bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Therapy Treatments Incorporating Equine Movement: A Pilot Study Exploring Kinetic Interactions between Children with Cerebral Palsy and the Horse
Authors: Lightsey Priscilla , Lee Yonghee , Krenek Nancy , Hur Pilwon 
Published: April 2021

Abstract
BackgroundPhysical therapy treatments incorporating equine movement is recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies examined kinematic outputs of the horses and children when mounted. In this pilot study, we examined the interaction between the horses and children with CP during physical therapy sessions where equine movement was utilized to better understand the effectiveness of this type of treatment.MethodsFour children with CP participated in eight physical therapy sessions incorporating hippotherapy as a treatment intervention. Functional mobility was assessed using the Timed Up Go or 10m Walk Test. Inertial measurement unit sensors, attached to children and horses, recorded movements and tracked acceleration, angular velocity, and body orientation. Correlation between vertical accelerations of children and horses were analyzed. In addition, peak frequencies of vertical accelerations of children and horses were compared.ResultsFunctional tests modestly improved over time. The children’s movements, (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse’s walk, demonstrated by reduced frequency errors and increased correlation.ConclusionsThe findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse’s movement. Since the horse’s gait at a walk mimics the human gait this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for the neuromuscular system to experience a typical gait pattern. The horse’s movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional which can facilitate motor learning. Thus, the increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work.Trial registrationTexas A&M University Institutional Review Board. IRB2018-0064. Registered 8 March 2018. Link: https://rcb.tamu.edu/humans/irb and https://github.com/pilwonhur/HPOT
Identification and Characterization of Circular RNA Profiling in Kahin-Beck Disease
Authors: Li Peilin , Wang Ying , Yang Xiaodong , Gao Dalong , Tan Sijia , Li Wenyu , Zhang Feng , Guo Xiong , Wu Cuiyan 
Published: April 2021

Abstract
Objective. Circular RNAs (circRNAs) have been manifested as novel regulatory molecules involved in various diseases processes, but their role in Kashin-Beck disease (KBD) has not been investigated. The aim of this study was to identify their expression profile and functions in KBD.Methods. Primary chondrocytes were isolated from human cartilage and cultured in vitro. The circRNA expression of chondrocytes was performed by microarray analysis. The differentially expressed circRNAs were further characterized by chromosome distribution, circRNA-miRNA correlation analysis, gene ontology (GO) and pathway analysis. Miranda was used to predict the target miRNAs of specific circRNAs. Cytoscape software was used to visualize the circRNA-miRNA interaction network to reveal the gene regulation mechanism of specific circRNAs.Results. In total, 886 circRNAs were discovered to be differentially expressed between the two groups, and of these, 348 were upregulated and 538 were downregulated in the KBD group (≥2-fold change). Gene ontology and pathway analysis revealed that compared to normal group, many processes that were over-represented in KBD group were related to nervous system development, cell periphery, laminin interactions, focal adhesion, extracellular matrix (ECM)-receptor interaction. Conclusion. The study revealed the aberrant expression profile of circRNA between KBD group and normal group, the outcomes may have potential significance in the pathogenesis and diagnostic markers of KBD.
Use of Research Electronic Data Capture (REDCap) in different phases of a COVID-19 randomized controlled trial: A practical example
Authors: Kianersi Sina , Luetke Maya , Ludema Christina , Valenzuela Alexander , Rosenberg Molly 
Published: April 2021

Abstract
Background: Randomized controlled trials (RCT) are considered the ideal design for evaluating the efficacy of interventions. However, conducting a successful RCT has technological and logistical challenges. Defects in randomization processes (e.g., allocation sequence concealment) and flawed masking could bias an RCT’s findings. Moreover, investigators need to address other logistics common to all study designs, such as study invitations, eligibility screening, consenting procedure, and data confidentiality protocols. Research Electronic Data Capture (REDCap) is a secure, browser-based web application widely used by researchers for survey data collection. REDCap offers unique features that can be used to conduct rigorous RCTs.Methods: In September and November 2020, we conducted a parallel group RCT among Indiana University Bloomington (IUB) undergraduate students regarding their seropositivity for Coronavirus Disease 2019 (COVID-19) antibodies. In the current report, we discuss how we used REDCap to conduct the different components of this RCT. We further share XML REDCap files and instructional videos that investigators can use when designing and conducting their RCTs.Results and Conclusions: We report on the different features that REDCap offers to complete various parts of a large RCT, including sending study invitations and recruitment, eligibility screening, consenting procedures, lab visit appointment and reminders, data collection and confidentiality, randomization, blinding of treatment arm assignment, returning test results, and follow-up surveys. REDCap offers powerful tools for longitudinal data collection and conduct of rigorous and successful RCTs.
Development of a dynamic interactive web tool to enhance understanding of multi-state model analyses: MSMplus
Authors: Skourlis Nikolaos , Crowther Michael J. , Andersson Therese M-L. , Lambert Paul C. 
Published: April 2021

Abstract
Background: Multi-state models are used in complex disease pathways to describe a process where an individual moves from one state to the next, taking into account competing states during each transition. In a multi-state setting, there are various measures to be estimated that are of great epidemiological importance. However, increased complexity of the multi-state setting and predictions over time for individuals with different covariate patterns may lead to increased difficulty in communicating the estimated measures. The need for easy and meaningful communication of the analysis results motivated the development of a web tool to address these issues. Results: MSMplus is a publicly available web tool, developed in RShiny, with the aim of enhancing the understanding of multi-state model analyses results. The results from any multi-state model analysis are uploaded to the application in a pre-specified format. Through a variety of user-tailored interactive graphs, the application contributes to an improvement in communication, reporting and interpretation of multi-state analysis results as well as comparison between different approaches. The predicted measures that can be supported by MSMplus include, among others, the transition probabilities, the transition intensity rates, the length of stay in each state, the probability of ever visiting a state and user defined measures. Representation of differences, ratios and confidence intervals of the aforementioned measures are also supported. MSMplus is a useful tool that enhances communication and understanding of multi-state model analyses results. Conclusions: Further use and development of web tools should be encouraged in the future as a means to communicate scientific research.
Analyzing the Essential Proteins Set of Plasmodium Falciparum PF3D7&nbsp;for Novel Drug Targets Identification Against Malaria
Authors: Ali Fawad , Wali Hira , Jan Saadia , Aslam Muneeba , Ahmad Imtiaz , Afridi Sahib Gul , Shams Suliaman , Khan Asifullah 
Published: April 2021

Abstract
Background: Plasmodium falciparum is an obligate intracellular parasite of humans that causes malaria. P. falciparum is a major public health threat to human life responsible for high mortality. Currently, the risk of multi-drug resistance of P. falciparum is rapidly increasing. There is a need to address new anti-malarial therapeutics strategies to combat the drug-resistance threat.Methods: We retrieved the P. falciparum essential proteins from the recently published studies. Pathogen essential proteins were initially scanned against human host and its gut microbiome proteome sets by comparative proteomics analyses. The human host non-homologs essential proteins of P. falciparum were additionally analyzed for druggability potential via in silico methods to possibly identify novel therapeutic targets.Results: The analyses identified six P. falciparum essential and human host non-homolog proteins that follow the key druggability features. These druggable targets have not catalogued so far in the Drugbank repository. These prioritized proteins seem novel and promising drug targets against P. falciparum due to their key protein-protein interactions features in pathogen-specific biological pathways and to hold appropriate drug-like molecule binding pockets. Conclusion: The prioritized protein targets may worthy to test in malarial drug discovery program to overcome the anti-malarial resistance issues. The in-vitro and in-vivo studies might be promising for additional validation of these prioritized lists of drug targets against malaria.
Using GAM regression analysis to identify proper heat-warning thresholds: a population-based observational study
Authors: Lung Shih-Chun Candice , Yeh Jou-Chen Joy , Hwang Jing-Shiang 
Published: April 2021

Abstract
Background

Climate change has augmented heat-related illnesses and deaths. Selecting proper thresholds in a heat-warning system is critical to reducing health risks.
Methods

This work evaluates the applicability of a modified generalized additive model (GAM) at different spatial scales, and identifies proper heat-warning thresholds using empirical morbidity and mortality records of 18 years from a population database and taking into account substantial health risk increases of the lag effects of 0–2 days. Reference-adjusted risk ratio (RaRR), i.e., risk ratio of threshold candidates against that of a reference, was respectively evaluated for heat-related emergency and hospital visits and all-cause mortality. The threshold with the highest RaRR among the candidates with infrequent occurrence is potentially the best one. Wet-bulb globe temperature (WBGT) and temperature were both used heat indicator in the model for comparison.
Results

It was found that WBGT is a more sensitive heat-health indicator than temperature. The highest RaRR with WBGT for the whole Taiwan island was observed to shift from lag 0 in emergency visits (1.44) to lags 0–1 in hospital visits (1.18) and also to lag 1 in all-cause mortality (1.04). For different age groups, children had the highest RaRR with WBGT of emergency visits on lag 0 (1.87) while the elderly had the highest RaRR for all-cause mortality on lag 0 (1.04), for hospital visits on lag 1 (1.23), and for emergency visits on lag 2 (1.38), respectively. Emergency visit is the most sensitive heat-related health record and should thus be employed, if available, to select heat-warning threshold. With the highest RaRR in emergency visits and the occurring frequency considered, the best area-specific thresholds can be chosen for various sizes of population at-risk. The novel RaRR allows comparison of health risks across different categories, providing a solid scientific basis for threshold selection.
Conclusions

This work demonstrated the feasibility and flexibility of the proposed approach which considers substantial enhancement of health risks on lags 0 to 2, removes the rare-event interference, and accommodates at-risk populations of different sizes. This methodology can be applied by authorities worldwide for selecting proper heat-health thresholds according to their own morbidity/mortality records.
Short-term effects of gaseous pollutants on cause-specific cerebrovascular disease among patients with type 2 diabetes: case-crossover evidence from Beijing, China
Authors: Liu Xiangtong , Li Zhiwei , Guo Moning , Lu Feng , Deginet Aklilu , Liu Mengmeng , Xu Xiaolin , Luo Yanxia , Hu Yaoyu , Li Yutong , Wu Mengqiu , Liu Mengyang , Tao Lixin , Guo Xiuhua 
Published: April 2021

Abstract
Background: The association between gaseous pollutants and cerebrovascular morbidity has been widely studied; however, the association in patients with type 2 diabetes has remained unknown in developing countries.Methods: A time-stratified case-crossover design combined with a distributed lag nonlinear model was adopted to estimate the short-term effects of gaseous pollutants (nitrogen dioxide [NO2], sulfur dioxide [SO2], ozone [O3], and carbon monoxide [CO]) on cerebrovascular cases among patients with type 2 diabetes in Beijing. In addition, our study explored the variability across sex and age groups.Results: A total of 223,216 (male 57.6% and elderly 61.7%) cerebrovascular cases were reported from 2014 to 2018. The cumulative exposure-response curves were U-shaped for NO2, J-shaped for SO2, and V-shaped for O3 and CO. Extreme low-O3, low-CO and high-CO increased the risk of cerebrovascular morbidity, with the maximum relative risk (RR) of 1.14 (95% CI: 1.01-1.28) (1st vs median), 1.02 (95% CI: 1.01-1.03) (1st vs median) and 1.25 (95% CI: 1.09-1.45) (99th vs median), respectively, appearing at lag0-13. Elderly individuals aged over 65 years were susceptible to extremely low-O3 (maximum RR: 1.27, 95% CI: 1.08-1.48). Men and elderly individuals were more susceptible to extremely high-CO, and the maximum RR was 10% [1.31 (1.11-1.54) vs. 1.19 (1.00, 1.41)] and 26% higher [1.41(1.17-1.69) vs. 1.12 (0.97, 1.30)] than women and adults, respectively. Conclusions: NO2, SO2, O3 and CO presented nonlinear and lagged effects on cerebrovascular disease among patients with type 2 diabetes, which may vary by sex and age. Our study added to the limited evidence for the risk of cerebrovascular disease due to gaseous pollutants among patients with comorbid type 2 diabetes.
Advancing Health Equity During the COVID-19 Pandemic through Digital Medical Interpretation Platforms
Authors: Sharfuddin Nazia , Mathura Pamela , Ling Emily , Bruseker Ellen , Rajeh Areej , Woods Jennifer , Suranyi Yvonne , Kassam Narmin 
Published: April 2021

Abstract
Background: Medical Interpretation Services (MIS) is the gold-standard that should be used during clinical assessments with patients who have limited English proficiency (LEP) or have hearing loss. The COVID-19 pandemic has highlighted the urgent need for clear, concise medical communication between patients and clinicians to prevent the spread of COVID-19 and ensure public safety. Cost of MIS is covered by the provincial health authority in Alberta; however, it is not consistently utilized across the province.Aim: To implement digital MIS in the Emergency Department (ED) of one urban teaching hospital, improving accuracy of clinical assessment and to provide patient-centered communication. Methods: Applying quality improvement methodology, an intervention comprised of digital MIS technology and education was trialed for 6 months. To assess intervention effect, the number of MIS minutes and calls were measured monthly and a questionnaire was developed and administered to determine ED healthcare providers’ awareness, technology accessibility and perception of MIS integration into the clinical workflow. Results: Digital MIS was utilized consistently in the ED from the beginning of the COVID-19 pandemic (March 2020) and over the subsequent six months. The cost avoidance due to digital MIS usage was estimated to be $19,612.16. ED healthcare providers indicated that digital MIS helped smooth communication with patients and reduced the time it took to gather and provide accurate information. Conclusion: Providing digital MIS access, education and training is a means to advance health equity, by improving accuracy of clinical assessment and patient-centered care in the ED.
Care Model and Effectiveness of Dementia Special Care Units-- a Cross-sectional Survey in China
Authors: Dong Xiaoxin , Sun Tongda , Jia Rangcheng , Zhao Lingbo , Sun Ning 
Published: April 2021

Abstract
Background: Dementia special care unit (D-SCU) is a main care mode for the elderly with dementia, and has increased steadily internationally. However, little is known about the D-SCUs of China. The present study aimed to analyze and summarize the types and standards of D-SCUs in China, and evaluate the care efficiency of the D-SCU care model.Methods: A cross-sectional survey was conducted between June 2018 and July 2019 in 6 cities of China. Quantitative data about the basic information and the care satisfaction were collected from 25 care facilities in the 6 cities. Qualitative data about the care status of the elderly with dementia, the standards, the management and the operation of the D-SCUs were collected among the 25 care facilities and the 3 cities that had issued standards for setting D-SCUs. Grounded theory method was used to analyze the qualitative data, and data envelopment analysis (DEA) method was applied to evaluate the care efficiency of the D-SCU care model.Results: The technical efficiency, pure technical efficiency and scale efficiency of care facilities with D-SCUs were higher than those of care facilities without D-SCUs (P=0.016, P=0.022, and P=0.021, respectively). The types of D-SCUs could be divided into independent, semi- independent, semi-dependent and dependent according to the architecture, physical space, and management mode. The standards for the area, environment, beds, service items of the D-SCUs were various among the 3 cities that had issued standards for setting D-SCUs.Conclusions: The care model of D-SCUs is effective and professional, and can be further promoted in China. The exploration and standard research on the D-SCUs should be strengthened in future.
Impact of ICU saturation on hospital mortality from COVID-19 in a secondary care center in Iztapalapa, Mexico City
Authors: Alanís-Naranjo José Martín , Anguiano-Álvarez Víctor Manuel , Hammeken-Larrondo Eduardo Federico 
Published: April 2021

Abstract
INTRODUCTION: A saturated intensive care unit (ICU) setting and socioeconomic factors such as higher poverty rates have been associated with increased rates of in-hospital mortality of COVID-19 patients. Mexico City has become the national epicenter of the pandemic, with Mexico’s highest death toll. Iztapalapa is the delegation with the highest population density and the most notorious conditions of marginalization in Mexico City. We describe the clinical characteristics and risk factors associated with mortality in 164 patients who received care in a hospital ward setting due to ICU saturation in a hospital in Iztapalapa, Mexico City.MATERIALS AND METHODS: In this retrospective cohort study, data from confirmed COVID-19 patients hospitalized between April 1, 2020 and May 31, 2020 were collected. Patients were categorized into different subgroups: alive vs. deceased and intubated vs. non-intubated for analysis between groups. A p-value <0.05 was considered statistically significant.RESULTS: In this setting, 67% of the patients required mechanical ventilation, and 32.3% needed vasopressor support, with in-hospital mortality of 68.3%. The most common complications during hospitalization were acute kidney injury (36%) and acute respiratory distress syndrome (34.8%). We observed similar factors associated with death as previous studies: male sex, older age, comorbidities, laboratory values indicating increased inflammatory/organ failure markers, and severe disease at admission. Additionally, we found that routine use of intravenous antibiotics was associated with a higher rate of in-hospital mortality (RR 3.45, 95% CI 1.69-7.06, p <0.001).CONCLUSIONS: Patients hospitalized due to COVID-19 in a saturated ICU setting had higher mortality than the rates in other studies reported globally.
Combination therapy with PD-1 blockade and radiofrequency ablation for recurrent hepatocellular carcinoma：A retrospective study
Authors: Wang Xiaofei , Chen Shu , Bi Huaqiang , Xia Feng , Feng Kai , Ma Kuansheng , Ni Bing 
Published: April 2021

Abstract
Background: The aim of this study was to evaluate whether combined therapy with PD-1 blockade (anti-PD-1) and radiofrequency ablation (RFA) was superior to RFA monotherapy for recurrent hepatocellular carcinoma (HCC).METHODS: A total of 127 patients who underwent anti-PD-1 plus RFA treatment (n = 41) or RFA alone treatment (n = 86) for recurrent HCC were enrolled in this retrospective study. Clinical data including post-RFA HCC recurrence (the primary end point), overall survival (OS) (the secondary end point), adverse events and toxic effects were retrospectively analyzed.RESULTS: The 1-year recurrence-free survival rates for the anti-PD-1 plus RFA and RFA groups were 36.6% and 16.3%, respectively. The corresponding overall survival rates for the two groups were 95.1% and 74.4%, respectively. There were statistically significant differences between the two groups in recurrence-free survival rate (P = 0.002) or overall survival rate (P = 0.008). Tumor number, TNM stage and anti-PD-1 treatment were demonstrated to be important factors associated with 1-year recurrence-free survival probability by univariate and multivariate analyses. Univariate and multivariate analyses demonstrated that tumor number, TNM stage and anti-PD-1 treatment were significant prognostic factors for OS. RFA treatment-related adverse events were pleural effusion requiring drainage and mild or moderate increase in body temperature. Grade 3 or higher events related to anti-PD-1 treatment occurred in 12.8% (6) patients and were infrequent.CONCLUSIONS: Combination therapy of anti-PD-1 plus RFA was superior to RFA alone in improving survival for recurrent HCC.
Desmoplastic Fibroma of the Left 6th Rib in a 35-year-old Man: a Case Report and Literature Review
Authors: Zhang Kai , Weibin Wu , Jiexia Guan , Yonghui Wu , Huiguo Chen , Xiaojun Li , Lijia Gu , Jian Zhang 
Published: April 2021

Abstract
Background: Desmoplastic fibroma (DF) is a rare, benign tumor. The most common sites are the long tubular bones and mandible. Although generally considered a benign tumor, it can invade surrounding tissues and has a high rate of local recurrence after incomplete surgical excision. However, there is currently no stantard treatment. Here we present a novel case of DF in the left 6th rib in a 35-year-old man.Case presentation: The man presented to our center with left chest pain and swelling. Enhanced computed tomography (CT) showed a 4.5×2.0 cm mass on the left 6th rib with pathological fracture. Wide resection was performed. Open biopsy revealed that the tumor destroyed medullary cavity and partially broke through the bone cortex. Pathologically, the tumor was composed of spindle-shaped cells arranging in a woven pattern on a backgroung of abundant collagenous fiber. No β-catenin were detected. Based on the pathological and radiological findings, a final diagnosis of DF was made. No postoperative adjuvant treatments were administerded. Fortunately, there was no evidence of recurrence 22 months after surgery. Conclusions: DF originated from rib is a kind of extremly rare benign tumor but locally aggressive and show unique biologically features. Wide resection or total resection can effectively reduce the risk of local recurrence when compared with curettage. Rarity of the tumor favors documentation in literature.