bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual-task versus single-task gait rehabilitation after stroke: the protocol of the cognitive-motor synergy multicenter, randomized, controlled superiority trial (SYNCOMOT)
Authors: Tasseel-Ponche Sophie , Roussel Martine , Toba Monica N. , Sader Thibaud , Barbier Vincent , Delafontaine Arnaud , Meynier Jonathan , Picard Carl , Constans Jean-Marc , Schnitzler Alexis , Godefroy Olivier , Yelnik Alain Pierre 
Published: March 2023

AbstractBackgroundGait disorders and cognitive impairments are prime causes of disability and institutionalization after stroke. We hypothesized that relative to single-task gait rehabilitation (ST GR), cognitive-motor dual-task (DT) GR initiated at the subacute stage would be associated with greater improvements in ST and DT gait, balance, and cognitive performance, personal autonomy, disability, and quality of life in the short, medium and long terms after stroke.MethodsThis multicenter (n=12), two-arm, parallel-group, randomized (1:1), controlled clinical study is a superiority trial. Withp<0.05, a power of 80%, and an expected loss to follow-up rate of 10%, the inclusion of 300 patients will be required to evidence a 0.1-m.s−1gain in gait speed. Trial will include adult patients (18–90 years) in the subacute phase (0 to 6 months after a hemispheric stroke) and who are able to walk for 10 m (with or without a technical aid). Registered physiotherapists will deliver a standardized GR program (30 min three times a week, for 4 weeks). The GR program will comprise various DTs (phasic, executive function, praxis, memory, and spatial cognition tasks during gait) in the DT (experimental) group and gait exercises only in the ST (control) group. The primary outcome measure is gait speed 6 months after inclusion. The secondary outcomes are post-stroke impairments (National Institutes of Health Stroke Scale and the motor part of the Fugl-Meyer Assessment of the lower extremity), gait speed (10-m walking test), mobility and dynamic balance (timed up-and-go test), ST and DT cognitive function (the French adaptation of the harmonization standards neuropsychological battery, and eight cognitive-motor DTs), personal autonomy (functional independence measure), restrictions in participation (structured interview and the modified Rankin score), and health-related quality of life (on a visual analog scale). These variables will be assessed immediately after the end of the protocol (probing the short-term effect), 1 month thereafter (the medium-term effect), and 5 months thereafter (the long-term effect).DiscussionThe main study limitation is the open design. The trial will focus on a new GR program applicable at various stages after stroke and during neurological disease.Trial registrationNCT03009773. Registered on January 4, 2017.
Unhealthy lifestyle associated with increased risk of macro- and micro-vascular comorbidities in patients with long-duration type 2 diabetes: results from the Taiwan Diabetes Registry
Authors: Ho Li-Ju , Sheu Wayne Huey-Herng , Lo Su-Huey , Yeh Yen-Po , Hwu Chii-Min , Huang Chien-Ning , Hsieh Chang-Hsun , Kuo Feng-Chih 
Published: March 2023

Abstract
Background
Unhealthy lifestyle has been associated with obesity and type 2 diabetes. Whereas its association with vascular complications in patients with long-duration of type 2 diabetes is still uncertain.

Methods
A total of 1188 patients with long-duration of type 2 diabetes from the Taiwan Diabetes Registry (TDR) data were analyzed. We stratified the severity of unhealthy lifestyle via scoring three factors (sleep duration <7 or >9 h, sit duration ≥ 8h, and meal numbers ≥ with night snack) and analyzed their associations with the development of vascular complications using logistic regression analysis. Besides, we also included 3285 patients with newly diagnosed type 2 diabetes as the comparison.

Results
Increased numbers of factors that stand for unhealthy lifestyle were significantly associated with the development of cardiovascular disease, peripheral arterial occlusion disease (PAOD) and nephropathy in patients with long-duration of type 2 diabetes. After adjusting multiple covariables, having ≥ 2 factors of unhealthy lifestyle remained significant associations with cardiovascular disease and PAOD, with an odds ratio (OR) of 2.09 (95% confidence interval [CI] 1.18–3.69) and 2.68 (95% CI 1.21–5.90), respectively. Among individual factor for unhealthy lifestyle behaviors, we revealed that eating ≥ 4 meals per day with night snack increased the risk of cardiovascular disease and nephropathy after multivariable adjustment (OR of 2.60, 95% CI 1.28–5.30; OR of 2.54, 95% CI 1.52–4.26, respectively). Whereas sit duration for ≥ 8 h per day increased the risk of PAOD (OR of 4.32, 95% CI 2.38–7.84).

Conclusion
Unhealthy lifestyle is associated with increased prevalence of macro- and micro-vascular comorbidities in Taiwanese patients with long-duration type 2 diabetes.
Impact of tooth brushing on oral bacteriota and health care-associated infections among ventilated COVID-19 patients: an intervention study
Authors: Gregorczyk-Maga Iwona , Pałka Anna , Fiema Mateusz , Kania Michal , Kujawska Anna , Maga Paweł , Jachowicz-Matczak Estera , Romaniszyn Dorota , Chmielarczyk Agnieszka , Żółtowska Barbara , Wójkowska-Mach Jadwiga 
Published: March 2023

Abstract
Background
Up to 48% of ventilated coronavirus disease 2019 (COVID-19) patients develop ventilator-associated pneumonia (VAP) during hospitalization in an ICU. Dysbiotic oral microbiota can colonize the lower respiratory tract and lead to VAP. It is recommended to introduce oral care strategies in the ICU to prevent VAP. In this study, we observed the impact of an oral hygienic protocol with tooth brushing on cultivable oral bacteriota, the incidence of HAI and patient safety among mechanically ventilated COVID-19 patients in an ICU setting.

Methods
In this prospective cohort study, we recruited 56 adult COVID-19 patients who qualified for mechanical ventilation. Patients were divided into 2 groups depending on the oral care procedure: standard and extended oral procedures with tooth brushing. Oral bacteriota samples were taken first within 36 h and after 7 days of intubation. Microorganisms were identified by MALDI/TOF mass spectrometry. bacterial health care-associated infection (HAI) cases were retrospectively analyzed by etiology. A PFGE study was performed for Klebsiella pneumoniae to check for clonal spreading of strains from oral bacteriota samples and HAI cases.

Results
We observed significant dysbiosis and a decrease in cultivable oral bacteriota diversity, with a high frequency of potentially pathogenic species, including Acinetobacter baumannii and K. pneumoniae. The HAI incidence rate was high (55.2/1000 patient-days), most commonly of K. pneumoniae and A. baumannii etiologies, which correlated with the presence of A. baumannii and K. pneumoniae in the oral samples. Strains isolated from VAP cases were the same as oral isolates in 8 cases. The procedure with tooth brushing led to less frequent identification of A. baumannii in oral samples (55.6% vs. 5.3%, p = 0.001); however, it did not decrease the incidence of HAIs.

Conclusions
Dysbiotic oral bacteriota is an important source of respiratory pathogens. The introduction of tooth brushing in oral hygiene protocols in an ICU setting was effective in decreasing the extent of oral bacteriota dysbiosis; however, it did not reduce the risk of HAIs or mortality.
Trial registration: 1072.6120.333.2020.
Lack of concentration‐dependent local toxicity of highly concentrated (5%) versus conventional 0.5% bupivacaine following musculoskeletal surgery in a rat model
Authors: Steverink Jasper G. , van Tol Floris R. , Bruins Suzanne , Smorenburg Andre J. , Tryfonidou Marianna A. , Oosterman Bas J. , van Dijk Marijke R. , Malda Jos , Verlaan Jorrit‐Jan 
Published: March 2023

AbstractPurposeVarious sustained‐release formulations incorporate high bupivacaine concentrations but data on local toxicity is lacking. This study explores local toxic effects of highly concentrated (5%) bupivacaine compared to clinically used concentrations in vivo following skeletal surgery, to assess the safety of sustained‐release formulations with high bupivacaine concentrations.MethodsSixteen rats underwent surgery, in which screws with catheters affixed were implanted in the spine or femur in a factorial experimental design, allowing single‐shot or continuous 72 h local administration of 0.5%, 2.5% or 5.0% bupivacaine hydrochloride. During the 30‐day follow‐up, animal weight was recorded and blood samples were obtained. Implantation sites underwent histopathological scoring for muscle damage, inflammation, necrosis, periosteal reaction/thickening and osteoblast activity. Effects of bupivacaine concentration, administration mode and implantation site on local toxicity scores were analyzed.ResultsChi‐squared tests for score frequencies revealed a concentration‐dependent decrease in osteoblast count. Moreover, spinal screw implantation led to significantly more muscle fibrosis but less bone damage than femoral screw implantation, reflecting the more invasive muscle dissection and shorter drilling times related to the spinal procedure. No differences between bupivacaine administration modes regarding histological scoring or body weight changes were observed. Weight increased, while CK levels and leukocyte counts decreased significantly during follow‐up, reflecting postoperative recovery. No significant differences in weight, leukocyte count and CK were found between interventional groups.ConclusionThis pilot study found limited concentration‐dependent local tissue effects of bupivacaine solutions concentrated up to 5.0% following musculoskeletal surgery in the rat study population.
Large-scale expansion of human umbilical cord-derived mesenchymal stem cells using PLGA@PLL scaffold
Authors: Liu Yujie , Amissah Obed Boadi , Huangfang Xiaoying , Wang Ling , Dieu Habimana Jean de , Lv Linshuang , Ding Xuanyan , Li Junyi , Chen Ming , Zhu Jinmin , Mukama Omar , Sun Yirong , Li Zhiyuan , Huang Rongqi 
Published: March 2023

AbstractMesenchymal stem cells (MSCs) are highly important in biomedicine and hold great potential in clinical treatment for various diseases. In recent years, the capabilities of MSCs have been under extensive investigation for practical application. Regarding therapy, the efficacy usually depends on the amount of MSCs. Nevertheless, the yield of MSCs is still limited due to the traditional cultural methods. Herein, we proposed a three-dimensional (3D) scaffold prepared using poly lactic-co-glycolic acid (PLGA) nanofiber with polylysine (PLL) grafting, to promote the growth and proliferation of MSCs derived from the human umbilical cord (hUC-MSCs). We found that the inoculated hUC-MSCs adhered efficiently to the PLGA scaffold with good affinity, fast growth rate, and good multipotency. The harvested cells were ideally distributed on the scaffold and we were able to gain a larger yield than the traditional culturing methods under the same condition. Thus, our cell seeding with a 3D scaffold could serve as a promising strategy for cell proliferation in the large-scale production of MSCs. Moreover, the simplicity and low preparation cost allow this 3D scaffold to extend its potential application beyond cell culture.
Graphical Abstract
Chemical exposures and suspected impact on Gulf War Veterans
Authors: Elhaj Rami , Reynolds Joseph M. 
Published: March 2023

AbstractGulf War Illness (GWI) encompass a spectrum of maladies specific to troops deployed during the Persian Gulf War (1990–1991). There are several hypothesized factors believed to contribute to GWI, including (but not limited to) exposures to chemical agents and a foreign environment (e.g., dust, pollens, insects, and microbes). Moreover, the inherent stress associated with deployment and combat has been associated with GWI. While the etiology of GWI remains uncertain, several studies have provided strong evidence that chemical exposures, especially neurotoxicants, may be underlying factors for the development of GWI. This mini style perspective article will focus on some of the major evidence linking chemical exposures to GWI development and persistence decades after exposure.
Selenium deficiency and scurvy due to an imbalanced diet of snacks and lacto-fermenting drinks: a case report of a 7-year-old boy with autism spectrum disorder
Authors: Okada Makoto , Nagayama Yugo , Saiki Hitomi , Ito Kazutoshi , Yatsuga Shuichi , Nagamitsu Shinichiro 
Published: March 2023

Abstract
Background
There have been reports of isolated trace elements or vitamin deficiencies due to imbalanced diets, but no cases of selenium deficiency combined with scurvy have been reported.

Case presentation
A 7 year-old boy diagnosed with autistic spectrum disorder and mild psychomotor retardation, started an imbalanced diet including specific snacks and lacto-fermenting drinks from 5 years of age. Gingival hemorrhage and perioral erosions occurred at 6 years and 8 months of age, and he was referred to our hospital at 7 years of age. Slight tachycardia was found. Serum vitamin C level was 1.1 µg/dL (reference range (rr): 5–17.5 µg/dL), and selenium level was 2.8 µg/dL (rr: 7.7–14.8 µg/dL). He was diagnosed with both selenium deficiency and scurvy. Multivitamins and sodium selenate were administered for 12 days during admission, and symptoms of selenium deficiency and scurvy improved. After discharge, symptoms abated following the administration of multivitamins and regular administration of sodium selenate every 3 months.

Conclusions
We report a complicated case of both selenium deficiency and scurvy due to an imbalanced diet of snacks and lacto-fermenting drinks in a 7-year-old boy with autism spectrum disorder. In patients with imbalanced diet, regular blood tests including trace elements and vitamins are necessary.
Association between ESR1 rs2234693 single nucleotide polymorphism and uterine fibroids in Taiwanese premenopausal and postmenopausal women
Authors: Tyan Yeu-Sheng , Shen Chao-Yu , Tantoh Disline Manli , Hsu Shu-Yi , Chou Ying-Hsiang , Nfor Oswald Ndi , Liaw Yung-Po 
Published: March 2023

AbstractBackgroundUterine fibroids (UFs) are uterine smooth muscle neoplasms that affect women, especially during the reproductive stage. Both genetic and lifestyle factors affect the onset of the disease. We examined the association between the estrogen receptor 1 (ESR1) rs2234693 variant (whose genotypes are TT, TC, and CC) and UFs in Taiwanese premenopausal and postmenopausal women.MethodsWe linked individual-level data of 3588 participants from the Taiwan Biobank to the National Health Insurance Research Database at the Health and Welfare Data Science Center. The association of the ESR1 rs2234693 variant and other variables with UFs was determined by multiple logistic regression, and the results were presented as odds ratios and 95% confidence intervals (CIs).ResultsThe 3588 participants comprised 622 cases and 2966 controls. In all the participants, the ESR1 rs2234693 TC and CC genotypes compared to the reference genotype (TT) were associated with a lower risk of UFs. However, the results were significant only for the CC genotype (OR; 95% CI = 0.70; 0.52–0.93). Noteworthy, the association of TC and CC with UFs was dose-dependent (p-trend = 0.012). Based on menopausal status, both TC and CC were significantly and dose-dependently associated with a lower risk of UFs in premenopausal women (OR; 95% CI = 0.76; 0.59–0.98 for TC and 0.64; 0.43–0.95 for CC:p-trend = 0.010).ConclusionThe TC and CC genotypes of the ESR1 rs2234693 variant may reduce susceptibility to UFs, especially in premenopausal women.
Combination of Anatomical and Biological Factors to Predict Disease-Free Survival in Breast Cancer
Authors: Mohamed Rehab F. , Abdelhameed Donia H. , Mohamed Mohamed Alaa 
Published: March 2023

PURPOSE The combination of anatomical and biological factors of breast cancer in a new staging system has a prognostic role. This study investigates the prognostic value of the Bioscore among patients with breast cancer with respect to disease-free survival (DFS). MATERIAL AND METHODS This study included 317 patients with breast cancer who were identified between January 2015 and December 2018 at Clinical Oncology Department of Assiut University Hospital. Their cancer baseline characteristics were recorded: pathologic stage (PS), T stage (T), nodal stage (N), grade (G), estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) status. Univariate and two multivariate analyses were performed to identify which of these variables are associated with DFS. Model performance was quantified using Harrell's concordance index (C-index), and the Akaike information criterion (AIC) was used to compare model fits. RESULTS The significant factors in the univariate analysis were PS3, T2, T3, T4, N3, G2, G3, ER-negative, PR-negative, and HER2-negative. In the first multivariate analysis, PS3, G3, and ER-negative were the significant factors, and in the second multivariate analysis, T2, T4, N3, G3, and ER-negative were the significant factors. Two sets of models were built to determine the utility of combining variables. Models incorporating G and ER status had the highest C-index (0.72) for T + N + G + ER in comparison with (0.69) PS + G + ER and the lowest AIC (953.01) for T + N + G + ER and (966.9) for PS + G + ER. Conclusion Using the Bioscore in breast cancer staging helps to identify patients at increased risk of recurrence. It provides more optimistic prognostic stratification than the anatomical staging alone for DFS.
Circulating Chemerin Is Elevated in Women With Preeclampsia
Authors: Bartho Lucy A , Kandel Manju , Walker Susan P , Cluver Catherine A , Hastie Roxanne , Bergman Lina , Pritchard Natasha , Cannon Ping , Nguyen Tuong-Vi , Wong Georgia P , MacDonald Teresa M , Keenan Emerson , Hannan Natalie J , Tong Stephen , Kaitu’u-Lino Tu’uhevaha J 
Published: March 2023

AbstractBackground: Preeclampsia is a severe complication of pregnancy. Chemerin is an adipokine secreted from adipose tissue and highly expressed in placenta. This study evaluated the biomarker potential of circulating chemerin to predict preeclampsia.Methods: Maternal plasma and placenta were collected from women with early-onset preeclampsia (&lt;34 weeks), with preeclampsia and eclampsia, or before preeclampsia diagnosis (36 weeks). Human trophoblast stem cells were differentiated into syncytiotrophoblast or extravillous trophoblasts across 96 hours. Cells were cultured in 1% O2 (hypoxia) or 5% O2 (normoxia). Chemerin was measured by enzyme-linked immunosorbent assay (ELISA) and RARRES2 (gene coding chemerin) by reverse transcription-quantitative polymerase chain reaction.Results: Circulating chemerin was increased in 46 women with early-onset preeclampsia (&lt;34 weeks) compared to 17 controls (P &lt; .0006). Chemerin was increased in placenta from 43 women with early-onset preeclampsia compared to 24 controls (P &lt; .0001). RARRES2 was reduced in placenta from 43 women with early-onset preeclampsia vs 24 controls (P &lt; .0001).Chemerin was increased in plasma from 26 women with established preeclampsia (P = .006), vs 15 controls. Circulating chemerin was increased in 23 women who later developed preeclampsia vs 182 who did not (P = 3.23 × 10−6).RARRES2 was reduced in syncytiotrophoblast (P = .005) or extravillous trophoblasts (P &lt; .0001). Hypoxia increased RARRES2 expression in syncytiotrophoblast (P = .01) but not cytotrophoblast cells.Conclusions: Circulating chemerin was elevated in women with early-onset preeclampsia, established preeclampsia, and preceding preeclampsia diagnosis of preeclampsia. RARRES2 was dysregulated in placenta complicated by preeclampsia and may be regulated through hypoxia. Chemerin may have potential as a biomarker for preeclampsia but would need to be combined with other biomarkers.
Biblical and Theological Literacy and Victorian Studies Today
Authors: Larsen Timothy 
Published: March 2023

AbstractThis article explores the current state of biblical and theological literacy in the discipline of Victorian studies. It observes the ordinarily strong, careful, and impressive work done in recent decades, especially since some scholars have become interested in a postsecular approach to the field. It also, however, presents some egregious lapses in basic biblical and theological literacy that mar otherwise meticulous contemporary scholarship. This article hopes to open a conversation on how such glaring errors and misunderstandings have found their way into peer-reviewed work over and over again and to invite Victorian scholars to commit to finding ways to prevent this in the future.
Framework for virtual education of COVID-19 vaccines for Mandarin-speaking learners: an educational intervention module
Authors: Wang JiCi , Moy Benjamin M. , Kaufhold Ross T. , Muzaurieta Aurelio , Xia Yang , Jiang Shannon , Yim Angela , Chang Miller Jane , Zhou Shiwei , Lee Pearl , Hou Lisa , Lee Janilla , Heung Michael 
Published: March 2023

Background: In the United States, patients with limited English proficiency face significant barriers to comprehending and acting upon health-related information, particularly during the COVID-19 pandemic. The ability of health professionals to communicate COVID-19-related information to Mandarin-speaking patients has proved critical in discussions about vaccine efficacy, side effects, and post-vaccine protection. Methods: The authors created a one-hour educational module to help Mandarin-speaking medical students better convey COVID-19 vaccine information to Mandarin-only speakers. The module is composed of an educational guide, which introduced key terminology and addressed commonly asked questions, and pre- and post-surveys. The authors recruited 59 Mandarin-speaking medical students all of whom had previously completed a medical Mandarin elective. The module and surveys were distributed and completed in August 2021. Data analysis measured the change in aggregate mean for subjective five-point Likert-scale questions and change in percent accuracy for objective knowledge-based questions. Results: The educational module significantly improved participants' subjective comfort level in discussing the COVID-19 vaccine in English and Mandarin. The largest improvement in both English and Mandarin was demonstrated in the participants ability to explain differences between the COVID-19 vaccines, with an aggregate mean improvement of 0.39 for English and 1.48 for Mandarin. Survey respondents also demonstrated increased percent accuracy in knowledge-based objective questions in Mandarin. Conclusions: This module provides Mandarin-learning medical students with skills to deliver reliable information to the general population and acts as a model for the continued development of educational modules for multilingual medical professionals.