bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nuclear Imaging Data‐Driven Classification of Parkinson's Disease
Authors: Totsune Tomoko , Baba Toru , Sugimura Yoko , Oizumi Hideki , Tanaka Hiroyasu , Takahashi Toshiaki , Yoshioka Masaru , Nagamatsu Ken‐ichi , Takeda Atsushi 
Published: August 2023

ABSTRACTBACKGROUNDParkinson's disease (PD) is a heterogeneous neurodegenerative disorder characterized by motor and nonmotor symptoms. Several features have prognostic importance and have been used as key indicators for identifying clinical subtypes. However, the symptom‐based classification approach has limitations with respect to the stability of the obtained subtypes.OBJECTIVESThe purpose of this study was to identify subtypes of PD using nuclear imaging biomarkers targeting the cardiac sympathetic nervous and nigro‐striatal systems and to compare patterns of cortical morphological change among obtained subtypes.METHODSWe performed unbiased hierarchical cluster analysis using 123I‐metaiodobenzylguanidine cardiac scintigraphy and 123I‐N‐(3‐fluoropropyl)‐2β‐carbomethoxy‐3β‐(4‐iodophenyl) nortropane single photon emission computed tomography data for 56 patients with PD. We compared clinical characteristics and the patterns of cortical atrophy in the obtained clusters.RESULTSThree clusters were identified and showed distinct characteristics in onset ages and dopamine‐replacement therapy and deep brain stimulation requirements. According to the characteristics, clusters were classified into two subtypes, namely, “cardio‐cortical impairment (CC)” and “dopaminergic‐dominant dysfunction (DD)” subtype. The three clusters were named according to subtype and time since onset in which 14 patients were classified as “early DD,” 25 as “advanced DD,” and 17 as “early CC.” Compared with the early DD subtype, the early CC subtype showed parietal‐dominant diffuse cortical atrophy and the advanced DD subtype showed left‐side predominant mild cortical atrophy.CONCLUSIONSNuclear imaging biomarker–based classification can be used to identify clinically and pathologically relevant PD subtypes with distinct disease trajectories. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Can social prescribing put the ‘social’ into the biopsychosocial management of people with long‐term musculoskeletal disorders?
Authors: O’Sullivan Declan J. , Bearne Lindsay M. , Harrington Janas M. , McVeigh Joseph G. 
Published: August 2023

AbstractBackgroundChronic musculoskeletal disorders (MSD) are a significant burden on individuals' quality of life and society and are made more complex by the presence of multimorbidity. It is recommended that interventions targeting MSD be sustainable, equitable and incorporate the biopsychosocial model of care (BPS).AimsA criticism of the BPS approach is that the social component of this model is not addressed adequately during the management of people with long‐term MSD and that a gap exists between theory and implementation. The use of social prescribing (SP) as an intervention to bridge this gap is discussed.Results and DiscussionSocial prescribing is a holistic non‐medical person‐centered approach to well‐being that utilizes link workers (LW) to support individuals with long‐term conditions (LTC) in the community. Social prescribing referrals are received from primary healthcare practitioners to LW and range from light touch signposting for employment or financial advice to more intensive support for LTC such as obesity, decreased physical activity and mental health needs.ConclusionThere is evidence to suggest that SP interventions are effective in the management of LTC; however, due to the paucity of high‐quality evidence, it is difficult to be conclusive. Large‐scale randomised controlled trials are recommended to support the use of SP interventions in the management of LTC.
The neuromuscular evaluation of postural orthostatic tachycardia syndrome
Authors: Owens Micaela R. , Kaur Divpreet 
Published: August 2023

AbstractPostural orthostatic tachycardia syndrome (POTS) is a diagnosis with a wide spectrum of symptomatology and a variety of clinicopathological associations, including hereditary, autoimmune, and infectious associations. There is little consensus regarding the appropriate diagnostic approach to the condition. The aim of this work was to provide guidance on the initial diagnosis and when and how to expand diagnostic testing. We define the “typical” POTS patient as younger, female, and with a normal examination apart from joint hyperextensibility. Red flags for “atypical” POTS would be older age at onset, male, prominent syncope, review of systems suggestive of specific alternative diagnoses, examination abnormalities other than joint hyperextensibility, or disease refractory to nonpharmacological and other first‐line treatments. Although a limited evaluation is appropriate in POTS with typical features, we recommend an expanded and individualized workup in atypical cases, including additional cardiac testing, autonomic testing, neuropathy workup, and/or autoimmune workup (including consideration of Guillain–Barré syndrome), depending on clinical presentation. We emphasize the importance of shared decision‐making in this condition for which treatment remains primarily symptomatic regardless of etiology.
Appropriate handling and storage reduce the risk of bacterial growth in enteral feeding systems reused within 24 hours
Authors: Hubbard Gary P. , Van Wyk Johanna , Grinyer Louise , Onley Richard , White Sean , Fleming Carole‐Anne , Baxter Janet , Forwood Laura , Stratton Rebecca J. 
Published: August 2023

AbstractBackgroundEnteral tube feeding can require considerable amounts of plastic equipment including delivery sets and containers, often disposed of after a single feeding session because of bacterial contamination concerns. The aim of this research was to assess whether reuse of delivery sets and containers for up to 24 h is safe from a microbiological perspective.MethodsFour enteral tube feeding systems (FS) were tested under hygienic controlled or repeated inoculation challenge conditions using key foodborne pathogens, to assess bacterial growth over time (FS1: ready‐to‐hang, closed 1‐L system with delivery set reused, stored at room temperature [RT]; FS2: a prepared, powdered, open 1‐L system with delivery set and container reused, stored at RT; FS3 and FS4: prepared, powdered, open 200‐ml bolus systems with delivery set and container reused, stored at RT [FS3] and refrigeration [FS4]). Feed samples were cultured at 0.5, 6.5, 12.5, 18.5, and 24.5 h with >2 Δlog considered significant bacterial growth.ResultsUnder hygienic control, FS1, FS3, and FS4 were below the level of enumeration (<5 CFU/g) for all bacteria tested, at all time points. In FS2, significant bacterial growth was observed from 18.5 h. Under repeated bacterial inoculation challenge, no significant growth was observed in FS1 and FS4 over 24.5 h; however, significant growth was observed in FS2 after 6.5 h and in FS3 after 10–12 h.ConclusionWith hygienic handling technique, there is limited bacterial growth with reuse of delivery sets and containers over 24 h. Refrigeration between feeding sessions and using boluses of reconstituted powdered feed reduce bacterial growth risk.
State‐mandated school‐based BMI assessments and self‐reported adolescent health behaviors
Authors: Churchill Brandyn F. 
Published: August 2023

AbstractI provide novel evidence on the role of imperfect information in shaping childhood obesity. Between 2003 and 2017, 24 states began requiring schools to perform Body Mass Index assessments on students. Using the 1991 to 2017 National and State Youth Risk Behavior Surveys and a stacked difference‐in‐differences identification strategy, I show that these state‐mandated school‐based BMI assessments were associated with an increase in the likelihood that teens described themselves as overweight and reported that they were trying to lose weight. The relationship was most pronounced for overweight teens, suggesting that the assessments improved awareness about BMI status among this group, though I also find that non‐overweight teen girls were subsequently more likely to incorrectly describe themselves as overweight. While I do not detect meaningful changes in exercise or calorie‐limiting behaviors, I do find that these state‐mandated school‐based BMI assessments were associated with a modest reduction in BMI.
Pediatric cancer patient emergency department visits and disposition by sociodemographic and economic characteristics
Authors: O'Connell Caitlin P. , Johnson Kimberly J. , Brown Derek S. 
Published: August 2023

AbstractBackgroundLimited research has been conducted on cancer‐related emergency department (ED) patterns among pediatric cancer patients, including whether there are differences in the characteristics of individuals who seek ED care for cancer complications. The objectives of this study were to determine whether rates and disposition of cancer‐related ED visits and hospital admissions in childhood cancer patients differ by sociodemographic factors.MethodsA cross‐sectional analysis of ED encounters with a cancer diagnosis code among patients aged 0–19 years from the 2019 National Emergency Department Sample (NEDS) was conducted. Weighted logistic regression models were utilized to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for a primary cancer‐related encounter, and hospital admission overall and by subgroup characteristics.ResultsOf the unweighted 6,801,711 ED encounters in children aged 0–19 years, 10,793 were classified as visits by cancer patients. ED encounters of Hispanic versus non‐Hispanic White pediatric cancer patients had higher odds of having a cancer‐related primary diagnosis (OR = 1.15, 95% CI: 1.04–1.27). ED encounters of non‐Hispanic Black pediatric patients and those in the lowest zip code income quartile had higher odds of hospital admission (OR = 1.28, 95% CI: 1.08–1.53; OR = 1.30, 95% CI: 1.15–1.46), while rurality was associated with lower odds of hospital admission (OR = 0.69, 95% CI: 0.57–0.83).ConclusionThese results suggest that pediatric cancer patients from certain under‐resourced communities are more likely to use the ED for cancer treatment complications, and their encounters are more likely to result in admission to the hospital.
Frequency of toll‐like receptor 4 variants and association with treatment response in children with primary immune thrombocytopenia
Authors: Ahmed Heba A. , Fahmy Eman M. , Abdelkreem Elsayed , Mahmoud Ekram A. , Nafady Asmaa , Ahmed Eman H. 
Published: August 2023

AbstractObjectives: To investigate the frequency of toll‐like receptor 4 (TLR4) variants c.896A>G (p.Asp299Gly) and c.1196C>T (p.Thr399Ile) among Egyptian children with primary immune thrombocytopenia (pITP), and their association with disease course and response to treatment.Methods: A case–control study that included 80 children with pITP and 50 age‐ and sex‐matched healthy controls. TLR4 c.896A>G and c.1196C>T variants were genotyped using polymerase chain reaction–restriction fragment length polymorphism. Patients were classified according to their response to treatment after 3 months as responders and nonresponders.Results: Compared with controls, children with pITP had significantly higher minor allele frequencies of TLR4 p.Asp299Gly (16.25% vs. 6%, odds ratio [OR] 3.04, 95% confidence interval [CI]: 1.16–9.36, p = .014) and p.Thr399Ile (20% vs. 4%, OR 6, 95% CI: 2.02–24.01, p < .001). The presence of p.Asp299Gly variant was significantly associated with chronic ITP (OR 7.78, 95% CI: 2.04–35.69, p < .001) and non‐response to therapy with steroid (OR 11.67, 95% CI: 1.32–104.08, p = .012), but not thrombopoietin‐receptor agonist (OR 1.67, 95% CI: 0.35–8.19, p = .464). Likewise, having p.Thr399Ile variant was significantly associated with chronic ITP (OR 5.14, 95% CI: 1.6–17.4, p = .002) and non‐response to therapy with steroid (OR 6.1, 95% CI: 1.01–49.06, p = .046) but not thrombopoietin‐receptor agonist (OR 1.57, 95% CI: 0.33–7.58, p = .515).Conclusion: The presence of TLR4 p.Asp299Gly or p.Thr399Ile variant may be associated with ITP predisposition, chronicity, and non‐response to upfront steroid therapy. These findings enhance our understanding of the complex pathophysiology of pITP with potentially important clinical implications.
Variant histology of pediatric nodular lymphocyte‐predominant Hodgkin lymphoma with IgD and CD30 expression
Authors: Ali Nesreen , Moussa Emad , Khorshed Eman , Zaghloul Mohamed S. , Elnashar Amr , Abdalla Amr 
Published: August 2023

AbstractBackgroundNodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL), recently known as nodular lymphocyte‐predominant B‐cell lymphoma (NLPBL), accounts for 5%–10% of Hodgkin lymphoma (HL). Different morphologic patterns of NLPBL are identified and categorized as typical patterns (type A and B) and variant histologic patterns (types C, D, E, and F).Patients and methodWe investigated different morphologic patterns, CD30 and IgD expression in pediatric patients with NLPBL diagnosed at the Children's Cancer Hospital Egypt.ResultsForty‐six (53%) of the patients exhibited a typical histologic pattern, whereas the remaining (47%) exhibited variant histologic pattern. Variant histology is associated with unfavorable clinical characteristics, such as advanced stages, B‐symptoms, and extranodal involvements, particularly bone marrow and bone infiltration, with p‐values of .06, .05, and 0.01%, respectively. Additionally, 39% of patients with variant histology experienced disease progression or relapse, compared to only 15.2% of patients with typical patterns (p = .009). Types C and D are related to decreased event‐free survival (EFS), as shown by a p‐value of .05. The 5‐year EFS for patients with variant histology was 94.4% for the rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone (RCHOP) versus 33.3% for the adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). IgD expression in lymphocyte‐predominant (LP) cells was detected in 44 (50%) patients, while CD30 expression in LP cells was found in 39 (44%) patients.ConclusionVariant histology of NLPBL was associated with advanced disease stages and a poor prognosis, while expression of IgD and CD30 in LP cells was not. The poor outcome of variant histology improved with the RCHOP regimen.
Development of a template for operative reporting of pediatric cancer surgery in limited‐resource settings by using a modified Delphi method
Authors: Abdelhafeez Abdelhafeez , Harrison Derek , Nugud Faisal , Sanhouri Kanan , Grant Christa N. , Aronson Daniel C. , Bukhari Zaitun , Israels Trijin , Langer Monica , Sharma Shilpa , Munanzvi Kudzayi , Muzira Arlene , Moreno Amabelle , Ngongola Amon , Shalkow Jaime , Abib Simone , Lakhoo Kokila 
Published: August 2023

AbstractPurposeA comprehensive operative report for cancer surgery is crucial for accurate disease staging, risk stratification, and therapy escalation/de‐escalation, which affects the outcome. Narrative operative reports may fail to include some critical findings. Furthermore, standardized operative reports can form the basis of a local registry, which is often lacking in limited‐resource settings (LRSs). In adult literature, synoptic operative reports (SOR) contain more key findings than narrative operative reports. In the LRSs, where the capacity of diagnostic pathology services is typically suboptimal, the value of a thorough operative report is even greater. The aim of this study was to develop a SOR template to help standardize childhood cancer surgery reporting in LRSs.MethodsTwenty‐three experts in pediatric cancer with extensive experience practicing in LRSs were invited to participate in a modified Delphi procedure. SOR domains for pediatric oncology surgery were drafted based on a literature search and then modified based on experts’ opinions. The experts anonymously answered multiple rounds of online questionnaires until all domains and subdomains reached a consensus, which was predefined as 70% agreement.ResultsSixteen experts participated in the study, and two rounds of the survey were completed. Twenty‐one domains were considered relevant, including demographics, diagnosis, primary site, preoperative disease stage, previous tumor biopsy or surgery, preoperative tumor rupture, neoadjuvant therapy, surgical access, type of resection, completeness of resection, tumor margin assessment, locoregional tumor extension, organ resection, intraoperative tumor spillage, vascular involvement, lymph node sampling, estimated blood loss, intraoperative complications and interventions to address them, specimen names, and specimen orientation.ConclusionWe developed a SOR template for pediatric oncology surgery in LRSs. Consensus for all 21 domains and associated subdomains was achieved using a modified Delphi procedure.
Crashworthiness analysis and multi‐objective optimization of Al/CFRP hybrid tube with initial damage under transverse impact
Authors: Cai Weiwen , Ma Qihua , Wang Yazhe , Gan Xuehui 
Published: August 2023

AbstractDamage can cause uncontrollable changes during the service of a structure, leading to a reduction in mechanical properties and ultimately to structural failure. This paper presents an experimental and numerical study of the crashworthiness of thin‐walled Al/CFRP hybrid tubes with pre‐existing transverse compression damage under transverse impact loading. Experiments shows that initial damage has a more limited effect on the energy absorption capacity of hybrid tubes under impact loading, but has a greater effect on their deformation pattern and the evolution of damage. After impact, cracks on the surface of the damaged tube propagate into multiple, discontinuous cracks with a total length similar to the length of the tube. Conversely, only short cracks are generated on the intact tube. Subsequent finite element simulations demonstrate the validity and accuracy of a coupled multi‐loads model and explore the effect of different structural parameters (winding angle and number of CFRP layers, and thickness of Al tube) on the crashworthiness of the hybrid tubes. Finally, a multi‐objective snake optimizer algorithm (MOSO) was used to obtain an optimal hybrid tube structure for multiple loading conditions in order to minimize the effect of initial damage on the crashworthiness of the hybrid tube. In comparison to the simulation outcomes for the original structure, the peak crushing force (PCF) decreased by 28.46%, whereas the specific energy absorption (SEA) increased by 44.59%.Highlight
The effect of pre‐existing damage on the crashworthiness and deformation pattern of hybrid tube structures is investigated by means of experimental and numerical simulations.
A multi‐step finite element model was developed using the restart method to realize the crashworthiness analysis of the hybrid tube under multiple load coupling conditions.
The prediction accuracy of four surrogate models for the crashworthiness of hybrid tubes is compared and analyzed.
The multi‐objective snake optimizer algorithm (MOSO) is proposed to obtain the optimum hybrid tube structure for multiple loading conditions.
Microstructure development and mechanical performance of MWCNTs/GNPs filled SEBS with different block content
Authors: Alavi Kosar , Tarashi Sara , Nazockdast Hossein , Rafizadeh Mehdi 
Published: August 2023

AbstractPolystyrene‐poly (ethylene‐butylene)‐polystyrene (SEBS) nanocomposites have been regarded as promising thermoplastic elastomers for several industries owing to their distinct molecular platforms and properties. However, extending their applications requires a thorough understanding of the microstructural changes that nanoparticles induce in SEBS chains. In this work, we used two types of SEBS varying in polystyrene (PS) hard block contents to study the relationship between the structural changes and viscoelastic/mechanical properties of SEBS hybrid nanocomposites containing different multi‐walled carbon nanotubes: graphene nanoplatelets ratios. According to the results, the viscoelastic responses were strongly influenced by the PS block content and nanoparticles ratio, which had an appreciable contribution to the nanoparticles' dispersion state. This was explained in terms of intensified microphase separation induced by the favorable interactions between the carbon‐based nanoparticles and PS blocks. It was also found that the samples containing higher hard block content demonstrated more significant mechanical performance and toughness, which were enhanced by the addition of nanoparticles such that the highest ultimate strength of 24.58 MPa was obtained for the S30C0.5G0.5 sample. Furthermore, some mechanisms, including molecular disentanglements, dissociation of inter/intra‐molecular interactions, the orientation of the rubbery polyethylene butylene chains, and PS microdomain rearrangement, were supposed to interpret the energy dissipation capability of SEBS nanocomposites.
Damage analysis of Nomex honeycomb sandwich structures using image processing and artificial intelligence approaches
Authors: Demirci Ibrahim , Saritas Ismail 
Published: August 2023

AbstractIn this study, a method was developed to detect impact damage and determine the damage propagation in increasing and repetitive impacts. The effect of nanographene additives on the propagation of delamination damage in the top face layer of a sandwich structure was investigated using the developed method. In addition, the effects of nanographene on visible (VID) or barely visible damage (BVID) formation were investigated, and the stiffness of the sandwich structures was evaluated. An ultrasonic C‐scan nondestructive testing was used to visualize the damage, and the numerical values of the damaged areas of the sandwich structures at different energy levels were determined using an image processing method. The obtained values were used in artificial neural network (ANN) training to estimate the impact energy at which the structural integrity of the sandwich structures was disrupted. It was observed that the nanographene additive was effective in maintaining rigidity of the sandwich structures and therefore, slowed the delamination damage progression in increasing and repeated impacts. The damage areas of the neat sandwich structures (NSS) and graphene nanoplatelets doped sandwich structures (GSS) structures at the first impact 5j energy level was 1004 and 811 mm2, respectively. At the first impact, 20% less damage occurred in the GNP‐doped sandwich structures. The increasing and repetitive last impact energies at the end of the neural network training were 5j + 35j in NSS and 5j + 50j in GSS. The method allows for a detailed examination of the damage progression of sandwich structures under increasing and repeated impact loads.Highlights
Low‐velocity impact tests of Nomex honeycomb sandwich structures were performed.
Damage formation and propagation in sandwich structures were investigated.
The non‐destructive test C‐scan method was used to determine BVID.
The damaged areas were determined using an image processing method.
The damage areas were estimated using artificial neural networks.