bluuebunny/crossref_metadata_2025_split huggingface dataset:
A practical guide to botulinum neurotoxin treatment of shoulder spasticity 2: Injection techniques, outcome measurement scales, and case studies
Authors: Wissel Jörg , Camões-Barbosa Alexandre , Carda Stefano , Hoad Damon , Jacinto Jorge 
Published: December 2022

IntroductionBotulinum neurotoxin type A (BoNT-A) is a first-line treatment option for post-stroke spasticity, reducing pain and involuntary movements and helping to restore function. BoNT-A is frequently injected into the arm, the wrist, the hand, and/or the finger muscles but less often into the shoulder muscles, despite clinical trials demonstrating improvements in pain and function after shoulder BoNT-A injection.MethodsIn part 2 of this two-part practical guide, we present an experts' consensus on the choice of outcome measurement scales and goal-setting recommendations for BoNT-A in the treatment of shoulder spasticity to increase awareness of shoulder muscle injection with BoNT-A, alongside the more commonly injected upper limb muscles. Expert consensus was obtained from five European experts with a cumulative experience of more than 100 years of BoNT-A use in post-stroke spasticity. Case studies are included as examples of approaches taken in the treatment of shoulder spasticity.ResultsAlthough the velocity-dependent increase in muscle tone is often a focus of patient assessment, it is only one component of spasticity and should be assessed as part of a wider range of measurements. For outcome measurement following BoNT-A injection in shoulder muscles, shoulder-specific scales are recommended. Other scales to be considered include Pain Numerical Rating and/or global functioning, as well as the quality of life and global perception of benefit scores.Goal setting is an essential part of the multidisciplinary management process for spasticity; goals should be patient-centric, realistic, and achievable; functional-focused goal statements and a mixture of short- (3–6 month) and long-term (9–18 month) goals are recommended. These can be grouped into symptomatic, passive function, active function, involuntary movement, and global mobility.Clinical evaluation tools, goal setting, and outcome expectations for the multipattern treatment of shoulder spasticity with BoNT-A should be defined by the whole multidisciplinary team, ensuring patient and caregiver involvement.DiscussionThese recommendations will be of benefit to clinicians who may not be experienced in evaluating and treating spastic shoulders.
Role of serum ceruloplasmin in the diagnosis of Wilson's disease: A large Chinese study
Authors: Yang Yue , Hao Wenjie , Wei Taohua , Tang LuLu , Qian Nannan , Yang Yulong , Xi Hu , Zhang Shijie , Yang Wenming 
Published: December 2022

BackgroundConventionally, serum ceruloplasmin levels below the lower reference limit (0. 20 g/L) is considered a diagnostic cutoff point for Wilson's disease (WD). However, the lower reference limit varies with assay methodologies and the individuals in the included studies. The objective of this study was to determine the optimal cutoff value of serum ceruloplasmin levels for the diagnosis of WD in a large Chinese cohort and to identify factors associated with serum ceruloplasmin.MethodsThe cutoff value of ceruloplasmin levels was developed based on a retrospective derivation cohort of 3,548 subjects (1,278 patients with WD and 2,270 controls) and was validated in a separate validation cohort of 313 subjects (203 patients with WD and 110 controls). The performance of immunoassay was tested by receiver operating characteristic curve (ROC) analysis, and differences among the groups were analyzed by using the Mann–Whitney U-test and the Kruskal–Wallis test.ResultsThe conventional cutoff of serum ceruloplasmin levels of &lt;0.2 g/L had an accuracy of 81.9%, which led to a false-positive rate of 30.5%. The optimal cutoff of the serum ceruloplasmin level for separating patients with WD from other participants was 0.13 g/L, as determined by ROC analysis. This cutoff value had the highest AUC value (0.99), a sensitivity of 97.0%, and a specificity of 96.1%. Moreover, it prevented unnecessary further investigations and treatments for 492 false-positive patients. By determining the correlation between serum ceruloplasmin and phenotypes/genotypes in patients with WD, we found that the serum ceruloplasmin level was lower in early-onset patients and higher in late-onset patients. Interestingly, patients with the R778L/R919G genotype had higher serum ceruloplasmin levels than patients with other hot spot mutation combinations.ConclusionOur work determined the optimal cutoff value of serum ceruloplasmin levels for the diagnosis of WD and identified differences in serum ceruloplasmin levels with respect to the age of symptom onset and ATP7B mutations, which may provide some valuable insights into the diagnosis and counsel of patients with WD.
Adding value to strawberry agro-industrial by-products through ultraviolet A-induced biofortification of antioxidant and anti-inflammatory phenolic compounds
Authors: Villamil-Galindo Esteban , Antunes-Ricardo Marilena , Piagentini Andrea Marcela , Jacobo-Velázquez Daniel A. 
Published: December 2022

BackgroundThe revalorization of agro-industrial by-products by applying ultraviolet A (UVA) radiation to biofortify with phenolic compounds has been studied in recent times, showing improvements in the individual and total phenolic content and their bioactivity. Therefore, the main aim of this work was to optimize the biofortification process of phenolic compounds by UVA radiation to strawberry agro-industrial by-products (RF). Moreover, the effect of UVA radiation on the potential biological activity of the phenolics accumulated in RF due to the treatment was also determined.MethodsThe assays followed a factorial design with three variables at three levels: UVA dose (LOW, MEDIUM, and HIGH), storage temperature (5, 10, and 15°C), and storage time (0, 24, 48, and 72 h). At each experimental condition, phenylalanine ammonia-lyase (PAL) and polyphenol oxidase (PPO) enzymatic activities, total phenolic compound content (TPC), phenolics profile (TPCHPLC), and agrimoniin content (AGN) were evaluated; and the optimal UVA dose, storage time, and temperature were determined. In vitro bioaccessibility of the accumulated phenolic compound was studied on RF tissue treated with UVA at optimal process conditions. The digested extracts were tested for antiproliferative activity in colorectal cancer cells, cellular antioxidant capacity, and anti-inflammatory activity.ResultsThe results showed that applying UVA-HIGH (86.4 KJ/m2) treatment and storing the tissue for 46 h at 15°C increased PAL activity (260%), phenolic content (240%), and AGN (300%). The biofortification process improves the bioaccessibility of the main phenolic compound of RF by 9.8 to 25%. The digested optimum extract showed an IC50 for HT29 and Caco-2 cells of 2.73 and 5.43 μg/mL, respectively, and presented 60% cellular antioxidant capacity and 30% inhibition of NOX production.ConclusionThe RF treated with UVA is an excellent source of phenolic compounds; specifically, ellagitannins and the UVA radiation proved to be efficient in biofortify RF, significantly improving the phenolic compounds content and their bioactive properties with adequate bioaccessibility, adding value to the strawberry agro-industrial by-products.
Modelling of immune response in chronic myeloid leukemia patients suggests potential for treatment reduction prior to cessation
Authors: Karg Elena , Baldow Christoph , Zerjatke Thomas , Clark Richard E. , Roeder Ingo , Fassoni Artur C. , Glauche Ingmar 
Published: December 2022

IntroductionDiscontinuation of tyrosine kinase inhibitor (TKI) treatment is emerging as the main therapy goal for Chronic Myeloid Leukemia (CML) patients. The DESTINY trial showed that TKI dose reduction prior to cessation can lead to an increased number of patients achieving sustained treatment free remission (TFR). However, there has been no systematic investigation to evaluate how dose reduction regimens can further improve the success of TKI stop trials.MethodsHere, we apply an established mathematical model of CML therapy to investigate different TKI dose reduction schemes prior to therapy cessation and evaluate them with respect to the total amount of drug used and the expected TFR success.ResultsOur systematic analysis confirms clinical findings that the overall time of TKI treatment is a major determinant of TFR success, while highlighting that lower dose TKI treatment for the same duration is equally sufficient for many patients. Our results further suggest that a stepwise dose reduction prior to TKI cessation can increase the success rate of TFR, while substantially reducing the amount of administered TKI.DiscussionOur findings illustrate the potential of dose reduction schemes prior to treatment cessation and suggest corresponding and clinically testable strategies that are applicable to many CML patients.
Can popular films instil carcinophobia? Images of cancer in popular Polish cinema
Authors: Domaradzki Jan 
Published: December 2022

IntroductionAlthough cancer is currently considered a serious socio-medical challenge and health education in Poland has been positioned as a public health priority, the impact of popular culture on people’s ideas about cancer has been neglected. This study therefore aims to analyse the way popular Polish films portray cancer and the experience of cancer.Material and MethodsSeven popular Polish films featuring cancer were analysed both quantitatively and qualitatively. The main categories included in the coding frame were disease, therapy, patient, physicians/oncologists and psychosocial issuses related to cancer.ResultsPolish films fail to provide the audience with basic information about the disease, its diagnoses and treatment and cancer is often represented as a mysterious disease with an unclear cause, an unpredictable and unsuccessful course of treatment, characterised by pain, suffering and inevitable death. Films may therefore instil carcinophobia. Since films accurately reflect problems of daily life faced by cancer patients and their families they have educational potential.ConclusionAlthough Polish films reinforce harmful stereotypes about cancer, its treatment, oncological institutions and specialists, cinema has the ability to raise the public’s and health professionals’ awareness regarding the psycho-social and emotional strains faced by cancer patients and the medical problems related to cancer.
Trends in the contributions of atopic family history to pediatric food sensitization and allergy
Authors: Fang Heping , Ma Zhuoying , Chen Lin , Xian Ruoling , Wang Juan , Chen Jing , Li Haiqi , Hu Yan 
Published: December 2022

ObjectiveFamily history of atopic diseases (FHA) contributes to food allergy (FA). But little is known whether FHA primarily increases IgE–mediated, non–IgE–mediated FA, or both. And the trends in the contributions of FHA to food sensitization (FS) and FA remain unclear. We aim to clarify the associations among FHA, FS and FA and to understand the trends in the contributions of FHA to FS and FA.MethodsWe used chi–square test and mediating effect model to analyze the associations among FHA, FS and FA through comparisons between two cross–sectional investigations on FA in children under 2 years old in 2009 and 2019.ResultsIn 2009 and 2019, the positive FHA proportion tended to be increasing without significance (28.9% to 31.6%, P = 0.39). Subgroup analysis showed the FS rate in FA group decreased significantly (37/39 to 44/62, P = 0.003). In 2009, the FS rate and FA prevalence were higher in FHA (+) group than in FHA (–) group (26% vs. 14.7%, P = 0.008 and 15% vs. 7.7%, P = 0.03), and FS had a complete mediating effect on the association between FHA and FA (Z = 2.54, P = 0.011), but the results lost significance in 2019.ConclusionsThe association between FHA and FA was completely mediated by FS, which means FHA mainly increases IgE–mediated FA. And the contributions of FHA to FS and FA tended to be stabilized or even diminished, which means FHA alone could no longer be enough to screen high–risk children.
Panax notoginseng preparation plus aspirin versus aspirin alone on platelet aggregation and coagulation in patients with coronary heart disease or ischemic stroke: A meta-analysis of randomized controlled trials
Authors: Dai Lulu , Zhang Ying , Jiang Yuerong , Chen Keji 
Published: December 2022

Purpose: We aimed to evaluate the effects of Panax notoginseng preparations (PNP) containing Panax Notoginseng Saponins (PNS) or Panaxatriol Saponin (PTS) on platelet aggregation and coagulation in the adjuvant treatment of coronary heart disease (CHD) and ischemic stroke (IS).Methods: Randomized controlled trials (RCTs) comparing the combination of PNP and aspirin (ASA) versus ASA alone for CHD or IS were searched in eight databases. Subgroup analysis was performed according to saponin category. When statistical heterogeneity was significant, sensitivity analysis was performed using the leave-one-out approach. Funnel plot, Egger’ test, and Begg’ test was adopted to detect publication bias.Results: Twenty RCTs involving 2216 patients were analyzed. Compared with ASA alone, PNP plus ASA had a stronger inhibitory effect on in PAgR [PNS, WMD = −6.10 (−7.25, −4.95), p &lt; 0.00001; PTS, WMD = −3.53 (−4.68, −2.38), p &lt; 0.00001]; PNS plus ASA better reduced FIB [WMD = −0.43 (−0.49, −0.36)] and DD [WMD = −0.59 (−0.67, −0.51), p &lt; 0.00001], while PLT (p = 0.07) and PT (p = 0.34) were not significantly different; PTS plus ASA better prolonged PT [WMD = 1.90 (1.47, 2.32), p &lt; 0.00001] and PT-INR [WMD = 0.22 (0.11, 0.32), p &lt; 0.0001], whereas no significant difference in DD (p = 0.1) and bleeding-related events (positive fecal occult blood, p = 0.96; upper gastrointestinal bleeding, p = 0.67; subcutaneous hemorrhage, p = 0.51; bulbar conjunctival hemorrhage, p = 0.51; hematuria, p = 0.58). There was no significant difference between PNP plus ASA and ASA alone in terms of gastrointestinal side effect (PNS, p = 0.65; PTS, p = 0.56) and urticaria (PNS, p = 0.57; PTS, p = 0.55).Conclusion: PNP combined with ASA might produce stronger antiplatelet aggregation and anticoagulation effects without increasing bleeding risk, gastrointestinal side effects, and urticaria compared with ASA alone.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42022339234.
Effect of aspirin in patients with established asymptomatic carotid atherosclerosis: A systematic review and meta-analysis
Authors: Hu Xianjin , Hu Yao , Sun Xiankun , Li Ying , Zhu Ye 
Published: December 2022

Background: Aspirin is widely used as an antiplatelet agent for secondary prevention in patients with atherosclerotic cardiovascular disease. However, it remains unclear whether aspirin can prevent the progression of carotid atherosclerosis or reduce vascular events and all-cause death.Methods: We performed a meta-analysis of the effect of aspirin in asymptomatic carotid atherosclerotic patients. Electronic databases including Pubmed, EMBase, ISI Web, Medline, Cochrane, and clinicaltrial.gov were searched for relevant randomized controlled trials. A total of five studies (841 individuals, 2,145 person-years) were included in this study. Two reviewers independently performed the study assessment and data extraction. Forest plots were used to assess the efficacy of aspirin. Egger’s test was used to evaluate publication bias.Results: Aspirin did not alleviate the progression of carotid intima-media thickness (cIMT) compared with control patients (WMD: −0.05 mm, 95% confidence interval 95%CI: −0.12, 0.03). In subset analysis, aspirin was only associated with regression of cIMT when compared with the empty/placebo group (WMD: −0.10 mm, 95%CI: −0.18, −0.02). In type 2 diabetes mellitus, there were no statistical significance between groups (WMD: 0.10 mm, 95%CI: −0.31, 0.50). For the main vascular events and all-cause death, there were no differences between the aspirin group (RR: 0.73, 95%CI: 0.41, 1.31) and the control group (RR: 0.88, 95%CI: 0.41, 1.90). For outcome events, similar results were observed when patients were classified by different cIMT value (p &gt; 0.05). The risk of gastrointestinal bleeding was similar between participants receiving and not receiving aspirin therapy (RR: 1.04, 95%CI: 0.07, 16.46).Conclusion: In patients with asymptomatic carotid atherosclerosis, low-dose aspirin may slightly alleviate the progression of cIMT, but does not reduce vascular events and all-cause death.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier PROSPERO
Influence of rapidly oscillating inspired O2 and N2 concentrations on pulmonary vascular function and lung fluid balance in healthy adults
Authors: Kelley Eli F. , Carlson Alex R. , Wentz Robert J. , Ziegler Briana L. , Johnson Bruce D. 
Published: December 2022

Introduction: Aircrew may experience rapidly oscillating inspired O2/N2 ratios owing to fluctuations in the on-board oxygen delivery systems (OBOG). Recent investigations suggest these oscillations may contribute to the constellation of physiologic events in aircrew of high-performance aircraft. Therefore, the purpose of this study was to determine whether these “operationally-relevant” environmental challenges may cause decrements in measures of pulmonary vascular physiology.Methods: Thirty healthy participants (Age: 29 ± 5 years) were recruited and assigned to one of the three exposures. Participants were instrumented for physiologic monitoring and underwent baseline cardiopulmonary physiology testing (ground level) consisting of a rebreathe method for quantifying pulmonary blood flow (Qc), pulmonary capillary blood volume (Vc) and alveolar–capillary conductance (Dm). Ultrasound was used to quantify “comet tails” (measure of lung fluid balance). After baseline testing, the participants had two 45 min exposures to an altitude of 8,000 ft where they breathed from gas mixtures alternating between 80/20 and 30/70 O2/N2 ratios at the required frequency (30 s, 60 s, or 120 s), separated by repeat baseline measure. Immediately and 45 min after the second exposure, baseline measures were repeated.Results: We observed no changes in Qc, Dm or Vc during the 60 s exposures. In response to the 30 s oscillation exposure, there was a significantly reduced Qc and Vc at the post-testing period (p = 0.03). Additionally, exposure to the 120 s oscillations resulted in a significant decrease in Vc at the recovery testing period and an increase in the Dm/Vc ratio at both the post and recovery period (p &lt; 0.01). Additionally, we observed no changes in the number of comet tails.Conclusion: These data suggest “operationally-relevant” changes in inspired gas concentrations may cause an acute, albeit mild pulmonary vascular derecruitment, reduced distention and/or mild pulmonary-capillary vasoconstriction, without significant changes in lung fluid balance or respiratory gas exchange. The operational relevance remains less clear, particularly in the setting of additional environmental stressors common during flight (e.g., g forces).
Promoting caregiver involvement at the public library: An evaluation of a math and science storytime program for young children
Authors: Gaias Larissa , Taylor Michelle , Pratt Megan E. , Whelan Mariko 
Published: December 2022

IntroductionPublic libraries are asset institutions that provide important spaces for families to engage in meaningful, authentic STEM learning. However, limited budgets and a model centered on open-access and broad inclusion makes conducting rigorous evaluations in these spaces, such as randomized control trials, challenging. There is a need to consider evaluation designs that consider both rigor and feasibility. The aims of the present study were to: (1) describe an innovative interactive parent–child interactive storytime program, Fun with Math and Science (FMS); and (2) conduct a preliminary evaluation of FMS in a large, urban public library setting, using a quasi-experimental static group comparison design.Methods and ResultsPost-test scores for caregivers who completed the program in the fall or winter (n = 80) were compared to pre-test scores for caregivers who completed the program the following spring (n = 35); Fall/winter caregivers scored higher on program items related to concrete behaviors to support math and science learning, but significant differences were not found on items related to caregiving beliefs or general caregiving practices. Demographic differences were also found related to program outcomes.DiscussionResults are discussed both in terms of implications for the development and implementation of caregiver-child interactive programming, as well as the use of innovative analytic approaches to program evaluation in community settings.
Increased both cortical activation and functional connectivity after transcranial direct current stimulation in patients with post-stroke: A functional near-infrared spectroscopy study
Authors: Yang Caihong , Zhang Tingyu , Huang Kaiqi , Xiong Menghui , Liu Huiyu , Wang Pu , Zhang Yan 
Published: December 2022

BackgroundPrevious studies have shown that cognitive impairment is common after stroke. Transcranial direct current stimulation (tDCS) is a promising tool for rehabilitating cognitive impairment. This study aimed to investigate the effects of tDCS on the rehabilitation of cognitive impairment in patients with stroke.MethodsTwenty-two mild–moderate post-stroke patients with cognitive impairments were treated with 14 tDCS sessions. A total of 14 healthy individuals were included in the control group. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Cortical activation was assessed using functional near-infrared spectroscopy (fNIRS) during the verbal fluency task (VFT).ResultsThe cognitive function of patients with stroke, as assessed by the MMSE and MoCA scores, was lower than that of healthy individuals but improved after tDCS. The cortical activation of patients with stroke was lower than that of healthy individuals in the left superior temporal cortex (lSTC), right superior temporal cortex (rSTC), right dorsolateral prefrontal cortex (rDLPFC), right ventrolateral prefrontal cortex (rVLPFC), and left ventrolateral prefrontal cortex (lVLPFC) cortical regions. Cortical activation increased in the lSTC cortex after tDCS. The functional connectivity (FC) between the cerebral hemispheres of patients with stroke was lower than that of healthy individuals but increased after tDCS.ConclusionThe cognitive and brain functions of patients with mild-to-moderate stroke were damaged but recovered to a degree after tDCS. Increased cortical activation and increased FC between the bilateral cerebral hemispheres measured by fNIRS are promising biomarkers to assess the effectiveness of tDCS in stroke.