bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐Related Quality of Life After Breast Reconstruction: Comparing Outcomes Between Reconstruction Techniques Using the BREAST‐Q
Authors: Kuhlefelt Charlotta , Homsy Pauliina , Repo Jussi P. , Jahkola Tiina , Kauhanen Susanna 
Published: July 2022

AbstractBackgroundReconstruction of the breast following mastectomy can improve patients’ health‐related quality of life (HRQL). We aimed to assess HRQL in women after mastectomy and breast reconstruction and to identify differences in HRQL related to the reconstruction method used.MethodsA cross‐sectional study was performed on patients who had undergone breast reconstruction in Helsinki University Hospital between 08/2017 and 7/2019. The postoperative HRQL was assessed using the BREAST‐Q (2.0) Reconstruction Module. The results were compared between patients with different reconstruction methods using the Kruskal–Wallis test.ResultsA total of 146 patients were identified. Microvascular flaps (n = 77) were the most common method for primary breast reconstruction, followed by latissimus dorsi (LD) flaps (n = 45), fat grafting (n = 18) and implant reconstruction (n = 6). The satisfaction with breasts was high in all groups (median 61, IQR 49–71). The physical well‐being of the chest was high regardless of the reconstructive method (median 100, IQR 80–100). However, women with fat grafting reported more adverse effects of radiation (median 17, IQR 14–17 vs. 18, IQR 17–18 for other groups, p = 0.02). Donor site morbidity was low, and patients reported high satisfaction with the back (median 66/100, IQR57‐90) and abdomen (median 9/12, IQR 8–10), and physical well‐being of the back (median 61/100, IQR 53–70) and abdomen (median 65/100, IQR 60–86).ConclusionsThe patient‐reported HRQL after breast reconstruction is high. Most women report being satisfied with the reconstruction, irrespective of the reconstruction method used. The reconstruction method can thus be chosen individually in cooperation between the patient and the surgeon.
The first patient-reported outcomes from the Utrecht Prostate Cohort (UPC): the first platform facilitating ‘trials within cohorts’ (TwiCs) for the evaluation of interventions for prostate cancer
Authors: Teunissen Frederik R. , Willigenburg Thomas , Meijer Richard P. , van Melick Harm H. E. , Verkooijen Helena M. , van der Voort van Zyp Jochem R. N. 
Published: July 2022

Abstract
Purpose
To describe the development and first outcomes of the Utrecht Prostate Cohort (UPC): the first ‘trials within cohorts’ (TwiCs) platform for prostate cancer (PCa).

Methods
All non-metastasized, histologically proven PCa patients who are planned to receive standard of care are eligible for inclusion in UPC. Patients provide informed consent for the collection of clinical and technical patient data, physician-reported outcomes, and patient-reported outcomes (PROs) up to 10 years post-treatment. Additionally, patients may provide broad consent for future randomization for experimental-intervention trials (TwiCs). Changes in PROs (EPIC-26 questionnaire domains) of the participants who received standard of care were analyzed using Wilcoxon signed-rank tests.

Results
In two years, 626 patients were enrolled, 503 (80.4%) of whom provided broad consent for future randomization. Among these, 293 (46.8%) patients underwent magnetic resonance-guided adaptive radiotherapy (MRgRT), 116 (18.5%) CT-guided external beam radiation therapy (EBRT), 109 (17.4%) robot-assisted radical prostatectomy (RARP), and 65 (10.4%) patients opted for active surveillance. Patients treated with MRgRT and CT-guided EBRT showed a transient but significant decline in urinary irritative/obstructive and bowel domain scores at 1-month follow-up. RARP patients showed a significant deterioration of urinary incontinence domain scores between baseline and all follow-up moments and significant improvement of urinary irritative/obstructive domain scores between baseline and 9- and 12-month follow-up. All radical treatment groups showed a significant decline in sexual domain scores during follow-up. Active surveillance patients showed no significant deterioration over time in all domains.

Conclusion
The first results from the UPC study show distinct differences in PROs between treatment options for PCa.
Registration No.: NCT04228211.
Acute corticospinal tract diffusion tensor imaging predicts 6-month functional outcome after intracerebral haemorrhage
Authors: Schwarz G. , Kanber B. , Prados F. , Browning S. , Simister R. , Jäger R. , Ambler G. , Wheeler-Kingshott C. A. M. Gandini , Werring David J. 
Published: July 2022

Abstract
Introduction
Diffusion tensor imaging (DTI) can assess the structural integrity of the corticospinal tract (CST) in vivo. We aimed to investigate whether CST DTI metrics after intracerebral haemorrhage (ICH) are associated with 6-month functional outcome and can improve the predictive performance of the existing ICH score.

Methods
We retrospectively included 42 patients with DTI performed within 5 days after deep supratentorial spontaneous ICH. Ipsilesional-to-contralesional ratios were calculated for fractional anisotropy (rFA) and mean diffusivity (rMD) in the pontine segment (PS) of the CST. We determined the most predictive variables for poor 6-month functional outcome [modified Rankin Scale (mRS) > 2] using the least absolute shrinkage and selection operator (LASSO) method. We calculated discrimination using optimism-adjusted estimation of the area under the curve (AUC).

Results
Patients with 6-month mRS > 2 had lower rFA (0.945 [± 0.139] vs 1.045 [± 0.130]; OR 0.004 [95% CI 0.00–0.77]; p =  0.04) and higher rMD (1.233 [± 0.418] vs 0.963 [± 0.211]; OR 22.5 [95% CI 1.46–519.68]; p = 0.02). Discrimination (AUC) values were: 0.76 (95% CI 0.61–0.91) for the ICH score, 0.71 (95% CI 0.54–0.89) for rFA, and 0.72 (95% CI 0.61–0.91) for rMD. Combined models with DTI and non-DTI variables offer an improvement in discrimination: for the best model, the AUC was 0.82 ([95% CI 0.68–0.95]; p = 0.15).

Conclusion
In our exploratory study, PS-CST rFA and rMD had comparable predictive ability to the ICH score for 6-month functional outcome. Adding DTI metrics to clinical-radiological scores might improve discrimination, but this needs to be investigated in larger studies.
Parkinson’s disease multimodal complex treatment improves gait performance: an exploratory wearable digital device-supported study
Authors: Scherbaum Raphael , Moewius Andreas , Oppermann Judith , Geritz Johanna , Hansen Clint , Gold Ralf , Maetzler Walter , Tönges Lars 
Published: July 2022

Abstract
Background
Wearable device-based parameters (DBP) objectively describe gait and balance impairment in Parkinson’s disease (PD). We sought to investigate correlations between DBP of gait and balance and clinical scores, their respective changes throughout the inpatient multidisciplinary Parkinson’s Disease Multimodal Complex Treatment (PD-MCT), and correlations between their changes.

Methods
This exploratory observational study assessed 10 DBP and clinical scores at the start (T1) and end (T2) of a two-week PD-MCT of 25 PD in patients (mean age: 66.9 years, median HY stage: 2.5). Subjects performed four straight walking tasks under single- and dual-task conditions, and four balance tasks.

Results
At T1, reduced gait velocity and larger sway area correlated with motor severity. Shorter strides during motor-motor dual-tasking correlated with motor complications. From T1 to T2, gait velocity improved, especially under dual-task conditions, stride length increased for motor-motor dual-tasking, and clinical scores measuring motor severity, balance, dexterity, executive functions, and motor complications changed favorably. Other gait parameters did not change significantly. Changes in motor complications, motor severity, and fear of falling correlated with changes in stride length, sway area, and measures of gait stability, respectively.

Conclusion
DBP of gait and balance reflect clinical scores, e.g., those of motor severity. PD-MCT significantly improves gait velocity and stride length and favorably affects additional DBP. Motor complications and fear of falling are factors that may influence the response to PD-MCT. A DBP-based assessment on admission to PD inpatient treatment could allow for more individualized therapy that can improve outcomes.

Trial registration number and date
DRKS00020948 number, 30-Mar-2020, retrospectively registered.
Subthalamic deep brain stimulation for refractory Gilles de la Tourette’s syndrome: clinical outcome and functional connectivity
Authors: Dai Lulin , Xu Wenying , Song Yunhai , Huang Peng , Li Ningfei , Hollunder Barbara , Horn Andreas , Wu Yiwen , Zhang Chencheng , Sun Bomin , Li Dianyou 
Published: July 2022

Abstract
Background
Deep brain stimulation (DBS) is a promising novel approach for managing refractory Gilles de la Tourette’s syndrome (GTS). The subthalamic nucleus (STN) is the most common DBS target for treating movement disorders, and smaller case studies have reported the efficacy of bilateral STN-DBS treatment for relieving tic symptoms. However, management of GTS and treatment mechanism of STN-DBS in GTS remain to be elucidated.

Methods
Ten patients undergoing STN-DBS were included. Tics severity was evaluated using the Yale Global Tic Severity Scale. The severities of comorbid psychiatric symptoms of obsessive–compulsive behavior (OCB), attention-deficit/hyperactivity disorder, anxiety, and depression; social and occupational functioning; and quality of life were assessed. Volumes of tissue activated were used as seed points for functional connectivity analysis performed using a control dataset.

Results
The overall tics severity significantly reduced, with 62.9% ± 26.2% and 58.8% ± 27.2% improvements at the 6- and 12-months follow-up, respectively. All three patients with comorbid OCB showed improvement in their OCB symptoms at both the follow-ups. STN-DBS treatment was reasonably well tolerated by the patients with GTS. The most commonly reported side effect was light dysarthria. The stimulation effect of STN-DBS might regulate these symptoms through functional connectivity with the thalamus, pallidum, substantia nigra pars reticulata, putamen, insula, and anterior cingulate cortices.

Conclusions
STN-DBS was associated with symptomatic improvement in severe and refractory GTS without significant adverse events. The STN is a promising DBS target by stimulating both sensorimotor and limbic subregions, and specific brain area doses affect treatment outcomes.
Prevalence of intronic repeat expansions in RFC1 in Dutch patients with CANVAS and adult-onset ataxia
Authors: Ghorbani Fatemeh , de Boer-Bergsma Jelkje , Verschuuren-Bemelmans Corien C. , Pennings Maartje , de Boer Eddy N. , Kremer Berry , Vanhoutte Els K. , de Vries Jeroen J. , van de Berg Raymond , Kamsteeg Erik-Jan , van Diemen Cleo C. , Westers Helga , van de Warrenburg Bart P. , Verbeek Dineke S. 
Published: July 2022

AbstractRecently, an intronic biallelic (AAGGG)n repeat expansion in RFC1 was shown to be a cause of CANVAS and adult-onset ataxia in multiple populations. As the prevalence of the RFC1 repeat expansion in Dutch cases was unknown, we retrospectively tested 9 putative CANVAS cases and two independent cohorts (A and B) of 395 and 222 adult-onset ataxia cases, respectively, using the previously published protocol and, for the first time optical genome mapping to determine the size of the expanded RFC1 repeat. We identified the biallelic (AAGGG)n repeat expansion in 5/9 (55%) putative CANVAS patients and in 10/617 (1.6%; cohorts A + B) adult-onset ataxia patients. In addition to the AAGGG repeat motif, we observed a putative GAAGG repeat motif in the repeat expansion with unknown significance in two adult-onset ataxia patients. All the expanded (AAGGG)n repeats identified were in the range of 800–1299 repeat units. The intronic biallelic RFC1 repeat expansion thus explains a number of the Dutch adult-onset ataxia cases that display the main clinical features of CANVAS, and particularly when ataxia is combined with neuropathy. The yield of screening for RFC1 expansions in unselected cohorts is relatively low. To increase the current diagnostic yield in ataxia patients, we suggest adding RFC1 screening to the genetic diagnostic workflow by using advanced techniques that attain long fragments.
Training deep material networks to reproduce creep loading of short fiber-reinforced thermoplastics with an inelastically-informed strategy
Authors: Dey Argha Protim , Welschinger Fabian , Schneider Matti , Gajek Sebastian , Böhlke Thomas 
Published: July 2022

AbstractDeep material networks (DMNs) are a recent multiscale technology which enable running concurrent multiscale simulations on industrial scale with the help of powerful surrogate models for the micromechanical problem. Classically, the parameters of the DMNs are identified based on linear elastic precomputations. Once the parameters are identified, DMNs may process inelastic material models and were shown to reproduce micromechanical full-field simulations with the original microstructure to high accuracy. The work at hand was motivated by creep loading of thermoplastic components with fiber reinforcement. In this context, multiple scales appear, both in space (due to the reinforcements) and in time (short- and long-term effects). We demonstrate by computational examples that the classical training strategy based on linear elastic precomputations is not guaranteed to produce DMNs whose long-term creep response accurately matches high-fidelity computations. As a remedy, we propose an inelastically informed early stopping strategy for the offline training of the DMNs. Moreover, we introduce a novel strategy based on a surrogate material model, which shares the principal nonlinear effects with the true model but is significantly less expensive to evaluate. For the problem at hand, this strategy enables saving significant time during the parameter identification process. We demonstrate that the novel strategy provides DMNs which reliably generalize to creep loading.
Dynamics of cardiovascular and baroreflex readjustments during a light-to-moderate exercise transient in humans
Authors: Taboni Anna , Fagoni Nazzareno , Fontolliet Timothée , Vinetti Giovanni , Ferretti Guido 
Published: July 2022

Abstract
Purpose
We hypothesised that, during a light-to-moderate exercise transient, compared to an equivalent rest-to-exercise transient, (1) a further baroreflex sensitivity (BRS) decrease would be slower, (2) no rapid heart rate (HR) response would occur, and (3) the rapid cardiac output (CO) response would have a smaller amplitude (A1). Hence, we analysed the dynamics of arterial baroreflexes and the HR and CO kinetics during rest-to-50 W (0–50 W) and 50-to-100 W (50–100 W) exercise transients.

Methods
10 subjects performed three 0–50 W and three 50–100 W on a cycle ergometer. We recorded arterial blood pressure profiles (photo-plethysmography) and R-to-R interval (RRi, electrocardiography). The former were analysed to obtain beat-by-beat mean arterial pressure (MAP) and stroke volume (SV). CO was calculated as SV times HR. BRS was measured by modified sequence method.

Results
During 0–50 W, MAP transiently fell (− 9.0 ± 5.7 mmHg, p < 0.01) and BRS passed from 15.0 ± 3.7 at rest to 7.3 ± 2.4 ms mmHg−1 at 50 W (p < 0.01) promptly (first BRS sequence: 8.1 ± 4.6 ms mmHg−1, p < 0.01 vs. rest). During 50–100 W, MAP did not fall and BRS passed from 7.2 ± 2.6 at 50 W to 3.3 ± 1.3 ms mmHg−1 at 100 W (p < 0.01) slowly (first BRS sequence: 5.3 ± 3.1 ms mmHg−1, p = 0.07 vs. 50 W). A1 for HR was 9.2 ± 6.0 and 6.0 ± 4.5 min−1 in 0–50 W and 50–100 W, respectively (p = 0.19). The corresponding A1 for CO were 2.80 ± 1.54 and 0.91 ± 0.55 l∙min−1 (p < 0.01).

Conclusion
During 50–100 W, with respect to 0–50 W, BRS decreased more slowly, in absence of a prompt pressure decrease. BRS decrease and rapid HR response in 50–100 W were unexpected and ascribed to possible persistence of some vagal tone at 50 W.
COVID-19 in children and adolescents: MIS(-C)-taken diagnoses
Authors: van der Steen M. , Leroy P. L. , Driessen G. J. A. , Bannier M. A. G. E. 
Published: July 2022

AbstractMultisystem inflammatory syndrome in children (MIS-C) is an inflammatory condition associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is characterized by fever, gastro-intestinal symptoms, cardiovascular complications, conjunctivitis, skin involvement, elevated inflammatory markers, and coagulation abnormalities. The current ongoing COVID-19 pandemic causes an increased alertness to MIS-C. In combination with the heterogeneous clinical spectrum, this could potentially lead to diagnostic blindness, misdiagnosis of MIS-C, and overtreatment with expensive IVIG treatment. This report demonstrates the challenge of accurately distinguishing MIS-C from other more common inflammatory pediatric diseases, and the need to act with caution to avoid misdiagnoses in the current pandemic. We present a case series of 11 patients suspected of MIS-C based on the current definitions. Three of them were eventually diagnosed with a different disease.Conclusion: Current definitions and diagnostic criteria lack specificity which potentially leads to misdiagnosis and overtreatment of MIS-C. We emphasize the need to act with caution in order to avoid MIS(-C)-taken diagnoses in the current pandemic.What is Known:• A pediatric multisystem inflammatory disease associated with SARS-CoV-2 has been described (MIS-C).• There are three definitions being used for MIS-C, all including fever for at least 24 h, laboratory evidence of inflammation, clinically severe illness with multi-organ (≥ 2) involvement, and no alternative plausible diagnosis.What is New:• MIS-C has a heterogeneous clinical spectrum without distinctive features compared to more common childhood diseases. Current definitions and diagnostic criteria for MIS-C lack specificity which leads to misdiagnosis and overtreatment.• Amid the current excessive attention to COVID-19 and MIS-C, pediatricians should remain vigilant to avoid mistaken diagnoses.
Schmerzmittelgebrauch in Deutschland
Authors: Diener Hans-Christoph , Lehmacher Walter , Kroth Elmar , Lampert Anette , Weiser Thomas 
Published: July 2022

Zusammenfassung
Hintergrund
Publizierte Daten zum Pro-Kopf-Gebrauch von Schmerzmitteln in Deutschland liegen nur bis zum Jahr 2005 vor. In der vorliegenden Analyse wurden Daten für die Jahre 2008 bis 2019 ausgewertet. Es wurde der Gebrauch von rezeptpflichtigen wie rezeptfreien Analgetika untersucht, mögliche Einflussgrößen wurden diskutiert.

Methodik
Der Pro-Kopf-Gebrauch von verschreibungspflichtigen und rezeptfreien Analgetika wurde auf Basis von verlässlichen Daten zu Rezepten und Bareinkäufen in Apotheken ermittelt (IMS Pharmascope®). Für rezeptfreie Präparate wurde zudem eine Auswertung nach Wirkstoffen vorgenommen. Zusätzlich wurden Werbeaufwendungen pharmazeutischer Hersteller und Veränderungen der Abgabewege als mögliche Einflussgrößen analysiert.

Ergebnisse
Innerhalb des Beobachtungszeitraums ist der Gebrauch von verschreibungspflichtigen Analgetika angestiegen, während der Gebrauch von rezeptfreien Analgetika gesunken ist. Monopräparate machen den Großteil des Absatzes von rezeptfreien Schmerzmitteln aus. Der Anteil von Kombinationspräparaten war in den letzten Jahren rückläufig.

Diskussion
Der Gebrauch von rezeptfreien Analgetika in Deutschland war zwischen 2008 und 2019 rückläufig. Damit setzt sich der Trend ab 1995, der in einer vorherigen Untersuchung beobachtet wurde, fort. Externe Faktoren wie der Anstieg von Werbeausgaben oder der leichtere Zugang über Versandapotheken scheinen den Gebrauch nicht zu beeinflussen.
Land–sea thermal contrast associated with summer monsoon onset over the Chao Phraya River basin
Authors: Yamada Tomohito J. , Shrivastava Sourabh , Kato Ryosuke 
Published: July 2022

AbstractEarlier onset of the Southeast Asian summer monsoon (SAM) was observed over the Chao Phraya River basin in Thailand using Thai Meteorological Department-derived high-resolution merged rainfall data from 1981 to 2016. SAM variability depends on numerous local and global factors, including thermal conditions over the Bay of Bengal (BoB) and Tibetan Plateau (TbT). Despite tremendous past research efforts, the effect of thermal heat contrast on the SAM remains unclear. Using observational and reanalysis datasets, we found that the absolute value of total heat over the BoB was increasing. However, the interannual variability of total heat was greater over the TbT. Changes in surface temperature (± 1.5 °C), air thickness (± 20 m), and geopotential height over the TbT were associated with the timing of SAM onset. The results also suggested that significant changes in air thickness are driven by surface temperature differences over the TbT, while changes in the integrated apparent heat source and integrated apparent moisture sink of ± 100 W m−2 resulted in anomalous convective activities over the BoB and mainland of the Indochina Peninsula in years of early and late SAM onset. At the intraseasonal timescale, Madden–Julian oscillation (MJO) was observed over the Indian Ocean and Western Hemisphere for 4–10 days in years of early SAM onset. The opposite situation was found for years of late SAM onset, with MJO located over the Western Pacific Ocean and Maritime Continent.
The persistent effects of foetal growth on child and adolescent mental health: longitudinal evidence from a large population-based cohort
Authors: Dooley Niamh , Healy Colm , Cotter David , Clarke Mary , Cannon Mary 
Published: July 2022

AbstractLow birth weight for one’s gestational age is associated with higher rates of child psychopathology, however, most studies assess psychopathology cross-sectionally. The effect of such foetal growth restriction appears to be strongest for attention problems in childhood, although adult studies have found associations with a range of outcomes, from depression to psychosis. We explore how associations between foetal growth and psychopathology change across age, and whether they vary by sex. We used a large nationally representative cohort of children from Ireland (N ~ 8000). Parents completed the Strengths and Difficulties Questionnaire (SDQ) at 3 time points (age 9, 13 and 17). Outcomes included a total problems scale and subscales measuring attention/hyperactivity, peer, conduct and emotional problems. Foetal growth had significant associations with all problem scales, even after controlling for sex, socioeconomic factors and parental mental health. The magnitude of these effects was small but relatively stable across ages 9–17. In males, foetal growth had the strongest associations with attention/hyperactivity and peer problems, whereas females showed more widespread associations with all four subscales. There was a trend for the association between foetal growth and emotional problems to increase with advancing age, approaching the borderline-abnormal threshold by age 17. Reduced foetal growth predicted persistently higher scores on all measured aspects of child and adolescent psychopathology. Associations with child attention/hyperactivity may generalize to a wider array of adult psychopathologies via adolescent-onset emotional problems. Future studies should explore potential age-dependent effects of foetal growth into the early 20s.