bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of hip flexor stretching with and without abdominal exercises in asymptomatic individuals with hyperlordosis
Authors: Janyathitipath Thanachaporn , Sakulsriprasert Prasert , Wattananon Peemongkon , Kantha Phunsuk 
Published: July 2022

Background/AimsHyperlordosis is associated with shortened hip flexor muscles, causing low back pain. The aim of this study was to investigate the effects of hip flexor stretching with and without abdominal exercises in individuals with hyperlordosis.MethodsA total of 30 participants with hyperlordosis, aged between 20 and 30 years, were divided into three groups. Participants in the hold-relax group performed hold-relax stretching for 10 seconds, five repetitions, on both legs. Participants in the abdominal hollowing group performed hold-relax stretching and added an abdominal hollowing exercise for 10 seconds a repetition, 10 repetitions a set for three sets. Participants in the curl-up group performed hold-relax stretching and then performed curl-up exercises for 10 repetitions a set for three sets. The angle of lumbar lordosis, hip muscle length (degrees), percentage of maximum voluntary contraction of transversus abdominis and internal abdominal oblique, external abdominal oblique, rectus abdominis, lumbar erector spinae and multifidus muscles were investigated at pre-test, post-test and followed up 3 days after the end of the intervention.ResultsSignificant within-group differences were found in the angle of lumbar lordosis for all groups (P<0.05), muscle length of hip flexor, and percentage of maximum voluntary contraction of the lumbar erector spinae and multifidus muscles in the curl-up group (P<0.05). The significant difference between pre-test and follow up in the hold-relax group and curl-up group reflects the retention of at least 3 days.ConclusionsHold-relax stretching can reduce the angle of lumbar lordosis and increase hip muscle length. In the curl-up group, the lumbar erector spinae and multifidus muscles decreased. Therefore, performing curl-up exercises after hold-relax stretching is recommended to decrease the angle of lumbar lordosis and percentage of maximum voluntary contraction of lumbar erector spinae and multifidus muscles.
Comparing the effects of cognitive dual tasking on balance and gait motor performance in people with mild multiple sclerosis and healthy individuals
Authors: Yakut Hatice , Maden Tuba Kaplan , Akçalı Aylin Hengirmen 
Published: July 2022

Background/Aims People with multiple sclerosis show both cognitive and postural impairment, and various static and dynamic postural activities may be affected under conditions of cognitive distraction. The aim of this study was to determine the effects of cognitive dual tasking on the balance and gait motor performance of people with mild multiple sclerosis (Expanded Disability Status Scale score of 2.0 ± 1.3) and healthy people and to compare these two groups in terms of performing single and dual tasks. Methods People with mild multiple sclerosis (n=39) and healthy individuals (n=33) performed static balance tests (Romberg's Test, tandem stance test, single-legged stance test) and dynamic balance tests (Functional Reach Test, Four Square Step Test, Timed Up and Go Test, 10-Metre Walk Test), with and without a word list generation test (single and dual tasks). Independent t-tests were used to evaluate differences between the two groups, and paired t-tests were used for single or dual tasks for all static and dynamic tests. The magnitude of differences in tasks between measures was expressed as Cohen's d. Results Dual task effects were more evident during dynamic balance tests in participants with multiple sclerosis and healthy participants (specifically the Timed Up and Go Test and 10-Metre Walk Test) (P<0.001). There was a significant difference between both groups only in terms of static balance (P<0.001). Conclusions Dynamic balance and gait were shown to be more affected when performing the dual cognitive task than static balance in people with multiple sclerosis. Dual tasks should be included in diagnoses.
Efficacy and safety of cryoballoon pulmonary vein isolation for paroxysmal and persistent atrial fibrillation: A comparison with radiofrequency ablation
Authors: Choi Ji-Hoon , Park Seung-Jung , Park Kyoung-Min , Kim June Soo , On Young Keun 
Published: July 2022

Background
Cryoballoon ablation was established as an effective and safe modality to achieve pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF). However, its role in persistent atrial fibrillation (PersAF) remains unclear.

Objective
This study aimed to evaluate the efficacy and safety of cryoballoon PVI in PAF and PersAF comparing conventional radiofrequency catheter ablation (RFCA).

Methods
Two hundred patients undergoing cryoballoon ablation for symptomatic AF were consecutively enrolled in this retrospective study. For comparison, 210 patients undergoing RFCA in the same period were included. The primary outcome was a recurrence of any atrial tachyarrhythmias (ATas) after the index ablation. 12-lead ECG and 24-hour Holter monitoring were obtained at 1,3,6 and 9–12 months.

Results
PVI by cryoablation alone was achieved in 197 patients (98.5%). ATas-free survival at 12 months post-ablation was 72.7% in the cryoablation and 80.6% in the RFCA group (P = 0.123), respectively. The cryoablation showed comparable efficacy maintaining sinus rhythm compared with RFCA in PAF (P = 0.539), whereas in PersAF, ATas-free survival was significantly lower in cryoablation (P = 0.039). PV reconnection was observed in the majority of patients (14/16, 87.5%) who receive redo RFCA. Complications were encountered in 10 patients, including femoral arteriovenous fistula (n = 1), transient phrenic nerve palsy (n = 8), and minimal amount pericardial effusion (n = 1).

Conclusion
The efficacy of cryoballoon PVI is comparable with conventional RFCA in PAF, whereas PVI alone using cryoballoon may not be insufficient to maintaining sinus rhythm in PersAF. The safety of cryoballlon PVI is tolerable.
Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis
Authors: Geta Teshome Gensa , Gebremedhin Samson , Omigbodun Akinyinka O. 
Published: July 2022

BackgroundIn Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.Materials and methodsThe published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2statistical test for heterogeneity, and the Egger’s and Begg’s tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.ResultAfter screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.ConclusionAlmost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.Registration number(ID: CRD42020211054).
How does it all end? Trends and disparities in health at the end of life
Authors: Vierboom Yana C. 
Published: July 2022

Objectives
To consider trends and disparities in end-of-life health in the US.

Methods
I use data from the National Health Interview Survey, linked to death records through 2015, for respondents who died at ages 65+ to compare the prevalence of three health outcomes in the last six years of life across time, sex, age, race, and educational attainment. Self-rated health (SRH) is available for respondents interviewed in years 1987–2014, while information on activities of daily living (ADL) and instrumental activities of daily living (IADL) is available for the period 1997–2014.

Results
By the end of the study period, individuals reported two fewer months of fair/poor health at the end of life than those dying in earlier years. In contrast, time lived with at least one activity limitation at the end of life generally remained comparable. Compared to men, women on average reported an additional year of living with an IADL limitation before death, and an additional eight months with an ADL limitation. Despite sex differences in disability, both sexes reported similar periods of fair/poor SRH before death. Similarly, while individuals who lived to older ages experienced a longer disabled period before death than individuals who died at younger ages, all age groups were equally likely to report fair/poor SRH. Black adults and adults with less formal schooling also spent more time with an end-of-life disability. For men, these racial and socioeconomic disparities lessened as death approached. For women, inequalities persisted until death.

Discussion
These findings suggest that despite increasing life expectancy, the period of poor health and disability prior to death has not recently been extended. Black women and women with less than a high school degree, require extended support at the end of life.
Predictors of improvement in quality of life at 12-month follow-up in patients undergoing anterior endoscopic skull base surgery
Authors: Buchlak Quinlan D. , Esmaili Nazanin , Bennett Christine , Wang Yi Yuen , King James , Goldschlager Tony 
Published: July 2022

BackgroundPatients with pituitary lesions experience decrements in quality of life (QoL) and treatment aims to arrest or improve QoL decline.ObjectiveTo detect associations with QoL in trans-nasal endoscopic skull base surgery patients and train supervised learning classifiers to predict QoL improvement at 12 months.MethodsA supervised learning analysis of a prospective multi-institutional dataset (451 patients) was conducted. QoL was measured using the anterior skull base surgery questionnaire (ASBS). Factors associated with QoL at baseline and at 12-month follow-up were identified using multivariate logistic regression. Multiple supervised learning models were trained to predict postoperative QoL improvement with five-fold cross-validation.ResultsASBS at 12-month follow-up was significantly higher (132.19,SD = 24.87) than preoperative ASBS (121.87,SD = 25.72,p<0.05). High preoperative scores were significantly associated with institution, diabetes and lesions at the planum sphenoidale / tuberculum sella site. Patients with diabetes were five times less likely to report high preoperative QoL. Low preoperative QoL was significantly associated with female gender, a vision-related presentation, diabetes, secreting adenoma and the cavernous sinus site. Top quartile change in postoperative QoL at 12-month follow-up was negatively associated with baseline hypercholesterolemia, acromegaly and intraoperative CSF leak. Positive associations were detected for lesions at the sphenoid sinus site and deficient preoperative endocrine function. AdaBoost, logistic regression and neural network classifiers yielded the strongest predictive performance.ConclusionIt was possible to predict postoperative positive change in QoL at 12-month follow-up using perioperative data. Further development and implementation of these models may facilitate improvements in informed consent, treatment decision-making and patient QoL.
Anomaly detection in time series
Authors: Schmidl Sebastian , Wenig Phillip , Papenbrock Thorsten 
Published: July 2022

Detecting anomalous subsequences in time series data is an important task in areas ranging from manufacturing processes over finance applications to health care monitoring. An anomaly can indicate important events, such as production faults, delivery bottlenecks, system defects, or heart flicker, and is therefore of central interest. Because time series are often large and exhibit complex patterns, data scientists have developed various specialized algorithms for the automatic detection of such anomalous patterns. The number and variety of anomaly detection algorithms has grown significantly in the past and, because many of these solutions have been developed independently and by different research communities, there is no comprehensive study that systematically evaluates and compares the different approaches. For this reason, choosing the best detection technique for a given anomaly detection task is a difficult challenge.
This comprehensive, scientific study carefully evaluates most state-of-the-art anomaly detection algorithms. We collected and re-implemented 71 anomaly detection algorithms from different domains and evaluated them on 976 time series datasets. The algorithms have been selected from different algorithm families and detection approaches to represent the entire spectrum of anomaly detection techniques. In the paper, we provide a concise overview of the techniques and their commonalities; we evaluate their individual strengths and weaknesses and, thereby, consider factors, such as effectiveness, efficiency, and robustness. Our experimental results should ease the algorithm selection problem and open up new research directions.
Asymptotic topology of excursion and nodal sets of Gaussian random fields
Authors: Gayet Damien 
Published: July 2022

Abstract
Let M be a compact smooth manifold of dimension n with or without boundary, or an affine polytope, and let

f
:

M
→
ℝ

{f:M\to\mathbb{R}}

be a smooth Gaussian random field. It is very natural to suppose that for a large positive real u, the random excursion set

{

f
≥
u

}

{\{f\geq u\}}

is mostly composed of a union of disjoint topological n-balls. Using the constructive part of (stratified) Morse theory, we prove that in average, this intuition is true, and provide for large u the asymptotic of the expected number of such balls, and so of connected components of

{

f
≥
u

}

{\{f\geq u\}}

. We similarly show that in average, the high nodal sets

{

f
=
u

}

{\{f=u\}}

are mostly composed of spheres, with the same asymptotic than the one for excursion set. A quantitative refinement of these results using the average of the Euler characteristic proved in former works by Adler and Taylor provides a striking asymptotic of the constant defined by Nazarov and Sodin, again for large u. This new Morse theoretical approach of random topology also applies to spherical spin glasses with large dimension.
Production of cellulose nanofibers and sugars using high dry matter feedstock
Authors: Moulin Jordão Cabral , Soares Durães Alisson Farley , Jørgensen Henning , Moreira Francys K. V. , Sanadi Anand Ramesh , Denzin Tonoli Gustavo Henrique 
Published: July 2022

Abstract
Sugars are a sustainable platform for producing chemicals and polymers, while cellulose nanofibers (CNF) are sustainable materials with high specific mechanical properties that have an important role to play in many applications. This study highlights the feasibility of producing sugars and CNF using high dry matter (DM) content of 20 %. A commercial enzyme cocktail at low dosage, 5 mg EP/g DM, and a high 15 mg EP/g DM, were used to hydrolyze the pulp cellulose to produce sugars and CNF. HPLC was used to evaluate the cellulose conversion rate and amount of sugar realized. The CNF were studied using TEM, the diameter of the CNF were measured and estimate the crystallinity. The cellulose conversion plateaued at about 48 h for both the low and high dosage, indicating inhibition due to higher sugar concentration and/or increased recalcitrance of the remaining CNF. The CNF obtained at low enzyme indicated the fibrils were insufficiently separated. At the high dosage, less clumps were observed and with smaller diameter than with the low enzyme dosage. The high dosage also produced CNF with significantly higher crystallinity index, confirming that amorphous cellulose portions readily underwent enzymatic hydrolysis and left more recalcitrant CNF.
The coexistence of autoimmune diabetes and maturity-onset diabetes of the young (MODY): a case series
Authors: O’Donovan Eimear Mary , Sanchez-Lechuga Begona , Prehn Emma , Byrne Maria Michelle 
Published: July 2022

Summary
The coexistence of autoimmune diabetes and maturity-onset diabetes (MODY) is rare. The absence of pancreatic autoantibodies is a key factor prompting MODY genetic testing. In this study, we report three cases of young-onset diabetes with progressive beta-cell dysfunction, strongly positive glutamic acid decarboxylase (GAD) antibodies, and genetic confirmation of pathogenic gene variants of HNF-1A, HNF-4A, and ABCC8-MODY. The first case is a woman diagnosed with HNF-1A-MODY diabetes more than 30 years after her diagnosis of adult-onset diabetes at 25 years. She required insulin after her fourth pregnancy. She became ketotic on oral hypoglycaemic agents (OHAs) and subsequently, her GAD antibodies tested positive. The second case is a woman diagnosed with diabetes at 17 years who was subsequently diagnosed with HNF-4A-MODY after many hypoglycaemic episodes on low-dose insulin. GAD antibodies were strongly positive. The last case is a man diagnosed with diabetes at 26 years who was well controlled on OHAs and required insulin years later due to sudden deterioration in glycaemic control. His ABCC8-MODY was diagnosed upon realisation of strong family history and his GAD antibodies tested positive. All subjects are now treated with insulin. Less than 1% of subjects with MODY have positive autoantibodies. These cases highlight individuals who may have two different types of diabetes simultaneously or consecutively. Deterioration of glycaemic control in subjects with MODY diabetes should highlight the need to look for the emergence of autoantibodies. At each clinic visit, one should update the family history as MODY was diagnosed in each case after the development of diabetes in their offspring.

Learning points

These cases highlight the rare coexistence of autoimmune diabetes and MODY.

Deterioration of glycaemic control in subjects with MODY diabetes should highlight the emergence of autoantibodies.

One should revise and update the family history as the diagnosis of MODY was made after the development of diabetes in offspring.

Understanding the spectrum of diabetes allows for precision medicine.
Mitral valve chord rupture in a pregnant patient with uncontrolled hyperthyroidism
Authors: Fox Tamaryn , Akhtar Hamza , Blocher Nissa , Anastasopoulou Catherine 
Published: July 2022

Summary
Graves’ disease can have multiple cardiac manifestations. A rare complication is that of severe mitral regurgitation secondary to mitral valve chordae rupture, due to both compromise of valve integrity by deposition of glycosaminoglycans and the hemodynamic stresses of thyrotoxicosis. Pregnancy, with its related hemodynamic changes, is another setting in which mitral valve chordae rupture has occasionally been documented. We present a unique case of a 36-year-old female with uncontrolled Graves’ disease who presented during pregnancy at 13 weeks gestation with atrial flutter and features of congestive heart failure. Echocardiogram found severe mitral regurgitation secondary to a ruptured mitral chord. She was treated conservatively with diuresis and ultimately delivered her baby without complication at 28 weeks when she had preterm premature rupture of membranes. She is currently on methimazole and propranolol and pending definitive management of her Graves’ disease. This represents not only a rare cardiac complication in a patient with Graves’ disease but also is the first in the literature, to our knowledge, which describes this complication in a pregnant patient with Graves’ disease.

Learning points

Thyroid disease can have multiple effects on the heart through hemodynamic and structural changes and can result in heart failure, arrhythmias, valvular disease, and pulmonary hypertension.

Graves’ disease can cause glycosaminoglycan deposition in valvular tissue resulting in fragile leaflets that can rupture with little stress.

Pregnancy and thyrotoxicosis have similar hemodynamic consequences with increased cardiac output and reduced systemic vascular resistance.

Be vigilant in those with hyperthyroidism with a new murmur or features of acute heart failure, as a ruptured valve chord can result in increased morbidity and mortality if not recognized and addressed quickly.
Estrategias de posicionamiento en clínicas privadas de Manabí; caso clínica Calderón - Bahía de Caráquez
Authors: Calderón Intriago Mario Patricio , Saltos Briones Gladys María 
Published: July 2022

El trabajo de investigación se realizó con la finalidad de determinar las estrategias básicas que conllevan al posicionamiento de clínicas privadas en la provincia de Manabí - Ecuador. En el estudio se analiza el caso de la Clínica Calderón (CliniCalderón) que se encuentra ubicada en la ciudad de Bahía de Caráquez, uno de los lugares más afectados por el terremoto que afectó la Provincia de Manabí el 16 de abril del 2016. A pesar de los múltiples cambios que sufrió la ciudad como consecuencia del movimiento telúrico que devastó varios sectores de la urbe, el área de la salud, uno de las más afectados por el sismo, jamás quedó desprotegido permitiendo que este centro médico gane prestigio en el mercado con relación a otras unidades que prestan los mismos beneficios a los habitantes de la localidad y sus alrededores. Para el efecto se utilizó una metodología descriptiva, técnicas e instrumentos como la observación y revisión documental, a través de un análisis de fortalezas, oportunidades, debilidades y amenazas (FODA) se determinó el predominio de las fortalezas sobre las debilidades y las oportunidades frente a las amenazas, atribuyendo como resultado que la Clínica Calderón es reconocida por el buen trato, profesionalismo de su personal y la calidad de servicio que brinda a sus usuarios. Dentro de los planes de la clínica se establece un mejoramiento en el control y cuidado de sus equipos médicos que permita seguir ofreciendo un servicio óptimo de calidad a sus clientes.