,1/2,3,1/3, \ldots )$$

(

ω
=

1
,

2
,
1
/
2
,
3
,
1
/
3
,
…
)

under the condition $$\gamma^{\prime\prime}_{0} = \cos \theta_{o} \approx 0$$

γ
0
″

=
cos

θ
o

≈
0

. We use the fourth-order Runge–Kutta method to find the periodic solutions in the closed interval of the time t and to compare the analytical method with the numerical one.
Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 patients—a case series
Authors: Agrawal Akshat , Sen Kamal Kumar , Satapathy Gitanjali , Sethi Humsheer Singh , Sharawat Ajay , Reddy Dwarampudi Sindhu 
Published: January 2021

Abstract
Background
Spontaneous pneumomediastinum, pneumothorax and spontaneous subcutaneous emphysema are rare entities. A rising trend in the setting of COVID-19 even in patients who are not put on invasive ventilation can suggest an alternative aetiology.

Case presentation
We describe four cases which presented with suspected symptoms of COVID-19 and were diagnosed with pneumomediastinum, pneumothorax, and subcutaneous emphysema which would have been missed if not for computed tomography scan performed at the time of admission. Three of these cases had no prior history of any iatrogenic intervention, and the fourth person developing pneumothorax and subcutaneous emphysema after intubation.

Conclusions
Pneumomediastinum, pneumothorax and subcutaneous emphysema can be noted as a complication of COVID-19 itself as well as the complication of management of COVID-19.
New lipase-producing Streptomyces isolated from halo-alkaline habitat in Wadi El Natrun: polyphasic identification and statistical optimization of enzyme production
Authors: Mohamed Mohamed A. , Awad Hassan M. 
Published: January 2021

Abstract
Background
Bioprospecting lipase producers in non-conventional habitats are the way to find special enzymes of diverse applications. Halo-alkaline marshes in Wadi El Natrun in Egypt are some of the most stable ecological systems in the world, and because of the double extremities of alkalinity and salinity, they harbor individual microbes capable of adapting stress conditions.

Results
Eight strains were recovered from the coastline soil of Al-Beida Lake in Wadi El Natrun and have been tested for lipase production. Among the eight isolates, the strain SBLWN_MH2 was the most active producer of lipase (7.5 U/ml). The crude SBLWN_MH2 lipase showed activity over a wide pH range (3.5 to 13) with an optimum pH at 10.5, and it was able to show more than 75% of its highest activity at pH elevated up to 13. The identification using phenotypic and genotypic methods strongly indicated that the strain SBLWN_MH2 belonged to the genus Streptomyces with a similarity of 99%. Thus, it has been given the suggested name Streptomyces sp. SBLWN_MH2 (MG593538). SBLWN_MH2 produced extracellular lipase in modified starch casein medium supplemented with different oils or Tween-80, and the potential production rate has been attained in the case of linseed oil after 3 days. Further experiments have been carried out to optimize medium composition through Box-Behnken design and response surface methodology, and it was possible to achieve more than 3.5-fold increase in lipase production.

Conclusions
The present study indicates that Streptomyces sp. SBLWN_MH2 is a potential lipase producer and could be fruitfully employed in the large-scale production of highly alkaline lipase.