bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative motor deficits and depressive symptoms predict quality of life in patients with Parkinson’s disease at different time points after surgery for subthalamic stimulation: a retrospective study
Authors: Semmler Carolin , Stopic Vasilija , Jost Stefanie T. , Fink Gereon R. , Weiss Peter H. , Barbe Michael T. 
Published: February 2024

Abstract
Background
While subthalamic nucleus deep brain stimulation (STN-DBS) improves the quality of life (QoL) of patients with Parkinson’s disease (PD), the clinical parameters that predict this improvement remain debated. This retrospective study explored whether preoperative motor, cognitive, and affective parameters predict QoL or its components at 6 and 12 months after STN-DBS surgery.

Methods
QoL was assessed with the Parkinson’s Disease Questionnaire-39 (PDQ-39) before (baseline), at 6 months (N = 90) and 12 months (N = 63) after STN-DBS surgery. Changes in the PDQ-39 and its subdomains were analysed with Wilcoxon signed-rank tests. In total, seven motor, cognitive, and affective parameters recorded at baseline were used in multiple linear regressions to predict QoL and its subdomains.

Results
QoL had improved significantly at six months post STN-DBS surgery. After 12 months, this effect remained significant but was less pronounced. At both time points, significant improvements in mobility, activities of daily living, stigma, and bodily discomfort were present. Correlation and linear regression analyses showed that preoperative QoL status and changes in QoL at 6 and 12 months after surgery were driven by preoperative dopaminergic medication, as well as motor (UPDRS-III medOFF and PIGD-subscore medOFF) and affective (HADS anxiety and depression) symptoms. In contrast, preoperative cognitive performance did not predict QoL at any time point.

Conclusion
Data show that preoperative motor and affective symptoms drive both QoL baseline status and changes in QoL after STN-DBS surgery. Thus, these clinical parameters need to be assessed appropriately to provide comprehensive presurgical advice to patients suffering from PD.
NiMBaLWear analytics pipeline for wearable sensors: a modular, open-source platform for evaluating multiple domains of health and behaviour
Authors: Beyer Kit B. , Weber Kyle S. , Cornish Benjamin F. , Vert Adam , Thai Vanessa , Godkin F. Elizabeth , McIlroy William E. , Van Ooteghem Karen 
Published: February 2024

Abstract
Background
Recent technological advances have led to a surge in the use of wearable devices for personal health and fitness monitoring; however, clinical uptake of wearable devices for remote or ‘free-living’ measurement of daily health-related behavior has lagged. To advance the field, there is need for valid and reliable outcomes across multiple health domains specific to the cohorts or patients of interest and centralized tools to build capacity for use of these data. The NiMBaLWear pipeline provides a flexible and integrated approach to wearables analytics applied to raw sensor data that considers multiple, inter-related physiological and behavioral signals to provide a holistic view of health status.

Results & discussion
NiMBaLWear is a modular, open-source, wearable sensor analytic pipeline that quantifies physical activity, mobility, and sleep from raw single- or multi-sensor free-living data collected over multiple days. Data captured from any device, in different possible formats, are standardized prior to processing. Data preparation includes accelerometer autocalibration, cross-device synchronization, and non-wear detection. Validated, domain-specific algorithms detect events, generate outcome measures, and output standardized tabular data and user-friendly summary collection reports. NiMBaLWear was developed in Python using an iterative and incremental software development process, which included a combination of semi-automated inspection and expert review of data collected from 286 participants across two remote-measurement studies. A comparative analysis revealed a paucity of open-source packages capable of deriving and sharing health-related behavioral outcomes across multiple domains from multi-sensor wearables data. Forthcoming improvements to the pipeline will leverage sensor fusion techniques to add new, and refine existing, domain- and disease-specific analytics, and optimize pipeline accessibility and reporting.

Conclusion
The NiMBaLWear pipeline transforms raw multi-sensor wearables data into accurate and relevant outcomes across multiple health domains to objectively characterize and measure an individual’s daily health-related behavior. NiMBaLWear’s focus on high-quality, clinically relevant outcomes, as well as end-user optimization, provides a foundation for innovation to improve the utility of wearables for clinical care and self-management of health.
Association of Baseline Tumor-Specific Neoantigens and CD8+ T-Cell Infiltration With Immune-Related Adverse Events Secondary to Immune Checkpoint Inhibitors
Authors: Kerepesi Csaba , Abushukair Hassan Mohammed , Ricciuti Biagio , Nassar Amin H. , Adib Elio , Alessi Joao V. , Pecci Federica , Rakaee Mehrdad , Fadlullah Muhammad Zaki Hidayatullah , Tőkés Anna-Mária , Rodig Scott J. , Awad Mark M. , Tan Aik Choon , Bakacs Tibor , Naqash Abdul Rafeh 
Published: February 2024

PURPOSE Recent evidence has shown that higher tumor mutational burden strongly correlates with an increased risk of immune-related adverse events (irAEs). By using an integrated multiomics approach, we further studied the association between relevant tumor immune microenvironment (TIME) features and irAEs. METHODS Leveraging the US Food and Drug Administration Adverse Event Reporting System, we extracted cases of suspected irAEs to calculate the reporting odds ratios (RORs) of irAEs for cancers treated with immune checkpoint inhibitors (ICIs). TIME features for 32 cancer types were calculated on the basis of the cancer genomic atlas cohorts and indirectly correlated with each cancer's ROR for irAEs. A separate ICI-treated cohort of non–small-cell lung cancer (NSCLC) was used to evaluate the correlation between tissue-based immune markers (CD8+, PD-1/L1+, FOXP3+, tumor-infiltrating lymphocytes [TILs]) and irAE occurrence. RESULTS The analysis of 32 cancers and 33 TIME features demonstrated a significant association between irAE RORs and the median number of base insertions and deletions (INDEL), neoantigens (r = 0.72), single-nucleotide variant neoantigens (r = 0.67), and CD8+ T-cell fraction (r = 0.51). A bivariate model using the median number of INDEL neoantigens and CD8 T-cell fraction had the highest accuracy in predicting RORs (adjusted r2 = 0.52, P = .002). Immunoprofile assessment of 156 patients with NSCLC revealed a strong trend for higher baseline median CD8+ T cells within patients' tumors who experienced any grade irAEs. Using machine learning, an expanded ICI-treated NSCLC cohort (n = 378) further showed a treatment duration–independent association of an increased proportion of high TIL (>median) in patients with irAEs (59.7% v 44%, P = .005). This was confirmed by using the Fine-Gray competing risk approach, demonstrating higher baseline TIL density (>median) associated with a higher cumulative incidence of irAEs ( P = .028). CONCLUSION Our findings highlight a potential role for TIME features, specifically INDEL neoantigens and baseline-immune infiltration, in enabling optimal irAE risk stratification of patients.
GAD65Abs Are Not Associated With Beta-Cell Dysfunction in Patients With T2D in the GRADE Study
Authors: Hampe Christiane S , Shojaie Ali , Brooks-Worrell Barbara , Dibay Sepideh , Utzschneider Kristina , Kahn Steven E , Larkin Mary E , Johnson Mary L , Younes Naji , Rasouli Neda , Desouza Cyrus , Cohen Robert M , Park Jean Y , Florez Hermes J , Valencia Willy Marcos , Palmer Jerry P , Balasubramanyam Ashok 
Published: February 2024

Abstract

Context
Autoantibodies directed against the 65-kilodalton isoform of glutamic acid decarboxylase (GAD65Abs) are markers of autoimmune type 1 diabetes (T1D) but are also present in patients with Latent Autoimmune Diabetes of Adults and autoimmune neuromuscular diseases, and also in healthy individuals. Phenotypic differences between these conditions are reflected in epitope-specific GAD65Abs and anti-idiotypic antibodies (anti-Id) against GAD65Abs. We previously reported that 7.8% of T2D patients in the GRADE study have GAD65Abs but found that GAD65Ab positivity was not correlated with beta-cell function, glycated hemoglobin (HbA1c), or fasting glucose levels.

Context
In this study, we aimed to better characterize islet autoantibodies in this T2D cohort. This is an ancillary study to NCT01794143.

Methods
We stringently defined GAD65Ab positivity with a competition assay, analyzed GAD65Ab-specific epitopes, and measured GAD65Ab-specific anti-Id in serum.

Results
Competition assays confirmed that 5.9% of the patients were GAD65Ab positive, but beta-cell function was not associated with GAD65Ab positivity, GAD65Ab epitope specificity or GAD65Ab-specific anti-Id. GAD65-related autoantibody responses in GRADE T2D patients resemble profiles in healthy individuals (low GAD65Ab titers, presence of a single autoantibody, lack of a distinct epitope pattern, and presence of anti-Id to diabetes-associated GAD65Ab). In this T2D cohort, GAD65Ab positivity is likely unrelated to the pathogenesis of beta-cell dysfunction.

Conclusion
Evidence for islet autoimmunity in the pathophysiology of T2D beta-cell dysfunction is growing, but T1D-associated autoantibodies may not accurately reflect the nature of their autoimmune process.
Genetic Myelopathies
Authors: Stavros Kara 
Published: February 2024

ABSTRACT

OBJECTIVE
This article provides an overview of genetic myelopathies, a diverse group of inherited, degenerative conditions that may be broadly categorized as motor neuron disorders, disorders of spinocerebellar degeneration, leukodystrophies, and hereditary spastic paraplegia. Clinical examples from each category are provided to illustrate the spectrum of genetic myelopathies and their distinguishing features that aid in differentiating genetic myelopathies from potentially treatable acquired causes of myelopathy.

LATEST DEVELOPMENTS
Advances in genetic testing have vastly enhanced current knowledge of genetic myelopathies and the ability to diagnose and provide appropriate counseling to patients and their families. However, potential health care disparities in access to genetic testing is a topic that must be further explored. Although treatment for most of these conditions is typically supportive, there have been recent therapeutic breakthroughs in treatments for amyotrophic lateral sclerosis, spinal muscular atrophy, and Friedreich ataxia.

ESSENTIAL POINTS
Genetic myelopathies may present with chronic and progressive symptoms, a family history of similar symptoms, and involvement of other structures outside of the spinal cord. Imaging often shows spinal cord atrophy, but cord signal change is rare. Exclusion of reversible causes of myelopathy is a key step in the diagnosis. There are many different causes of genetic myelopathies, and in some cases, symptoms may overlap, which underscores the utility of genetic testing in confirming the precise underlying neurologic condition.
Immune-Mediated Myelopathies
Authors: Levy Michael 
Published: February 2024

ABSTRACT

OBJECTIVE
Immune-mediated myelopathies are conditions in which the immune system attacks the spinal cord. This article describes the distinguishing characteristics of immune-mediated myelopathies and treatment strategies for patients affected by these disorders.

LATEST DEVELOPMENTS
New biomarkers, such as aquaporin 4 and myelin oligodendrocyte glycoprotein antibodies, in the blood and spinal fluid have led to the identification of antigen-specific immune-mediated myelopathies and approved therapies to prevent disease progression.

ESSENTIAL POINTS
The first step in the diagnosis of an immune-mediated myelopathy is confirming that the immune system is the cause of the attack by excluding non–immune-mediated causes. The second step is to narrow the differential diagnosis based on objective biomarkers such as serology and MRI patterns. The third step is to treat the specific immune-mediated myelopathy by using evidence-based medicine.
Structural Myelopathies
Authors: Onofrei Ligia V. 
Published: February 2024

ABSTRACT

Objective
This article illustrates the clinical importance, diagnosis, and management of degenerative and nondegenerative structural myelopathies. It also aims to create a diagnostic approach for the evaluation of patients with suspected degenerative myelopathies.

Latest Developments
There is considerable interest in developing diagnostic methods that can assist in deciding if surgery is indicated in patients with structural myelopathy and the optimal timing for surgery. Diffusion tensor imaging has emerged as a promising imaging modality although it is not used routinely in clinical practice. Neuroprotective medications and interventions are being studied in patients with degenerative myelopathies.

Essential Points
Structural myelopathies and particularly degenerative myelopathies are common disorders that are routinely encountered in clinical practice, with symptoms that frequently overlap with other neurologic disorders. The prompt diagnosis and treatment of patients are essential in achieving good functional outcomes.
Traumatic Spinal Cord Injury
Authors: Izzy Saef 
Published: February 2024

ABSTRACT

OBJECTIVE
This article provides a review of the initial clinical and radiologic evaluation and treatment of patients with traumatic spinal cord injuries. It specifically highlights essential knowledge for neurologists who encounter patients with these complex injuries.

LATEST DEVELOPMENTS
There has been improvement in the care of patients with traumatic spinal cord injuries, particularly in the prehospital evaluation, approach for immediate immobilization, standardized spinal clearance, efficient triage, and transportation of appropriate patients to traumatic spinal cord injury specialized centers. Advancements in spinal instrumentation have improved the surgical management of spinal fractures and the ability to manage patients with spinal mechanical instability. The clinical evidence favors performing early surgical decompression and spine stabilization within 24 hours of traumatic spinal cord injuries, regardless of the severity or location of the injury. There is no evidence that supports the use of neuroprotective treatments to improve outcomes in patients with traumatic spinal cord injuries. The administration of high-dose methylprednisolone, which is associated with significant systemic adverse effects, is strongly discouraged. Early and delayed mortality rates continue to be high in patients with traumatic spinal cord injuries, and survivors often confront substantial long-term physical and functional impairments. Whereas the exploration of neuroregenerative approaches, such as stem cell transplantation, is underway, these methods remain largely investigational. Further research is still necessary to advance the functional recovery of patients with traumatic spinal cord injuries.

ESSENTIAL POINTS
Traumatic spinal cord injury is a complex and devastating condition that leads to long-term neurologic deficits with profound physical, social, and vocational implications, resulting in a diminished quality of life, particularly for severely affected patients. The initial management of traumatic spinal cord injuries demands comprehensive interdisciplinary care to address the potentially catastrophic multisystem effects. Ongoing endeavors are focused on optimizing and customizing initial management approaches and developing effective therapies for neuroprotection and neuroregeneration to enhance long-term functional recovery.
Infectious Myelopathies
Authors: Fletcher Anita M. , Bhattacharyya Shamik 
Published: February 2024

ABSTRACT

Objective
Infectious myelopathy of any stage and etiology carries the potential for significant morbidity and mortality. This article details the clinical presentation, risk factors, and key diagnostic components of infectious myelopathies with the goal of improving the recognition of these disorders and guiding subsequent management.

Latest Developments
Despite our era of advanced multimodal imaging and laboratory diagnostic technology, a causative organism often remains unidentified in suspected infectious and parainfectious myelopathy cases. To improve diagnostic capability, newer technologies such as metagenomics are being harnessed to develop diagnostic assays with a greater breadth of data from each specimen and improvements in infection identification. Conventional assays have been optimized for improved sensitivity and specificity.

Essential Points
Prompt recognition and treatment of infectious myelopathy decreases morbidity and mortality. The key diagnostic tools include serologies, CSF analysis, and imaging; however clinical presentation, epidemiologic risk factors, and history of recent illness are all vital to making the proper diagnosis because current laboratory and imaging modalities are often inconclusive. The cornerstone of recommended treatment is targeted antimicrobials with appropriate immune modulation, surgical intervention, supportive care, and interdisciplinary involvement, all of which further improve outcomes for patients with infectious myelopathy.
Intrasellar Arachnoid Diverticulae as a Risk Factor for Intraoperative Cerebrospinal Fluid Leakage in Patients Undergoing Endoscopic Transsphenoidal Surgery
Authors: Sarkar Sauradeep , Corrales C. Eduardo , Laws Edward R. , Smith Timothy R. 
Published: February 2024

BACKGROUND AND OBJECTIVES:
Intrasellar arachnoid diverticulae can often be identified on preoperative imaging in patients undergoing endoscopic transsphenoidal surgery. The objective of this study was to characterize arachnoid diverticulae both qualitatively and quantitatively in a large institutional cohort of patients with pituitary tumors and to evaluate its association with intraoperative cerebrospinal fluid (CSF) leak.

METHODS:
Preoperative imaging studies of 530 patients who underwent primary endoscopic transsphenoidal resection of pituitary tumors were examined both quantitatively and qualitatively for the presence of an intrasellar arachnoid diverticulum. A matched cohort analysis was performed to compare patients with a “significant” (>50% sellar depth) diverticulum with those with nonsignificant/no diverticulum. Morphologically, diverticulae were separately classified as Type 1 (ventral CSF cleft with no tumor/gland tissue between sellar face and infundibulum) or Type 2 (central CSF cleft with tumor/gland tissue between sellar face and infundibulum).

RESULTS:
Arachnoid diverticulae were noted in 40.2% of cases, and diverticulum depth was linearly correlated with tumor size and body mass index. A significant diverticulum was identified in 66 cases (12.5%) and was significantly associated with the functional tumor subtype (P = .005) and intraoperative CSF leak (P < .001). Type 1 clefts were associated with nonfunctional pathology (P = .034) and the presence of suprasellar extension (P = .035) and tended to be deeper than Type 2 clefts (P < .001), with a higher incidence of intraoperative CSF leak (P = .093). On logistic regression analysis, only the presence of a significant diverticulum was independently associated with intraoperative CSF leak (odds ratio 4.545; 95% CI 2.418-8.544; P < .001).

CONCLUSION:
The presence of an intrasellar arachnoid diverticulum should alert the surgeon to an elevated risk of intraoperative CSF leak during transsphenoidal surgery for pituitary tumors. A relatively limited surgical exposure tailored to the craniocaudal extent of the sellar pathology should be considered in these patients.
Advancing Sustainable Development, Responsibility and Civic Engagement in Greece: Analyzing the Interplay of Education, Employment, and Political Involvement within the European Policy Framework for Youth
Authors: Taliouris Evangelos , Chourdakis Marinos , Moraitakis Nikolaos 
Published: February 2024

Democracy, social welfare and environmental modernization are issues in EU political agenda that deal with the future generations, therefore this paper will elaborate the political will for European Youth in EU and Greece by 2030. More specifically, this paper will analyze the social challenges that youth faced in EU since 2020 from Covid-19 to the war period and the future via Sustainable Development Agenda. The social challenges will be analyzed first towards the Sustainable Development Goals (4, 8) in EU and Greece, whilst it is necessary these challenges to be associated with the sense of political belonging in EU for youth. EU has launched a strategy for youth that is mainly based on 11 Goals under public discussion and consultation “The Euro-pean Youth Goals 2019-2027”. During crisis periods (financial, Covid-19, war), the negative socioeconomic outcomes were an uncertain risk for youth regarding their SD potentials, while political engagement and the sence of political belonging in EU pub-lic affairs seems to be associated with goals 9 and 11 in Youth Strategy. Although EU and its member states (including Greece) have a significant institutional tradition in social welfare and considered as one of the best place to live, political steps need to be taken in order to ensure youth capability to meet their own needs. These values are strongly associated with SD and its definition 36 years after Brundtland report and the significant institutional tradition in social welfare, which is considered very im-portant in order future generation to ensure youth capability to meet their own needs in Europe and Greece towards democracy, social welfare, environmental moderniza-tion and economic competitiveness.
Η Μεταναστευτική Πολιτική ως η Μεγάλη Πρόκληση της Ευρωπαϊκής Πολιτικής
Authors: Μυρωτής Παναγιώτης 
Published: February 2024

Από το 2014 και έπειτα ένας νέος τομέας πολιτικής ενσωματώθηκε στην εθνική αλλά και ευρωπαϊκή ατζέντα, ένα νέο ζήτημα, αυτό της μετανάστευσης. Η μεταναστευτική κρίση που κορυφώθηκε το 2015 είχε ως αποτέλεσμα, όχι μόνο την μετακίνηση μεγάλου αριθμού μεταναστών προς την Ευρώπη, αλλά ταυτόχρονα πολλές τριβές και νέες συγκρούσεις μεταξύ των καρτών- μελών της Ευρωπαϊκής Ένωσης. Στόχος του εν λόγω κειμένου είναι να εστιάσει στην υφιστάμενη κατάσταση στον τομέα της ευρωπαϊκής μεταναστευτικής πολιτικής, να αναδείξει τα ζητήματα που προκύπτουν σήμερα από το φαινόμενο της μετανάστευσης και εν κατακλείδι να επιχειρήσει να προτείνει κάποιους χειρισμούς, που μπορούν να ‘ελέγξουν’ και να διαχειριστούν αυτό το πολυδιάστατο φαινόμενο. Η απόπειρα ανάδειξης του εν λόγου στόχου γίνεται μέσω της μελέτης πρωτογενών πηγών (στατιστικά στοιχεία φορέων αποφάσεις θεσμών) καθώς και δευτερογενών (αναλύσεις και μελέτες για το ζήτημα).