bluuebunny/crossref_metadata_2025_split huggingface dataset:
A proposed framework for point of care lung ultrasound by respiratory physiotherapists: scope of practice, education and governance
Authors: Smith Mike , Hayward Simon , Innes Sue 
Published: June 2022

Abstract
Background
Point of care ultrasound (PoCUS) has the potential to provide a step change in the management of patients across a range of healthcare settings. Increasingly, healthcare practitioners who are not medical doctors are incorporating PoCUS into their clinical practice. However, the professional, educational and regulatory environment in which this occurs is poorly developed, leaving clinicians, managers and patients at risk.

Main body
Drawing upon existing medical and non-medical literature, the authors present a proposed framework for the use of PoCUS. Throughout, mechanisms for applying the principles to other professionals and healthcare settings are signposted. Application of the framework is illustrated via one such group of healthcare practitioners and in a particular healthcare setting: respiratory physiotherapists in the UK.
In defining the point of care LUS scope of practice we detail what structures are imaged, differentials reported upon and clinical decisions informed by their imaging. This is used to outline the educational and competency requirements for respiratory physiotherapists to safely and effectively use the modality. Together, these are aligned with the regulatory (professional, legal and insurance) arrangements for this professional group in the UK.
In so doing, a comprehensive approach for respiratory physiotherapists to consolidate and expand their use of point of care LUS is presented. This provides clarity for clinicians as to the boundaries of their practice and how to train in the modality; it supports educators with the design of courses and alignment of competency assessments; it supports managers with the staffing of existing and new care pathways. Ultimately it provides greater accessibility for patients to safe and effective point of care lung ultrasound.
For clinicians who are not respiratory physiotherapists and/or are not based in the UK, the framework can be adapted to other professional groups using point of care LUS as well as other point of care ultrasound (PoCUS) applications, thereby providing a comprehensive and sustainable foundation for PoCUS consolidation and expansion.

Conclusion
This paper presents a comprehensive framework to support the use of point of care LUS by respiratory physiotherapists in the UK. Mechanisms to adapt the model to support a wide range of other PoCUS users are outlined.
Effectiveness of isometric exercises on disability and pain of cervical spondylosis: a randomized controlled trial
Authors: Sadeghi Alireza , Rostami Mina , Ameri Sahand , Karimi Moghaddam Arezoo , Karimi Moghaddam Zhaleh , Zeraatchi Alireza 
Published: June 2022

Abstract
Background
Neck pain and disability is a significant public health problem with only very few evidence-based treatment option. The aim of this study was to evaluate the effect of isometric exercise on pain and disability of cervical spondylosis.

Methods
Twenty four patients with cervical osteoarthritis and neck pain (22 females and 2 males; mean age, 46.70 ± 13.71 years) were recruited and randomly allocated into 2 arms: neck isometric exercises (n = 12) and conservative management without exercise (n = 12). The Neck Disability Index (NDI) and Neck Pain and Disability Scale (NPAD) were used to assess participants at baseline and after 4 weeks.

Results
Basic characteristics, NDI score and NPAD score were not significantly different between groups at baseline. The exercise arm demonstrated significantly lower scores regarding NDI (mean, 17.41 vs. 25.58; P-value = 0.035) and NPAD (mean, 25.33 vs. 66.67; P < 0.001), compared to the control arm after 4 weeks. The exercise arm also showed significant within group reduction considering NDI and NPAD scores after 4 weeks (Both, P < 0.001).

Conclusion
Our findings suggested that isometric exercises might be a beneficial treatment for improving pain and disability caused by cervical spondylosis.
Trial registration This study was registered at irct.ir (Iranian Registry of Clinical Trials) with the code IRCT20220206053950N1, 07.05.2022, retrospectively registered.
Associations between parental bonding, social isolation and loneliness: do associations persist in later life and is isolation a mediator between parental bonding and loneliness?
Authors: Burns Annette , Leavey Gerard , O’Sullivan Roger 
Published: June 2022

Abstract
Background
Poor parental bonding in childhood has been associated with loneliness in younger populations. Whether these associations persists into middle and older adulthood is unclear. Additionally, given the overlapping relationship between loneliness and social isolation we sought to explore the role of social isolation in any associations present i.e. are those reporting worse parental bonding lonely due to less connections or are they more likely to be lonely regardless of isolation.

Methods
Analysis of a nationally representative longitudinal sample of adults aged 50 and over from the English Longitudinal Study of Ageing was undertaken. The current analysis was based on data for core participants across waves 3[2006/7] to 8[2016/17] with missing data across waves leading to analytical samples ranging from 4384 to 5173. Multivariate adjusted multinomial regression models were used to assess associations between parental bonding [PBI], isolation [score derived from data on living alone, frequency of contact with friends, family and children, and whether or not participate in social organisations] and loneliness [R-UCLA].

Results
Parental bonding scores were associated with later life loneliness according to overall PBI score [RRR .93 95%CI .92-.95], care [RRR .90 95%CI .88-.92] and overprotection [RRR 1.11 95%CI 1.08–1.14] subscale scores as well as when separated into maternal and paternal scores, with effects larger in relation to chronic loneliness. Parental bonding scores were also associated with isolation in later life, with the exception of maternal overprotection which was non-significant. The addition of isolation to the loneliness models however had no impact on associations indicating that isolation is not a mediator of the association between parental bonding and later life loneliness.

Conclusions
Associations between parental bonding and loneliness do persist into middle and older adulthood and were in line with hypothesis stronger for more chronic loneliness. Isolation did not explain these associations and those reporting more negative parental bonds were more likely to be lonely regardless of isolation.
A large-scale sentiment analysis of tweets pertaining to the 2020 US presidential election
Authors: Ali Rao Hamza , Pinto Gabriela , Lawrie Evelyn , Linstead Erik J. 
Published: June 2022

AbstractWe capture the public sentiment towards candidates in the 2020 US Presidential Elections, by analyzing 7.6 million tweets sent out between October 31st and November 9th, 2020. We apply a novel approach to first identify tweets and user accounts in our database that were later deleted or suspended from Twitter. This approach allows us to observe the sentiment held for each presidential candidate across various groups of users and tweets: accessible tweets and accounts, deleted tweets and accounts, and suspended or inaccessible tweets and accounts. We compare the sentiment scores calculated for these groups and provide key insights into the differences. Most notably, we show that deleted tweets, posted after the Election Day, were more favorable to Joe Biden, and the ones posted leading to the Election Day, were more positive about Donald Trump. Also, the older a Twitter account was, the more positive tweets it would post about Joe Biden. The aim of this study is to highlight the importance of conducting sentiment analysis on all posts captured in real time, including those that are now inaccessible, in determining the true sentiments of the opinions around the time of an event.
Machine learning approaches to the human metabolome in sepsis identify metabolic links with survival
Authors: Kosyakovsky Leah B. , Somerset Emily , Rogers Angela J. , Sklar Michael , Mayers Jared R. , Toma Augustin , Szekely Yishay , Soussi Sabri , Wang Bo , Fan Chun-Po S. , Baron Rebecca M. , Lawler Patrick R. 
Published: June 2022

Abstract
Background
Metabolic predictors and potential mediators of survival in sepsis have been incompletely characterized. We examined whether machine learning (ML) tools applied to the human plasma metabolome could consistently identify and prioritize metabolites implicated in sepsis survivorship, and whether these methods improved upon conventional statistical approaches.

Methods
Plasma gas chromatography–liquid chromatography mass spectrometry quantified 411 metabolites measured ≤ 72 h of ICU admission in 60 patients with sepsis at a single center (Brigham and Women’s Hospital, Boston, USA). Seven ML approaches were trained to differentiate survivors from non-survivors. Model performance predicting 28 day mortality was assessed through internal cross-validation, and innate top-feature (metabolite) selection and rankings were compared across the 7 ML approaches and with conventional statistical methods (logistic regression). Metabolites were consensus ranked by a summary, ensemble ML ranking procedure weighing their contribution to mortality risk prediction across multiple ML models.

Results
Median (IQR) patient age was 58 (47, 62) years, 45% were women, and median (IQR) SOFA score was 9 (6, 12). Mortality at 28 days was 42%. The models’ specificity ranged from 0.619 to 0.821. Partial least squares regression-discriminant analysis and nearest shrunken centroids prioritized the greatest number of metabolites identified by at least one other method. Penalized logistic regression demonstrated top-feature results that were consistent with many ML methods. Across the plasma metabolome, the 13 metabolites with the strongest linkage to mortality defined through an ensemble ML importance score included lactate, bilirubin, kynurenine, glycochenodeoxycholate, phenylalanine, and others. Four of these top 13 metabolites (3-hydroxyisobutyrate, indoleacetate, fucose, and glycolithocholate sulfate) have not been previously associated with sepsis survival. Many of the prioritized metabolites are constituents of the tryptophan, pyruvate, phenylalanine, pentose phosphate, and bile acid pathways.

Conclusions
We identified metabolites linked with sepsis survival, some confirming prior observations, and others representing new associations. The application of ensemble ML feature-ranking tools to metabolomic data may represent a promising statistical platform to support biologic target discovery.
Extracorporeal immune cell therapy of sepsis: ex vivo results
Authors: Klinkmann Gerd , Wild Thomas , Heskamp Benjamin , Doss Fanny , Doss Sandra , Arseniev Lubomir , Aleksandrova Krasimira , Sauer Martin , Reuter Daniel A. , Mitzner Steffen , Altrichter Jens 
Published: June 2022

Abstract
Background
Immune cell dysfunction plays a central role in sepsis-associated immune paralysis. The transfusion of healthy donor immune cells, i.e., granulocyte concentrates (GC) potentially induces tissue damage via local effects of neutrophils. Initial clinical trials using standard donor GC in a strictly extracorporeal bioreactor system for treatment of septic shock patients already provided evidence for beneficial effects with fewer side effects, by separating patient and donor immune cells using plasma filters. In this ex vivo study, we demonstrate the functional characteristics of a simplified extracorporeal therapy system using purified granulocyte preparations.

Methods
Purified GC were used in an immune cell perfusion model prefilled with human donor plasma simulating a 6-h treatment. The extracorporeal circuit consisted of a blood circuit and a plasma circuit with 3 plasma filters (PF). PF1 is separating the plasma from the patient’s blood. Plasma is then perfused through PF2 containing donor immune cells and used in a dead-end mode. The filtrated plasma is finally retransfused to the blood circuit. PF3 is included in the plasma backflow as a redundant safety measure. The donor immune cells are retained in the extracorporeal system and discarded after treatment. Phagocytosis activity, oxidative burst and cell viability as well as cytokine release and metabolic parameters of purified GCs were assessed.

Results
Cells were viable throughout the study period and exhibited well-preserved functionality and efficient metabolic activity. Course of lactate dehydrogenase and free hemoglobin concentration yielded no indication of cell impairment. The capability of the cells to secret various cytokines was preserved. Of particular interest is equivalence in performance of the cells on day 1 and day 3, demonstrating the sustained shelf life and performance of the immune cells in the purified GCs.

Conclusion
Results demonstrate the suitability of a simplified extracorporeal system. Furthermore, granulocytes remain viable and highly active during a 6-h treatment even after storage for 3 days supporting the treatment of septic patients with this system in advanced clinical trials.
Cross cultural adaptation and validation of Nepali Version of Activity Scale for Kids (ASK)
Authors: Shakya Regan , Suwal Renuka , Adhikari Ishwar , Shrestha Jasmine , Gyawali Subham , Shrestha Archana 
Published: June 2022

Abstract
Background
Activity Scale for Kids (ASK) is self reported, widely used tool to measure the physical disability in children aged 5–15 years. It has two versions; ASK-performance version and ASK-capability version, both with excellent psychometric properties in English and other translated languages. However, the tool is not available in Nepali. The aim of our study is to translate, culturally adapt and validate the tool in the context of the Nepali population.

Methods
A standard translation guideline was used to translate both the versions of ASK tool into the Nepali language. One hundred and two participants were assessed to establish the reliability and validity of the tool. Internal consistency and test retest reliability was established using cronbach’s alpha and intra class correlation coefficient. Validity was established by three methods; ceiling and floor effects, group discriminations, and comparing the results of ASK with the Nepali version of KINDL.

Results
The mean age of the sample participants were 12.74 years (SD 2.2). The internal consistency and test retest reliability for both the Nepali versions of ASK was significant at 0.98 and 0.94 respectively. The tool had a negligible ceiling effect (< 5%) but a moderate floor effect (ASKp-Np 7.8% and ASKc-Np 8.8%). It was able to discriminate between the mobility aid required for moving inside and outside the home environment. Moderate correlation was observed between the both the Nepali versions of ASK and the total score of KINDL (r = 0.5).

Conclusions
Nepali version of ASK is reliable and valid tool to measure physical disability in the Nepali pediatric population.
Long-term efficacy and risk factors for stent occlusion in portal vein stent placement: a multi-institutional retrospective study
Authors: Nakai Hirotsugu , Shimizu Hironori , Taniguchi Takanori , Kawahara Seiya , Yamaoka Toshihide , Sasaki Naoya , Isoda Hiroyoshi , Nakamoto Yuji 
Published: June 2022

Abstract
Background
Surgical treatment for PV (portal vein) stenosis/occlusion can pose a fatal risk of massive bleeding from severe adhesions and collateral vessel formation. PV stents placement is a minimally invasive and effective procedure for PV stenosis/occlusion, but PV stents sometimes occlude. The relationship between post-stent PV hemodynamics and stent occlusion has not been thoroughly investigated. Certain precautions during PV stent placement may reduce the risk of stent occlusion. This study aimed to evaluate long-term outcomes of PV stent patency and investigate factors including PV hemodynamics associated with stent occlusion.

Materials and methods
Thirty-four consecutive patients with PV stenosis/occlusion who underwent PV stent placement in four institutions between December 2006 and February 2021 were retrospectively examined. The primary study endpoints were technical success, clinical success, and cumulative stent patency rate. The secondary endpoints were risk factors of stent occlusion. A univariable Cox proportional hazards model with sixteen variables was used to determine predictors of stent occlusion. Factors with p-value ≤ 0.1 in univariable analysis were included in the multivariable analysis. Alpha was set at 0.05.

Results
Technical and clinical success rates were 88.2% and 79.4%, respectively. Six patients (17.7%) experienced stent occlusion. The cumulative stent patency rate at six months, one year, and three years was 79.1%, 79.1%, and 65.9%, respectively. In the univariate analysis, the variables with p-value ≤ 0.1 were lesion length > 4 cm, hepatofugal collateral vein visualization after stent placement, and residual stenosis > 30% after stent placement. In the multivariate analysis, residual stenosis > 30% after stent placement was significantly associated with stent occlusion (hazard ratio, 10.80; 95% confidence interval, 1.08–108.44; p = 0.04).

Conclusion
PV stent placement was technically feasible and effective in improving portal hypertension. However, stent occlusion was not uncommon. Residual stenosis > 30% after stent placement was significantly associated with stent occlusion. We should pay attention to correctly assess the range of stenosis and release the stenosis as much as possible.
Yield performance, adaptability and processing qualities of pre-release potato clones under different Rwandan agro-ecologies
Authors: Placide Rukundo , Theophile Ndacyayisenga , Vandamme Elke , Claude Nshimiyimana Jean , Thiago Mendes 
Published: June 2022

AbstractFive new potato clones (CIP393280.64, CIP393371.58, CIP393077.159, CIP396018.241, and CIP398190.615) and two local checks (Kinigi and Kirundo) were evaluated in fourteen sites under the National Performance Trials (NPTs) for two growing seasons using a randomized complete block design with three replications to identify their yield performance, adaptability and processing qualities. The data related to yield (number and weight of tubers per plot, marketable and unmarketable yields, and total yields) and processing qualities (tuber shape and depth of eyes, dry matter content, frying time, crisps color, taste, crunch, waste percentage, and conversion rate) were collected and analysed using GenStat 20th edition. The analysis of variance revealed significant effects of clone, site, and clone by site interaction on fresh tuber yield. Across all sites for both seasons, the clones CIP393077.159, CIP393371.58, and CIP393280.64 revealed the yields of 31, 28. and 27 tons/ha that fall in the same range of yields as local checks Kinigi and Kirundo with 30 and 35 tons/ha, respectively. Based on yield stability index (YSI) ranking combining high yield and stability, the first four genotypes were Kirundo, CIP393077.159, CIP39601.241, and CIP393371.58 with YSI of 16.6, 11.3, 9.1, and 7.3, respectively. All the new tested potato clones revealed higher dry matter (DM) content that was above 18% of total fresh weight except CIP396018.241 which had a DM content of 17% of fresh weight. This dry matter content was comparable with the dry matter content of local check Kinigi, the most popular varieties variety used for French fries in Rwanda. Based on crisps color, the clones CIP393077.159, CIP393280.64, CIP396018.241, CIP398190.615 showed the same trend as local check Kinigi. The crisps from these clones were ranked as good or very good for taste and crunch. The results of this study highlighted that the clones CIP393371.58 and CIP393077.159 can be recommended as candidate for new varieties for high fresh tuber yields; while the clones CIP398190.615, CIP396018.241, and CIP393280.64 can be recommended as candidate for new potato varieties for crisps and French fries.
Prognosis of Patients With Primary Melanoma Stage I and II According to American Joint Committee on Cancer Version 8 Validated in Two Independent Cohorts: Implications for Adjuvant Treatment
Authors: Garbe Claus , Keim Ulrike , Amaral Teresa , Berking Carola , Eigentler Thomas K. , Flatz Lukas , Gesierich Anja , Leiter Ulrike , Stadler Rudolf , Sunderkötter Cord , Tüting Thomas , Utikal Jochen , Wollina Uwe , Zimmer Lisa , Zouboulis Christos C. , Ascierto Paolo A. , Eggermont Alexander M.M. , Grob Jean-Jacques , Hauschild Axel , Sekulovic Lidija Kandolf , Long Georgina V. , Luke Jason J. , Michielin Olivier , Peris Ketty , Schadendorf Dirk , Kirkwood John M. , Lorigan Paul C. ,   on behalf of the Central Malignant Melanoma Registry (CMMR)
Published: June 2022

PURPOSE The first randomized trial of adjuvant treatment with checkpoint inhibitor in stage II melanoma reported a significant reduction in risk of tumor recurrence. This study evaluates two independent data sets to further document survival probabilities for patients with primary stage I and II melanoma. PATIENTS AND METHODS The Central Malignant Melanoma Registry (CMMR) in Germany evaluated 17,544 patients with a primary diagnosis of stage I and II melanoma from 2000 to 2015. The exploratory cohort consisted of 6,725 patients from the Center for Dermato-Oncology at the University of Tübingen, and the confirmatory cohort consisted of 10,819 patients from 11 other German centers. Survival outcomes were compared with published American Joint Committee on Cancer version 8 (AJCCv8) stage I and II survival data. RESULTS For the two CMMR cohorts in stage IA compared with the AJCCv8 cohort, melanoma-specific survival rates at 10 years were 95.1%-95.6% versus 98%; 89.7%-90.9% versus 94% in stage IB; 80.7%-83.1% versus 88% in stage IIA; 72.0%-79.9% versus 82% in stage IIB; and 57.6%-64.7% versus 75% in stage IIC, respectively. Recurrence rates were approximately twice as high as melanoma-specific mortality rates in stages IA-IIA. CONCLUSION The melanoma-specific survival rates in the two CMMR cohorts across stages I and II are less favorable than published in AJCCv8. This has important implications for the consideration of adjuvant treatment in this population.
Homozygous Variant in KASH5 Causes Premature Ovarian Insufficiency by Disordered Meiotic Homologous Pairing
Authors: Zhang Qian , Tao Chengqiu , Gao Shuchang , Li Shan , Xu Bingying , Ke Hanni , Wang Yiyang , Zhang Feng , Qin Yingying , Zhang Ling , Guo Ting 
Published: June 2022

Abstract

Context
Premature ovarian insufficiency (POI) affects 1% to 3.7% of women at reproductive age, and its etiology is heterogeneous. The linker of nucleoskeleton and cytoskeleton (LINC) complex, consisting of KASH5 and SUN1, plays an indispensable role in meiotic homolog pairing, determining the ovarian reserve. However, their roles in the pathogenesis of POI are unknown.

Objective
To investigate the role of KASH5 variation in the pathogenesis of POI.

Design
Whole-exome sequencing was performed in a pedigree with 2 POI patients. The pathogenicity of identified variant was illustrated by in vitro functional studies, and its effect on ovarian function and meiosis was confirmed by histological analysis and oocyte spreads with Kash5 C-terminal deleted mice model.

Results
A homozygous splicing site variant in KASH5 (c.747G &gt; A) was identified. In vitro studies found the variant disturbed the nuclear membrane localization of KASH5 and its binding with SUN1. Moreover, the Kash5 C-terminal deleted mice revealed defective meiotic homolog pairing and accelerated depletion of oocytes.

Conclusions
The splicing site variant in KASH5 is responsible for POI due to defective meiotic homolog pairing and accelerated depletion of oocytes. Our study is the first to report disorganized LINC complex participating in POI pathogenesis, potentially suggesting the essential roles of meiotic telomere attachment and dynein-driven proteins for chromosome movement in ovarian function maintenance.