bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central nervous system involvement in patients with diffuse large B cell lymphoma: analysis of the risk factors and prognostic from a single-center retrospective cohort study
Authors: Ma Jingjing , Li Qing , Shao Jie , Ma Yan , Lin Zhiguang , Kang Hui , Chen Bobin 
Published: October 2019

Abstract
Purpose The aim of this study was to identify the risk factors for central nervous system (CNS) involvement in systemic diffuse large B-cell lymphoma (DLBCL) patients and to explore prognostic for DLBCL patients with CNS involvement (relapse or progression). Method This was a retrospective cohort study in our hospital. Data were collected from all DLBCL patients diagnosed in our institutes from January, 2013 to June, 2018. Clinical information was collected from medical records. Result The participants included 138 patients with DLBCL. Among them, 38 patients were diagnosed as CNS lymphoma, including 15 patients exhibited CNS involvement while DLBCL were pathologically confirmed, and 23 patients developed CNS lymphoma during or after initial chemotherapy. The median disease-free interval to CNS involvement was 13 months. Multivariate analysis identified elevated serum lactate dehydrogenase(LDH) level [hazard ratio(HR)=4.035; 95% confidence interval(95%CI):1.147~14.195] was independent predictor of CNS involvement. The median progression-free survival (PFS) and overall survival (OS) time of DLBCL patients with CNS involved were 12.5 months and 22 months, respectively. Multivariate prognostic analysis showed that eastern cooperative oncology group (ECOG) score>2(P=0.018; HR=7.333; 95%CI:1.424~42.002), elevated serum LDH level (P=0.046; HR=6.510; 95%CI:1.035~40.949), deep lesion (P=0.005; HR=10.957; 95%CI:2.050~58.569), and CNS with systemic involvement (P=0.023; HR=2.730; 95%CI:1.151~6.479) were independent poor prognostic factors for the patients. The cases with lymphocyte absolute count >0.75×109/L (HR=0.047; 95%CI:0.003~0.732) had better prognosis. The OS of DLBCL patients with secondary CNS lymphoma was inferior to DLBCL patients without CNS involvement. There was no significant difference between the patients with CNS and extra-CNS involvement. There was no significant difference between the patients with CNS involvement and stage III-IV DLBCL cases without CNS lymphoma. Conclusion In conclusion, elevated serum LDH was independent high-risk factor for secondary CNS lymphoma. For patients DLBCL with CNS involvement, ECOG score>2, elevated serum LDH level, deep lesion, lymphocyte absolute count ≤0.75×109/L and CNS with systemic involvement retained a significant association with outcome.
Differences in fear of falling and fall risk indicators among white and black older adults: a cross sectional study
Authors: Bay Allison Anne , Ramachandran Smrithi , Silverstein Hayley A. , Song Jiayang , Hart Ariel R. , Bozorg Ariyana , Hackney Madeleine E. 
Published: October 2019

Abstract
Background Falling among older adults is common and can cause chronic health complications. This study investigated differences between White and Black community-dwelling older adults in fall history, fear of falling, and indicators of fall risk.Methods All assessments and analyses were conducted in a clinical laboratory at Emory University in the Department of General Medicine and Geriatrics on 84 diverse community-dwelling older adults (White, n=37; Black, n=47). Statistical analyses included one-way ANOVA for continuous variables, the Fisher exact test for categorical variables, the Mann-Whitney-Wilcoxon test for ordinal variables, and an ordinal logistic regression model to examine which factors predicted fear of falling. Measures included fall history, fear of falling, and fall risk indicators. The Montreal Cognitive Assessment, Activities-Specific Balance Confidence Score, Gait Speed, Short Form 12 Physical Component Score and Mental Component Score, fear of falling and quality of life rating scales and demographics questionnaires were administered.Results Falls history was not significantly different between groups. Black participants had significantly fewer years of education (p=.007), lower MoCA scores (p=0.002), and slower fast gait speed (p=0.032) than White participants. However, Black participants reported significantly less fear of falling (p=0.043). Race (Black/White) (p=<0.001), sex (p=0.028), preferred gait speed (p=0.036), and a dichotomous variable of use of assistive device for walking (p=0.023) were significant predictors of fear of falling in the logistical model.Conclusions These factors may explain the observed differences in fear of falling observed between white and black groups in this study. This work offers an explanation of possible factors related to the well-documented yet poorly understood fact that while Black older adults have more risk factors for falling, White older adults tend to fall more frequently and are more afraid of falling.
Medication omission rates in New Zealand Residential Aged Care Homes: a national description
Authors: Garratt Stephanie M , Kerse Ngaire M , Peri Kathryn , Jonas Monique F 
Published: October 2019

Abstract
Background Medication administration is a key service offered to individuals residing in residential aged care homes (RAC homes). A medication omission is an event where a prescribed medication is not taken by a resident before the next scheduled dose. Medication omissions are typically classed as errors, they have the potential to lead to harm if poorly managed, but may also stem from good clinical decision-making. Studies that critically appraise or support medication omissions in healthcare settings are limited. There is uncertainty around which medication omissions are problematic and how many on average a patient should experience. There have been several hospital-based studies, with limited sample sizes, timeframes, and inconsistent reporting of omissions. As the first population-level, RAC Home-specific study of its kind, this study quantifies the incidence, prevalence, and types of medication omissions in RAC homes on a national scale. Methods A retrospective review of de-identified, medication administration e-records from December 1 st 2016 to December 31 st 2017 was conducted. Demographic details of residents, care staff competency levels, medications, and RAC ownership types were included in the review and analysis. Results A total of 11, 015 residents from 374 RAC homes had active medication charts; 8,020 resided in care over the entire data collection period. A mean rate of 3.40 medications doses were omitted per 100 dispensed medications doses per resident (s.d. 7.27). Approximately 73% of residents had at least one dose omission. The most common selected omission category was ‘not-administered’ (49.9%), followed by ‘refused’ (34.6%). The mean rate of omission was found to be slightly higher in corporate operated RAC Homes (3.73 versus 3.33), with greater variation. The most commonly omitted medications were Analgesics and Laxatives. Forty-eight percent of all dose omissions were recorded without a comment justifying the omission. Conclusions Compared to other studies medication omissions within RAC homes in New Zealand are not as common as previously proposed. This study sets out the first national-level rate of medication omissions per resident over a one-year timeframe. Subsequent studies will address the medications omitted, the clinical significance of omissions and the place of medication omissions within clinical decision-making.
Sensor-based Characterization of Daily Walking: A New Paradigm in Frailty Assessment
Authors: Kumar Danya Pradeep , Toosizadeh Nima , Mohler Jane , Ehsani Hossein , Laksari Kaveh 
Published: October 2019

Abstract
Background Frailty is an increasingly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is a prime indicator of frailty.Objective The goal of this study was to develop an algorithm that discriminates between frailty groups (non-frail, pre-frail, and frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA).Methods DPA was acquired for 48 hours from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Purposeful continuous bouts of walking (≥60s) without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables.Results 126 older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and purposeful walking quantitative measures were significantly different between non-frail and pre-frail as well as non-frail and frail groups ( p <0.05). Using the logistic model pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity.Discussion Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty.
Does the Medical Insurance System Play a Real Role in Reducing Catastrophic Economic Burden in Elderly Patients with Cardiovascular Disease in China? Implication for Accurately Targeting Vulnerable Characteristics.
Authors: Ma Meiyan , Li Ye , Wang Nianshi , Wu Qunhong , Jiao Mingli , Shan Linghan , Sun Tao , Li Heng , Gao Han , Fu Xuelian , Tian Wanxin , Xia Qi , Hao Yanhua 
Published: October 2019

Abstract
Abstract
Background:The vulnerability of cardiovascular disease (CVD) patients’ health abilities, combined with the severity of the disease and the overlapping risk factors, can cause such people to bear the economic burden of the disease due to the use of medical services.We estimated the economic burden of patients with CVD，and identified the weak link in the design of the medical insurance.
Methods:Data from 5,610 middle-aged and elderly with CVD were drawn from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). The recommended method of the World Health Organization (WHO) was adopted to calculate catastrophic health expenditure (CHE), impoverishment by medical expenses (IME), and applied the treatment-effect model to analyze the determinants of CHE.
Results:The incidence of CHE was 19.9% of the CVD, compared to 7.6% of the sample households trapped in IME. The incidence of CHE in CVD participating in medical insurance was 2.6% higher than for uninsured families (16.3%).Family size, health satisfaction,combine with other chronic diseases, having hospitalization and disabled members, and participating in insurance were found to be significantly associated with the likelihood of CHE.
Conclusions:Elderly with physical vulnerabilities were more prone to CHE. The medical insurance only reduced barriers to accessing health resources for elderly with CVD, but lacked policy inclination for high-utilization populations,and had poorly accurate identification of vulnerable characteristics of CVD,which in turn affects the economic protection ability of the medical insurance. The dispersion between the multiple medical security systems leads to the existence of blind spots in the economic risk protection of individuals and families.
Keywords:cardiovascular disease, catastrophic health expenditure, impoverishment by medical expense, medical insurance, elderly households
A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention
Authors: Kneis Sarah , Wehrle Anja , Dalin Daniela , Wiesmeier Isabella Katharina , Lambeck Johann , Gollhofer Albert , Bertz Hartmut , Maurer Christoph 
Published: October 2019

Abstract
Background Postural instability presents a common and disabling consequence of chemotherapy-induced peripheral neuropathy (CIPN). However, knowledge about postural behavior of CIPN patients is sparse. With this pilot study, we used a new approach to i) characterize postural impairments as compared to healthy subjects, ii) allocate possible abnormalities to a set of parameters describing sensorimotor function, and iii) evaluate the effects of a balance-based exercise intervention.Methods We analyzed spontaneous and externally perturbed postural control in eight CIPN patients before and after a balance-based exercise intervention by using a modification of an established postural control model. These findings were compared to 15 matched healthy subjects.Results Spontaneous sway amplitude and velocity were larger in CIPN patients compared to healthy subjects. CIPN patients’ reactions to external perturbations were smaller compared to healthy subjects, indicating that patients favor vestibular over proprioceptive sensory information. The balance-based exercise intervention up-weighted proprioceptive information in patients.Conclusions CIPN patients’ major postural deficit may relate to underuse of proprioceptive information that results in a less accurate posture control as spontaneous sway results indicate. The balance-based exercise intervention is able to partially correct for this abnormality. Our study contributes to a better understanding of postural impairments in CIPN patients and suggests an effective treatment strategy.
Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations
Authors: Ellakwa Amin Faisal , Zaki Marwa Ali , Ashour Rana Mohammed 
Published: October 2019

Abstract
Objectives:to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs).
Background: Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes.
Methods:Non-randomized controlled trialwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µmat 6 mm diameter utilizing either optimized (aberration free) or corneal WFG patterns (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively.
Results: Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one.
Conclusions: both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs at 6 mm diameter with better aberrometric outcomes in corneal WFG group.
Pituitary apoplexy accompanying temporal lobe epilepsy as a complication: case report
Authors: Shijo Katsunori , Yoshimura Sodai , Mori Fumi , Yamamuro Shun , Sumi Koichiro , Oshima Hideki , Yoshino Atsuo 
Published: October 2019

Abstract
Background : Pituitary apoplexy is an acute clinical syndrome caused by infarction and/or hemorrhage of pituitary adenoma, which typically presents with severe headache, visual deterioration, and endocrine abnormalities. However, temporal lobe epileptic seizure has not been viewed as a symptom of pituitary apoplexy in the literature.
Case presentation : To elucidate further such a rare complication of temporal lobe epilepsy-like seizure, we describe here the rare clinical manifestations of a 55-year-old previously healthy male with pituitary apoplexy harboring headache, combined palsies involving cranial nerves III to VI, endocrinologic disturbances, and temporal lobe epilepsy-like seizure. In addition, we discuss the temporal lobe epilepsy associated with pituitary adenoma based on the literature.
Conclusion : Although further accumulation of clinical data is needed, we would like to emphasize the importance of recognition of temporal lobe epilepsy-like seizure due to pituitary apoplexy, and to suggest that early surgery should be considered as an option in patients displaying such a rare complication.
Physiological and transcriptome analysis reveal molecular mechanism in Salvia miltiorrhiza leaves of near-isogenic male fertile lines and male sterile lines
Authors: Wang Ruihong , Jiang Han , Zhou Ziyun , Guo Hongbo , Dong Juane 
Published: October 2019

Abstract
Background: Our previous study finds that male sterility in Salvia miltiorrhiza could result in stunted growth and reduced biomass, but their molecular mechanisms have not yet been revealed. In this article, we investigate the underlying mechanism of male sterility and its impact on plant growth and metabolic yield by using physiological analysis and mRNA sequencing (RNA-Seq).
Results: In this study, transcriptomic and physiological analysis were performed to identify the mechanism of male sterility in mutants and its impact on plant growth and metabolic yield. Through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, it is found that the pathways are mainly enriched in processes including organ development, primary metabolic process and secondary metabolic process. Physiological analysis show that the chloroplast structure of male sterile mutants of S. miltiorrhiza is abnormally developed, which could result in decrease in leaf gas exchange ( A , E and gs ), chlorophyll fluorescence (Fv, Fm and Fv/Fm), and the chlorophyll content. Expression level of 7 differentially expressed genes involved in photosynthesis-related pathways is downregulated in male sterile lines of S. miltiorrhiza , which could explain the corresponding phenotypic changes in chlorophyll fluorescence, chlorophyll content and leaf gas exchange. Transcriptomic analysis establishes the role of disproportionating enzyme 1 ( DPE1 ) as catalyzing the degradation of starch, and the role of sucrose synthase 3 ( SUS3 ) and cytosolic invertase 2 ( CINV2 ) as catalyzing the degradation of sucrose in the S. miltiorrhiza mutants. The results also confirm that phenylalanine ammonialyase ( PAL ) is involved in the biosynthesis of rosmarinic acid and salvianolic acid B, and flavone synthase ( FLS ) is an important enzyme catalyzing steps of flavonoid biosynthesis.
Conclusions: Our results from the physiological and transcriptome analysis reveal underlying mechanism of plant growth and metabolic yield in male sterile mutants, and provide insight into the crop yield of S. miltiorrhiza.
Seeds as Economical Production Platform for Recombinant Proteins
Authors: Khan Muhammad Sarwar , Joyia Faiz Ahmad , Mustafa Ghulam 
Published: October 2019

:The cost-effective production of high-quality and biologically active recombinant molecules especially proteins is extremely desirable. Seed-based recombinant protein production platforms are considered as superior choice owing to lack of human/animal pathogenic organisms, lack of cold chain requirements for transportation and long-term storage, easy scalability and development of edible biopharmaceuticals in plants with objective to be used in purified or partially processed form is desirable. This review article summarizes the exceptional features of seed-based biopharming and highlights the needs of exploiting it for commercial purposes. Plant seeds offer a perfect production platform for high-value molecules of industrial as well as therapeutic nature owing to lower water contents, high protein storage capacity, weak protease activity and long-term storage ability at ambient temperature. Exploiting extraordinarily high protein accumulation potential, vaccine antigens, antibodies and other therapeutic proteins can be stored without effecting their stability and functionality up to years in seeds. Moreover, ability of direct oral consumption and post-harvest stabilizing effect of seeds offer unique feature of oral delivery of pharmaceutical proteins and vaccine antigens for immunization and disease treatment through mucosal as well as oral route.
High Dietary Fat Modulates Neurobehavioural Effect of Lopinavir/ Ritonavir in Mice
Authors: Onaolapo Olakunle J. , Adeyemi Oluwole I. , Amujoyegbe Omolola J. , Fasola Eunice A. , Olofinnade Anthony T. , Onaolapo Adejoke Y. 
Published: October 2019

Background:
Lopinavir/Ritonavir (LR) is a protease inhibitor used human immunodeficiency
virus infection management. There have been issues regarding the effects of fat on LR efficacy and
the possibility of neurological deficits following prolonged use, there is however a dearth of research
examining this.

Aims:
The effects of LR administered with normal or High-Fat Diet (HFD) on neurobehaviour, neurochemistry
and oxidative stress in healthy mice were examined.

Methods:
Mice were randomly-assigned into eight groups of ten (n=10) animals each. The groups
were normal control [Standard Diet, (SD)], HFD control, 3 groups of LR incorporated into SD
(100/25, 200/50 and 400/100 mg/kg of feed), and 3 groups of LR with HFD (100/25, 200/50 and
400/100 mg/kg of feed). Mice were fed daily for six weeks, following which open field, elevated-plus
maze (EPM), radial-arm maze and Y-maze behaviours were scored. Twenty-four hours after tests,
mice were euthanised and brains were homogenised for estimation of oxidative stress, L-glutamate
level and acetylcholinesterase activity.

Results:
LR was associated with a reduction in HFD-induced weight gain, suppression of open-field
behaviours with SD, and counteraction of HFD-induced changes in working-memory, open-field and
anxiety-related behaviours. Also, LR causes increased lipid peroxidation and superoxide dismutase activity;
and a decrease in brain glutamate, irrespective of dietary composition. Increased fat catabolism
leading to increased oxidative stress could possibly account for the weight changes, while a decrease in
brain glutamate could account for the changes in open-field behaviours in mice fed SD.

Conclusion:
LR alters neurobehaviour, oxidative stress and brain glutamate in mice; however, only its
effects on neurobehaviour are affected by diet.