bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-stroke fatigue is associated with resting state posterior hypoactivity and prefrontal hyperactivity
Authors: Cotter Georgia , Salah Khlif Mohamed , Bird Laura , E Howard Mark , Brodtmann Amy , Egorova-Brumley Natalia 
Published: September 2021

Background Fatigue is associated with poor functional outcomes and increased mortality following stroke. Survivors identify fatigue as one of their key unmet needs. Despite the growing body of research into post-stroke fatigue, the specific neural mechanisms remain largely unknown. Aim This observational study aimed to identify resting state brain activity markers of post-stroke fatigue. Method Sixty-three stroke survivors (22 women; age 30–89 years; mean 67.5 ± 13.4 years) from the Cognition And Neocortical Volume After Stroke study, a cohort study examining cognition, mood, and brain volume in stroke survivors following ischemic stroke, underwent brain imaging three months post-stroke, including a 7-minute resting state functional magnetic resonance imaging. We calculated the fractional amplitude of low-frequency fluctuations, which is measured at the whole-brain level and can detect altered spontaneous neural activity of specific regions. Results Forty-five participants reported experiencing post-stroke fatigue as measured by an item on the Patient Health Questionnaire-9. Fatigued compared to non-fatigued participants demonstrated significantly lower resting-state activity in the calcarine cortex ( p < 0.001, cluster-corrected pFDR = 0.009, k = 63) and lingual gyrus ( p < 0.001, cluster-corrected pFDR = 0.025, k = 42) and significantly higher activity in the medial prefrontal cortex ( p < 0.001, cluster-corrected pFDR = 0.03, k = 45). Conclusions Post-stroke fatigue is associated with posterior hypoactivity and prefrontal hyperactivity reflecting dysfunction within large-scale brain systems such as fronto-striatal-thalamic and frontal-occipital networks. These systems in turn might reflect a relationship between post-stroke fatigue and abnormalities in executive and visual functioning. This whole-brain resting-state study provides new targets for further investigation of post-stroke fatigue beyond the lesion approach.
Survival and drug persistence in patients receiving inhaled treprostinil at doses greater than 54 µg (nine breaths) four times daily
Authors: Shapiro Shelley , Mandras Stacy , Restrepo‐Jaramillo Ricardo , Shen Eric , Broderick Meredith , Rao Youlan , Lee Dasom , Nelsen Andrew C. 
Published: September 2021

Treprostinil is a prostacyclin approved for the treatment of pulmonary arterial hypertension. Commercial data sets indicate that approximately 20–25% of patients are prescribed a higher dose than the maximum recommended dosage of nine breaths per treatment session (bps) (54 μg), four times a day (QID) and numerous studies have demonstrated the safety of doses >9 bps QID. This phase 4, retrospective analysis of specialty pharmacy records assessed the effects of inhaled treprostinil at doses >9 bps QID. Patients receiving inhaled treprostinil between September 2009 and June 2018 were included, and a random sampling of 5000 patients was selected for further analysis. Subjects were grouped based on the highest dose reached for ≥2 months within a rolling six‐month window and were followed for up to three years. Of the total of 5000 patients analyzed, 28.5% received >9 bps QID. Survival rates were significantly higher in the >9 bps QID dosing group for years one, two, and three (P < 0.001). The time to transition to parenteral therapy was significantly longer for those at doses >9 bps (17.5 months) compared to doses ≤9 bps (9.5 moths; P < 0.0001). Drug persistence was also significantly higher for those taking >9 bps at years 1, 2, and 3 (P < 0.0001). Patients receiving inhaled treprostinil at doses >9 bps QID had a higher rate of survival and drug persistence over a three‐year period, suggesting that higher doses may provide clinically relevant benefits while remaining tolerable.
Emotional impact of COVID-19 lockdown and mitigation options: A cross-sectional survey of households in Ebonyi State, Nigeria
Authors: Elom Nwamaka A , Nwimo Ignatius O , Elom Sampson Omena , Alegu Deborah N , Afoke Eunice N , Okpata Onyekachi O , Ogodo Juliet O , Ilo Cajetan I , Okeworo Chukwuma G , Elom Chinyere O 
Published: September 2021

Background: Coronavirus disease 19 (COVID-19) has continued to plague households, leading to lockdown problems. Adopting appropriate mitigation strategies can reduce the impact on family members. Purpose: To assess the emotional impact of COVID-19 epidemic lockdown and mitigation measures among households in Ebonyi State. Methods: Cross-sectional survey design was used to study 516 participants. Emotional impact of COVID-19 lockdown ( r = 0.73) and mitigation options ( r = 0.92) questionnaire was used for data collection. Of the 516 copies of the questionnaire distributed, 493 copies (95.5% return rate) were used for data analysis. Data were analysed using descriptive statistics, standard deviations, and t-tests. Results: The data showed the emotional impact of the COVID-19 epidemic was high (2.97 ± 0.48) on households. They embraced friendly communication and communication with their partners, maintaining regular contact with their loved ones by phone, email, social media, or video conference to alleviate the COVID-19 lockdown. No significant differences were found in the emotional impact for location ( p > 0.05). Significant differences were not observed in many gender-based mitigation options. Conversely, a significant difference existed in the mitigation options based on location ( t = 3.143, p < 0.05). However, there was no significant difference in friendly interactions and communication with partners ( t = 0.354, p > 0.05), finding opportunities to develop excellent and promising news and images ( t = 0.770, p > 0.05) and maintaining regular communication with loved ones via phone, email, social media, and video conference ( t = 0.448, p > 0.05). Conclusion: The emotional impact of COVID-19 confinement was significant on family life and was more prevalent among men and urban dwellers. There is need to organise an awareness campaign on fundamental ways to overcome emotional distress using media targeting family members to promote emotional health.
More from less: Study on increasing throughput of COVID-19 screening and testing facility at an apex tertiary care hospital in New Delhi using discrete-event simulation software
Authors: Gowda Naveen R , Khare Amitesh , Vikas H , Singh Angel R , Sharma D K , Poulose Ramya , John Dhayal C 
Published: September 2021

Background One of the challenges has been coping with an increasing need for COVID-19 testing. A COVID-19 screening and testing facility was created. There was a need for increasing throughput of the facility within the existing space and limited resources. Discrete event simulation was used to address this challenge. Methodology A cross-sectional interventional study was done from September 2020 to October 2020. Detailed process mapping with all micro-processes was done. Patient arrival patterns and time taken at each step were measured by two independent observers at random intervals over two weeks. The existing system was simulated and a bottleneck was identified. Two possible alternatives to the problem were simulated and evaluated. Results Scenario 1 showed a maximum throughput of 316. The average milestone times of all the processes after the step of “Preparation of sampling kits” jumped 62%; from 82 to 133 min. Staff state times also showed that staff at this step was stretched and medical lab technicians were underutilized. Scenario 2 simulated the alternative with lesser time spent on sampling kit preparation with a 22.4% increase in throughput, but could have led to impaired quality check. Scenario 3 simulated with increased manpower at the stage of bottleneck with 26.5% increase in throughput and was implemented on-ground. Conclusion Discrete event simulation helped to identify the bottleneck, simulate possible alternative solutions without disturbing the ongoing work, and finally choose the most suitable intervention to increase throughput, without the need for additional space allocation. It therefore helped to optimally utilize resources and get “more from less.”
Combined Use of Tranexamic Acid and Rivaroxaban in Posterior/Transforaminal Lumbar Interbody Fusion Surgeries Safely Reduces Blood Loss and Incidence of Thrombosis: Evidence From a Prospective, Randomized, Double-Blind, Placebo-Controlled Study
Authors: Li Xiang , Jiao Guangjun , Li Jingyi , Ji Weibin , Hao Zhiwei , Gong Fangli , Chen Yunzhen 
Published: September 2021

Study Design: A prospective, randomized, double-blind, placebo-controlled study. Objectives: There are few studies examining the balance between preventing venous thrombus embolism (VTE) and reducing blood loss in posterior/transforaminal lumbar interbody fusion (PLIF/TLIF) surgeries. This study aimed to evaluate the efficacy and safety of the combine application of TXA and rivaroxaban in patients undergoing PLIF/TLIF and explore relevant factors related to blood loss and VTE. Methods: Patients in group A which was the control group received 0.9% NaCl solution intravenously. Group B was treated by an intravenous injection of 2 g tranexamic acid (TXA) and the local use of 1 g intraoperatively. Group C was treated the same as group B intraoperatively, and they received 10 mg rivaroxaban qd treatment postoperatively. Eligible patients with an Autar score ≤ 10 were randomly assigned to group A or group B. Patients with an Autar score >10 were allocated into group C. Results: The intraoperative blood loss and postoperative drainage were lower in groups B and C than in group A ( P < .001). The blood transfusion rate in group B was lower than that in group A ( P < .001), while the incidence of VTE in group C was lower ( P < .001). Four factors were found to be positively correlated with obvious total blood loss ( P < .05). The data showed that 5 factors were correlated with the development of a thrombus ( P < .1). Conclusions: The combination of TXA and rivaroxaban in PLIF/TLIF patients is safe and effective in reducing D-dimer levels associated with VTE and reducing blood loss.
List of theses in Foreign Missions and Related Subjects Accepted during the Academic Year 1959–1960
Authors: Person Laura 
Published: September 2021

The compiler expresses gratitude to the professors of missions and all other persons who through reports, or otherwise, have made the following compilation of theses possible. The theses reported are principally in the field of world missions and the ecumenical church, or are related to subjects of especial interest to students and scholars in missions, and were written during the years of 1959 and 1960. The annotations which follow various titles have been written by the professors who reported them. Theses which concern anthropology, rural, or agricultural missions are included in the general list and may be found as a group in the index. The report includes papers from 26 theological schools and seminaries and from 11 universities and colleges. Inquiries concerning a title should not be addressed to the Missionary Research Library but to the sohool where a thesis has originated or, in the case of Ph.D. dissertations, to University Miorofilms, Ino., Ann Arbor, Michigan. An index to subjects will be found on page 8.
Bringing Our Missionary Methods under the Word of God
Authors: Newbigin Bishop Lesslie 
Published: September 2021

The Presbyterian Church in the United States held a very significant Consultation on World Missions at Montreat, North Carolina, from the thirteenth to the nineteenth of October, 1962. Some 250 delegates/members and executives of the Board of World Missions of The Presbyterian Church in the U.S., other officials of that Church, representative missionaries, and nationals from the areas of its overseas mission work/$$, consultants and observers met for frank and intense discussion of problems of the Christian mission. The following article is an address which Bishop Newbigin delivered before the Consultation on October 14. It deals with the foundational consideration which ought to characterize every inquiry into the motives, strategies, structures, and practices of the mission of Christ and His Church. The address is reproduced here by permission of the author and the Board of World Missions of the Presbyterian Church in the U.S.
A Short History of the Presbyterian Church among the Mountain Tribes in Taiwan
Authors: Cheng Lien-min 
Published: September 2021

The author of this article is Professor of Church History at Taiwan Theological College, Taipei, Taiwan. The paper was prepared originally for the Fifth Theological Study Institute of the Association of Theological Schools in South-East Asia., held in Singapore in 1963. It has been revised and up-dated for this publication of it. We think it particularly significant that this article should appear in print just prior to the Centennial celebrations of the introduction of Protestant Christianity into Taiwan. The celebrations will be held in Taiwan in June 1965.
World Hunger and the Christian Conscience
Authors: Riddle Katharine P. 
Published: September 2021

The year 1965 was the year when the American Protestant churches, almost with one voice, declared intolerable the fact that more than half the people of the world live in perpetual hunger.1 Although the North Atlantic countries – predominantly Christian — enjoy a standard of living and a level of economic affluence unprecedented in history, hunger is still on the increase in Latin America, Africa, and Asia. The brutal disparity between the “haves” and the “have-nots” is an offense to the Christian conscience. This situation caused the National Council of the Churches of Christ in the U.S.A. to call on its “Division of Overseas Ministries to press on with its analysis of United States church programs abroad with the view of making recommendations as to how the churches may, more effectively and more ecumenically, play their proper role in meeting the needs of the hungry.”2 In response to this mandate, a survey3 was conducted during 1965 by two agencies of the Division of Overseas Ministries, the Committee on Agriculture and Rural Life (CARL) and Church World Service. This article is based on the findings and recommendations that resulted from the survey and on the guidelines for future programming suggested by it.
Problem – and Promise – in African Journalism
Authors: Hilton Bruce 
Published: September 2021

Twenty editors of Christian newspapers and magazines in Africa came together earlier this year to discuss the challenges of their work. Arriving from points as widely scattered as Ethiopia and South Africa, Lagos and Nairobi, they spent nearly a month at the Africa Literature Center in Kitwe, Zambia, discussing both the theological and the practical. Nearly all serve in areas of rapid urbanization and technological revolution, and nearly all face restriction or censorship from their churches or their governments. Reproduced here are a few of the papers read by seminar participants. They reveal something of life on that changing continent; they also reflect problems that are common to those who try to edit Christians journals anywhere in the world today.
Some Ideas on the Direction of Chinese Theological Development
Authors: Chao Jonathan Tien-En 
Published: September 2021

(An analysis of the features contributing to the lack of Chinese theological productivity and a presentation of some ideas on the biblical direction of Chinese theological development; together with a preliminary bibliography. (Since the beginning of the Cultural Revolution in August 1966, there has been no word of any theological activity in mainland China. The last remaining theological center, Nanking Theological Seminary, has been closed.)
Long-term medication reduction in controlled glaucoma with iTrack ab-interno canaloplasty as a standalone procedure and combined with cataract surgery
Authors: Khaimi Mahmoud A. 
Published: September 2021

Purpose: To evaluate the long-term effectiveness of iTrack (Nova Eye Medical, Fremont, USA) ab-interno canaloplasty performed as a standalone procedure, or combined with cataract surgery, in reducing antiglaucoma medication dependence and maintaining intraocular pressure within target range in patients with controlled primary open-angle glaucoma. Methods: This is a retrospective, single-center, case series study of patients who underwent iTrack ab-interno canaloplasty as a standalone procedure ( n = 34) or in combination with cataract surgery ( n = 11). Eyes with controlled mild or moderate glaucoma (intraocular pressure ⩽17 mmHg) were included; those with prior glaucoma surgeries were excluded. The primary outcome was the mean reduction in glaucoma medication and the secondary outcome was the maintenance of controlled intraocular pressure postoperatively. Results: A total of 35 patients (45 eyes) with a mean age of 73 ± 9.7 years were included in the study. For all eyes, a significant decrease (61%) in the mean number of medications was seen at 36 months (1.89 ± 0.93 versus 0.60 ± 0.82; p < 0.001), with 56% (14/25) of eyes medication free. No significant difference was observed in the reduction of medication use whether iTrack was performed with or without cataract surgery at 12 and 36 months. Mean baseline intraocular pressure of 14.42 ± 2.2 mmHg for all eyes was maintained at the 12-, 24-, and 36-month follow-up visits (14.6 ± 3.65, 15.06 ± 2.26, and 14.19 ± 2.91, respectively), with no significant difference between the two groups ( p = 0.08). Conclusion: The iTrack ab-interno canaloplasty significantly reduced medication dependency and maintained intraocular pressure within target range in patients with controlled mild or moderate primary open-angle glaucoma, while showing a good safety profile, both as a standalone procedure or in combination with cataract surgery.
DKK1 activates noncanonical NF-κB signaling via IL-6–induced CKAP4 receptor in multiple myeloma
Authors: Li Xin , Wang Jingjing , Zhu Shuai , Zheng Jinxin , Xie Ying , Jiang Hongmei , Guo Jing , Wang Yixuan , Peng Ziyi , Wang Mengqi , Wang Jingya , Wang Sheng , Zhong Yuping , Liu Zhiqiang 
Published: September 2021

Abstract
Proteasome inhibitors, such as bortezomib (BTZ), represent the key elements in chemotherapy regimens for multiple myeloma (MM), whereas acquired chemoresistance and ultimately relapse remain a major obstacle. In the current study, we screened differently expressed cytokines in bortezomib-resistant MM cells and found that Dickkopf-1 (DKK1) level was remarkably augmented, whereas CD138 level was significantly suppressed. DKK1 in vitro specifically enhanced the resistance of myeloma cells to bortezomib treatment, and excessive DKK1 drove CD138 downregulation via inhibition of canonical Wnt signaling. Notably, DKK1 mainly induced drug resistance in MM cells via the receptor of CKAP4. Mechanistically, CKAP4 transduced DKK1 signal and evoked NF-κB pathway through recruiting and preventing cullin associated and neddylation dissociated 1 from hampering the assembly of E3 ligase-mediated ubiquitination of IκBα. In addition, we found that interleukin-6 (IL-6) stimulated CKAP4 expression to generate drug resistance, and disturbance of DKK1-CKAP4 axis improved sensitivity to BTZ treatment of MM and attenuated bone destruction in a mouse model. Collectively, our study revealed the previously unidentified role of DKK1 in myeloma drug resistance via Wnt signaling dependent and independent manners, and clarified the importance of antagonism of DKK1-IL-6 loop in bone marrow microenvironment.
Anti-cysteine/spacer antibodies that open ADAMTS13 are a common feature in iTTP
Authors: De Waele Laure , Curie Alexandre , Kangro Kadri , Tellier Edwige , Kaplanski Gilles , Männik Andres , Tersteeg Claudia , Joly Bérangère S. , Coppo Paul , Veyradier Agnès , De Meyer Simon F. , Roose Elien , Vanhoorelbeke Karen 
Published: September 2021

Abstract
Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is caused by an autoantibody-mediated deficiency in ADAMTS13. In healthy individuals, ADAMTS13 has a folded conformation in which the central spacer (S) domain interacts with the C-terminal CUB domains. We recently showed that ADAMTS13 adopts an open conformation in iTTP and that patient immunoglobulin G antibodies (IgGs) can open ADAMTS13. Anti-ADAMTS13 autoantibodies in patients with iTTP are directed against the different ADAMTS13 domains, but almost all patients have autoantibodies binding to the cysteine/spacer (CS) domains. In this study, we investigated whether the autoantibodies against the CS and CUB domains can disrupt the S-CUB interaction of folded ADAMTS13, thereby opening ADAMTS13. To this end, we purified anti-CS and anti-CUB autoantibodies from 13 patients with acute iTTP by affinity chromatography. The successfully purified anti-CS (10/13 patients) and anti-CUB (4/13 patients) autoantibody fractions were tested further in our ADAMTS13 conformation enzyme-linked immunosorbent assay to study whether they could open ADAMTS13. Interestingly, all purified anti-CS fractions (10/10 patients) were able to open ADAMTS13. On the other hand, only half of the purified anti-CUB fractions (2/4 patients) opened ADAMTS13. Our finding highlights that anti-CS autoantibodies that open ADAMTS13 are a common feature of the autoimmune response in iTTP.
Combination brentuximab vedotin and bendamustine for pediatric patients with relapsed/refractory Hodgkin lymphoma
Authors: Forlenza Christopher J. , Gulati Nitya , Mauguen Audrey , Absalon Michael J. , Castellino Sharon M. , Franklin Anna , Keller Frank G. , Shukla Neerav 
Published: September 2021

AbstractIn patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL), achieving a complete metabolic response (CMR) after salvage therapy is associated with superior outcomes, and optimal treatments must be identified. The combination of brentuximab vedotin and bendamustine (BVB), although highly active in adult patients, has not been extensively evaluated in pediatric patients with R/R HL. We performed a multicenter, retrospective review of pediatric patients &lt;21 years of age with R/R HL treated with BVB from January 2016 through July 2019. Response was assessed by local radiologists according to Lugano classification criteria. Twenty-nine patients (17 relapsed, 12 refractory) with a median age of 16 years (range, 10-20) were treated with BVB and received a median of 3 cycles of therapy (range, 2-7). Patients received an infusion of 1.8 mg/kg of BV on day 1 with bendamustine 90 mg/m2 on days 1 and 2 of 3-week cycles. Nineteen patients (66%) achieved a CMR (95% CI, 46-82). An objective response was observed in 23 patients (objective response rate, 79%; 95% CI, 60-92). The most common grade 3 and 4 toxicities were hematologic, and 3 patients (10%) experienced grade 3 infusion reactions. Seventeen of 18 patients underwent successful mobilization and collection of stem cells. Sixteen patients (13 autologous, 3 allogeneic) received a consolidative transplant after BVB. The 3-year post-BVB event-free and overall survival were 65% (95% CI, 46-85) and 89% (95% CI, 74-100), respectively. For pediatric patients with R/R HL, BVB was well tolerated and compared favorably with currently accepted salvage regimens.