bluuebunny/crossref_metadata_2025_split huggingface dataset:
Periodic paralysis with normokalemia in a patient with hyperthyroidism
Authors: Wang Pin-Han , Liu Kuan-Ting , Wu Yen-Hung , Yeh I-Jeng 
Published: November 2018

Abstract

Rationale:
Thyrotoxic periodic paralysis is characterized by a sudden onset of hypokalemia and paralysis. This condition mainly affects the lower extremities and is secondary to thyrotoxicosis. The underlying hyperthyroidism is often subtle without typical symptoms such as palpitations, tremors, anxiety, and weight loss; this causes a difficulty in early diagnosis. Here, we reported a case of periodic paralysis in a patient with hyperthyroidism whose potassium level was within the normal range.

Patient concerns:
A 33-year-old Taiwanese man presented to the emergency department with bilateral limb weakness (more severe in the lower limbs than in the upper limbs). On arrival, the patient's vital status was stable with clear consciousness. He denied experiencing recent trauma, back pain, chest pain, abdominal pain, headache or dizziness, or a fever episode. Physical examination showed no specific findings. Neurological examination showed weakness in the muscles of the bilateral upper and lower limbs. Muscle weakness was more severe in the proximal site than in the distal site.

Diagnosis:
Blood examination showed normal complete blood count, normal renal and liver function, and normal potassium (3.5 mmol/L, normal range 3.5–5.1 mmol/L), sodium, and calcium levels; however, the examination showed impaired thyroid function (thyroid stimulating hormone: 0.04 uIU/mL, normal range 0.34–5.60 uIU/mL; free T4: 1.96 ng/dL, normal range 0.61–1.12 ng/dL). Brain computed tomography without contrast showed no obvious intra-cranial lesion.

Interventions:
Intravenous potassium infusion (20 mEq/L) with normal saline was prescribed for the patient.

Outcomes:
After treatment, the patient felt a decrease in limb weakness. He was discharged from our emergency department with a scheduled follow-up in the endocrine outpatient department.

Lessons:
TPP should be considered as a differential diagnosis in young Asian men presenting with limb paralysis that is more severe in the proximal site and in the lower limbs than in the distal site and in the upper limbs, respectively. It is important for emergency department physicians to consider TPP as a differential diagnosis as it can occur even if the patient's potassium level is within the normal range.
Isolated hook of hamate fracture in sports that require a strong grip comprehensive literature review
Authors: Kim Heejae , Kwon Bumsun , Kim Jihyun , Nam Kiyeun 
Published: November 2018

Abstract

Background:
The aim of the study was to report characteristics of isolated hook of hamate fractures related to sports that require a strong grip and to identify factors affecting early diagnosis and recovery period.

Methods:
A comprehensive literature search was conducted using MEDLINE, EMBASE, SCOPUS, Web of Science, the Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and the clinical trials registry and database of the US National Institutes of Health (ClinicalTrials.gov). There were no limits on the language or year of publication.
This article included case reports and literature reviews for patients with isolated hook of hamate fractures related to sports that require a strong grip from 1977 to 2016.
Two experienced reviewers extracted data from each study. The following data were extracted: sample size, patient's characteristics, cause of injury, injury side, time to diagnosis and symptoms, physical examination results, diagnostic work-up, treatment, complications, and recovery period.

Results:
A total of 21 case reports and literature reviews with 120 patients satisfied our inclusion criteria. There was no significant difference in the time to diagnosis between the group before computed tomography (CT) was widely used and the group after CT was widely used. Recovery period showed a positive relationship with age (coefficient = 0.418, P < .01), time from injury to diagnosis or surgery (coefficient = 0.206, P < .05), and type of athlete (coefficient = 0.270, P < .01). On multiple stepwise regression analysis, recovery period was significantly associated with age (β = 0.418, P = .00), but not with time from injury to diagnosis or surgery.

Conclusions:
Advance in diagnostic techniques does not guarantee early diagnosis of hook of hamate fractures. Strong suspicion of the disease with physical examination and carefully hearing patient's history are important for early diagnosis and management for patients with hook of hamate fractures.
Ability of preschoolers to achieve maximal exercise and its correlation with oxygen uptake efficiency slope ∼ an observational study by direct cardiopulmonary exercise testing
Authors: Tuan Sheng-Hui , Su Hung-Tzu , Chen Yi-Jen , Chen Chia-Hsin , Tsai Wan-Jung , Chen Guan-Bo , Lin Ko-Long 
Published: November 2018

Abstract
The oxygen uptake efficiency slope (OUES) is a well-established substitute for maximum oxygen uptake (

JOURNAL/medi/04.03/00005792-201811160-00059/inline-graphic4/v/2023-09-15T184246Z/r/image-tiff

O2 max) in submaximal exercise effort among adolescents and adults. Few studies have analyzed the exercise capacity (EC) and OUES of children aged 4 to 6 (preschoolers). Body fat has been proved to negatively affect EC among schoolchildren. The purposes of this study were to assess the capacity of preschoolers in achieving

JOURNAL/medi/04.03/00005792-201811160-00059/inline-graphic5/v/2023-09-15T184246Z/r/image-tiff

O2 max and evaluate the correlation of peak metabolic equivalent (peak MET) and peak oxygen consumption (peak O2) with OUES. We also evaluated if body fat affected EC among preschoolers.
Forty-three preschoolers under the ramped Bruce protocol of treadmill exercise testing had been retrospectively studied. The criteria for achieving

JOURNAL/medi/04.03/00005792-201811160-00059/inline-graphic6/v/2023-09-15T184246Z/r/image-tiff

O2 max included respiratory exchange ratio (RER) >1.1, heart rate (HR) >85% of age-predicted maximum, and HR >200 bpm. OUES was calculated by the 75% (OUES-75) and the entire (OUES-100) duration of the testing and normalized by body surface area. Body fat was measured using vector bioelectrical impedance analysis. The fat mass (FM) index and fat-free mass index (FFMI) were defined as FM or FFM (kg) divided by height squared (m2), respectively.
The mean age of the participants was 5.70 ± 0.56. Seventy-nine percent of preschoolers met at least 1 criterion, 36.84% met 2 criteria, and none met all 3 criteria for

JOURNAL/medi/04.03/00005792-201811160-00059/inline-graphic7/v/2023-09-15T184246Z/r/image-tiff

O2. OUES-75 was moderately positively correlated with peak MET (P = .034; Spearman's rho = 0.324) and peak O2 (P <.001; Spearman's rho = 0.667). OUES-100 was moderately to highly positively correlated with peak MET (P <.001; Spearman's rho = 0.592) and peak O2 (P <.001; Spearman's rho = 0.825). There were moderate to high positive correlations between FFMI and peak O2 (P <.001; Spearman's rho = 0.668), OUES-75 (P <.001; Spearman's rho = 0.642), and OUES-100 (P < .001; Spearman's rho = 0.670).
None of the preschoolers reached all 3 criteria for

JOURNAL/medi/04.03/00005792-201811160-00059/inline-graphic8/v/2023-09-15T184246Z/r/image-tiff

O2max. OUES-75 and OUES-100 might be indicators of peak O2 at submaximal effort. Preschoolers with higher FFMI had better EC during treadmill exercise testing.
Prenatal diagnosis and pregnancy outcome analysis of thickened nuchal fold in the second trimester
Authors: Li Lushan , Fu Fang , Li Ru , Liu Zequn , Liao Can 
Published: November 2018

Abstract
To summarize the results of prenatal diagnoses and pregnancy outcomes of fetuses with thickened nuchal fold (TNF) in the second trimester.
From 2009 to 2016, we studied 72 pregnant women with fetal nuchal fold (NF) measurements over 5 mm at 14 to 19 + 6 weeks or 6 mm at 20 to 28 weeks of gestation who received prenatal diagnosis. Karyotypes were first used to detect common chromosomal diseases, and then chromosome microarray analysis (CMA) was performed if karyotypes were normal. Prognoses were followed up by documentation in the hospital or over the telephone.
In total, 12 fetuses with chromosomal defects, including 5 pathogenic copy number variants (CNVs) were detected. The risk of chromosomal defects when a TNF was associated with structural malformations (SMs) (35.5%) was much greater than that of an isolated TNF (3.7%) and a TNF associated with soft markers (0%). The rate of SMs when the NF measured ≥10 mm was greater than that NF measured 5 to 7.9 mm or 8 to 9.9 mm. Totally 27 fetuses had adverse pregnancy outcome.
A TNF is not only associated with a high risk of trisomy 21 but also with other chromosomal abnormalities, including pathogenic CNVs. The rates of SMs and adverse outcomes increase when the NF thickness increases.
Impairments in Postural Control and Retest Reliability of Dynamic Posturographic Measures After Lung Transplantation
Authors: Ebenbichler Gerold , Doblhammer Stephan , Pachner Melanie , Habenicht Richard , Kienbacher Thomas , Mair Patrick , Zemková Erika , Hirjaková Zuzana , Jaksch Peter , Klepetko Walter 
Published: November 2018

Objectives
The aims of the study were to classify impairments in postural control using computerized posturography in lung transplant recipients undergoing subacute rehabilitation and to examine the retest reliability of these measures.

Methods
In a prospective repeated-measures study, 50 lung transplant recipients underwent clinical and quantitative posturographic testing (SMART EquiTest), which included the sensory organization test, motor control test, and limits of stability test. Testing was repeated after 1 to 2 days and upon completion of rehabilitation, 2 mos later. Main outcome measures were the following: sensory organization test–composite score, motor control test–latency and amplitude scaling, limits of stability test–movement velocity, and endpoint excursion/maximum excursion.

Results
At the beginning of rehabilitation, the mean sensory organization test–composite score and limits of stability test, but not the motor control test scores, were below normative reference values and and did not return to normal after rehabilitation. Intraclass correlation coefficients(2,1) yielded excellent relative reliability for all posturographic tests. The smallest detectable differences observed for the sensory organization test and limits of stability test exceeded the mean changes observed upon completion of rehabilitation.

Conclusions
Impairments in sensory and anticipatory postural control were insufficiently restored after subacute lung transplantation rehabilitation. The little sensitivity of the sensory organization test-composite score or limits of stability test scores to detect a minimal change in performance due to rehabilitation limits the clinical applicability of these tests as objective outcome measures in lung transplantation rehabilitation.
Laboratory-Reflex Cryptococcal Antigen Screening Is Associated With a Survival Benefit in Tanzania
Authors: Faini Diana , Kalinjuma Aneth Vedastus , Katende Andrew , Mbwaji Gladys , Mnzava Dorcas , Nyuri Amina , Glass Tracy R. , Furrer Hansjakob , Hatz Christoph , Boulware David R. , Letang Emilio ,   on behalf of the KIULARCO Study Group
Published: November 2018

Background:
Cryptococcal antigen (CrAg) screening in persons with advanced HIV/AIDS is recommended to prevent death. Implementing CrAg screening only in outpatients may underestimate the true CrAg prevalence and decrease its potential impact. Our previous 12-month survival/retention in CrAg-positive persons not treated with fluconazole was 0%.

Methods:
HIV testing was offered to all antiretroviral therapy–naive outpatients and hospitalized patients in Ifakara, Tanzania, followed by laboratory-reflex CrAg screening for CD4 <150 cells/μL. CrAg-positive individuals were offered lumbar punctures, and antifungals were tailored to the presence/absence of meningitis. We assessed the impact on survival and retention-in-care using multivariate Cox-regression models.

Results:
We screened 560 individuals for CrAg. The median CD4 count was 61 cells/μL (interquartile range 26–103). CrAg prevalence was 6.1% (34/560) among individuals with CD4 ≤150 and 7.5% among ≤100 cells/μL. CrAg prevalence was 2.3-fold higher among hospitalized participants than in outpatients (12% vs 5.3%, P = 0.02). We performed lumbar punctures in 94% (32/34), and 31% (10/34) had cryptococcal meningitis. Mortality did not differ significantly between treated CrAg-positive without meningitis and CrAg-negative individuals (7.3 vs 5.4 deaths per 100 person-years, respectively, P = 0.25). Independent predictors of 6-month death/lost to follow-up were low CD4, cryptococcal meningitis (adjusted hazard ratio 2.76, 95% confidence interval: 1.31 to 5.82), and no antiretroviral therapy initiation (adjusted hazard ratio 3.12, 95% confidence interval: 2.16 to 4.50).

Conclusions:
Implementing laboratory-reflex CrAg screening among outpatients and hospitalized individuals resulted in a rapid detection of cryptococcosis and a survival benefit. These results provide a model of a feasible, effective, and scalable CrAg screening and treatment strategy integrated into routine care in sub-Saharan Africa.
Heparin-induced tau filaments are polymorphic and differ from those in Alzheimer’s and Pick’s diseases
Authors: Zhang Wenjuan , Falcon Benjamin , Murzin Alexey G. , Fan Juan , Crowther R. Anthony , Goedert Michel , Scheres Sjors H.W. 
Published: November 2018

AbstractThe assembly of microtubule-associated protein tau into abundant filamentous inclusions underlies a range of neurodegenerative diseases. The finding that tau filaments adopt different conformations in Alzheimer’s and Pick’s diseases raises the question of what kinds of structures of tau filaments form in vitro. Here, we used electron cryo-microscopy (cryo-EM) and negative-stain immuno-gold electron microscopy (immuno-EM) to characterise filaments that were assembled from recombinant full-length human tau with four (2N4R) or three (2N3R) microtubule-binding repeats in the presence of heparin. 4R tau assembles into at least four different types of filaments. Cryo-EM structures of three types of 4R filaments reveal similar “kinked hairpin” folds, in which the second and third repeats pack against each other. 3R tau filaments are structurally homogeneous, and adopt a dimeric core, where the third repeats of two tau molecules pack against each other in a parallel, yet asymmetric, manner. None of the heparin-induced tau filaments resemble those of Alzheimer’s or Pick’s disease, which have larger cores with different repeat compositions. Our results indicate that tau filaments are structurally versatile, and raise questions about the relevance of in vitro assembled amyloids.
Research on the performance of industrial innovation of small and medium-sized enterprises in China
Authors: Lu Guoqing , Dai Peng , Zhang Xia 
Published: November 2018

PurposeThe purpose of this paper is to test the relationship between innovation performance and innovation spillover effects, innovation inputs, innovation outputs and industrial effects.Design/methodology/approachThe analysis framework including variables such as innovation spillover effect, innovation input, innovation output and industrial effect was constructed. Through the investigation and analysis of the innovation activities of China’s GEM listed companies in 2014–2016, the innovation performance and the above factors were tested.FindingsThe research shows that enterprise performance has a significant positive correlation with innovation input and innovation output, but there is no significant correlation or even negative correlation with innovation environment and industry background such as government support and innovation opportunities, and the spillover effect is significant. The negative correlation is also negatively correlated with innovative human capital investment, company age and company Q.Originality/valueInnovation is the real source of economic growth, and industrial innovation is the system integration of technological innovation, product innovation, market innovation, etc., which is the basic determinant of national competitiveness.
Exploring the relationships between gamification and motivational needs in technology design
Authors: Tang Jian , Zhang Ping 
Published: November 2018

PurposeDrawing upon the motivational affordance theory, this paper aims to investigate how gamification design and human motivational needs are associated in extant literature.Design/methodology/approachThe authors conducted a literature analysis of 60 journal articles that studied motivational influences of gamification in information technology design. Content analysis was used to identify game design features and motivation variables studied in prior literature, and correspondence analysis was used to show the co-occurrence of game design features and basic motivational needs.FindingsThe results showed that four types of game design features and eight basic motivational needs are studied in this pool of literature. Correspondence analysis indicates some interesting associations between game design features and basic human needs.Research limitations/implicationsThis research used a motivational affordance perspective to interpret the impact of game design features and suggested directions for future investigations. It is limited due to its sample size and considered as an exploratory study.Practical implicationsThis research provided suggestions for technology designers that game design features vary in their motivational influence, and therefore, game design features should be used accordingly to meet users’ motivational needs.Originality/valueThis research is one of initial studies which explored the association between game design features and basic motivational needs. The findings of this study provide the groundwork for guidelines and strategies to facilitate motivational design in information technology.
Water conservation behavior: is what we say what we do?
Authors: Parker Janna M. , Sams Doreen , Poddar Amit , Manoylov Kalina 
Published: November 2018

Purpose
The purpose of this study (mixed-method) was to examine the effectiveness of two types of marketing interventions on water conservation behavior and to compare behaviors to self-reported conservation claims.

Design/methodology/approach
This paper consists of four phases (advertisement selection focus group, behavioral trace field study, self-report survey and follow-up focus group). In the USA, residing in a dormitory typically includes a fee for water without quantity restrictions. The subjects for this research were college students who lived in dormitories at a medium-sized university in southeastern USA where metering individual water consumption is not possible.

Findings
The results of the field study phase of student water conservation behaviors were not congruent with the participants’ self-reported behaviors. Phase 2 yielded results contrary to published laboratory experimental research in which cause-related claims were effective.

Research limitations/implications
This research was limited by a single sample (one university), time (13 weeks) and the inability to measure individual consumption behavior. However, valuable findings were obtained, and suggestions surfaced for future research.

Practical implications
Using eco-feedback technology and advertisements may result in significant cost savings. While findings were somewhat inconclusive, there was evidence that the use of the eco-feedback technology could result in cost savings for the subject university.

Originality/value
The behavioral trace study is one of the first field research studies in the marketing discipline designed to examine resource conservation behavior in an impactful way. Further, this research used a single sample triangulated methodology across Phases 2, 3 and 4.
Typology of creative entrepreneurs and entrepreneurial success
Authors: Chen Ming-Huei , Chang Yu-Yu , Pan Ju-Yun 
Published: November 2018

PurposeThe rise of creative economy has been the subject of considerable interest in the recent literature. Despite the growing effort to investigate entrepreneurship in creative industries, little work has been done to scrutinize the relationship between individual attributes of creative entrepreneurs and the new venture outcomes. Prior research shows that entrepreneurial creativity and opportunity recognition are the major determinants of entrepreneurs’ behavioral posture in the new venture process. Therefore, this study aims to explore the typology of creative entrepreneurs’ attitude to new venture creation using entrepreneurial creativity and opportunity recognition to categorize entrepreneurs in creative industries.Design/methodology/approachA sample of 291 entrepreneurs in creative industries of Taiwan and cluster analysis was used to categorize the research data.FindingsThe results identify four types of creative entrepreneurs, namely “creative constructionist”, “creative opportunist”, “creative designer” and “creative producer”. To better understand the role of creative entrepreneurs in affecting new venture success, the career outcomes perceived by entrepreneurs were compared between different categories. Results suggest that entrepreneurs who are categorized as “creative constructionist” have better career success in firm’s creative performance, personal career achievement, social reputation, entrepreneurial satisfaction and entrepreneurial happiness. Moreover, findings also suggest that constructionist type of creative entrepreneurs have the lowest intention to quit the entrepreneurial career.Originality/valueThis paper confirms that entrepreneurial creativity and opportunity recognition complement each other to accomplish entrepreneurs’ career success. Its findings shed light on entrepreneurs’ attribute typology as well as how the typology is linked to entrepreneurial career success in creative industries. Theoretical contributions and practical implications are discussed.