bluuebunny/crossref_metadata_2025_split huggingface dataset:
DESIGN, IMPLEMENTATION AND EVALUATION OF A SMART TOOTHBRUSH FOR INDIVIDUALS WITH DEMENTIA
Authors: Shakeri Jannati Mohammad E. , O’Byrne Sarah K , Moussavi Zahra 
Published: June 2023

Abstract
Dementia in general and Alzheimer’s Disease in particular, is one of the most challenging health conditions in our century. Experiencing cognitive decline, resulting in relying on others for daily living activities and impairment in basic mental tasks are the main symptoms. There are yet no proven treatments to slow or prevent neurodegenerative dementia progression; thus, dementia patients eventually need full-time care. To help patients to stay in their own homes longer and ease the caregiver burden, Smart Assistive Technology (SAT) products may be beneficial. One of the basic activities that Alzheimer’s patients in particular need help with, are basic hygiene needs such as brushing their teeth. A smart toothbrush has been designed and implemented as a pilot study towards development of a SAT for basic hygiene functions of dementia patients, while it can also have educational application for children. The design includes hardware and software. The hardware includes 9-Axis motion sensor, individually addressable light-emitting diodes (LEDs), Bluetooth Light Energy (BLE) communication module, laser distance sensor and other electrical components. The software includes real-time monitoring of several dependent and independent tasks using an algorithm to assist the users and transmit that data to a smartphone application. The real-time monitoring system of the designed prototype assists the users by visual and auditory means. It is anticipated the designed prototype will assist people with dementia, and hopefully prolong the time they can be cared for at home; it may also be used for oral hygiene education and instruction in general.
HAND MOVEMENT GLOVE FOR CHILD WITH TITINOPATHY
Authors: Bass Hannah , Foster Charles , Santhanaraj Akshaya , Kumar Shourya 
Published: June 2023

Abstract
Patients with titinopathy or hand paralysis often lack quality, low cost therapeutic tools to aid in gaining hand strength and range of motion. As a result, our team sought to develop a way to increase flexion and passive motion in the hand of a patient with titinopathy in order to gain functionality. This paper outlines the design and development of a novel therapeutic glove for a 4 year old boy with a neuromuscular disease that prevents him from flexing the two distal joints of his fingers.
The team has developed a low-cost hand movement glove (HMG) to be used as a supplement to traditional physical therapy. The device utilizes a motor-cable system secured to each finger, allowing for independent and synchronized flexion of each finger. Phase I of prototyping resulted in a working model to assess the finger movement mechanism and overall wearability of the device. Phase II utilized an Arduino Uno microcontroller, circuit switch, PCA9685 driver board, micro servo motors, a cotton woven glove, and 3-D printed components to characterize a more robust model allowing independent flexion of each finger.
Initial testing has proven the device’s ability to achieve physiologically relevant degrees of flexion in each finger. Upon completion of further testing, we anticipate this device having a profound impact as an additional tool utilized in the patient’s physical therapy regimen to allow for regained flexion at both proximal and distal interphalangeal joints.
A RECONFIGURABLE, ADDITIVELY MANUFACTURED VIBROTACTILE STIMULATION DEVICE FOR CHRONIC PAIN
Authors: Adams Josh , Demarest Phillip , Donovan Kara , Brunner Dr. Peter , Burton Dr. Harold , Haroutounian Dr. Simon , Leuthardt Dr. Eric , Gorlewicz Dr. Jenna 
Published: June 2023

Abstract
This paper presents an experimental chronic pain rehabilitation therapy utilizing vibration-based stimulation of the hand, wrist and lower arm, which has shown promise in reducing pain ratings in chronic pain patients (n=5) over a six-week treatment period. Based on the clinical need and practical use discoveries of that first trial, this paper outlines the development of a second-generation device that activates specific nerves through vibrotactile stimulation applied to the skin. Several major steps in this process were the iterative design process, physical prototyping, conceptual modeling, and benchtop testing. Furthermore, this next generation device was tested with epilepsy patients undergoing invasive monitoring (stereotactic electroencephalography, sEEG) to collect electrophysiological measurements via implanted electrodes in the brain. Early findings showed differential modulation of delta power in response to 2 Hz median nerve stimulation, but not during 12 Hz median nerve stimulation or 2 Hz ulnar nerve stimulation, hence indicating differential encoding of vibration features depending on frequency and spatial parameters. These patient trials also served to collect feedback for the continued development of the device to improve aspects such as ease of use, patient comfort, and ideal application of the vibration stimulus. Testing and development are ongoing with the enhancement of vibration isolating structures, more comfortable contact points, more durable additively manufactured structures, and embedded force sensors in the device.
Intensified follow-up of patients with type 1 diabetes and poor glycaemic control: a multicentre quality improvement collaborative based on data from the Norwegian Diabetes Register for Adults
Authors: Vonheim Madsen Tone , Cooper John Graham , Carlsen Siri , Loevaas Karianne , Rekdal Magne , Igland Jannicke , Sandberg Sverre , Ueland Grethe Åstrøm , Iversen Marjolein Memelink , Sølvik Una 
Published: June 2023

BackgroundPatients with type 1 diabetes mellitus (T1DM) and poor glycaemic control are at high risk of developing microvascular and macrovascular complications. The aim of this study was to determine if a quality improvement collaborative (QIC) initiated by the Norwegian Diabetes Register for adults (NDR-A) could reduce the proportion of patients with T1DM with poor glycaemic control (defined as glycated haemoglobin (HbA1c)≥75 mmol/mol) and reduce mean HbA1c at participating clinics compared with 14 control clinics.MethodMulticentre study with controlled before and after design. Representatives of 13 diabetes outpatient clinics (n=5145 patients with T1DM) in the intervention group attended four project meetings during an 18-month QIC. They were required to identify areas requiring improvement at their clinic and make action plans. Continuous feedback on HbA1c outcomes was provided by NDR-A during the project. In total 4084 patients with type 1 diabetes attended the control clinics.ResultsBetween 2016 and 2019, the overall proportion of patients with T1DM and HbA1c≥75 mmol/mol in the intervention group were reduced from 19.3% to 14.1% (p<0.001). Corresponding proportions in the control group were reduced from 17.3% (2016) to 14.4% (2019) (p<0.001). Between 2016 and 2019, overall mean HbA1c decreased by 2.8 mmol/mol (p<0.001) at intervention clinics compared with 2.3 mmol/mol (p<0.001) at control clinics. After adjusting for the baseline differences in glycaemic control, there were no significant differences in the overall improvement in glycaemic control between intervention and control clinics.ConclusionsThe registry linked QIC did not result in a significantly greater improvement in glycaemic control at intervention clinics compared with control clinics. However, there has been a sustained improvement in glycaemic control and importantly a significant reduction in the proportion of patients with poor glycaemic control at both intervention and control clinics during and after the QIC time frame. It is possible that some of this improvement may be due to a spillover effect from the QIC.
A Survey on Influence Maximization: From an ML-Based Combinatorial Optimization
Authors: Li Yandi , Gao Haobo , Gao Yunxuan , Guo Jianxiong , Wu Weili 
Published: June 2023

Influence Maximization (IM) is a classical combinatorial optimization problem, which can be widely used in mobile networks, social computing, and recommendation systems. It aims at selecting a small number of users such that maximizing the influence spread across the online social network. Because of its potential commercial and academic value, there are a lot of researchers focusing on studying the IM problem from different perspectives. The main challenge comes from the NP-hardness of the IM problem and #P-hardness of estimating the influence spread, thus traditional algorithms for overcoming them can be categorized into two classes: heuristic algorithms and approximation algorithms. However, there is no theoretical guarantee for heuristic algorithms, and the theoretical design is close to the limit. Therefore, it is almost impossible to further optimize and improve their performance.
With the rapid development of artificial intelligence, technologies based on Machine Learning (ML) have achieved remarkable achievements in many fields. In view of this, in recent years, a number of new methods have emerged to solve combinatorial optimization problems by using ML-based techniques. These methods have the advantages of fast solving speed and strong generalization ability to unknown graphs, which provide a brand-new direction for solving combinatorial optimization problems. Therefore, we abandon the traditional algorithms based on iterative search and review the recent development of ML-based methods, especially Deep Reinforcement Learning, to solve the IM problem and other variants in social networks. We focus on summarizing the relevant background knowledge, basic principles, common methods, and applied research. Finally, the challenges that need to be solved urgently in future IM research are pointed out.
Aerobic Exercise Alters the Melanoma Microenvironment and Modulates ERK5 S496 Phosphorylation
Authors: Savage Hannah , Pareek Sumedha , Lee Jonghae , Ballarò Riccardo , Conterno Minussi Darlan , Hayek Karma , Sadullozoda Mumina , Lochmann Brooke S. , McQuade Jennifer L. , LaVoy Emily C. , Marmonti Enrica , Patel Hetal , Wang Guangyu , Imanishi Masaki , Kotla Sivareddy , Abe Jun-ichi , Schadler Keri 
Published: June 2023

Abstract
Exercise changes the tumor microenvironment by remodeling blood vessels and increasing infiltration by cytotoxic immune cells. The mechanisms driving these changes remain unclear. Herein, we demonstrate that exercise normalizes tumor vasculature and upregulates endothelial expression of VCAM1 in YUMMER 1.7 and B16F10 murine models of melanoma but differentially regulates tumor growth, hypoxia, and the immune response. We found that exercise suppressed tumor growth and increased CD8+ T-cell infiltration in YUMMER but not in B16F10 tumors. Single-cell RNA sequencing and flow cytometry revealed exercise modulated the number and phenotype of tumor-infiltrating CD8+ T cells and myeloid cells. Specifically, exercise caused a phenotypic shift in the tumor-associated macrophage population and increased the expression of MHC class II transcripts. We further demonstrated that ERK5 S496A knock-in mice, which are phosphorylation deficient at the S496 residue, “mimicked” the exercise effect when unexercised, yet when exercised, these mice displayed a reversal in the effect of exercise on tumor growth and macrophage polarization compared with wild-type mice. Taken together, our results reveal tumor-specific differences in the immune response to exercise and show that ERK5 signaling via the S496 residue plays a crucial role in exercise-induced tumor microenvironment changes.
See related Spotlight by Betof Warner, p. 1158
Evaluating Work Impairment as a Source of Financial Toxicity in Cancer Healthcare and Negative Impacts on Health Status
Authors: Mudaranthakam Dinesh Pal , Nollen Nicole , Wick Jo , Hughes Dorothy , Welch Danny , Calhoun Elizabeth 
Published: June 2023

How the socioeconomic factors intersect for a particular patient can determine their susceptibility to financial toxicity, what costs they will encounter during treatment, the type and quality of their care, and the potential work impairments they face. The primary goal of this study was to evaluate financial factors leading to worsening health outcomes by the cancer subtype. A logistic model predicting worsening health outcomes while assessing the most influential economic factors was constructed by the University of Michigan Health and Retirement Study. A forward stepwise regression procedure was implemented to identify the social risk factors that impact health status. Stepwise regression was done on data subsets based on the cancer types of lung, breast, prostate, and colon cancer to determine whether significant predictors of worsening health status were different or the same across cancer types. Independent covariate analysis was also conducted to cross-validate our model. On the basis of the model fit statistics, the two-factor model has the best fit, that is, the lowest AIC among potential models of 3270.56, percent concordance of 64.7, and a C-statistics of 0.65. The two-factor model used work impairment and out-of-pocket costs, significantly contributing to worsening health outcomes. Covariate analysis demonstrated that younger patients with cancer experienced more financial burdens leading to worsening health outcomes than elderly patients aged 65 years and above. Work impairment and high out-of-pocket costs were significantly associated with worsening health outcomes among cancer patients. Matching the participants who need the most financial help with appropriate resources is essential to mitigate the financial burden.

Significance:
Among patients with cancer, work impairment and out-of-pocket are the two primary factors contributing to adverse health outcomes. Women, African American or other races, the Hispanic population, and younger individuals have encountered higher work impairment and out-of-pocket costs due to cancer than their counterparts.
Comprehensive Transcriptomics Profiling of MicroRNA Reveals Plasma Circulating Biomarkers of Hypertrophic Cardiomyopathy and Dysregulated Signaling Pathways
Authors: Liang Lusha W. , Hasegawa Kohei , Maurer Mathew S. , Reilly Muredach P. , Fifer Michael A. , Shimada Yuichi J. 
Published: June 2023

Background:
Hypertrophic cardiomyopathy (HCM) is caused by mutations in genes coding for proteins essential for myocardial contraction. However, it remains unclear through which signaling pathways these gene mutations mediate HCM pathogenesis. Growing evidence indicates that microRNAs (miRNAs) play an important role in the regulation of gene expression. We hypothesized that transcriptomics profiling of plasma miRNAs would reveal circulating biomarkers and dysregulated signaling pathways in HCM.

Methods:

We conducted a multicenter case-control study of cases with HCM and controls with hypertensive left ventricular hypertrophy. We performed plasma transcriptomics profiling of miRNAs using RNA sequencing. We developed a transcriptomics-based discrimination model using samples retrieved during the first two-thirds of the study period at one institution (training set). We prospectively tested its discriminative ability in samples collected thereafter from the same institution (prospective test set). We also externally validated the model by applying it to samples collected from the other institutions (external test set). We executed pathway analysis of dysregulated miRNAs with univariable
P
<0.05.

Results:
This study included 555 patients (392 cases and 163 controls). One thousand one hundred forty-one miRNAs passed our quality control filters. The area under the receiver operating characteristic curve of the transcriptomics-based model derived from the training set was 0.86 (95% CI, 0.79–0.93) in the prospective test set and 0.94 (95% CI, 0.90–0.97) in the external test set. Pathway analysis revealed dysregulation of the Ras-MAPK (mitogen-activated protein kinase) pathway and pathways related to inflammation in HCM.

Conclusions:
This study utilized comprehensive transcriptomics profiling with RNA sequencing in HCM, revealing circulating miRNA biomarkers and dysregulated pathways.
A Regime Shift on Weddell Sea Continental Shelves with Local and Remote Physical and Biogeochemical Implications is Avoidable in a 2°C Scenario
Authors: Nissen Cara , Timmermann Ralph , Hoppema Mario , Hauck Judith 
Published: June 2023

Abstract
Tipping points in the Earth system describe critical thresholds beyond which a single component, part of the system, or the system as a whole changes from one stable state to another. In the present-day Southern Ocean, the Weddell Sea constitutes an important dense-water formation site, associated with efficient deep-ocean carbon and oxygen transfer and low ice-shelf basal melt rates. Here, a regime shift will occur when continental shelves are continuously flushed with warm, oxygen-poor offshore waters from intermediate depth, leading to less efficient deep-ocean carbon and oxygen transfer and higher ice-shelf basal melt rates. We use a global ocean–biogeochemistry model including ice-shelf cavities and an eddy-permitting grid in the southern Weddell Sea to address the susceptibility of this region to such a system change for four twenty-first-century emission scenarios. Assessing the projected changes in shelf–open-ocean density gradients, bottom-water properties, and on-shelf heat transport, our results indicate that the Weddell Sea undergoes a regime shift by 2100 in the highest-emission scenario, SSP5–8.5, but not yet in the lower-emission scenarios. The regime shift is imminent by 2100 in the scenarios SSP3–7.0 and SSP2–4.5, but avoidable under the lowest-emission scenario SSP1–2.6. While shelf-bottom waters freshen and acidify everywhere, bottom waters in the Filchner Trough undergo accelerated warming and deoxygenation following the system change, with implications for local ecosystems and ice-shelf basal melt. Additionally, deep-ocean carbon and oxygen transfer decline, implying that the local changes ultimately affect ocean circulation, climate, and ecosystems globally.
Homemade Dart Attacks in Hawai’i
Authors: Balaraman Prashanth K. , Ng Karen , Perry Kyle , Hayashi Michael S. 
Published: June 2023

Over a 4.5-year period (September 2014 to March 2019), 7 patients presented to the State’s only Level I Trauma Center with penetrating injuries inflicted by homemade metallic darts. Previously described in Micronesia, these are the first domestic cases of assaults utilizing this type of weaponry. Retrospective chart review was conducted for all patients who presented to our institution with a dart injury within the study period. Details regarding demographics, imaging, and patient management were collected and described herein. All 7 patients were male with a median age of 24.6 years impaled with darts that penetrated through the deep muscle and tissue layers of the neck, torso, or extremity. Three patients required operative intervention and no mortalities were observed. The depth of penetration and proximity to vital structures highlight the potential for life-threatening injuries from these homemade darts.
The Gradual and Immediate Violence of an Engineered Conflict: School Closings, Public Housing, Law Enforcement, and the Future of Black Life in Chicago
Authors: Stovall David 
Published: June 2023

Background/Context: This article considers violence, both structurally and interpersonally, in Chicago, a city that moves to isolate and contain many of its Black working-class/low-income/no-income residents. Violence (particularly death by gun violence) should never be understood as a singular social problem that requires unilateral decisions on how to address the issue. Instead, it is critical to understand that homicides and other forms of violence are often the outcomes of conflict exacerbated by planned scarcity and abandonment (engineered conflict). In short, we should consider these conflicts as largely engineered by the state, declaring some Chicago residents to be of value along the lines of race, class, gender, age, (dis)ability, and sexual orientation, while others are deemed disposable. Purpose/Objective/Research Question/Focus of Study: Instead of the deficit narrative of crazed, pathological criminals roaming the streets, another conversation pushes us to understand violence beyond the acts that result in bodily harm or death, and begin to consider the structural conditions that increase the chances of a violent act taking place. For these reasons, this article contemplates the following questions: What pushes people to be in conflict with each other while remaining reluctant to strike back at the system that has largely engineered the conditions of marginalization, isolation, and containment? More important, for those who have decided to resist, what are they doing to address the situation while building new realities for themselves and the people they care about? Research Design: The design of the study is qualitative, utilizing archival and current data on school closings, the destruction of public housing, and law enforcement. Utilizing conceptual design, the study positions engineered conflict as a material and ideological process with the goal of rendering certain Black communities in Chicago disposable. Conclusions/Recommendations: Instead of ending with the adage that “there’s nothing we can do about it,” we should understand that people who find state-sanctioned violence to be unacceptable are operating in ways that are proactive and compelling. Local organizations throughout the city have created their own unique processes in developing strategies to address affordable housing, quality education, and public safety. Their consideration of fugitive possibilities (strategies that are not based in commonplace policy solutions offered by the state) and actions is critical in a city that attempts to enforce a logic of disposability on their humanity.
Ribociclib-induced visual hallucination in a patient with metastatic breast cancer
Authors: Kapagan Tanju , Bulut Nilufer , Demirer Serhat , Erdem Gokmen Umut 
Published: June 2023

Introduction Cyclin-dependent kinase (CDK) 4/6 inhibitors are widely used in combination with aromatase inhibitors or fulvestrant for the treatment of locally advanced or metastatic hormone receptor-positive (HR+), human epidermal growth factor 2-negative (HER2-) breast cancer. Hematological toxicities (e.g. neutropenia, thrombocytopenia, anemia, lymphopenia, or febrile neutropenia), infections, decreased appetite, exhaustion, headache, dizziness, cough, nausea, vomiting, diarrhea, alopecia, rash, increased alanine aminotransferase and aspartate aminotransferase levels, and QT interval prolongation are frequent side effects associated with the use of CDK 4/6 inhibitors. However, to our knowledge, no case of hallucination associated with CDK 4/6 inhibitor use has been described in the English-language literature. Case report We report a case of a 72-year-old woman with metastatic breast cancer who developed visual hallucinations after receiving ribociclib, a CDK 4/6 inhibitor, and letrozole for 3 days. Cranial imaging and blood tests did not reveal the cause of the hallucinations. Management and outcome The visual hallucinations completely resolved within 4 days after the ribociclib treatment was terminated. The patient received only letrozole for 2 weeks, and ribociclib treatment was restarted 2 weeks later. Visual hallucinations recurred on the third day of treatment, and ribociclib treatment was discontinued again. The patient recovered completely from visual hallucinations 4 days after discontinuation. Subsequently, treatment was continued with letrozole and palbociclib, another CDK 4/6 inhibitor. Hallucinations did not recur during follow-up. Discussion To our knowledge, this is the first reported case of hallucinations caused by ribociclib; notably, it shows that symptoms may develop in the early stage of treatment.