bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Multi-Modal MRI for Differentiating of Parkinson's Disease and Progressive Supranuclear Palsy Using Machine Learning
Authors: Talai Aron S. , Sedlacik Jan , Boelmans Kai , Forkert Nils D. 
Published: April 2021

Background: Patients with Parkinson's disease (PD) and progressive supranuclear palsy Richardson's syndrome (PSP-RS) often show overlapping clinical features, leading to misdiagnoses. The objective of this study was to investigate the feasibility and utility of using multi-modal MRI datasets for an automatic differentiation of PD patients, PSP-RS patients, and healthy control (HC) subjects.Material and Methods: T1-weighted, T2-weighted, and diffusion-tensor (DTI) MRI datasets from 45 PD patients, 20 PSP-RS patients, and 38 HC subjects were available for this study. Using an atlas-based approach, regional values of brain morphology (T1-weighted), brain iron metabolism (T2-weighted), and microstructural integrity (DTI) were measured and employed for feature selection and subsequent classification using combinations of various established machine learning methods.Results: The optimal machine learning model using regional morphology features only achieved a classification accuracy of 65% (67/103 correct classifications) differentiating PD patients, PSP-RS patients, and HC subjects. The optimal machine learning model using only quantitative T2 values performed slightly better and achieved an accuracy of 75.7% (78/103). The optimal classifier using DTI features alone performed considerably better with 95.1% accuracy (98/103). The optimal multi-modal classifier using all features also achieved an accuracy of 95.1% but required more features and achieved a slightly lower F1-score compared to the optimal model using DTI features alone.Conclusion: Machine learning models using multi-modal MRI perform significantly better than uni-modal machine learning models using morphological parameters based on T1-weighted MRI datasets alone or brain iron metabolism markers based on T2-weighted MRI datasets alone. However, machine learnig models using regional brain microstructural integrity metrics computed from DTI datasets perform similar to the optimal multi-modal machine learning model. Thus, given the results from this study cohort, it appears that morphology and brain iron metabolism markers may not provide additional value for classification compared to using DTI metrics alone.
Serum Phosphate and 1-Year Outcome in Patients With Acute Ischemic Stroke and Transient Ischemic Attack
Authors: Zhang Jun-Fang , Jing Jing , Meng Xia , Pan Yuesong , Wang Yi-Long , Zhao Xing-Quan , Lin Jin-Xi , Han Xin-Sheng , Song Bin-Bin , Jia Zheng-Chang , Wu Song-Di , Chen Xiao-Fei , Xue Wen-Jun , Anderson Craig S. , Wu Yun-Cheng , Wang Yong-Jun 
Published: April 2021

Objective: To determine the association between serum phosphate level and 1-year clinical outcomes in patients with acute ischemic stroke and transient ischemic attack.Methods: We included 7,353 patients with acute ischemic stroke and transient ischemic attack from the China National Stroke Registry III for analysis. Participants were divided into 4 groups according to serum phosphate quartiles. Composite end point included recurrent stroke, myocardial infarction, other ischemic vascular events, and all-cause mortality. Poor functional outcome is defined as modified Rankin Scale score of 3 to 6. Multivariable Cox regression or logistic regression was used to evaluate the independent association of serum phosphate with 1-year all-cause mortality, recurrent stroke, composite end point and poor functional outcome.Results: The mean age of the included 7,353 patients was 62.5 years, and 68.6% of them were men. Plotting hazard ratios over phosphate levels suggested a U-shaped association especially for recurrent stroke and composite end point, and therefore the third quartile group was set as reference group. Compared with the third quartile of phosphate (1.06–1.20 mmol/L), the adjusted hazard ratios/odds ratios (95% CI) of the lowest quartile (&lt;0.94 mmol/L) were 0.98 (0.67–1.42) for all-cause mortality, 1.31 (1.05–1.64) for stroke recurrence, 1.26 (1.02–1.57) for composite end point, and 1.27 (1.01–1.61) for poor functional outcome, and the adjusted odds ratio of the highest quartile (≥1.2 mmol/L) was 1.40 (1.11–1.77) for poor functional outcome.Conclusions: Serum phosphate may be an independent predictor of stroke recurrence, composite end point and poor functional outcome after ischemic stroke.
Effect of Low Intensity Transcranial Ultrasound Stimulation on Neuromodulation in Animals and Humans: An Updated Systematic Review
Authors: Kim Taewon , Park Christine , Chhatbar Pratik Y. , Feld Jody , Mac Grory Brian , Nam Chang S. , Wang Pu , Chen Mengyue , Jiang Xiaoning , Feng Wuwei 
Published: April 2021

Background: Although low-intensity transcranial ultrasound stimulation (LI-TUS) has received more recognition for its neuromodulation potential, there remains a crucial knowledge gap regarding the neuromodulatory effects of LI-TUS and its potential for translation as a therapeutic tool in humans.Objective: In this review, we summarized the findings reported by recently published studies regarding the effect of LI-TUS on neuromodulation in both animals and humans. We also aim to identify challenges and opportunities for the translation process.Methods: A literature search of PubMed, Medline, EMBASE, and Web of Science was performed from January 2019 to June 2020 with the following keywords and Boolean operators: [transcranial ultrasound OR transcranial focused ultrasound OR ultrasound stimulation] AND [neuromodulation]. The methodological quality of the animal studies was assessed by the SYRCLE's risk of bias tool, and the quality of human studies was evaluated by the PEDro score and the NIH quality assessment tool.Results: After applying the inclusion and exclusion criteria, a total of 26 manuscripts (24 animal studies and two human studies) out of 508 reports were included in this systematic review. Although both inhibitory (10 studies) and excitatory (16 studies) effects of LI-TUS were observed in animal studies, only inhibitory effects have been reported in primates (five studies) and human subjects (two studies). The ultrasonic parameters used in animal and human studies are different. The SYRCLE quality score ranged from 25 to 43%, with a majority of the low scores related to performance and detection bias. The two human studies received high PEDro scores (9/10).Conclusion: LI-TUS appears to be capable of targeting both superficial and deep cerebral structures to modulate cognitive or motor behavior in both animals and humans. Further human studies are needed to more precisely define the effective modulation parameters and thereby translate this brain modulatory tool into the clinic.
Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer
Authors: Xia Shujun , Chen Yilai , Zhan Weiwei , Zhou Wei 
Published: April 2021

BackgroundTo compare the sampling adequacy and diagnostic efficiency of ultrasound-guided fine-needle aspiration with 22-, 25-gauge needles and capillary sampling with 22-gauge needle in the biopsy of cervical lymph node.MethodsA total of 130 cervical lymph nodes from 103 patients were consecutively included in the prospective study. Each suspected lymph node was aspirated with a 22-gauge needle, capillary sampled with a 22-gauge needle and aspirated with a 25-gauge needle. The adequacy rates and nondiagnostic rates of obtained specimen were calculated.ResultsOf the 130 suspected lymph nodes, there were 77 lymph nodes&lt;6.0 mm and 53 lymph nodes≥6.0mm in the smallest dimension. Both FNA22G and FNC22G got significantly higher sampling adequacy than FNA25G for the total lymph nodes. For lymph nodes&lt;6.0 mm, the sampling adequacy was significantly higher with FNA22G than with FNA25G for each parameter and the cumulative score (all P&lt;0.05), while no difference were seen between FNA22G and FNC22G, and between FNC22G and FNA25G. There were higher nondiagnostic rates for FNA25G compared with FNA22G and FNC22G in all lymph nodes and in each size subgroups. FNA25G yielded more diagnostically inadequate specimens than FNA22G and FNC22G did in the total lymph nodes (P=0.002), in lymph nodes&lt;6.0 mm (P=0.014), and in those ≥ 6.0 mm (P=0.000).ConclusionsFNA22G and FNC22G obtained more diagnostically adequate specimens than FNA25G in cervical lymph nodes. FNA22G and FNC22G may be more suitable than FNA25G in diagnosing cervical lymph nodes. FNA22G and FNC22G may yield specimens with similar quality.
Combination of Side-Swing Flap With Negative-Pressure Wound Therapy Is Superior to Open Excision or Flap Alone in Children With Pilonidal Sinus—But at What Cost?
Authors: Dorth Deborah , Königs Ingo , Elrod Julia , Ghadban Tarik , Reinshagen Konrad , Boettcher Michael 
Published: April 2021

Background: Pilonidal sinus (PS) disease frequently occurs in adolescents and young adults, and in many cases involves wide excision or local flaps as treatment. These treatments are associated with a significant recurrence rate, a long healing time, and thus absence from school or work. The hybrid technique, which is a combination of side-swing plasty with negative-pressure wound therapy (NPWT) may improve these outcomes. The aim of the study was to compare the latter with other current methods.Methods: Children presenting with a pilonidal sinus to two referral centers for pediatric surgery from January 2017 till June 2019 and subsequent (1) slide-swing plasty, (2) open excision, or (3) slide-swing plasty in combination with NPWT were included in this retrospective study. Type of therapy, number of interventions, duration of hospitalization, complications, and recurrence rate were recorded. In addition, data was retrieved from the national diagnosis-related group for inpatient statistics, for all patients who underwent surgery for pilonidal sinus in 2015 and 2016.Results: In total, 85 children were included, with a mean age of 15 years and a near equal gender distribution (53% female). The minimum follow-up was 1 year. In 56% open resection was performed, while 18% underwent a slide-swing plasty and 26% a slide-swing plasty in combination with NPWT. While the hybrid technique was superior regarding recurrence rate in comparison to open excision (24 vs. 5%, p = 0.047), it had significantly longer hospital stay [17.41 (15.63) vs. 3.65 (1.68) days, p &lt; 0.001] and number of interventions [4.14 (4.07) vs. 1.04 (0.29), p &lt; 0.001].Conclusions: Management of PS disease using slide-swing plasty in combination with NPWT is an effective treatment and is associated with low recurrence rate and minimal morbidity. However, this type of treatment is accompanied by an elongated hospitalization time and more frequent interventions. A diligent case by case evaluation and thorough patient counseling is thus necessary when choosing the right technique for the treatment of PS disease.
Postnatal Management in Congenital Lower Urinary Tract Obstruction With and Without Prenatal Vesicoamniotic Shunt
Authors: Jank Marietta , Stein Raimund , Younsi Nina 
Published: April 2021

Purpose: Congenital lower urinary tract obstruction (cLUTO) includes a heterogeneous group of conditions caused by a functional or mechanical outlet obstruction. Early vesicoamniotic shunting (VAS) possibly reduces the burden of renal impairment. Postpartum, pediatric urologists are confronted with neonates who have a shunt in place and a potentially impassable urethra with a narrow caliber. Early management of these patients can be challenging. Here, we would like to share the approach we have developed over time.Materials and Methods: We conducted a single-center retrospective analysis from 2016 to 2020 and included all patients diagnosed with cLUTO. Data focusing on time point and type of intervention was collected. Furthermore, patients with temporary diversion via a percutaneous VAS were selected for a more detailed review.Results: In total, 71 cases of cLUTO were identified during the study period. Within this group, 31 neonates received postnatal management and surgical intervention in our center. VAS was performed in 55% of these cases (N = 17). The postnatal treatment varied between transurethral or suprapubic catheterization and early Blocksom vesicostomy. In five infants with VAS, the urinary drainage was secured through the existing VAS by inserting a gastric tube (N = 1) or a 4.8 Fr JJ-stent (N = 4). To our knowledge, this is the first report of a stent-in-stent scheme, which can remain indwelling until the definite treatment.Conclusion: Having a secure urine drainage through a VAS allows the often premature infant to grow until definite surgery can be performed. This avoids placing a vesicostomy, which requires anesthesia.
Community-Based Interventions to Improve the Control of Non-Communicable Diseases in Underserved Rural Areas in Brazil: A Before-and-After Study
Authors: Lemos Macedo Jéssica Caline , de Carvalho Vivian Carla Honorato dos Santos , Cortes Taciana Borges Andrade , Soares Daniela Arruda , Mistro Sóstenes , Kochergin Clavdia Nicolaevna , Rumel Davi , Oliveira Marcio Galvão 
Published: April 2021

Background: Hypertension and diabetes mellitus are the second and third highest leading causes of disability-adjusted life-years (DALY), respectively, in Brazil. The clinical outcomes of chronic diseases are influenced by various factors. Therefore, there is a need for multifaceted interventions to achieve a decrease in the rate of DALY, with a better control of these diseases.Objective: To verify whether sustainable long-term interventions, such as health worker training and provision of health education to the patients, contribute to health improvements in patients with hypertension and diabetes from rural communities.Methods: Over a 6 month period, educational and medical interventions were provided to optimize the treatment of hypertension and diabetes. Furthermore, blood pressure and glycated hemoglobin (HbA1c) measurements were taken at baseline and after the interventions.Results: The monitored hypertensive patients (n = 276) had a reduction of 13.4 mmHg (p = 0.021) and 5.8 mmHg (p &lt; 0.001) in mean systolic and diastolic blood pressure, respectively. Diabetic patients who were followed-up (n = 71) achieved a 0.55% (p = 0.185) reduction in HbA1c level. The desired blood pressure level (&lt;140/90 mmHg) was achieved in 38.8% of patients with hypertension, whereas the desired level of HbA1c (&lt;7.0% for adults and &lt;8.0% for the elderly) was achieved in 16.9% of patients with diabetes; in addition, 38.0% had a reduction of HbA1c of at least 1%.Conclusion: The results showed that the interventions improved the blood pressure and HbA1c levels in patients with hypertension and diabetes from rural communities in a municipality in Northeast Brazil.
No Evidence of Systematic Change of Physical Activity Patterns Before and During the Covid-19 Pandemic and Related Mood States Among Iranian Adults Attending Team Sports Activities
Authors: Aghababa Alireza , Zamani Sani Seyed Hojjat , Rohani Hadi , Nabilpour Maghsoud , Badicu Georgian , Fathirezaie Zahra , Brand Serge 
Published: April 2021

Objective: To cope with the Coronavirus Disease 2019 (COVID-19) pandemic health authorities released social restrictions. Such social restrictions impacted on the people's possibilities to move deliberately in a public space and to gather with other people. In the present study, we investigated the impact of COVID-19-related restrictions (“confinement”) on physical activity (PA) patterns before and during the confinement among team sports participants. Such PA patterns were further related to current mood states, and possible sex differences were also explored.Methods: A total of 476 adults exercising team sport (football, futsal, volleyball, handball, and basketball; mean age: 24.66 years; 48.1% females) completed a series of self-rating questionnaires covering sociodemographic information, former and current PA patterns, and current mood states.Results: Compared with the period before the confinement, PA intensity decreased, but PA frequency increased during the confinement. Past, current, and changes in physical activity patterns were unrelated to participants' mood states. Sex differences in mood were spurious. Sex differences in physical activity patterns were modest, with male participants reporting a higher physical activity intensity during the confinement.Conclusions: The present pattern of results suggests that the COVID-19-related confinement did not impact in a uniform fashion on PA patterns of adults attending team sports. Furthermore, mood states were unrelated to current physical activity patterns. Given the complex psychosocial situation of COVID-19-related confinement, it appeared very unlikely that sole physical activity patterns could counterbalance possible impaired states of mood and behavior.
Perspectives on expert generalist practice among Japanese family doctor educators: a qualitative study
Authors: Kaneko Makoto , Oishi Ai , Sawa Noriaki , Irving Greg , Fujinuma Yasuki 
Published: April 2021

BackgroundExpert generalist practice (EGP) is increasingly being viewed as the defining expertise of generalist care. In Japan, several prominent family doctors consider it important and relevant in the Japanese context. However, no study has examined Japanese family doctor educators’ perceptions of EGP.AimTo explore Japanese family doctor educators’ perceptions of EGP.Design & settingA qualitative study among family doctor educators in Japan.MethodFocus group interviews were conducted using a semi-structured interview guide following a short lecture on EGP. A qualitative description method was adopted and the framework method was used to conduct thematic analysis.ResultsParticipants were 18 family medicine doctor educators, including 11 directors and six associate directors of family medicine training programmes. The results suggested that the concept of EGP was important and applicable to primary care in Japan. Participants’ perceptions on EGP pertained to the following four areas: impact of EGP, triggers for EGP, enablers for EGP, and educational strategies for EGP.ConclusionThe concept of EGP may be useful in clinical practice in Japan, especially in complex patient care. A clearer framework for or description of EGP, and of non-traditional methods, such as ascetic practice and awareness of the self, were proposed as possible educational strategies.
Expression Analysis of Big Mom Characters in One Piece Comic 89 (Badend Musical)
Authors: Nurlatifah Yeni , Kasmana Kankan 
Published: April 2021

One Piece comics are about the world of pirates, and are the best-selling comics in history. Like most comics, One Piece comics consist of protagonist and antagonist. The depiction of One Piece comics is the same as the usual depiction of Japanese comics, namely using Mango style with narrative content and the use of black and white. Depictions of moments, image details and character expressions become important in black and white comics to bring the narrative to life. For character portrayals, comics look for alternatives to emphasize expression in their comic images. This research focuses on the analysis of one of the most antagonists in the one piece comic is Big Mom. This study aims to find out the characteristics of visualizing the expression of Big Mom characters in One Piece comics using visual language by means of wimba 4 (depiction). The research method used is Bahasa Rupa by classifying images of Big Mom's expression through a form language method. The results of the analysis showed a depiction of expression, using a detailed draw of lines on the eyes, eyebrows, nose and mouth. The way it is portrayed in Big Mom's expressions uses expressive depictions, distortions and lines. Expressive depictions use thick lines that give a wrinkle effect on the forehead, eyes, nose and around the mouth. Depiction of enlarged distortion, used on parts of the eyes, nose, mouth and teeth. The depiction of the line is used as a shadow and effect so that the antagonistic expression of Big Mom feels sharp.
Interior Photograph Experiment of The House Tour Hotel Bandung
Authors: Putra Sandy Dwi , Kasmana Kankan 
Published: April 2021

The rapid advancement of information and communication technology influences the growth of creative industries such as firms in the fields of architecture, real estate and interior. The firm uses the advantages of information and communication technology, namely the internet and social media to conduct marketing. The use of social media as a marketing strategy of real estate and interior firms today is increasingly used as a promotional medium. The use of photos especially for interior promotion requires good photography techniques, has the power to stir consumer perception of interior services. This research aims to conduct photography experiments on the interior of The House Tour Hotel, designed by an architecture firm called Be Good Design Architect, this experiment was conducted to find out the techniques of photography in photographing the interior. The method used is photography experimentation using photography techniques based on literature and photographic methods from interviews with professional photographer Mario Wibowo. The result of this experiment is interior photo taken from the bedroom room of The House Tour Hotel.
Developing Ideal Leadership Perception of Accounting Students Through The 360 Degrees Leadership Education
Authors: Hanny Hanny , Dewi Nunik Lestari , Setiana Sinta , Halim Meliana 
Published: April 2021

This study aims to determine the effect of 360 Degree Leadership Education on the perception of Accounting Students about the ideal leadership principles and to analyze the difference of the Accounting student’s leadership perception before and after got this education. We hope that this study can contribute to support the Accounting Profession to have the professional Accountants who deserve to lead this profession in time to come.
The research data were obtained through some questionnaires that have been distributed to 100 students who haven’t got the 360 Degree Leadership Education and 100 other students who have got it in 2019. We used Non-Probability Sampling with the Purposive Sampling Method to get representative sample. We also used the descriptive analysis, Simple Linear Regression, and the comparative hypothesis testing to test the hypothesis.
The results show that the 360 Degree Leadership Education influences the leadership perception of the Accounting students by 27.5%. This research indicates that there is different leadership perception between these two groups of students. Furthermore, it shows that the Accounting student who haven’t got the 360 Degree Leadership Course tend to agree with the myth of leadership while the other students who have got it show the opposite tendency.
Keywords: 360 Degree Leadership Education; Leadership Perception; Accounting Students.