bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teleneurorehabilitation program (virtual reality) for patients with balance disorders: descriptive study
Authors: Maldonado-Díaz Marcos , Vargas Patricia , Vasquez Ricardo , Gonzalez-Seguel Felipe , Rivero Betel , Hidalgo-Cabalín Viviane , Gutierrez-Panchana Tania 
Published: August 2021

Abstract
Background
Balance disorders are common in patients with neurological or vestibular diseases. Telerehabilitation program is a treatment to be as safe as conventional treatment. One of the most used methods to perform telerehabilitation is the incorporation of Virtual Reality. In general, rehabilitation programs train predictive postural control, so the patient does not always acquire the necessary autonomy to react to situations of instability. On the other hand, the objective and systematic supervision and measurement of these programs is limited, making it necessary to create clinical protocols with precise and measurable rehabilitation objectives. This study present the training selection methodology and clinical protocol for patients with balance disorders inserted in a Telerehabilitation Program based on Virtual Reality.

Methods
Descriptive study where physiotherapists were trained to use RehaMetrics®. To evaluate their level of agreement in the selection of the exercise clusters developed, the Interobserver Reliability was measured through the kappa statistic. Subsequently, the exercises were applied to a group of patients recruited with sedentary trunk control (Berg Balance Scale = 3 points in item 3), mild or normal cognitive level (Montreal Cognitive Assessment> 21 points), and prescribed for tele-rehabilitation by a doctor.

Results
The agreement among the expert physiotherapists irrespective of the cluster exceeds 80%, which indicates a very good strength of agreement, while the novices reached a level of agreement of 45%, which suggests a moderate strength of agreement. All clinical outcomes showed statistically significant differences between the median times, as did the Maximum Width Left Side (MWLS) (cm). The average number of minutes of training was 485.81 (SD 246.49 min), and the number of sessions performed during the 4 weeks of intervention was 17 (SD 7.15 sessions).

Conclusions
This analysis what had excellent interobserver reliability with trained physiotherapists. Regarding the second phase of the study, the results show a statistically significant difference between the initial and final evaluation of the clinical tests, which could result in better performance in aspects such as: balance, gait functionality, meter walked and cognition. Telerehabilitation Program based on Virtual Reality is an excellent alternative to provide continuity of treatment to patients with balance disorders.
Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel’s COVID-19 vaccination program
Authors: Rosen Bruce , Waitzberg Ruth , Israeli Avi , Hartal Michael , Davidovitch Nadav 
Published: August 2021

AbstractAs of March 31, 2021, Israel had administered 116 doses of vaccine for COVID-19 per 100 population (of any age) – far more than any other OECD country. It was also ahead of other OECD countries in terms of the share of the population that had received at least one vaccination (61%) and the share that had been fully vaccinated (55%). Among Israelis aged 16 and over, the comparable figures were 81 and 74%, respectively. In light of this, the objectives of this article are:

To describe and analyze the vaccination uptake through the end of March 2021

To identify behavioral and other barriers that likely affected desire or ability to be vaccinated

To describe the efforts undertaken to overcome those barriers

Israel’s vaccination campaign was launched on December 20, and within 2.5 weeks, 20% of Israelis had received their first dose. Afterwards, the pace slowed. It took an additional 4 weeks to increase from 20 to 40% and yet another 6 weeks to increase from 40 to 60%. Initially, uptake was low among young adults, and two religious/cultural minority groups - ultra-Orthodox Jews and Israeli Arabs, but their uptake increased markedly over time.In the first quarter of 2021, Israel had to enhance access to the vaccine, address a moderate amount of vaccine hesitancy in its general population, and also address more intense pockets of vaccine hesitancy among young adults and religious/cultural minority groups. A continued high rate of infection during the months of February and March, despite broad vaccination coverage at the time, created confusion about vaccine effectiveness, which in turn contributed to vaccine hesitancy. Among Israeli Arabs, some residents of smaller villages encountered difficulties in reaching vaccination sites, and that also slowed the rate of vaccination.The challenges were addressed via a mix of messaging, incentives, extensions to the initial vaccine delivery system, and other measures. Many of the measures addressed the general population, while others were targeted at subgroups with below-average vaccination rates. Once the early adopters had been vaccinated, it took hard, creative work to increase population coverage from 40 to 60% and beyond.Significantly, some of the capacities and strategies that helped Israel address vaccine hesitancy and geographic access barriers are different from those that enabled it to procure, distribute and administer the vaccines. Some of these strategies are likely to be relevant to other countries as they progress from the challenges of securing an adequate vaccine supply and streamlining distribution to the challenge of encouraging vaccine uptake.
An extended approach to value chain analysis
Authors: Knez Klemen , Jaklič Andreja , Stare Metka 
Published: August 2021

AbstractIn the article, we propose a comprehensive methodology of value chain analysis in the international input–output framework that introduces a new measure of value chain participation and an extended typology of value chains, with the novel inclusion of domestic value chain to address the extent of fragmentation of purely domestic production. This allows for the simultaneous analysis of both global and domestic production fragmentation, the complex patterns of their evolution and their impact on economic development. The main contribution of the proposed methodology is conceptual: it permits the measurement of all value chain paths that pass through each country-sector from production to final consumption, whether the path includes downstream linkages, upstream linkages or their combination. Empirical application of this methodology shows the importance of including domestic fragmentation in value chain analysis: The fragmentation of both global and domestic levels of production has a significant positive correlation with economic growth. This implies that the effects of global production fragmentation must be analysed together with the changing structure of the fragmentation of domestic production to obtain the whole picture, one that might provide important information for policymaking and industrial policy.
Tendon grafts with preserved muscle demonstrate similar biomechanical properties to tendon grafts stripped of muscular attachments: a biomechanical evaluation in a porcine model
Authors: Funchal Luis Fernando Zukanovich , Astur Diego Costa , Pizzolatti André Luiz Almeida , Grimaldi Arthur Paiva , Jimenez Andrew Esteban , Moré Ari Digiácomo Ocampo , de Mello Roesler Carlos Rodrigo , Cohen Moises 
Published: August 2021

Abstract
Purpose
(1) To evaluate the biomechanical properties of a porcine flexor digitorum superficialis tendon graft with preserved muscle fibers and (2) to compare these results with the biomechanical properties of a porcine tendon graft after removal of associated muscle.

Methods
Eighty-two porcine forelegs were dissected and the flexor digitorum superficialis muscle tendons were harvested. The study comprised of two groups: Group 1 (G1), harvested tendon with preserved muscle tissue; and Group 2 (G2), harvested contralateral tendon with removal of all muscle tissue. Tests in both groups were conducted using an electro-mechanical material testing machine (Instron, model 23-5S, Instron Corp., Canton, MA, USA) with a 500 N force transducer. Yield load, stiffness, and maximum load were evaluated and compared between groups.

Results
The behavior of the autografts during the tests followed the same stretching, deformation, and failure patterns as those observed in human autografts subjected to axial strain. There were no significant differences in the comparison between groups for ultimate load to failure (p = 0.105), stiffness (p = 0.097), and energy (p = 0.761).

Conclusion
In this porcine model biomechanical study, using autograft tendon with preserved muscle showed no statistically significant differences for yield load, stiffness, or maximum load compared to autograft tendon without preserved muscle. The preservation of muscle on the autograft tendon did not compromise the mechanical properties of the autograft.

Level of evidence
Level III Controlled laboratory study
Effect of thinning intensity on understory herbaceous diversity and biomass in mixed coniferous and broad-leaved forests of Changbai Mountain
Authors: Wang Gerong , Sun Yue , Zhou Mo , Guan Naiqian , Wang Yuwen , Jiang Runhua , Liu Zhiyu , Wu Mengjia , Xia Fucai 
Published: August 2021

Abstract
Background
Herbs are an important part of the forest ecosystem, and their diversity and biomass can reflect the restoration of vegetation after forest thinning disturbances. Based on the near-mature secondary coniferous and broad-leaved mixed forest in Jilin Province Forestry Experimental Zone, this study analyzed seasonal changes of species diversity and biomass of the understory herb layer after different intensities of thinning.

Results
The results showed that although the composition of herbaceous species and the ranking of importance values were affected by thinning intensity, they were mainly determined by seasonal changes. Across the entire growing season, the species with the highest importance values in thinning treatments included Carex pilosa, Aegopodium alpestre, Meehania urticifolia, and Filipendula palmata, which dominated the herb layer of the coniferous and broad-leaved mixed forest. The number of species, Margalef index, Shannon-Wiener index and Simpson index all had their highest values in May, and gradually decreased with months. Pielou index was roughly inverted “N” throughout the growing season. Thinning did not increase the species diversity. Thinning can promote the total biomass, above- and below-ground biomass. The number of plants per unit area and coverage were related to the total biomass, above- and below-ground biomass. The average height had a significantly positive correlation with herb biomass in May but not in July. However, it exerted a significantly negative correlation with herb biomass in September. The biomass in the same month increased with increasing thinning intensity. Total herb biomass, above- and below-ground biomass showed positive correlations with Shannon-Winner index, Simpson index and Pielou evenness index in May.

Conclusions
Thinning mainly changed the light environment in the forest, which would improve the plant diversity and biomass of herb layer in a short time. And different thinning intensity had different effects on the diversity of understory herb layer. The findings provide theoretical basis and reference for reasonable thinning and tending in coniferous and broad-leaved mixed forests.
ICPFuzzer: proprietary communication protocol fuzzing by using machine learning and feedback strategies
Authors: Lin Pei-Yi , Tien Chia-Wei , Huang Ting-Chun , Tien Chin-Wei 
Published: August 2021

AbstractThe fuzzing test is able to discover various vulnerabilities and has more chances to hit the zero-day targets. And ICS(Industrial control system) is currently facing huge security threats and requires security standards, like ISO 62443, to ensure the quality of the device. However, some industrial proprietary communication protocols can be customized and have complicated structures, the fuzzing system cannot quickly generate test data that adapt to various protocols. It also struggles to define the mutation field without having prior knowledge of the protocols. Therefore, we propose a fuzzing system named ICPFuzzer that uses LSTM(Long short-term memory) to learn the features of a protocol and generates mutated test data automatically. We also use the responses of testing and adjust the weight strategies to further test the device under testing (DUT) to find more data that cause unusual connection status. We verified the effectiveness of the approach by comparing with the open-source and commercial fuzzers. Furthermore, in a real case, we experimented with the DLMS/COSEM for a smart meter and found that the test data can cause a unusual response. In summary, ICPFuzzer is a black-box fuzzing system that can automatically execute the testing process and reveal vulnerabilities that interrupt and crash industrial control communication. Not only improves the quality of ICS but also improves safety.
Evaluation of the frequency and patterns of thyroid dysfunction in patients with metabolic syndrome
Authors: El-Hay Gehad Abd El-Shaker Abd , Argoon Salah Abdelazim , Mousa Naglaa Mohamed M. A. 
Published: August 2021

Abstract
Background
Metabolic syndrome (MetS) and thyroid dysfunction have a degree of close association, and each of them affects the other. Due to the associated cardiovascular events, MetS has increased morbidity and mortality. The study tried to detect the frequency of thyroid function in patients with MetS. This is a case control study that recruited 100 patients with MetS and 100 healthy control subjects.

Results
Patients with MetS had significantly higher body mass index and waist circumference. Also, frequency of thyroid dysfunction was significantly higher in MetS group (32% vs. 9%; P<0.001). The most frequent form of thyroid dysfunction was subclinical hypothyroidism: 21% of the MetS group and 6% of the control group. Out of the studied patients with MetS, 13 (13%) patients had three criteria, 55 (55%) patients had four criteria, and 32 (32%) patients had five criteria for MetS.

Conclusion
Patients with MetS are vulnerable to develop thyroid dysfunction mainly subclinical hypothyroidism. So, it is recommended to perform regular screening for those patients as regard thyroid dysfunction.
Amivantamab in EGFR Exon 20 Insertion–Mutated Non–Small-Cell Lung Cancer Progressing on Platinum Chemotherapy: Initial Results From the CHRYSALIS Phase I Study
Authors: Park Keunchil , Haura Eric B. , Leighl Natasha B. , Mitchell Paul , Shu Catherine A. , Girard Nicolas , Viteri Santiago , Han Ji-Youn , Kim Sang-We , Lee Chee Khoon , Sabari Joshua K. , Spira Alexander I. , Yang Tsung-Ying , Kim Dong-Wan , Lee Ki Hyeong , Sanborn Rachel E. , Trigo José , Goto Koichi , Lee Jong-Seok , Yang James Chih-Hsin , Govindan Ramaswamy , Bauml Joshua M. , Garrido Pilar , Krebs Matthew G. , Reckamp Karen L. , Xie John , Curtin Joshua C. , Haddish-Berhane Nahor , Roshak Amy , Millington Dawn , Lorenzini Patricia , Thayu Meena , Knoblauch Roland E. , Cho Byoung Chul 
Published: August 2021

PURPOSE Non–small-cell lung cancer (NSCLC) with epidermal growth factor receptor ( EGFR) exon 20 insertion (Exon20ins) mutations exhibits inherent resistance to approved tyrosine kinase inhibitors. Amivantamab, an EGFR-MET bispecific antibody with immune cell–directing activity, binds to each receptor's extracellular domain, bypassing resistance at the tyrosine kinase inhibitor binding site. METHODS CHRYSALIS is a phase I, open-label, dose-escalation, and dose-expansion study, which included a population with EGFR Exon20ins NSCLC. The primary end points were dose-limiting toxicity and overall response rate. We report findings from the postplatinum EGFR Exon20ins NSCLC population treated at the recommended phase II dose of 1,050 mg amivantamab (1,400 mg, ≥ 80 kg) given once weekly for the first 4 weeks and then once every 2 weeks starting at week 5. RESULTS In the efficacy population (n = 81), the median age was 62 years (range, 42-84 years); 40 patients (49%) were Asian, and the median number of previous lines of therapy was two (range, 1-7). The overall response rate was 40% (95% CI, 29 to 51), including three complete responses, with a median duration of response of 11.1 months (95% CI, 6.9 to not reached). The median progression-free survival was 8.3 months (95% CI, 6.5 to 10.9). In the safety population (n = 114), the most common adverse events were rash in 98 patients (86%), infusion-related reactions in 75 (66%), and paronychia in 51 (45%). The most common grade 3-4 adverse events were hypokalemia in six patients (5%) and rash, pulmonary embolism, diarrhea, and neutropenia in four (4%) each. Treatment-related dose reductions and discontinuations were reported in 13% and 4% of patients, respectively. CONCLUSION Amivantamab, via its novel mechanism of action, yielded robust and durable responses with tolerable safety in patients with EGFR Exon20ins mutations after progression on platinum-based chemotherapy.
Cancer Care in the Wake of a Cyberattack: How to Prepare and What to Expect
Authors: Ades Steven , Herrera Diego Adrianzen , Lahey Tim , Thomas Alissa A. , Jasra Sakshi , Barry Maura , Sprague Julian , Dittus Kim , Plante Timothy B. , Kelly Jamie , Kaufman Peter A. , Khan Farrah , Hammond Cory J. , Gernander Kelly , Parsons Polly , Holmes Chris 
Published: August 2021

PURPOSE:Cyberattacks targeting health care organizations are becoming more frequent and affect all aspects of care delivery. Cancer care is particularly susceptible to major disruptions because of the potential of immediate and long-term consequences for patients who often rely on timely diagnostic testing and regular administration of systemic therapy in addition to other local treatment modalities to cure or control their diseases. On October 28, 2020, a cyberattack was launched on the University of Vermont Health Network with wide-ranging consequences for oncology, including loss of access to all network intranet servers, e-mail communications, and the electronic medical record (EMR).METHODS:This review details the immediate challenges faced by hematology and oncology during the cyberattack. The impact and response on inpatient, outpatient, and special patient populations are described. Steps that other academic- and community-based oncology practices can take to lessen the brunt of such an assault are suggested.RESULTS:The two areas of immediate impact after the cyberattack were communications and lack of EMR access. The oncology-specific impact included loss of the individualized EMR chemotherapy plan templates and electronic safeguards built into multistep treatment preparation and delivery. With loss of access to schedules, basic patient information, encrypted communications platforms and radiology, and laboratory and pharmacy services, clinical outpatient care delivery was reduced by 40%. The infusion visit volume dropped by 52% in the first week and new patients could not access necessary services for timely diagnostic evaluation, requiring the creation of command centers to oversee ethical and transparent triage and allocation of systemic therapies and address new patient referrals. This included appropriate transfer of patients to alternate sites to minimize delays. Inpatient care including transitions of care was particularly challenging and addressing patient populations whose survival might be affected by delays in care.CONCLUSION:Oncology health care leaders and providers should be aware of the potential impact of a cyberattack on cancer care delivery and preventively develop processes to mitigate the impact.
Lrig1 and Lrig3 cooperate to control Ret receptor signaling, sensory axonal growth and epidermal innervation
Authors: De Vincenti Ana Paula , Alsina Fernando C. , Ferrero Restelli Facundo , Hedman Håkan , Ledda Fernanda , Paratcha Gustavo 
Published: August 2021

ABSTRACTNegative feedback loops represent a regulatory mechanism that guarantees that signaling thresholds are compatible with a physiological response. Previously, we established that Lrig1 acts through this mechanism to inhibit Ret activity. However, it is unclear whether other Lrig family members play similar roles. Here, we show that Lrig1 and Lrig3 are co-expressed in Ret-positive mouse dorsal root ganglion (DRG) neurons. Lrig3, like Lrig1, interacts with Ret and inhibits GDNF/Ret signaling. Treatment of DRG neurons with GDNF ligands induces a significant increase in the expression of Lrig1 and Lrig3. Our findings show that, whereas a single deletion of either Lrig1 or Lrig3 fails to promote Ret-mediated axonal growth, haploinsufficiency of Lrig1 in Lrig3 mutants significantly potentiates Ret signaling and axonal growth of DRG neurons in response to GDNF ligands. We observe that Lrig1 and Lrig3 act redundantly to ensure proper cutaneous innervation of nonpeptidergic axons and behavioral sensitivity to cold, which correlates with a significant increase in the expression of the cold-responsive channel TrpA1. Together, our findings provide insights into the in vivo functions through which Lrig genes control morphology, connectivity and function in sensory neurons.
A comprehensive series of Irx cluster mutants reveals diverse roles in facial cartilage development
Authors: Farmer D'Juan T. , Patel Punam , Choi Rachelle , Liu Chih-Yu , Crump J. Gage 
Published: August 2021

ABSTRACT
Proper function of the vertebrate skeleton requires the development of distinct articulating embryonic cartilages. Irx transcription factors are arranged in co-regulated clusters that are expressed in the developing skeletons of the face and appendages. IrxB cluster genes are required for the separation of toes in mice and formation of the hyoid joint in zebrafish, yet whether Irx genes have broader roles in skeletal development remains unclear. Here, we perform a comprehensive loss-of-function analysis of all 11 Irx genes in zebrafish. We uncover conserved requirements for IrxB genes in formation of the fish and mouse scapula. In the face, we find a requirement for IrxAb genes and irx7 in formation of anterior neural crest precursors of the jaw, and for IrxBa genes in formation of endodermal pouches and gill cartilages. We also observe extensive joint loss and cartilage fusions in animals with combinatorial losses of Irx clusters, with in vivo imaging revealing that at least some of these fusions arise through inappropriate chondrogenesis. Our analysis reveals diverse roles for Irx genes in the formation and later segmentation of the facial skeleton.
osr1couples intermediate mesoderm cell fate with temporal dynamics of vessel progenitor cell differentiation
Authors: Perens Elliot A. , Diaz Jessyka T. , Quesnel Agathe , Askary Amjad , Crump J. Gage , Yelon Deborah 
Published: August 2021

ABSTRACTTranscriptional regulatory networks refine gene expression boundaries to define the dimensions of organ progenitor territories. Kidney progenitors originate within the intermediate mesoderm (IM), but the pathways that establish the boundary between the IM and neighboring vessel progenitors are poorly understood. Here, we delineate roles for the zinc-finger transcription factor Osr1 in kidney and vessel progenitor development. Zebrafish osr1 mutants display decreased IM formation and premature emergence of lateral vessel progenitors (LVPs). These phenotypes contrast with the increased IM and absent LVPs observed with loss of the bHLH transcription factor Hand2, and loss of hand2 partially suppresses osr1 mutant phenotypes. hand2 and osr1 are expressed together in the posterior mesoderm, but osr1 expression decreases dramatically prior to LVP emergence. Overexpressing osr1 during this timeframe inhibits LVP development while enhancing IM formation, and can rescue the osr1 mutant phenotype. Together, our data demonstrate that osr1 modulates the extent of IM formation and the temporal dynamics of LVP development, suggesting that a balance between levels of osr1 and hand2 expression is essential to demarcate the kidney and vessel progenitor territories.