bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Pediatric Baseball and Softball Player Injuries
Authors: Farooqi Ali S. , Lee Alexander , Abreu Eric , Talwar Divya , Maguire Kathleen J. 
Published: December 2021

Background: Baseball and softball are popular sports in the United States and are responsible for a large number of youth sports injuries each year. Purpose: To investigate recent differences in youth baseball and softball injuries evaluated in nationwide emergency departments. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) database was examined for softball and baseball injuries in pediatric patients (age, 7-21 years) from 2010 through 2019. Patients were classified as children (age, 7-13 years), adolescents (age, 14-18 years), or young adults (age, 19-21 years). Case narratives were used to categorize injuries as contact injuries (hit by bat or ball), field injuries (sliding into base, collision with another player, catching, or running), throwing injuries, or other. Results: An unweighted total of 24,717 baseball injuries and 13,162 softball injuries were recorded. A nationwide estimate of 861,456 baseball injuries and 511,117 softball injuries were sustained during the studied time period, with estimated respective injury rates of 86,146 and 51,112 per year. Injured softball players were most commonly adolescent (47%) and female (92%), while injured baseball players were most commonly children (54%) and male (90%). There was a greater proportion of baseball-related injuries involving the head/neck (41%) as compared with softball-related injuries (30%) ( P < .01). Conversely, a greater proportion of softball-related injuries involved the lower extremity (32%) as compared with baseball-related injuries (19%) ( P < .01). When comparing diagnosis, softball injuries were more often sprains/strains (28%) than baseball injuries (18%) ( P < .01). When comparing mechanisms of injury, baseball athletes were more likely to be evaluated with contact injuries than were softball athletes (49% vs 40%, P < .01). Conclusion: Youth baseball athletes were more likely to be injured through contact mechanisms and had a higher proportion of injuries related to the head/neck/face, whereas softball injuries more frequently involved the lower extremity and resulted in a sprain/strain. League guidelines should focus on reducing contact injuries within youth baseball, and injury-prevention programs should focus on reducing lower extremity injuries in youth softball.
Foot and Ankle Injuries in Elite Taekwondo Athletes: A 4-Year Descriptive Analysis
Authors: Willauschus Maximilian , Rüther Johannes , Millrose Michael , Walcher Matthias , Lambert Christophe , Bail Hermann Josef , Geßlein Markus 
Published: December 2021

Background: Foot and ankle injuries are a common but underestimated problem in taekwondo. Detailed data on injury incidence rates (IIRs), patterns, and injury mechanism are missing. Purpose: The primary aims were to evaluate the prevalence of foot and ankle injuries and the exposure-adjusted IIR of elite taekwondo athletes during matches while training (ie, sparring) and in competitions. The secondary aims were to evaluate injury site, type, sport-specific mechanism, and time loss. Study Design: Descriptive epidemiology study. Methods: Athletes from a single national Olympic taekwondo training center were assessed prospectively for foot and ankle injuries over 4 years (between January 1, 2016, and December 31, 2019). Data were collected regarding number and type of injuries, anatomic location, and total exposure time during training and competition for each athlete. Injury mechanism and dominant foot were assessed via personal interview. Time loss from sport was analyzed retrospectively. The injury prevalence and IIR were calculated. Correlation between mechanism and injury type, location, and dominant foot was evaluated. Time loss according to location and injury type was assessed. The chi-square test and Fisher exact test were used to test for differences in sex, age, and taekwondo experience and for comparison of injury location and type, injury mechanism, and side dominance, respectively. Training and competition IIRs and prevalence were calculated with 95% CIs (for Poisson rates). Results: From an initial 107 athletes, 79 (73.8%) were included in the final data set. Of these athletes, 38 were injured (n = 112 injuries) for a prevalence of 48.1% (95% CI, 43%-52%). The overall IIR of the ankle joint was 13.14 injuries per 1000 athletes (95% CI, 1.5-25.9) and was significantly higher during competition versus training ( P < .001). Ankle joint injuries were most common (n = 71; 63%). Significantly more noncontact versus contact ankle ligament injuries (n = 46; 83%) occurred ( P < .001). The forefoot (n = 18; 66%) was mainly affected by contact injuries ( P < .001). Time loss was the highest for midfoot fractures (mean ± SD, 23.0 ± 0.6 days; range, 23-24 days). Conclusion: Noncontact ligamentous ankle injuries were most common, with a higher incidence during competition. Improvement of strength, endurance, and postural stability under strain is recommended for prevention.
Rice with Multilayer Aleurone: A Larger Sink for Multiple Micronutrients
Authors: Yu Ronald , Wu Xiaoba , Liu Jinxin , Howitt Crispin A. , Bird Anthony R. , Liu Chun-Ming , Larkin Philip J. 
Published: December 2021

AbstractDiet-related noncommunicable diseases impose a heavy burden on human health worldwide. Rice is a good target for diet-related disease prevention strategies because it is widely consumed. Liu et al. (Proc Natl Acad Sci USA 115(44):11327–11332, 2018. https://doi.org/10.1073/pnas.1806304115) demonstrated that increasing the number of cell layers and thickness of putative aleurone in ta2-1 (thick aleurone 2-1) mutant rice enhances simultaneously the content of multiple micronutrients. However, the increases of aleurone-associated nutrients were not proportional to the increases in the aleurone thickness. In this study, first, cytohistological analyses and transmission electron microscopy demonstrated that the multilayer in ta2-1 exhibited aleurone cell structural features. Second, we detected an increase in insoluble fibre and insoluble bound-phenolic compounds, a shift in aleurone-specific neutral non-starch polysaccharide profile, enhancement of phytate and minerals such as iron, zinc, potassium, magnesium, sulphur, and manganese, enrichment of triacylglycerol and phosphatidylcholine but slight reduction in free fatty acid, and an increase in oleic fatty acid composition. These findings support our hypothesis that the expanded aleurone-like layers in ta2-1 maintained some of the distinctive aleurone features and composition. We provide perspectives to achieve even greater filling of this expanded micronutrient sink to provide a means for multiple micronutrient enhancements in rice.
Limited need for hospital resources among patients brought to hospital by the emergency medical services
Authors: Magnusson Carl , Ryge Helena , Scott Filip , Herlitz Johan , Axelsson Christer 
Published: December 2021

Abstract
Background
In Sweden, the majority of patients who are transported to hospital by the emergency medical services (EMS) are relatively old and the majority suffer from comorbidity. About half these patients are admitted to a hospital ward and will stay in hospital. However, the other half will only make a visit to the emergency department (ED). The burden on the ED is extensive and many elderly patients have to stay for many hours in the ED.

Aim
To describe the patients who are brought to hospital by the EMS, with particular emphasis on those that were discharged from the ED, and to assess the proportion of these patients who did not require hospital resources, which could mean that they were candidates for primary care (PC).

Methods
An observational analysis of a cohort of patients who were transported to hospital by the EMS in 2016 in the Municipality of Gothenburg.

Results
In all, 5,326 patients were transported to hospital by the EMS of which 52% were discharged directly from the ED. These patients included 37% assessed as not requiring hospital resources. The three most common causes of contact with the EMS in this subset were abdominal pain (15%), back pain (8%) and non-specified disease (7%). Of these patients, 77% had contact with a physician in the ED, whereas 6% had contact with a nurse and 17% left the ED without any contact. Twenty-six per cent were given advice on follow-up in PC.

Conclusions
Among patients who were brought to hospital by the EMS, more than half were discharged directly from the ED. Among these patients, 37% were assessed as not requiring hospital resources. These patients comprised 15% of the overall study cohort and may be candidates for primary care.
Predictive value of fibrinogen in identifying inflammatory bowel disease in active stage
Authors: Chen Xiao-Fu , Zhao Yuan , Guo Yu , Huang Zhi-Ming , Huang Xie-Lin 
Published: December 2021

Abstract
Background
We aimed to externally validate for the first time the diagnostic ability of fibrinogen to identify active inflammatory bowel disease (IBD).

Methods
The research totally involved 788 patients with IBD, consisted of 245 ulcerative colitis (UC) and 543 Crohn’ s disease (CD). The Mayo score and Crohn disease activity index (CDAI) assessed disease activity of UC and CD respectively. The independent association between fibrinogen and disease activity of patients with UC or CD was investigated by multivariate logistic regression analyses. Area under the receiver operating characteristic curve (AUROC) assessed the performance of various biomarkers in discriminating disease states.

Results
The fibrinogen levels in active patients with IBD significantly increased compared with those in remission stage (P < 0.001). Fibrinogen was an independent predictor to distinguish disease activity of UC (odds ratio: 2.247, 95% confidence interval: 1.428–3.537, P < 0.001) and CD (odds ratio: 2.124, 95% confidence interval: 1.433–3.148, P < 0.001). Fibrinogen was positively correlated with the Mayo score (r = 0.529, P < 0.001) and CDAI (r = 0.625, P < 0.001). Fibrinogen had a high discriminative capacity for both active UC (AUROC: 0.806, 95% confidence interval: 0.751–0.861) and CD (AUROC: 0.869, 95% confidence interval: 0.839–0.899). The optimum cut-off values of fibrinogen 3.22 was 70% sensitive and 77% specific for active UC, and 3.87 was 77% sensitive and 81% specific for active CD respectively.

Conclusions
Fibrinogen is a convenient and practical biomarker to identify active IBD.
A study of students’ use of restraint systems in school transportation services in primary and secondary schools in northern Iran: an observational study
Authors: Yousefzade-Chabok Shahrokh , Azari Samira , Kouchakinejad-Eramsadati Leila , Rad Enayatollah Homaie , Hosseinnia Marjan , Khodadadi-Hassankiadeh Naema 
Published: December 2021

Abstract
Background
Traffic accidents are one of the leading causes of death and severe injury among child occupants of vehicles in most countries. This has led to the consideration of how to use restraint systems for students in school buses. The purpose of the present study was to determine the percentage of students’ use of restraint systems in school transportation services in 2020.

Methods
In the present cross-sectional observational study, seatbelt use was assessed in 400 students in school transport vehicles using a checklist. The observation team sat at their vehicle, at the nearest location on one of the three sides of the school’s entrance: they had by manually registering the variable in the checklist. They focused on exactly the first vehicle parked next to the school entrance. There were two other observers to validate the observations. Data were analyzed by SPSS software (version 21).

Results
The rate of using restraint systems was 11.3%, use of restraint systems in the Sport Utility Vehicles (SUVs) was significantly higher (P < 0.03), in areas with medium income (P < 0.009) and low income (p < 0.012) as well as when the students were sitting in the rear seats, using the seatbelt were significantly lower (P < 0.001). Seatbelt use in students was less in services driven by drivers over the age of 40 (P < 0.01) and more in vehicles driven by female drivers (P < 0.003) and newer vehicles (p < 0.001).

Conclusion
School authorities must enforce traffic safety rules for school transportation services. These rules should be taught to drivers, families, and students. A restraint system must be mandatory for all students. School officials must equip their buses with seatbelts and employ school bus assistants to encourage wearing seatbelts and prevent students from standing.
Clinicopathological characteristics of IgG4-related lung disease
Authors: Liu Jia , Liu Yuxiang , Shen Ximing , He Zhanghai , Yu Tingfeng , Pang Li , Jin Xiaoyan , Wang Lingyun 
Published: December 2021

Abstract
Background
Immunoglobulin G4-related lung disease (IgG4-RLD) is a rare entity. We retrospectively analyzed the clinical and histopathological characteristics of patients with pathologically confirmed IgG4-RLD to improve the diagnosis rate and reduce the risk of misdiagnosis.

Methods
We screened the pathological reports of 4838 patients with pulmonary surgery and/or biopsy specimens from April 2017 to April 2021 at Sun Yat-Sen Memorial Hospital affiliated with Sun Yat-Sen University, and specimens from 65 patients with suspected IgG4-RLD were subjected to immunohistochemical staining for IgG4 and IgG. Finally, 10 patients with definite IgG4-RLD that was pathologically confirmed were enrolled and analyzed.

Results
The incidence of pathologically confirmed IgG4-RLD was 0.2% (10/4838). The ten patients had an average age of 59.7 years at diagnosis, and the male-to-female ratio was 9:1. The initial clinical manifestations were nonspecific, and cough was the most common symptom (4/10). More than one organ was involved in most patients (8/10), and mediastinal/hilar lymph node involvement was often observed (7/10). Serum IgG4 was analyzed in 6 patients and found to be elevated. Serum tumor marker levels were within the normal range or were slightly elevated. Computed tomography (CT) of the chest and/or 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) imaging revealed that 5 patients had a mixed type, 3 patients had the solid nodular type, and 2 patients had the bronchovascular type. All pulmonary masses and large nodules with solid patterns had spiculated margins and inhomogeneous enhancement with or without pleural indentation and a lobulated appearance. Abundant lymphoplasmacytic cell infiltration and fibrosis were observed in all patients. The expression of IgG4 and IgG was upregulated in the pulmonary sections. Seven patients were treated with glucocorticoids with or without additional immunosuppressants and responded well.

Conclusions
The results of our study suggest that multiple imaging findings, an elevated serum IgG4 concentration, and no significant increase in serum tumor biomarkers could provide diagnostic support for IgG4-RLD, especially for isolated IgG4-RLD or IgG4-RLD that includes other organ involvement that does not aid in establishing the diagnosis.
Designing a synthetic simulator to teach open surgical skills for limb exploration in trauma: a qualitative study exploring the experiences and perspectives of educators and surgical trainees
Authors: Heskin L. , Simms C. , Traynor O. , Galvin R. 
Published: December 2021

Abstract
Background
Simulation is an important adjunct to aid in the acquisition of surgical skills of surgical trainees. The simulators used to adequately enable trainees to learn, practice and be assessed in surgical skills need to be of the highest standards. This study investigates the perceived requirements of simulation and simulators used to acquire skills in limb exploratory procedures in trauma.

Methods
Semi-structured interviews were conducted with an international group of 11 surgical educators and 11 surgical trainees who had experience with surgical simulation. The interviews focused on the perceptions of simulation, the integration of simulators within a curriculum and the features of a simulator itself. Interviews were recorded, transcribed and underwent thematic analysis.

Results
Analysis of the perspectives of surgical educators and surgical trainees on simulated training in limb trauma surgery yielded three main themes: (1) Attitudes to simulation. (2) Implementing simulation. (3) Features of an open skills simulator. The majority felt simulation was relevant, intuitive and a good way for procedure warmup and the supplementation of surgical logbooks. They felt simulation could be improved with increased accessibility and variety of simulator options tailored to the learner. Suggested simulator features included greater fidelity, haptic feedback and more complex inbuilt scenarios. On a practical level, there was a desire for cost effectiveness, easy set up and storage. The responses of the educators and the trainees were similar and reflected similar concerns and suggestions for improvement.

Conclusion
There is a clear positive appetite for the incorporation of simulation into limb trauma training. The findings of this will inform the optimal requirements for high quality implementation of simulation into a surgical trauma curriculum and a reference to optimal features desired in simulator or task trainer design.
Restorative treatment decisions for carious lesions: Do Russian dentists and dental students apply minimal intervention dentistry?
Authors: Drachev Sergei N. , Galieva Alexandra S. , Yushmanova Tatiana N. , Polivanaya Elena A. , Stangvaltaite-Mouhat Lina , Al-Mahdi Rania , Leinonen Jukka , Stein Linda Maria , Davidova Nadezhda G. , Al-Haroni Mohammed 
Published: December 2021

Abstract
Background
The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions.

Methods
We included 171 general dental practitioners and dental therapists (collectively referred to here as “dentists”) from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis.

Results
For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13–15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33–6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite.

Conclusions
The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results.
Transitioning to practice: a qualitative investigation of Australian graduate naturopath’s experiences of being in practice
Authors: Leach Matthew J. , Barnes Larisa A. J. , McLintock Andy , Diezel Helene M. , Ryan Kimberley , Steel Amie E. 
Published: December 2021

Abstract
Background
The transition from student to practitioner can be challenging, resulting in stress, burnout and attrition. While there has been ample research examining graduate medical and allied health practitioner experiences of transitioning to practice, there is a paucity of research exploring such experiences in newly qualified naturopathic medicine practitioners. In light of this knowledge gap, the objective of this study was to ascertain the experiences of practicing as a naturopath in Australia within the first 5 years post-graduation.

Methods
Using a qualitative descriptive approach, recent graduates of an Australian Bachelor of Naturopathy (or equivalent) program were invited to participate in a semi-structured telephone interview to address the study objective. Data were analysed utilising a framework approach.

Results
A total of 19 new graduates (94.7% female; 57.9% aged 40–59 years) undertook an interview. Five inter-related themes emerged from the data: practitioner, practice, proprietorship, professions, and perceptions. Connected with these themes were contrasting feelings, multiplicity of duties, small business challenges, professional collaboration, and professional identity, respectively.

Conclusions
Participants were generally content with their decision to become a naturopath. However, most were confronted by a range of challenges as they transitioned from graduate to practitioner, for which many felt ill-prepared. In light of the complexity of the issue, and the potential impact on the sustainability of the profession, it is evident that a multi-pronged, multi-stakeholder approach would be needed to better support graduate naturopath transition to practice.