bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ‘heROIC’ trial: Does the use of a robotic rehabilitation trainer change quality of life, range of movement and function in children with cerebral palsy?
Authors: Grodon Clare , Bassett Paul , Shannon Harriet 
Published: February 2023

AbstractBackgroundChildren with severe cerebral palsy (CP) (GMFCS IV/V) can find it difficult to access equipment that allows them to exercise effectively, potentially impacting their quality of life. Physiotherapists working within special schools are well placed to facilitate increased physical activity as part of the school day. This study explored whether the Innowalk Pro, a robotic rehabilitation trainer, could influence quality of life (measured by the CPCHILD questionnaire), in children with CP, alongside, joint range of movement, spasticity and functional goals of the lower limbs, measured by goniometry, modified Tardieu scale and goal attainment scoring, GAS, respectively.MethodsA prospective single‐arm, pre–post trial was undertaken. The Innowalk Pro was used four times a week for 30 min alongside usual physiotherapy care in a school setting over a 6‐week period. Outcomes were evaluated immediately pre/post intervention and at 6 weeks and 3 months post intervention. Analysis also explored differences between primary and secondary age participants.ResultsTwenty‐seven participants aged 5–18 years with a diagnosis of CP GMFCS IV/V (10 female, 17 male, mean age 12 years) were included from a convenience sample in a special school. Quality of life improved in 36% of participants, the majority of these being secondary aged. Knee extension reduced significantly 3 months post intervention. There were no meaningful changes in spasticity. GAS goals improved in 88% of participants after using the Innowalk Pro. GAS goals tended to decline after a break from using the equipment, with 21% declining by two or more units at 3 months post intervention.ConclusionA 6‐week course of the Innowalk Pro can improve quality of life and functional goals for children with CP aged 5–18 years. After a break of 6–12 weeks, functional goals tend to return to baseline. Further research is needed to explore different prescriptions of the Innowalk Pro, to see if increasing the time used/increasing the frequency or number of weeks it is used for can provide longer lasting benefits.
Parents' experience of the communication process of positivity at newborn screening for metabolic diseases: A qualitative study
Authors: Bani Marco , Russo Selena , Raggi Erika , Gasperini Serena , Motta Serena , Menni Francesca , Furlan Francesca , Cefalo Graziella , Paci Sabrina , Banderali Giuseppe , Marchisio Paola , Biondi Andrea , Strepparava Maria Grazia 
Published: February 2023

AbstractBackgroundThe process of receiving a communication of positivity for metabolic diseases at expanded newborn screening (ENBS) is extremely articulated, involves a variety of actors (parents, maternal and child departments, clinical centres and laboratories) and is open to a variety of outcomes from false positive to true positive cases. Receiving communication of positivity can be highly stressful for parents and requires an adequate communication process to give clear and reliable information without causing excessive worry. This qualitative study describes the parents' experience of receiving a communication of positivity to metabolic diseases at ENBS, and their assessment of the quality of the communication process and steps, with the main aim to identify the process' strengths and weaknesses and to advance tailored recommendations to improve the communication process.MethodFourteen in‐depth, semi‐structured phone interviews were conducted with parents whose children resulted positive to the ENBS. As part of the ENBS communication process, parents received a first phone call communication of positivity and a second in‐person communication at metabolic clinical centres (MCC). The framework analysis method was used to organize the data and identify emerging themes.ResultsParents were largely dissatisfied with the quality and depth of the information received and with the way the healthcare staff delivered the first communication phone call, which failed to create a caring, empathic and safe setting. Many parents tried to reduce the uncertainty by searching online information or consulting with other providers. Nevertheless, the majority of parents described the in‐person visit at MCC as clear, welcoming and reassuring.ConclusionMore efforts are needed to improve the quality of the communication process of the ENBS. Guidelines, recommendations and standard scripts to communicate positivity are needed along with programmes and educational resources to train tailored communication skills.
Nonalcoholic fatty liver disease from a primary care perspective
Authors: Clark Jeanne M. , Cryer Donna R. H. , Morton Michelle , Shubrook Jay H. 
Published: February 2023

AbstractNonalcoholic fatty liver disease (NAFLD) affects up to one‐third of the US population. Approximately one‐fifth of patients with NAFLD have nonalcoholic steatohepatitis (NASH), characterized by hepatocyte damage and inflammation with or without fibrosis. NASH leads to greater risk of liver‐related complications and liver‐related mortality, with the poorest outcomes seen in patients with advanced fibrosis. NASH is also associated with other metabolic comorbidities and conveys an increased risk of adverse cardiovascular outcomes and extrahepatic cancers. Despite its high prevalence, NAFLD is frequently underdiagnosed. This is a significant concern, given that early diagnosis of NAFLD is a key step in preventing progression to NASH. In this review, we describe the clinical impact of NASH from the perspective of both the clinician and the patient. In addition, we provide practical guidance on the diagnosis and management of NASH for primary care providers, who play a pivotal role in the frontline care of patients with NASH, and we use case studies to illustrate real‐world scenarios encountered in the primary care setting.
Role of cathepsin D induced by Porphyromonas gingivalis lipopolysaccharide in periodontitis
Authors: Jeong Hyun Woong , Chang Dong Sik , Kim June Soo , Hwang Young Sun 
Published: February 2023

AbstractPeriodontitis is an inflammatory disease of tooth‐supporting tissues caused by oral bacteria. Periodontal ligament loss and alveolar bone destruction occur in progressive periodontitis. Since gingival crevicular fluids (GCF) reflects the inflammatory environment of the periodontal pocket, it is a very important specimen for developing targets for periodontitis diagnosis. An antibody array was performed using GCF collected from healthy participants and patients with periodontitis to identify the proteolytic enzymes involved in periodontitis. Of 21 targets on the antibody array membrane, kallikrein 6 (KLK6), kallikrein 10 (KLK10), cathepsin A (CathA), and cathepsin D (CathD) showed higher levels in periodontitis GCF than in GCF from healthy participants. Lipopolysaccharide stimulation of Porphyromonas gingivalis (PG‐LPS) in immortalized gingival fibroblasts only increased CathD protein levels among the four targets. The substrate cleavage activity of CathD was increased in PG‐LPS‐treated immortalized gingival fibroblast extract. The PG‐LPS‐induced substrate cleavage effect was abolished by the CathD inhibitor pepstatin A. Osteoclast formation was promoted by treatment with conditioned media from PG‐LPS‐ treated immortalized gingival fibroblasts but inhibited by the CathD inhibitor pepstatin A. These results suggest that PG‐LPS affected the osteoclast formation process by increasing CathD expression in cells around the alveolar bone, thereby participating in periodontitis progression.
Trade‐offs and synergies between ecosystem productivity and stability in temperate grasslands
Authors: Mahaut Lucie , Choler Philippe , Denelle Pierre , Garnier Eric , Thuiller Wilfried , Kattge Jens , Lemauviel‐Lavenant Servane , Lavorel Sandra , Munoz François , Renard Delphine , Serra‐Diaz Josep M. , Viovy Nicolas , Violle Cyrille 
Published: February 2023

AbstractAimIt is crucial to monitor how the productivity of grasslands varies with its temporal stability for management of these ecosystems. However, identifying the direction of the productivity–stability relationship remains challenging because ecological stability has multiple components that can display neutral, positive or negative covariations. Furthermore, evidence suggests that the direction of the productivity–stability relationship depends on the biotic interactions and abiotic conditions that underlie ecosystem productivity and stability. We decipher the relationships between grassland productivity and two components of its stability in four habitat types with contrasting environments and flora.LocationFrance.Time period2000–2020.Major taxaGrassland plant species.MethodsWe used c. 20,000 vegetation plots spread across French permanent grasslands and remotely sensed vegetation indices to quantify grassland productivity and temporal stability. We decomposed stability into constancy (i.e., temporal invariability) and resistance (i.e., maximum deviation from average) and deciphered the direct and indirect effects of abiotic (namely growing season length and nitrogen input) and biotic (namely plant taxonomic diversity, trait diversity and community‐weighted mean traits) factors on productivity–stability relationships using structural equation models.ResultsWe found a positive relationship between productivity and constancy and a negative relationship between productivity and resistance in all habitats. Abiotic factors had stronger effects on productivity and stability compared with biotic factors. A longer growing season enhanced grassland productivity and constancy. Nitrogen input had positive and negative effects on grassland productivity and resistance, respectively. Trait values affected the constancy and resistance of grassland more than taxonomic and trait diversity, with effects varying from one habitat to another. Productivity was not related to any biotic factor.Main conclusionsOur findings reveal how vital it is to consider both the multiple components of stability and the interaction between environment and biodiversity to gain an understanding of the relationships between productivity and stability in real‐world ecosystems, which is a crucial step for sustainable grassland management.
Effects of pre‐analytical sample care and analysis methodology on measures of metabolic acidosis in hemodialysis patients
Authors: Correa Camilla C. , Figueiredo Mariana M. B. , Xavier Analucia R. , Kanaan Salim , Lugon Jocemir R. 
Published: February 2023

AbstractIntroductionWe evaluated the effects of pre‐analytical care on total carbon dioxide (tCO2) in hemodialysis patients, as calculated by blood gas analysis (ctCO2) or measured by an enzymatic assay (mtCO2).MethodsBlood samples were collected via vascular access before dialysis sessions. For blood gas analysis, eight aliquots were collected, refrigerated or non‐refrigerated, and analyzed at 0, 4, 8, and 24 h after collection. A blood sample was then collected for the enzymatic method and distributed into 14 aliquots. Half of the aliquots were refrigerated. The samples analyzed at time point 0 were centrifuged immediately. The remaining aliquots of both the refrigerated and non‐refrigerated clusters were centrifuged before storage. Samples were analyzed at 4, 8, and 24 h post‐collection.FindingsBy blood gas analysis, no significant change was found in bicarbonate values over time, either in the non‐refrigerated or refrigerated samples. ctCO2 values during the experiment showed a minor but statistically significant increase of questionable clinical relevance in both non‐refrigerated and refrigerated aliquots. In the enzymatic assay, the reduction in mtCO2 levels during the experiment was negligible. The median absolute reductions at the end of the experiment were 1.77, 1.21, 1.04, and 1.12 mmol/L for the non‐centrifuged/non‐refrigerated, centrifuged/non‐refrigerated, non‐centrifuged/refrigerated, and centrifuged/refrigerated aliquots, respectively.DiscussionOur results suggest that measured or calculated tCO2 levels of capped and cooled samples are adequate for analyzing the acid–base status of hemodialysis patients, even when such determination is not performed immediately after collection.
Effects of warm or cold compresses applied to the legs during hemodialysis on cramps, fatigue, and patient comfort: A placebo‐controlled randomized trial
Authors: Kesik Gülşah , Ozdemir Leyla , Yıldırım Tolga , Jabrayilov Jabrayil , Çeliksöz Gülseren 
Published: February 2023

AbstractIntroductionMuscle cramps and fatigue are common complications in hemodialysis patients and have been associated with reduced patient comfort. Among the complementary therapies advocated for the management of these complications have been the application of warm or cold compresses to the extremities during a hemodialysis treatment. In this study, we compared the effects of warm or cold compresses application on cramping, fatigue, and patient comfort.MethodsThis placebo‐controlled randomized trial was done in 69 patients, who were stratified and randomly allocated to three treatment arms. Two of the three groups included an intervention; application of either warm (n = 23) or cold (n = 23) compresses to the extremities during dialysis. The third group served as a placebo control (n = 23). The study period comprised 12 hemodialysis sessions. One week after the completion of the intervention, a follow‐up dialysis session was also evaluated. Data were collected at baseline (t0), during each of 12 intervention sessions (t1—t12), and at the follow‐up session t13. Cramps, fatigue, and patient comfort were evaluated using the Cramp Episode Follow‐up Chart, Piper's Fatigue Scale, and the Hemodialysis Comfort Scale, respectively.ResultsIn both the intervention and follow‐up sessions, cramping and fatigue were lower, and comfort was higher in each of the intervention groups compared to placebo controls Application of warm compresses was superior to use of cold compresses.DiscussionBoth warm and cold compress administration reduced muscle cramps, fatigue, and hemodialysis comfort in hemodialysis patients.
Biallelic mutations in FLG, TGM1, and STS genes segregated with different types of ichthyoses in eight families of Pakistani origin
Authors: Khan Niamatullah , Shah Khadim , Fozia Fozia , Khan Sher A. , Muhammad Nazif , Nasir Abdul , Ahmad Ijaz , Rehman Zia U. , Jan Abid , Muhammad Noor , Khan Saadullah 
Published: February 2023

AbstractBackgroundCongenital ichthyosis is a diverse group of keratinization disorders associated with generalized scaling of skin of varying severity. The non‐syndromic forms of congenital ichthyosis are further grouped into common ichthyosis (ichthyosis vulgaris and X‐linked ichthyosis), autosomal recessive congenital ichthyosis, and keratopathic ichthyosis.ObjectiveTo identify sequence variants involved in different forms of hereditary ichthyoses.MethodsWe studied eight families with different types of ichthyosis including four families with autosomal recessive congenital ichthyosis and four families with common ichthyosis. Whole exome sequencing and PCR based genotyping was carried out to find out the molecular basis of disease.ResultsIn one family, a novel duplication sequence variant NM_002016.2:c.2767dupT; NP_002007.1:p.Ser923PhefsTer2 was identified in FLG gene; in four families a previously reported nonsense sequence variant NM_000359.3:c.232C>T; NP_002007.1:p.Arg78Ter was identified in TGM1 gene, while, in three families of X‐linked recessive ichthyosis, the whole STS gene (NM_001320752.2; NP_001307681.2) regions were deleted.Study limitationGene expression studies have not been performed that would have strengthened the findings of computational analysis.ConclusionThis study highlights the significance of the c.232C>T variant in the TGM1 gene as a possible founder mutation, complete STS gene deletion as reported previously in Pakistani population, while novel sequence variant in the FLG gene expands the spectrum of variations in this gene. These findings may be used for genetic counseling of the studied families.
Disease‐free survival as a predictor of overall survival in localized renal cell carcinoma following initial nephrectomy: A retrospective analysis of Surveillance, Epidemiology and End Results‐Medicare datac
Authors: Haas Naomi B. , Song Yan , Willemann Rogerio Jaqueline , Zhang Su , Carley Christopher , Zhu JingJing , Bhattacharya Rituparna , Signorovitch James , Sundaram Murali 
Published: February 2023

ObjectivesThis study aimed to assess whether disease‐free survival (DFS) may serve as a predictor for long‐term survival among patients with intermediate‐high risk or high risk renal cell carcinoma (RCC) post‐nephrectomy when overall survival (OS) is unavailable.MethodsThe Surveillance, Epidemiology and End Results‐Medicare database (2007–2016) was used to identify patients with non‐metastatic intermediate‐high risk and high risk RCC post‐nephrectomy. Landmark analysis and Kendall's τ were used to evaluate the correlation between DFS and OS. Multivariable regression models were used to quantify the incremental OS post‐nephrectomy associated with increased time to recurrence among patients with recurrence, adjusting for baseline covariates.ResultsA total of 643 patients were analyzed; mean age of 75 years; >95% of patients had intermediate‐high risk RCC at diagnosis; 269 patients had recurrence post‐nephrectomy. For patients with versus without recurrence at the landmark points of 1, 3, and 5 years post‐nephrectomy, the 5‐year OS were 37.0% versus 70.1%, 42.3% versus 72.8%, and 53.2% versus 78.6%, respectively. The Kendall's τ between DFS and OS post‐nephrectomy was 0.70 (95% CI: 0.65, 0.74; p < 0.001). After adjusting for baseline covariates, patients with one additional year of time to recurrence were associated with 0.73 years longer OS post‐nephrectomy (95% CI: 0.40, 1.05; p < 0.001).ConclusionThe significant positive association of DFS and OS among patients with intermediate‐high risk and high risk RCC post‐nephrectomy from this study supports the use of DFS as a potential predictor of OS for these patients when OS data are immature.
Two‐stage distributionally robust optimization model for a pharmaceutical cold supply chain network design problem
Authors: Li Jinfeng , Liu Yankui , Yang Guoqing 
Published: February 2023

AbstractPharmaceutical safety has received increasing attention from governments and corporations, and building a safe and effective pharmaceutical cold supply chain network has become an important issue. This paper proposes a two‐stage pharmaceutical cold supply chain network design problem considering drug safety, in which the drug demand, transportation costs, and drug safety risk costs are assumed to be random variables. Due to the presence of uncertainty and the fact that information about the distribution of uncertain parameters is often only partially known, a distributionally robust optimization method is used to handle the uncertainty. A two‐stage distributionally robust optimization model is constructed, in which the reliability of the estimation of the demand necessary to satisfy the entire cold chain network is ensured to be greater than a certain predetermined level by introducing an ambiguous joint chance constraint. The decision process for the problem can be divided into strategic and operational decisions with the goal of minimizing the total costs related to facility construction, the purchase of raw materials, drug production, transportation, and safety risks. By introducing an ambiguity set with mean and covariance information to describe the uncertain parameters, the two‐stage model is eventually reformulated as a standard second‐order cone program, thus making it computationally tractable. Finally, numerical experiments are presented to demonstrate the effectiveness of the proposed models and optimization methods.
Factors associated with hemoglobin glycation index in adults with type 1 diabetes mellitus: The FGM‐Japan study
Authors: Sakane Naoki , Hirota Yushi , Yamamoto Akane , Miura Junnosuke , Takaike Hiroko , Hoshina Sari , Toyoda Masao , Saito Nobumichi , Hosoda Kiminori , Matsubara Masaki , Tone Atsuhito , Kawashima Satoshi , Sawaki Hideaki , Matsuda Tomokazu , Domichi Masayuki , Suganuma Akiko , Sakane Seiko , Murata Takashi 
Published: February 2023

ABSTRACTAims/IntroductionThe discrepancy between HbA1c and glucose exposure may have significant clinical implications; however, the association between the hemoglobin glycation index (HGI) and clinical parameters in type 1 diabetes remains controversial. This study aimed to find the factors associated with HGI (laboratory HbA1c − predicted HbA1c derived from the continuous glucose monitoring [CGM]).Materials and MethodsWe conducted a cross‐sectional study of adults with type 1 diabetes (n = 211, age 50.9 ± 15.2 years old, female sex = 59.2%, duration of CGM use = 2.1 ± 1.0 years). All subjects wore the CGM for 90 days before HbA1c measurement. Data derived from the FreeStyle Libre sensor were used to calculate the glucose management indicator (GMI) and glycemic variability (GV) parameters. HGI was defined as the difference between the GMI and the laboratory HbA1c levels. The participants were divided into three groups according to the HGI tertile (low, moderate, and high). Multivariate regression analyses were performed.ResultsThe female sex ratio, HbA1c, and % coefficient of variation (%CV) significantly increased over the HGI tertile, while eGFR and Hb decreased over the HGI tertile. In multivariate analysis, the factors associated with HGI were %CV and eGFR, after adjusting for HbA1c level and sex (R2 = 0.44).ConclusionsThis study demonstrated that HGI is associated with female sex, eGFR, and some glycemic variability indices, independently of HbA1c. Minimizing glycemic fluctuations might reduce HGI. This information provides diabetic health professionals and patients with personalized diabetes management for adults with type 1 diabetes.
Sex‐ and ethnic‐specific patterns in the incidence of hip fracture among older US Asian and non‐Hispanic White adults
Authors: Lo Joan C. , Chandra Malini , Lee David R. , Darbinian Jeanne A. , Gordon Nancy P. , Zeltser David W. , Grimsrud Christopher D. , Lee Catherine 
Published: February 2023

AbstractBackgroundAsian and Pacific Islander (Asian/PI) adults have lower hip fracture incidence than non‐Hispanic White (NHW) adults, but data regarding Asian/PI subgroups are limited. We compared hip fracture incidence among older US Asian/PI and NHW populations, including ethnic subgroup differences.MethodsUsing observational data from a California healthcare system, we identified Asian/PI and NHW adults aged ≥50 years (2000–2019) and followed subjects to 2021 for hip fracture determined by principal/primary hospital diagnosis or by secondary hospital diagnosis with hip/femur procedure codes. Age‐adjusted hip fracture incidence was calculated with 95% confidence intervals (CIs). Log‐Poisson regression was used to determine fracture incidence rate ratios (IRRs, [CI]; NHW or Chinese as reference) adjusting for age and year.ResultsAmong 215,359 Asian/PI and 776,839 NHW women, hip fracture incidence was 1.34 (1.28–1.40) and 2.97 (2.94–3.01) per 1000 person‐years, respectively, with IRR 0.45 (0.43–0.47). Among 188,328 Asian/PI and 697,046 NHW men, hip fracture incidence was 0.62 (0.58–0.67) and 1.81 (1.78–1.84) per 1000 person‐years, respectively, with IRR 0.34 (0.32–0.37). For the four largest Asian/PI subgroups, Filipina women (IRR 0.85 [0.75–0.96]) had lower, and Japanese (IRR 1.36 [1.20–1.54]) and South Asian (IRR 1.36 [1.07–1.72]) women had higher hip fracture incidence compared to Chinese women. Hip fracture incidence was only higher among South Asian (IRR 1.61 [1.21–2.14]) compared to Chinese men.ConclusionHip fracture incidence among US Asian/PI adults was 55% (women) and 66% (men) lower than NHW adults, but incidence varied by Asian/PI subgroup. The heterogeneity among Asian/PI adults highlights the importance of examining fracture risk by ethnic subgroup.