bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare resource utilization and costs associated with generalized myasthenia gravis: a retrospective matched cohort study using the National Health Insurance Research Database in Taiwan
Authors: Shen Shih-Pei , Herr Keira Joann , Liu Yanfang , Yang Chih-Chao , Tang Chao-Hsiun 
Published: July 2023

BackgroundWe estimated healthcare resource utilization (HRU) and costs in patients with generalized myasthenia gravis (gMG) in Taiwan.MethodsThis retrospective population-based, matched cohort study used the National Health Insurance Research Database to identify prevalent patients with gMG (cases) in 2019. In total, 2537 cases were matched (1:4) by age, sex, and urbanization level to 10148 randomly selected patients without gMG (comparators). A generalized linear regression model predicted the frequency of HRU and costs among service users. Costs attributable to gMG were obtained by subtracting all-cause HRU costs incurred by comparators from cases.ResultsThe mean age of all patients was 54.99 years and 55.97% were female. Compared with comparators, cases had significantly higher rates of hypertension (33.03%/24.26%), diabetes mellitus (18.92%/11.37%), malignancies (16.00%/4.08%), cardiovascular disease (11.35%/8.12%), thyroid-related conditions (5.99%/1.16%), respiratory illness/disorders (4.38%/1.22%), and neurotic disorders (4.65%/2.6%). Amongst users of healthcare resources, cases had a mean 10 additional outpatient visits, 0.62 inpatient stays, and 0.49 emergency room visits in 2019 compared with comparators (p &lt; 0.0001 for all). The mean (standard deviation) difference in all-cause healthcare costs between cases and comparators was NT$ 94997 (76431) [US$ 3133 (2521)], and was significantly higher for all categories (outpatient, inpatient, emergency room, drugs; p &lt; 0.0001 for all). Among employed persons, 13.18%/7.59% of cases/comparators changed employment status during the study (p &lt; 0.0001).ConclusiongMG presents a substantial burden on HRU and healthcare costs in Taiwan. A high attrition rate from full-time employment suggests additional societal costs. Improved treatments are needed to alleviate the burden of disease on individuals, healthcare systems, and economies.
Ataxia-telangiectasia in China: a case report of a novel ATM variant and literature review
Authors: Shao Li , Wang Haoyi , Xu Jianbo , Qi Ming , Yu Zhaonan , Zhang Jing 
Published: July 2023

BackgroundAtaxia-telangiectasia (A-T) is a multisystem genetic disorder involving ataxia, oculocutaneous telangiectasia, and immunodeficiency caused by biallelic pathogenic variants in the ATM gene. To date, most ATM variants have been reported in the Caucasian population, and few studies have focused on the genotype–phenotype correlation of A-T in the Chinese population. We herein present a Chinese patient with A-T who carries compound heterozygous variants in the ATM gene and conducted a literature review for A-T in China.Case presentationA 7-year-old Chinese girl presented with growth retardation, ataxia, medium ocular telangiectasia, cerebellar atrophy, and elevated serum alpha-fetoprotein (AFP) level, which supported the suspicion of A-T. Notably, the serum levels of immunoglobulins were all normal, ruling out immunodeficiency. Exome sequencing and Sanger sequencing revealed two likely pathogenic ATM variants, namely NM_000051.4: c.4195dup (p.Thr1399Asnfs*15) and c.6006 + 1G&gt;T (p.?), which were inherited from her father and mother, respectively. From the Chinese literature review, we found that there was a marked delay in the diagnosis of A-T, and 38.9% (7/18) of A-T patients did not suffer from immunodeficiency in China. No genotype–phenotype correlation was observed in this group of A-T patients.ConclusionThese results extend the genotype spectrum of A-T in the Chinese population and imply that the diagnosis of A-T in China should be improved.
Strain-specific changes in nucleus accumbens transcriptome and motivation for palatable food reward in mice exposed to maternal separation
Authors: Benoit Simon , Henry Mathilde , Fneich Sara , Mathou Alexia , Xia Lin , Foury Aline , Jouin Mélanie , Junien Claudine , Capuron Lucile , Jouneau Luc , Moisan Marie-Pierre , Delpierre Cyrille , Gabory Anne , Darnaudéry Muriel 
Published: July 2023

IntroductionIn humans, adversity in childhood exerts enduring effects on brain and increases the vulnerability to psychiatric diseases. It also leads to a higher risk of eating disorders and obesity. Maternal separation (MS) in mice has been used as a proxy of stress during infancy. We hypothesized that MS in mice affects motivation to obtain palatable food in adulthood and changes gene expression in reward system.MethodsMale and female pups from C57Bl/6J and C3H/HeN mice strains were subjected to a daily MS protocol from postnatal day (PND) 2 to PND14. At adulthood, their motivation for palatable food reward was assessed in operant cages.ResultsCompared to control mice, male and female C3H/HeN mice exposed to MS increased their instrumental response for palatable food, especially when the effort required to obtain the reward was high. Importantly, this effect is shown in animals fed ad libitum. Transcriptional analysis revealed 375 genes differentially expressed in the nucleus accumbens of male MS C3H/HeN mice compared to the control group, some of these being associated with the regulation of the reward system (e.g., Gnas, Pnoc). Interestingly, C57Bl/6J mice exposed to MS did not show alterations in their motivation to obtain a palatable reward, nor significant changes in gene expression in the nucleus accumbens.ConclusionMS produces long-lasting changes in motivation for palatable food in C3H/HeN mice, but has no impact in C57Bl/6J mice. These behavioral alterations are accompanied by drastic changes in gene expression in the nucleus accumbens, a key structure in the regulation of motivational processes.
Nutritional, bioactive compounds content, and antioxidant activity of brown seaweeds from the Red Sea
Authors: Ismail Mona M. , El Zokm Gehan M. , Miranda Lopez José M. 
Published: July 2023

IntroductionBrown seaweeds are excellent sources of bioactive molecules with a wide range of pharmacological effects, whose content can vary depending on several factors, including the origin and the environment in which the algae grow.MethodsThis study aimed to estimate 19 compounds regarding primary and secondary metabolites of eight brown macroalgal species from a clean Egyptian Red Sea coast. A proximate analysis, pigment, phenolic compounds, and vitamin contents were determined. In addition, the energy content and antioxidant activity were estimated to explore the potential application of algae as functional foods to encourage the species’ commercialization.ResultsBased on the chemical composition, Polycladia myrica was the most valuable species, with a comparatively high protein content of 22.54%, lipid content of 5.21%, fucoxanthin content of 3.12 μg/g, β-carotene content of 0.55 mg/100 g, and carbohydrate content of 45.2%. This species also acts as a great source of vitamin C, flavonoids, tannins, phenol content and total antioxidant capacity.DiscussionThe antioxidant activity of the selected algae indicated that its phenol, vitamin and pigment contents were powerful antioxidant compounds based on the structure–activity relationships. This result was verified by the strong correlation in statistical analysis at the 95% confidence level. From a worldwide perspective and based on the obtained results, these brown species may be reinforced as an essential line in future foods.
Questionnaire-based analysis of autism spectrum disorders and gastrointestinal symptoms in children and adolescents: a systematic review and meta-analysis
Authors: Gan Huizhong , Su Yanhong , Zhang Linlin , Huang Guolin , Lai Ciai , Lv Ying , Li Yongchun 
Published: July 2023

BackgroundGastrointestinal (GI) symptoms are frequently experienced by children with autism spectrum disorder (ASD), and these symptoms cause difficulties for these children and their families. However, studies of GI symptom prevalence differ significantly. This meta-analysis aimed to analyze the prevalence of GI symptoms in children with ASD.Methods and findingsPubMed, Scopus, Web of Science, EMBASE were electronically searched to collect all literature on gastrointestinal symptoms of children with ASD collected through questionnaires or scales from January 2012 to May 2021. Four researchers independently scanned the literature and extracted information on general characteristics. First author name, year of publication, geographical location, type of study, sample sizes of ASD and control (if any) children, sex and average age, number of GI cases, number of GI symptoms, GI assessment tools (gastrointestinal symptoms scale), autism diagnosis methods, and other necessary data were collected and analyzed using Stata V16. The questionnaires included the Rome, 6-GSI, GIQ, GSRS, GSIQ, ADI-R, PedsQL-GI, parent-report, GI-related, and self-administered questionnaires. Compared with typically developing (TD) children, the odds ratio for In children with ASD with at least one GI symptom was 3.64, and the total prevalence was 55%. The cumulative prevalence rates of various symptoms were summarized, showing that 37% of children with ASD had constipation, 21% had abdominal pain, 19% had diarrhea, 8% had vomiting, and 23% had abdominal distension.ConclusionsThe results of this meta-analysis on GI symptoms in ASD show that patients with ASD are more likely to develop symptoms than TD children. The prevalence of GI symptoms in In children with ASD was 55%.Systematic Review Registrationwww.crd.york.ac.uk/PROSPERO, identifier, #CRD42017080579.
Individualized antibiotic dosage regimens for patients with augmented renal clearance
Authors: Shi A-Xi , Qu Qiang , Zhuang Hai-Hui , Teng Xin-Qi , Xu Wei-Xin , Liu Yi-Ping , Xiao Yi-Wen , Qu Jian 
Published: July 2023

Objectives: Augmented renal clearance (ARC) is a state of enhanced renal function commonly observed in 30%–65% of critically ill patients despite normal serum creatinine levels. Using unadjusted standard dosing regimens of renally eliminated drugs in ARC patients often leads to subtherapeutic concentrations, poor clinical outcomes, and the emergence of multidrug-resistant bacteria. We summarized pharmaceutical, pharmacokinetic, and pharmacodynamic research on the definition, underlying mechanisms, and risk factors of ARC to guide individualized dosing of antibiotics and various strategies for optimizing outcomes.Methods: We searched for articles between 2010 and 2022 in the MEDLINE database about ARC patients and antibiotics and further provided individualized antibiotic dosage regimens for patients with ARC.Results: 25 antibiotic dosage regimens for patients with ARC and various strategies for optimization of outcomes, such as extended infusion time, continuous infusion, increased dosage, and combination regimens, were summarized according to previous research.Conclusion: ARC patients, especially critically ill patients, need to make individualized adjustments to antibiotics, including dose, frequency, and method of administration. Further comprehensive research is required to determine ARC staging, expand the range of recommended antibiotics, and establish individualized dosing guidelines for ARC patients.
Lunar and mars gravity induce similar changes in spinal motor control as microgravity
Authors: Swanenburg Jaap , Easthope Christopher A. , Meinke Anita , Langenfeld Anke , Green David A. , Schweinhardt Petra 
Published: July 2023

Introduction: Once more, plans are underway to send humans to the Moon or possibly even to Mars. It is therefore, important to know potential physiological effects of a prolonged stay in space and to minimize possible health risks to astronauts. It has been shown that spinal motor control strategies change during microgravity induced by parabolic flight. The way in which spinal motor control strategies change during partial microgravity, such as that encountered on the Moon and on Mars, is not known.Methods: Spinal motor control measurements were performed during Earth, lunar, Mars, and micro-gravity conditions and two hypergravity conditions of a parabola. Three proxy measures of spinal motor control were recorded: spinal stiffness of lumbar L3 vertebra using the impulse response, muscle activity of lumbar flexors and extensors using surface electromyography, and lumbar curvature using two curvature distance sensors placed at the upper and lower lumbar spine. The participants were six females and six males, with a mean age of 33 years (standard deviation: 7 years).Results: Gravity condition had a statistically significant (Friedmann tests) effect spinal stiffness (p &lt; 0.001); on EMG measures (multifidus (p = 0.047), transversus abdominis (p &lt; 0.001), and psoas (p &lt; 0.001) muscles) and on upper lumbar curvature sensor (p &lt; 0.001). No effect was found on the erector spinae muscle (p = 0.063) or lower curvature sensor (p = 0.170). Post hoc tests revealed a significant increase in stiffness under micro-, lunar-, and Martian gravity conditions (all p’s &lt; 0.034). Spinal stiffness decreased under both hypergravity conditions (all p’s ≤ 0.012) and decreased during the second hypergravity compared to the first hypergravity condition (p = 0.012).Discussion: Micro-, lunar-, and Martian gravity conditions resulted in similar increases in spinal stiffness, a decrease in transversus abdominis muscle activity, with no change in psoas muscle activity and thus modulation of spinal motor stabilization strategy compared to those observed under Earth’s gravity. These findings suggest that the spine is highly sensitive to gravity transitions but that Lunar and Martian gravity are below that required for normal modulation of spinal motor stabilization strategy and thus may be associated with LBP and/or IVD risk without the definition of countermeasures.
Differential effects of two-hit models of acute and ventilator-induced lung injury on lung structure, function, and inflammation
Authors: Bilodeaux Jill , Farooqi Huda , Osovskaya Maria , Sosa Alexander , Wallbank Alison , Knudsen Lars , Sottile Peter D. , Albers David J. , Smith Bradford J. 
Published: July 2023

Acute respiratory distress syndrome (ARDS) and acute lung injury have a diverse spectrum of causative factors including sepsis, aspiration of gastric contents, and near drowning. Clinical management of severe lung injury typically includes mechanical ventilation to maintain gas exchange which can lead to ventilator-induced lung injury (VILI). The cause of respiratory failure is acknowledged to affect the degree of lung inflammation, changes in lung structure, and the mechanical function of the injured lung. However, these differential effects of injury and the role of etiology in the structure-function relationship are not fully understood. To address this knowledge gap we caused lung injury with intratracheal hydrochloric acid (HCL) or endotoxin (LPS) 2 days prior to ventilation or with an injurious lavage (LAV) immediately prior to ventilation. These injury groups were then ventilated with high inspiratory pressures and positive end expiratory pressure (PEEP) = 0 cmH2O to cause VILI and model the clinical course of ARDS followed by supportive ventilation. The effects of injury were quantified using invasive lung function measurements recorded during PEEP ladders where the end-expiratory pressure was increased from 0 to 15 cm H2O and decreased back to 0 cmH2O in steps of 3 cmH2O. Design-based stereology was used to quantify the parenchymal structure of lungs air-inflated to 2, 5, and 10 cmH2O. Pro-inflammatory gene expression was measured with real-time quantitative polymerase chain reaction and alveolocapillary leak was estimated by measuring bronchoalveolar lavage protein content. The LAV group had small, stiff lungs that were recruitable at higher pressures, but did not demonstrate substantial inflammation. The LPS group showed septal swelling and high pro-inflammatory gene expression that was exacerbated by VILI. Despite widespread alveolar collapse, elastance in LPS was only modestly elevated above healthy mice (CTL) and there was no evidence of recruitability. The HCL group showed increased elastance and some recruitability, although to a lesser degree than LAV. Pro-inflammatory gene expression was elevated, but less than LPS, and the airspace dimensions were reduced. Taken together, those data highlight how different modes of injury, in combination with a 2nd hit of VILI, yield markedly different effects.
The effectiveness of adjusting resistance training loads through velocity-based techniques in experienced sprinters: a case series study
Authors: Muñoz de la Cruz Violeta , Agudo-Ortega Aarón , Sorgente Vincenzo , Turner Anthony P. , González-Ravé José María 
Published: July 2023

Introduction: This study aimed to determine if adjusting the loads via velocity-based training (VBT) in each session is more efficient in monitoring the relative intensity than programming loads assessing 1RM pre-training.Methods: To achieve this, six national level sprinters were randomly divided into two groups, i.e., adjusting loads (AL, n = 3) and not adjusting loads (NAL, n = 3), during twelve sessions of a squat training (ST) program. During this training intervention, the AL group adjusted the intensity for each session in the squat exercise depending on the speed the load was lifted after warmup. The NAL group, instead, progressed in the squat exercise referring to the 1RM estimated at pre-test. In addition, Parallel Squat (PSQ), Countermovement Jump (CMJ), Squat Jump (SJ), 30 m sprint standing start (30S) and 30 m sprint flying start (30F) tests were carried out before and after conducting the ST program.Results: Interestingly, AL performed the ST near their estimated velocities at 70%—75% 1RM, however with a wider gap at 80%—85% 1RM. The NAL group, instead, did not presented such a detectable behaviour across the whole ST. Moreover, both groups demonstrated improved performances in PSQ, CMJ, and SJ, whereas there were little changes in 30S and 30F after ST. Additionally, AL obtained a greater effect size than NAL in PSQ (0.60 vs. 0.35) but lower effect size in CMJ, SJ, 30S, and 30F (0.41 vs. 0.63, 0.30 vs. 0.40, 0.04 vs. 0.28 and 0.22 vs. 0.24). However, percentage change was greater in AL in all tests.Discussion: Based on these findings, we can conclude that further investigation into the AL strategy in VBT is warranted for sprinter athletes’ daily strength practices. The AL technique shows promise as a valuable tool for accurately adjusting and monitoring medium-high training loads to ensure they align with the intended intensity.
Pre-pandemic family resources and child self-regulation in children’s internalizing problems during COVID-19: a multi-level social-ecological framework for emotional resilience
Authors: Chen Luxi , Yeung Wei-Jun Jean 
Published: July 2023

IntroductionChildren’s psychological adjustment to adverse events can be determined by multiple risk and resilience factors. This study explored multi-level protective factors against children’s internalizing problems and investigated the mechanism regarding how diverse environmental and child-level resources influence children’s mental health in the context of COVID-19.MethodsOur participants included a nationally representative sample of 2,619 young children (48.3% girls) and their primary caregivers (95.1% mothers) in Singapore. They were a subset of the participants in the Singapore Longitudinal Early Development Study (SG LEADS). Data were collected over two waves—before the outbreak of the COVID-19 pandemic (Wave 1) when these children aged 3 to 6, and during the second year of the pandemic (Wave 2). Primary caregivers completed measures of verbal cognitive ability, self-control, economic stress, and positive and negative parental control in Wave 1. Children’s self-regulation was assessed by the Delay of Gratification task in Wave 1, and their internalizing problems were rated by their primary caregivers in both waves. Other pre-pandemic family and community characteristics were collected as covariates. Structural equation modeling was performed.ResultsPre-pandemic parental resources (i.e., verbal cognitive ability, self-control, and low economic stress) predicted children’s fewer internalizing problems during the pandemic and less aggravation of internalizing problems from before to during the pandemic, through more positive parental control (i.e., limit setting) and less negative parental control (i.e., harsh discipline). Moreover, children’s self-regulation during early childhood was predicted by their primary caregivers’ verbal cognitive ability and self-control, as well as positive parental control. Early childhood self-regulation further alleviated the aggravation of internalizing problems over time. Among the covariates, parental education, family income, parental psychological well-being, living with both parents, having a live-in domestic helper, and neighborhood quality also longitudinally predicted fewer child internalizing problems.DiscussionOur findings underscore the importance of nurturing children’s emotional resilience under adverse and uncertain circumstances by boosting protective factors in their social-ecological system, including community-, family-, parent-, and child-level resources.
Spatiotemporal parameters from remote smartphone-based gait analysis are associated with lower extremity functional scale categories
Authors: Rozanski Gabriela , Delgado Andrew , Putrino David 
Published: July 2023

ObjectiveSelf-report tools are recommended in research and clinical practice to capture individual perceptions regarding health status; however, only modest correlations are found with performance-based results. The Lower Extremity Functional Scale (LEFS) is one well-validated measure of impairment affecting physical activities that has been compared with objective tests. More recently, mobile gait assessment software can provide comprehensive motion tracking output from ecologically valid environments, but how this data relates to subjective scales is unknown. Therefore, the association between the LEFS and walking variables remotely collected by a smartphone was explored.MethodsProprietary algorithms extracted spatiotemporal parameters detected by a standard integrated inertial measurement unit from 132 subjects enrolled in physical therapy for orthopedic or neurological rehabilitation. Users initiated ambulation recordings and completed questionnaires through the OneStep digital platform. Discrete categories were created based on LEFS score cut-offs and Analysis of Variance was applied to estimate the difference in gait metrics across functional groups (Low-Medium-High).ResultsThe main finding of this cross-sectional retrospective study is that remotely-collected biomechanical walking data are significantly associated with individuals' self-evaluated function as defined by LEFS categorization (n = 132) and many variables differ between groups. Velocity was found to have the strongest effect size.DiscussionWhen patients are classified according to subjective mobility level, there are significant differences in quantitative measures of ambulation analyzed with smartphone-based technology. Capturing real-time information about movement is important to obtain accurate impressions of how individuals perform in daily life while understanding the relationship between enacted activity and relevant clinical outcomes.