bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to assess, detect, and manage joint involvement in the era of transformational therapies: Role of point‐of‐care ultrasound
Authors: Minno Matteo Nicola Dario Di , Martinoli Carlo , Pasta Gianluigi , De la Corte‐Rodriguez Hortensia , Samy Islam , Stephensen David , Timmer Merel A. , Winburn Ian 
Published: September 2022

AbstractBackgroundPatients with haemophilia experience recurring hemarthroses, mainly involving knees, elbows and ankles, which lead to haemophilic arthropathy, the major chronic complication of haemophilia. With new approaches to haemophilia treatment leading to fewer joint bleeds and, in some cases, no bleeding events, assessing whether current outcome assessment tools provide adequate sensitivity and specificity for management and care of patients with haemophilia is needed.MethodsAn overview of current imaging tools for monitoring joint health, novel osteochondral damage and synovial proliferation biomarkers, and the relationship between assessments for functionality and imaging modalities is provided. Usefulness and sensitivity of point‐of‐care ultrasound (POCUS) to complement other assessments and use of ultrasound to monitor haemophilic arthropathy are also examined.ResultsThis review provides rationale for haemophilia teams to move beyond traditional outcomes in joint imaging, as well as guidance and evidence on assessment of joint health for potential new treatment modalities, such as gene therapy. The role of POCUS in the existing paradigm for haemophilia care and management along with the use of ultrasound as a complement to other outcome assessment tools are also discussed. Finally, the clinical effects of subclinical bleeding on joint function are described, to motivate screening for synovial proliferation.ConclusionPOCUS can facilitate the early detection of joint damage and can monitor disease progression while providing insights into the efficacy of treatment regimens, and should be considered as an essential assessment tool for managing the care of patients with haemophilia.
Disparities in HIV continuum of care in the paediatric population: A real‐life study in Brazil
Authors: Ferreira Alexandre Alberto Cunha Mendes , Pinho Rosana Gonçalves Gonçalves , de Aquino Laís Martins , de Barros Perini Filipe , Fonseca Fernanda Fernandes , Tresse Alexsana Sposito , Pereira Gerson Fernando Mendes , Avelino‐Silva Vivian I. , Pascom Ana Roberta 
Published: September 2022

AbstractIntroductionPaediatric HIV follow‐up is challenging, and treatment indicators are markedly far from Joint United Nations Programme on HIV/AIDS (UNAIDS) goals. In this study, we describe the 2019 Brazilian HIV cascade according to age categories and sociodemographic variables and address temporal trends between 2009 and 2019.MethodsWe obtained data from the Brazilian Ministry of Health monitoring database. Cascade outcomes included retention in care, antiretroviral use, and viral suppression. We assessed the effect of age on timely initiation of antiretroviral treatment (ART; initiation with CD4+ T‐cell count ≥350 cells/mm3 or a first ART dispensation ≤30 days after the first CD4+ T‐cell measurement) and detectable HIV viral load (>50 copies/mL) in univariable and multivariable analysis adjusted for sex, race, and social vulnerability index (SVI). Temporal trends in timely ART initiation and viral suppression were evaluated graphically.ResultsAmong 771 774 people living with HIV, those in the youngest age categories had poorer indicators in the care cascade. Those in younger age groups, those with higher SVI, and those declaring Black and native Brazilian race/ethnicity had higher odds of having detectable viral load and delayed ART initiation. Although children living with HIV tend to start ART with higher CD4+ T‐cell counts, time–series analysis suggests that improvements in treatment indicators seen in the adult population are not observed in the paediatric population.ConclusionOur results highlight the challenges faced by children and adolescents living with HIV in achieving UNAIDS goals. Lower access to ART among children is a central barrier to improved paediatric care.
Structure evolution of wolframite‐type ZnZrC2O8 (C = Nb, Ta) ceramics in relation to microwave dielectric properties
Authors: Liu Kui , Zhang Huaiwu , Liu Cheng , Shi Liang , Wang Xueying , Li Jie , Liao Yulong , Zhang Dainan 
Published: September 2022

AbstractThe relationship among the sintering behavior, crystal structure, chemical bonding properties, and dielectric properties of wolframite‐type ZnZr(Nb1−xTax)2O8 (0.0 ≤ x ≤ 1.0) ceramics was investigated with the progressive replacement of Nb5+ by Ta5+. The optimum sintering temperature increases from 1225 to 1375°C with increasing Ta5+ content. The εr value falls from 27.34 to 22.34 due to a gradual decrease in bond ionicity and a shift in the Raman vibration modes toward higher wave numbers. The Q × f increases from 63 604 GHz (@6.71 GHz) to 115 631 GHz (@7.89 GHz), which is since the increase in the total lattice of chemical bonds. Moreover, the reduction in grain boundary area and the gradual lowering of the full width at half maximum of the Raman vibration modes contribute to the reduction in dielectric losses. First‐principles calculations illustrate that the growth in bandgap and electron cloud density in the internal space of the [Zn/ZrO6] octahedron leads to a reduction in dielectric loss. Furthermore, the reduced degree of oxygen octahedral distortion causes a change in τf from −46.56 to −37.40 ppm/°C.
What We Owe to Our Audience: The Hermeneutical Responsibility of Fiction Creators
Authors: Wojtkiewicz Kate 
Published: September 2022

ABSTRACTAs audiences demand better and more diverse representation in the fictions they consume, there is a question of how that demand should be placed on fiction creators. In this article, I answer this question by arguing creators of fiction have a hermeneutical responsibility to include diverse characters in their creations, and to do so without relying on harmful stereotypes. I cast this responsibility as the epistemic virtue of due diligence, offset by epistemic laziness and epistemic paralysis as the corresponding vices of absence and excess, respectively. Practicing either vice can constitute a type of hermeneutical gap described by Katharine Jenkins, in which harmful stereotypes (conceptions) become more accessible to epistemic agents than the more accurate concept. By blocking the agent's access to the accurate conception, such stereotypes create a hermeneutical gap and can contribute to hermeneutical injustices, as described by Miranda Fricker and José Medina.
Combination non‐invasive radiofrequency and electrical muscle stimulation: A synergistic combination for body contouring
Authors: Dayan Erez , Chilukuri Suneel , Bucky Louis , Bharti Gaurav , Gold Michael H. , Rohrich Rod 
Published: September 2022

AbstractIntroductionPatients desiring noninvasive body contouring increasing require a more comprehensive approach to soft tissue laxity, muscle, and adipose hypertrophy. Previous devices have typically focused on only adipose reduction, without impact on muscle or skin laxity. This study describes the first use of noninvasive bipolar radiofrequency in combination with electromagnetic muscle stimulation.MethodsThis study was an IRB‐approved study conducted at four sites (TN, TX, PA, NC). In all, 38 patients completed the three‐treatment regimen of combined non‐invasive bipolar RF and EMS. Efficacy of the Transform (InMode, Lake Forest, CA) treatment was assessed by numerous outcomes including sequential caliper measurements, circumference measurements, comfort during treatment, subject satisfaction, ultrasound measurements, blinded pictures evaluation, and histology.ResultsThe combination of non‐invasive bipolar RF with EMS was found to be safe and efficacious. The three‐treatment regimen was statistically efficacious as it related to (1) subject satisfaction, (2) 1 mm ultrasound, (3) 2 mm ultrasound, (4) average of 1 and 2 mm ultrasound, (5) caliper 1 measurements, (6) caliper 2 measurements, (7) average of caliper 1 and 2 measurements, (8) subject comfort, (9) widest circumference measure, (10) 2‐inches above circumference measure, (11) 2‐inches below circumference measure, (12) average circumference measure, and finally, (13) blinded evaluator photograph agreement.ConclusionThe combination of noninvasive bipolar radiofrequency and electrical muscle stimulation is a safe and effective method for treatment of skin laxity, adipose hypertrophy, and muscle.
The impact of an autonomous nurse‐led high‐flow nasal cannula oxygen protocol on clinical outcomes of infants with bronchiolitis
Authors: Elks Michelle , Young Jeanine , Kearney Lauren , Bernard Anne 
Published: September 2022

AbstractObjectiveTo investigate the relationship of the implementation of a nurse‐led high‐flow nasal cannula oxygen protocol on the clinical outcomes of infants with bronchiolitis in a regional paediatric unit.BackgroundBronchiolitis is a common lower respiratory illness and is the leading cause for hospitalisation of infants globally. Standard care involves the provision of supportive measures. Historically, supplemental oxygen was provided by low‐flow nasal cannula. High‐flow nasal cannula oxygen has been increasingly adopted despite limited evidence of its efficacy.MethodsThis study employed non‐equivalent, post‐implementation only design to explore clinical outcomes of infants with bronchiolitis admitted for high‐flow nasal cannula oxygen therapy. The study compared infants in the 24 months before and after the initiation of a high‐flow nasal cannula protocol. The primary clinical outcome was length of stay, secondary outcomes included time on high flow, weaning time, escalation of care and time outside of physiological parameters. Implementation strategy evaluation was measured by compliance with applying the protocol, reported as episodes of variance, and duration of variance. The StaRI checklist was selected as the most appropriate reporting guideline.ResultsA total of 80 patients were admitted with bronchiolitis and received high‐flow nasal cannula oxygen therapy during a 48‐month period; 37 patients were prior, and 43 after, the introduction of a nurse‐led high‐flow nasal cannula protocol. Length of stay was significantly reduced in the post‐implementation group compared to the historical control group (83.8 vs. 61.3 h). Time on high flow and weaning time was decreased in the post‐implementation group compared to the control group (33.5 vs. 26.7 h and 26 vs.12.25 h, respectively); however, these did not reach statistical significance. There was varied application of the HFNC protocol.ConclusionsThe implementation of a nurse‐led high‐flow nasal cannula protocol was associated with a reduced length of stay.Relevance to Clinical PracticeThis study demonstrated that infants with bronchiolitis that were treated with a nurse‐led high‐flow nasal cannula (HFNC) therapy protocol had positive effects on clinical outcomes including a shorter length of stay than compared with those with physician‐directed care in a regional paediatric unit. A weight‐based (2 L/kg) HFNC therapy was safely administered to infants with bronchiolitis in a regional hospital paediatric ward with no paediatric intensive care unit (PICU).
Unrecognized liver cirrhosis is common and associated with worse survival in hepatocellular carcinoma: A nationwide cohort study of 3473 patients
Authors: Vaz Juan , Strömberg Ulf , Midlöv Patrik , Eriksson Berne , Buchebner David , Hagström Hannes 
Published: September 2022

AbstractBackgroundData on unrecognized liver cirrhosis in patients with hepatocellular carcinoma (HCC) are derived mainly from cohorts with a risk of selection bias.ObjectivesIn a population‐based cohort study we aimed to determine the proportion, characteristics, and prognosis of HCC in patients with unrecognized cirrhosis.MethodsUsing the Swedish quality register for liver cancer and other nationwide registers, we identified all adults with HCC in Sweden between 2012 and 2018 (n = 3,473).ResultsThe final study cohort comprised 2670 patients with established cirrhosis, of which 1033 (39%) had unrecognized cirrhosis at HCC diagnosis. These patients were more often male, older, and had larger tumors, multinodular cancer, portal vein thrombosis, and extrahepatic metastasis compared to patients with known cirrhosis with HCC and under surveillance (34%). Compared to surveilled patients, those with unrecognized cirrhosis had worse median survival (0.89 years, 95% confidence interval [CI] = 0.78‐1.01 vs. 3.79 years, 95%CI = 3.19‐4.39), and an adjusted hazard ratio of 2.36 (95%CI = 2.09‐2.66). Patients with cirrhosis but not under surveillance (27%) and patients with unrecognized cirrhosis had similar characteristics, such as equal proportions diagnosed at late stage (79%).ConclusionsCirrhosis is often not recognized in patients with HCC. Unrecognized cirrhosis is associated with more advanced HCC at diagnosis and a worse prognosis. More efforts are needed to diagnose cirrhosis at an earlier stage.
Pterygoid muscle activity in speech: A preliminary investigation
Authors: Murray Greg M. , Carignan Christopher , Whittle Terry , Gal John A. , Best Catherine 
Published: September 2022

AbstractBackgroundSpeaking depends on refined control of jaw opening and closing movements. The medial pterygoid muscle (MPT), involved in jaw closing, and the lateral pterygoid muscle (LPT), involved in jaw opening, are two key mandibular muscles in mastication and are likely to be recruited for controlled movements in speech.ObjectivesThree hypotheses were investigated, that during speech the MPT and LPT: (1) were both active, (2) but exhibited different patterns of activity, (3) which fluctuated with the vowels and consonants in speech.MethodsIntramuscular EMG recordings were made from the right inferior head of the LPT and/or the right MPT in five participants during production of 40 target nonsense words (NWs) consisting of three syllables in the form /V1 C1V2 C2ə/ (V = vowel; C = consonant; ə = unstressed, reduced vowel), spoken by each participant 10 times per NW; analysis focussed on the target syllable, C1V2.ResultsBoth MPT and LPT exhibited robust increases in EMG activity during utterance of most NWs, relative to rest. Peak LPT activation was time‐locked to the final part of the target consonant (C1) interval when the jaw begins opening for the target vowel (V2), whereas peak MPT activation occurred around the temporal midpoint of V2, when the jaw begins closing for C2. EMG amplitude peaks differed in magnitude between “high” vowels, i.e., for which the tongue/jaw are high (e.g., in SEEK), and “low” vowels, i.e., for which the tongue/jaw are low (e.g., in SOCK).ConclusionsThese novel findings suggest a key role for the LPT and MPT in the fine control of speech production. They imply that speech may impose major synergistic demands on the activities of the MPT and the LPT, and thereby provide insights into the possible interactions between speech activities and orofacial activities (e.g. mastication) and conditions (e.g. Temporomandibular Disorders) that involve the masticatory muscles.
Diurnal changes in blood pressure and heart rate in children with narcolepsy with cataplexy
Authors: Wang Jingyu , Yan Zhihui , Dong Xiaosong , Li Jing , Zhao Long , Zhang Xueli , Lv Changjun , Zhao Ziyan , Strohl Kingman P. , Han Fang 
Published: September 2022

SummaryThe hypocretin neurons in the lateral hypothalamus are connected not only to brain alertness systems but also to brainstem nuclei that regulate blood pressure and heart rate. The premise is that regulation of blood pressure and heart rate is altered and affected by methylphenidate, a stimulant drug in children with narcolepsy with cataplexy. The changes in 24‐hr ambulatory systolic and diastolic blood pressure and heart rate were compared among pre‐treated narcolepsy with cataplexy patients (40 males, 10 females), with mean age 10.4 ± 3.5 years (M ± SD, range 5–17 years) with values from 100 archival age–sex–body mass index matched controls. Patients had a lower diurnal systolic blood pressure (−6.5 mmHg; p = 0.000) but higher heart rate (+11.0 bpm; p = 0.000), particularly evident in the waketime, while diastolic blood pressure was comparable. With methylphenidate (18 mg sustained release at 08:00 hours), patients with narcolepsy with cataplexy had higher systolic blood pressure (+4.6 mmHg, p = 0.015), diastolic blood pressure (+3.3 mmHg, p = 0.005) and heart rate (+7.1 bpm, p = 0.028) during wake time, but nighttime cardiovascular values were unchanged from pre‐treated values; amplitude variation in cardiovascular values was unchanged over 24 hr. In conclusion, children with narcolepsy with cataplexy had downregulation blood pressure profile but a higher heart rate, and lesser non‐dipping profiles. Daytime methylphenidate treatment increases only waketime blood pressure and further elevated heart rate values.
Various responses of pine marten morphology and demography to temporal climate changes and primary productivity
Authors: Wereszczuk A. , Fedotova A. , Marciszak A. , Popiołek M. , Zharova A. , Zalewski A. 
Published: September 2022

AbstractClimate and environmental changes affect species' morphology and ecology, with different responses to shifting abiotic and biotic factors observed across species. Here, we tested how the structural body size of the pine marten and its population sex ratio shifted over time alongside climate change. We analysed temporal changes in morphological traits using 11 measurements of pine marten skulls (N = 158) collected between 1903 and 2020 and originating from Poland. We linked them with climatic and primary production variations and assessed demographic shifts by calculating temporal sex ratio changes over 61 years (N = 205). Skull size, as a proxy of body size, increased in response to warmer and less snowy winters. However, changes in primary productivity rapidly shaped postorbital constriction regardless of shifts in body size, potentially demonstrating increased diet diversity in pine marten. Congruent with climate change, the population sex ratio has skewed towards males over time. Our results indicate that climate conditions and primary production affect the structural size of the skull, and we highlight the various potential responses of pine marten morphology and ecology to climate change. Recently, shifting population demographics resulting from these processes may constitute a threat to marten populations.
Spot It and Learn It! Word Learning in Virtual Peer‐Group Interactions Using a Novel Paradigm for School‐Aged Children
Authors: Levy Helena , Hanulíková Adriana 
Published: September 2022

AbstractWe use a novel paradigm to examine the effect of language exposure and variable input on the acquisition of words in primary school–aged children. Children growing up with different languages and foreign or regional accents in their input might benefit from their experience with variability when learning new words from peers with unfamiliar accents. We ask to what extent language and accent experience helps monolingual and bilingual children learn new words in the context of accent variability. Children (aged 7–11 years) played a computerized card game with virtual peers that resembles natural advanced lexical acquisition, during which new words are learned from child speakers and are produced actively in peer‐group interactions. Successful word learning was predicted by the amount of input in regional and foreign accents but not by exposure to other languages (i.e., bilingualism). We discuss how accent experience affects word learning under variable input conditions.
Effect of habitat topography on the structure and diversity of benthic communities across five marinas from the southwestern Atlantic Ocean
Authors: Marchetti Otávio César , Rodrigues Isadora Drovandi , Oricchio Felipe Theocharides , Dias Gustavo Muniz 
Published: September 2022

AbstractMarine urbanization promotes the addition of hard substrata that barely resembles natural substrate nearby. We manipulated habitat topography in five marinas across one of the most populated regions from the Southwestern Atlantic Ocean to describe the effect of habitat complexity on the diversity of benthic communities across sites with distinct conditions and biotas. The highest biomass was found in the two marinas under high pollution and freshwater disturbances, regardless of habitat complexity. Habitat topography did not affect species richness but determined the structure of sessile communities in all marinas. The structure of mobile communities was affected only in the most diverse site, increasing the abundance of isopods. In general, fragile ascidians, hydrozoans, and non‐calcified polychaetes dominated complex habitats, while structurally defended animals such as barnacles, serpulids, and encrusting bryozoans dominated simple habitats, suggesting that dominant species are selected by habitat complexity based on their morphological traits. However, the final community structure was also determined by differences across marinas, suggesting that the effect of increasing habitat topography is mostly site‐specific. Therefore, strategies to minimize the disparity between natural and artificial habitats must consider historic local community and a multiple stressors scenario.
Complications and treatment errors in periodontal therapy in medically compromised patients
Authors: Leira Yago , Cho Hana , Marletta Debora , Orlandi Marco , Diz Pedro , Kumar Navdeep , D’Aiuto Francesco 
Published: September 2022

AbstractPatients who are medically compromised may be at an increased risk of complications and treatment errors following periodontal therapy. A review of the evidence on the topic is presented, in relation to the type of complication reported, of periodontal treatment, and of patients' medical status. Further, a framework for risk assessment and appropriate treatment modifications is introduced, with the aim of facilitating the management of patients with existing comorbidities and reducing the incidence of treatment complications.
The contralateral effects of anticipated stimuli on brain activity measured by ERP and fMRI
Authors: Ohgami Yoshimi , Kotani Yasunori , Yoshida Nobukiyo , Akai Hiroyuki , Kunimatsu Akira , Kiryu Shigeru , Inoue Yusuke 
Published: September 2022

AbstractThe present study examined the effects of unilateral stimulus presentation on the right hemisphere preponderance of the stimulus‐preceding negativity (SPN) in the event‐related potential (ERP) experiment, and aimed to elucidate whether unilateral stimulus presentation affected activations in the bilateral anterior insula in the functional magnetic resonance imaging (fMRI) experiment. Separate fMRI and ERP experiments were conducted using visual and auditory stimuli by manipulating the position of stimulus presentation (left side or right side) with the time estimation task. The ERP experiment revealed a significant right hemisphere preponderance during left stimulation and no laterality during the right stimulation. The fMRI experiment revealed that the left anterior insula was activated only in the right stimulation of auditory and visual stimuli whereas the right anterior insula was activated by both left and right stimulations. The visual condition retained a contralateral dominance, but the auditory condition showed a right hemisphere dominance in a localized area. The results of this study indicate that the SPN reflects perceptual anticipation, and also that the anterior insula is involved in its occurrence.