bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care pathway analysis and evidence gaps in adult-onset Still’s disease: interviews with experts from the UK, France, Italy, and Germany
Authors: Ursini Francesco , Gregg Emily , Canon-Garcia Viviam , Rabijns Hilde , Toennessen Katrin , Bartlett Kaz , Graziadio Sara 
Published: September 2023

IntroductionAdult-onset Still’s disease (AOSD) is a rare systemic inflammatory disease of unknown etiology. Published AOSD data are limited, and clinical guidelines were lacking until recently. Managing AOSD remains largely empirical with uncertainties and high variability about the optimal care pathway. Therefore, we used a qualitative approach to collect clinical judgments from the UK, Italy, France and Germany to inform the development of an agreed care pathway. Our work aimed to decrease the uncertainty associated with clinical practice, inform future research in AOSD, and help identify standardized definitions and outcomes in this population.MethodsSemi-structured interviews and thematic analysis were conducted. Eleven clinicians were interviewed between May and July 2022: four were based in Italy, three in the UK, two in France, and two in Germany.ResultsIn this work, we identified the structure of the typical care pathway for AOSD patients, which can be used to inform future economic models in AOSD. The general structure of the pathway was similar across countries. Non-steroidal anti-inflammatory drugs are prescribed during the diagnostic workup while an additive approach is commonly used in confirmed cases: corticosteroids, conventional synthetic disease-modifying antirheumatic drugs, then biologic disease-modifying antirheumatic drugs (bDMARDs) (dose increased before switching). For severe presentations, more aggressive approaches with higher doses and early use of bDMARDs are used. The main elements of variation among countries and clinicians were the criteria used for diagnosis; order of bDMARDs and preferential treatments for articular and systemic patients; and tests for patient monitoring. There is also a lack of standardized outcome measures making comparisons and evidence synthesis challenging.ConclusionWe identified important evidence gaps for clinical practice, e.g., reliable tests or scores predictive of disease progression and treatment outcome, and recommendations for research, e.g., reporting of compliance rates and use of the Yamaguchi criteria for clinical study inclusion. Consensus is needed around the use of the Systemic score in clinical practice and the clinical utility of this score. A standardized definition of remission is also required in AOSD, and further research should look to identify and validate the specific laboratory markers to be considered when assessing remission.
A quasi-experimental study of fresh oxygen flow on patients’ oxygen reserve during mask-assisted ventilation under general anesthesia induction
Authors: Shi Yubo , Jin Ying , Song Jianli , Shi Jingfeng , Liu Xiaoying , Zhao Guoqing , Su Zhenbo 
Published: September 2023

BackgroundTo compare the effect of different amounts of fresh oxygen flow on oxygen reserve in patients undergoing general anesthesia.MethodsSeventy-two patients were enrolled in this quasi-experimental study. Patients were randomly divided into experimental groups with a fresh oxygen flow of 1 L/min, 2 L/min, 4 L/min, and 8 L/min (denoted as G1, G2, G3, and G4, respectively) for 2 min of mask-assisted ventilation. Safe apnea time (SAT) was the primary endpoint; SAT was defined as the time from the cessation of ventilation to the time the patient’s pulse oxygen saturation (SpO2) decreased to 90%. Ventilation indicators such as end-tidal oxygen concentration (EtO2), end-tidal carbon dioxide partial pressure (EtCO2), SpO2, and carbon dioxide (CO2) elimination amount, during mask-assisted ventilation, were the secondary endpoints.ResultsThe SAT of G1, G2, G3, and G4 were 305.1 ± 97.0 s, 315 ± 112.5 s, 381.3 ± 118.6 s, and 359 ± 104.4 s, respectively (p &gt; 0.05). The EtO2 after 2 min of mask-assisted ventilation in groups G1, G2, G3, and G4 were 69.7 ± 8.8%, 75.2 ± 5.0%, 82.5 ± 3.3%, and 86.8 ± 1.5%, respectively (p &lt; 0.05). Also, there was a moderate positive correlation between the fresh oxygen flow and EtO2 (correlation coefficient r = 0.52, 95% CI 0.31–0.67, p &lt; 0.0001). The CO2 elimination in the G1 and G2 groups was greater than that in the G4 group (p &lt; 0.05). There was no significant difference in other indicators among the groups (all p &gt; 0.05).ConclusionThe amount of fresh oxygen flow during mask-assisted ventilation was positively correlated with EtO2. Also, even though there was no significant difference, the patients’ oxygen reserves increased with the increase in fresh oxygen flow.
Gut microbiota is associated with spatial memory and seed-hoarding behavior of South China field mice (Apodemus draco)
Authors: Feng Enping , Yang Xifu , Zhao Kunming , Li Ying , Zhu Hanyi , Wang Zhenshan , Zhang Zhibin 
Published: September 2023

BackgroundScatter-hoarding animals store food in multiple locations within their home range and rely on spatial memory for subsequent localization and retrieval. The relationship between memory and scatter-hoarding behavior has been widely demonstrated, but the association of gut microbiota with spatial memory and seed-hoarding behavior of animals remains unclear.MethodsIn this study, by using enclosure behavior tests, memory tests including an object location test (OLT) and a novel object recognition test (NORT), and fecal microbiota transplantation (FMT) experiment, we evaluated the role of gut microbiota in affecting the memory and seed-hoarding behavior of rodents. According to their scatter-hoarding intensity, South China field mice (Apodemus draco) were divided into scatter-hoarding group (SG) and non-scatter-hoarding group (NG).ResultsWe found that the SG performed better than the NG in the NORT. FMT from SG donor mice altered the NG recipient mice’s gut microbiota structure. Further tests demonstrated FMT from SG donor mice increased memory of NG recipient mice in laboratory tests and seed larder hoarding intensity of NG recipient mice in enclosures.ConclusionOur results suggest gut microbiota could modulate the memory and seed-hoarding behavior of animals.
Addressing depression in older adults with Alzheimer’s through cognitive behavioral therapy: systematic review and meta-analysis
Authors: González-Martín Ana María , Aibar Almazán Agustín , Rivas Campo Yulieth , Rodríguez Sobrino Noelia , Castellote Caballero Yolanda 
Published: September 2023

ObjectivesThis systematic review and meta-analysis was conducted to provide an analysis of the published data about the effects of cognitive behavioral therapies on the depression of older adults with a diagnosis of Alzheimer’s disease.MethodsThis study was performed following the PRISMA 2020 guidelines. The search was performed between March and April 2023, using four electronic databases: PubMed, Web of Science, Cinhal and Scopus. Different keywords combined with Boolean operators were utilized. Only 11 articles were included out of the initial 212.ResultsCognitive behavioral therapy was found to reduce depression in individuals with Alzheimer’s, including treatments with low frequency but a longer intervention time.ConclusionThis systematic review and meta-analysis found that the psychosocial therapy cognitive behavioral therapy is effective in improving depression in individuals with a diagnosis of Alzheimer’s. However, results are inconclusive due to the disparity of the findings and the heterogeneity of the applied protocols, so more studies are needed on this topic.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=416396, CRD42023416396.
Health behaviors of people with multiple sclerosis and its associations with MS related outcomes: a German clinical cohort
Authors: Goldin Katharina , Riemann-Lorenz Karin , Daubmann Anne , Pöttgen Jana , Krause Nicole , Schröder Helmut , Heesen Christoph 
Published: September 2023

BackgroundHealth behaviors in persons with multiple sclerosis (pwMS) have been associated with MS-related disease outcomes.ObjectiveThe aim of the study was to gain knowledge about current patient health behaviors in a convenience sample representative for pwMS presenting to a large university-based outpatient clinic and to investigate associations between modifiable risk factors with physical impairment, quality of life (QoL) and cardiovascular comorbidities.MethodsA questionnaire was administered at the MS Outpatient Clinic of the University Medical Center Hamburg Eppendorf asking for health behaviors regarding dietary habits assessed with the German adaptation of the validated Spanish short Diet Quality Screener (sDQS), level of physical activity assessed with the Godin Leisure Time Questionnaire (GLTEQ) and tobacco smoking. Participants were asked to report cardiovascular comorbidities using items from the Self-Report Comorbidity Questionnaire for Multiple Sclerosis. Additionally, cardiovascular risk factors like blood pressure, height and weight (to calculate BMI) and waist circumference were measured. MS specific clinical data, e.g., disease course, duration, disability and MS-specific QoL were collected from the clinical database. Descriptive analyses were performed and multivariate regression analyses for complete cases were carried out for each of the three outcome variables including all mentioned modifiable risk factors (dietary behavior, smoking, physical activity and BMI) as independent variables.ResultsIn this sample of 399 pwMS the mean age was 42 years (SD 12.8) with a mean disease duration since diagnosis of 7.4 years (SD 8.4) and a mean EDSS of 2.8 (SD 1.9). 24% were current smokers, 44% were insufficiently physically active and 54% did not follow a healthy dietary pattern. 49% of this relatively young clinical population was overweight and 27% reported one or more cardiovascular comorbidities. Most modifiable risk factors showed no convincing associations with MS-related disease outcomes in the multiple regression analyses.ConclusionThis clinical cohort of pwMS shows a high prevalence of critical health behaviors and comorbidities and emphasizes the need for monitoring, education and assistance for behavior change in this population.
Autoimmune encephalitis in COVID-19 patients: a systematic review of case reports and case series
Authors: Xue Hua , Zeng Li , He Hongxian , Xu Dongxun , Ren Kaixin 
Published: September 2023

BackgroundThere is mounting evidence suggesting that autoimmune encephalitis (AE) can be observed as a neurological complication in patients with COVID-19. This review aimed to summarize the clinical manifestations, types, and outcomes of COVID-19-associated AE.MethodsA systematic search was conducted in the PubMed, Embase, and Web of Science databases to identify case reports and case series related to COVID-19-associated AE from 1 January 2020 to 31 March 2023. After a thorough screening and evaluation, irrelevant articles were excluded. Relevant information concerning types, clinical manifestations, and outcomes was extracted and synthesized.ResultsA total of 37 studies, comprising 34 case reports and 3 case series, were included in this review. Among the 42 COVID-19-associated AE patients, 21 (50%) cases were classified as an unknown antibodies (Ab) type of COVID-19-associated AE, 10 (23.80%) cases as anti-N-methyl-D-aspartate (NMDA) encephalitis, 4 (9.5%) cases as limbic encephalitis, and 3 (7.1%) cases as anti-myelin-oligodendrocyte-glycoprotein encephalitis, along with other rare types of AE. Disturbance of consciousness, seizures, and psychiatric symptoms were identified as the main clinical manifestations of COVID-19-associated AE. While the symptoms of AE displayed variation, most patients achieved full recovery although a few experienced residual symptoms of neurological damage.ConclusionThis systematic review comprehensively describes the characteristics of COVID-19-associated AE. The main type of COVID-19-associated AE identified in this study is an unknown Ab type of COVID-19-associated AE. Despite the potentially life-threatening risks of COVID-19-associated AE, the majority of patients survived, with some patients reporting residual neurological symptoms.
Prediction of stress-related gastrointestinal bleeding in patients with aneurysmal subarachnoid hemorrhage using caudate Hounsfield unit value in ASPECT score
Authors: Wang Ke , Yuan Kexin , Li Runting , Lin Fa , Chen Yu , Yang Jun , Han Heze , Li Tu , Jia Yitong , Zhou Yunfan , Zhang Haibin , Li Ruinan , Li Zhipeng , Zhao Yahui , Hao Qiang , Chen Xiaolin , Zhao Yuanli 
Published: September 2023

BackgroundStress-related gastrointestinal bleeding (SRGB) is one of the major complications after aneurysmal subarachnoid hemorrhage (aSAH), and it can present challenges in patient care and treatment. The aim of this study was to explore the clinical significance of the caudate Hounsfield unit (HU) value in the Alberta Stroke Program Early CT (ASPECT) score for predicting SRGB in patients with aSAH.MethodsWe retrospectively analyzed the data of 531 aSAH patients admitted to our institution between 2019 and 2022. Potential predictors of SRGB were identified using multivariate Cox regression analysis. We used a restricted cubic spline (RCS) to evaluate whether there is a nonlinear relationship between the right caudate HU value and SRGB. MaxStat analysis (titled as maximally selected rank statistics) was performed to identify the optimal cutoff point for the right caudate HU value. Another Kaplan–Meier method with the log-rank test was used to analyze the right caudate HU value in predicting the occurrence of SRGB.ResultsThe incidence rate of SRGB was 17.9%. In the multivariate Cox regression analysis, the right caudate HU value was an independent predictor of SRGB [Hazard ratio (HR) = 0.913; 95% confidence interval (CI): 0.847–0.983, and p = 0.016]. The RCS indicated that the incidence of developing SRGB reduces with increasing right caudate HU values (nonlinear p = 0.78). The optimal cut-off value of the right caudate HU was 25.1.ConclusionAmong aSAH patients, lower right caudate HU values indicated a higher risk of developing SRGB. Our findings provide further evidence for the relationship between the gastrointestinal system and the brain.
“PNP slows down” – linearly-reduced whole body joint velocities and altered gait patterns in polyneuropathy
Authors: Walz Isabelle D. , Waibel Sarah , Lippi Vittorio , Kammermeier Stefan , Gollhofer Albert , Maurer Christoph 
Published: September 2023

IntroductionGait disturbances are a common consequence of polyneuropathy (PNP) and a major factor in patients’ reduced quality of life. Less is known about the underlying mechanisms of PNP-related altered motor behavior and its distribution across the body. We aimed to capture whole body movements in PNP during a clinically relevant mobility test, i.e., the Timed Up and Go (TUG). We hypothesize that joint velocity profiles across the entire body would enable a deeper understanding of PNP-related movement alterations. This may yield insights into motor control mechanisms responsible for altered gait in PNP.Methods20 PNP patients (61 ± 14 years) and a matched healthy control group (CG, 60 ± 15 years) performed TUG at (i) preferred and (ii) fast movement speed, and (iii) while counting backward (dual-task). We recorded TUG duration (s) and extracted gait-related parameters [step time (s), step length (cm), and width (cm)] during the walking sequences of TUG and calculated center of mass (COM) velocity [represents gait speed (cm/s)] and joint velocities (cm/s) (ankles, knees, hips, shoulders, elbows, wrists) with respect to body coordinates during walking; we then derived mean joint velocities and ratios between groups.ResultsAcross all TUG conditions, PNP patients moved significantly slower (TUG time, gait speed) with prolonged step time and shorter steps compared to CG. Velocity profiles depend significantly on group designation, TUG condition, and joint. Correlation analysis revealed that joint velocities and gait speed are closely interrelated in individual subjects, with a 0.87 mean velocity ratio between groups.DiscussionWe confirmed a PNP-related slowed gait pattern. Interestingly, joint velocities in the rest of the body measured in body coordinates were in a linear relationship to each other and to COM velocity in space coordinates, despite PNP. Across the whole body, PNP patients reduce, on average, their joint velocities with a factor of 0.87 compared to CG and thus maintain movement patterns in terms of velocity distributions across joints similarly to healthy individuals. This down-scaling of mean absolute joint velocities may be the main source for the altered motor behavior of PNP patients during gait and is due to the poorer quality of their somatosensory information.Clinical Trial Registrationhttps://drks.de/search/de, identifier DRKS00016999.
Fear of heights shapes postural responses to vibration-induced balance perturbation at virtual height
Authors: Bzdúšková Diana , Marko Martin , Hirjaková Zuzana , Riečanský Igor , Kimijanová Jana 
Published: September 2023

IntroductionStanding upright at height is a challenging situation involving intense threat of balance loss and fall. The ability to maintain balance in such conditions requires properly resolving sensory conflicts and is influenced by fear. To get more insight on the role of fear in balance control at height, we explored the dynamics of postural behavior in the situation of enhanced threat of potential balance loss.MethodsIn 40 young individuals with varying fear of heights, we combined simulated exposure to height in a virtual reality environment with bilateral vibration of tibialis anterior muscles which evokes posture destabilization (the so-called vibration-induced falling).ResultsUnder such condition of enhanced postural threat, individuals with intense fear of heights showed stronger stiffening of posture compared with individuals with low fear of heights who react more flexibly and adaptively to posture destabilization. This group difference was evident already at ground level but further increased during virtual height exposure.DiscussionOur data show that fear of height significantly affects posture adaptation to balance-destabilizing events. Our findings demonstrate that the assessment of postural behavior during threatening situations in the virtual reality environment provides valuable insights into the mechanisms of balance control and may be used to develop novel strategies aimed at prevention of falls.
Investigating the technical feasibility of magnetoencephalography during transcranial direct current stimulation
Authors: Shirota Yuichiro , Fushimi Motofumi , Sekino Masaki , Yumoto Masato 
Published: September 2023

IntroductionMagnetoencephalography (MEG) can measure weak magnetic fields produced by electrical brain activity. Transcranial direct current stimulation (tDCS) can affect such brain activities. The concurrent application of both, however, is challenging because tDCS presents artifacts on the MEG signal. If brain activity during tDCS can be elucidated by MEG, mechanisms of plasticity-inducing and other effects of tDCS would be more comprehensively understood. We tested the technical feasibility of MEG during tDCS using a phantom that produces an artificial current dipole simulating focal brain activity. An earlier study investigated estimation of a single oscillating phantom dipole during tDCS, and we systematically tested multiple dipole locations with a different MEG device.MethodsA phantom provided by the manufacturer was used to produce current dipoles from 32 locations. For the 32 dipoles, MEG was recorded with and without tDCS. Temporally extended signal space separation (tSSS) was applied for artifact rejection. Current dipole sources were estimated as equivalent current dipoles (ECDs). The ECD modeling quality was assessed using localization error, amplitude error, and goodness of fit (GOF). The ECD modeling performance with and without tDCS, and with and without tSSS was assessed.ResultsMean localization errors of the 32 dipoles were 1.70 ± 0.72 mm (tDCS off, tSSS off, mean ± standard deviation), 6.13 ± 3.32 mm (tDCS on, tSSS off), 1.78 ± 0.83 mm (tDCS off, tSSS on), and 5.73 ± 1.60 mm (tDCS on, tSSS on). Mean GOF findings were, respectively, 92.3, 87.4, 97.5, and 96.7%. Modeling was affected by tDCS and restored by tSSS, but improvement of the localization error was marginal, even with tSSS. Also, the quality was dependent on the dipole location.DiscussionConcurrent tDCS-MEG recording is feasible, especially when tSSS is applied for artifact rejection and when the assumed location of the source of activity is favorable for modeling. More technical studies must be conducted to confirm its feasibility with different source modeling methods and stimulation protocols. Recovery of single-trial activity under tDCS warrants further research.
Usability and ease of use of long-term remote monitoring of physical activity for individuals with acquired brain injury in community: a qualitative analysis
Authors: Mazzeo Marie , Hernan Gabriel , Veerubhotla Akhila 
Published: September 2023

IntroductionObjective and continuous monitoring of physical activity over the long-term in the community is perhaps the most important step in the paradigm shift toward evidence-based practice and personalized therapy for successful community integration. With the advancement in technology, physical activity monitors have become the go-to tools for objective and continuous monitoring of everyday physical activity in the community. While these devices are widely used in many patient populations, their use in individuals with acquired brain injury is slowly gaining traction. The first step before using activity monitors in this population is to understand the patient perspective on usability and ease of use of physical activity monitors at different wear locations. However, there are no studies that have looked at the feasibility and patient perspectives on long-term utilization of activity monitors in individuals with acquired brain injury.MethodsThis pilot study aims to fill this gap and understand patient-reported aspects of the feasibility of using physical activity monitors for long-term use in community-dwelling individuals with acquired brain injury.ResultsThis pilot study found that patients with acquired brain injury faced challenges specific to their functional limitations and that the activity monitors worn on the waist or wrist may be better suited in this population.DiscussionThe unique wear location-specific challenges faced by individuals with ABI need to be taken into account when selecting wearable activity monitors for long term use in this population.