bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional quality of the food choices of Canadian children
Authors: Hack Salma , Jessri Mahsa , L’Abbé Mary R. 
Published: May 2021

Abstract
Background
The release of the Canadian Community Health Survey (CCHS), Nutrition 2015 provides a unique opportunity since CCHS 2004 to investigate food choices of Canadian children and adolescents at a national level.

Objective
This study examined the quality and quantity of food choices of children ages 2–8 years and adolescents 9–18 years, using Health Canada’s Surveillance Tool Tier System 2014. It is hypothesized that Canadian children and adolescents are consuming diets poor in nutritional quality based on evidence from the last national nutrition survey in 2004.

Design
Intakes from CCHS 2015, 24-h dietary recall were categorized into Health Canada’s Tiers 1–4, based on CNF/CFG classification system and thresholds for nutrients to limit i.e., total fat, saturated fats, sugars, and sodium to assess quality of food choices. Additionally, dietary intakes were grouped according to Canada’s 2007 food guide servings as the 2019 food guide was not available.

Results
Majority of foods reported by children 2–18 years were categorized as Tier 2 and Tier 3 foods. Investigation of energy contributions from the Tier 4 and “other foods” represented 21–25% of daily calorie intake and of these foods, high fat and/or high sugar foods contributed majority of daily calories to these categories.

Conclusions
This study showed Canadian children 2–18 years are consuming diets high in nutrients recommended to limit. Evidence from this study provides a unique opportunity to improve the nutritional quality of foods, and the food choices of children.
Depth to magnetic basement in the Anambra Basin, Benue Trough of Nigeria from aeromagnetic data: A prelude for hydrocarbon exploration
Authors: Olagundoye Olatunbosun O. , Okereke Chiedu S. , Edet Aniekan E. , Obi Dominic , Ukpong Aniediobong 
Published: May 2021

Data transformation, regional-residual separation, trend analysis, and analytic signal (AS) depth estimation were applied to aeromagnetic data covering the Anambra Basin, which is a major depocenter in the Benue Trough, southeast Nigeria, with the primary objectives of accentuating the attributes of magnetic sources and determining if sufficient sediment thickness exists for hydrocarbon generation, maturation, and expulsion. The application of data transformation techniques (such as map projection, merging, and reduction-to-pole) and regional-residual ensured the computation of a crustal magnetic field that would be suitable for magnetic analyses. Results indicate that the magnetic basement in the basin forms an undulating surface overlain by sediments with an average thickness ranging between 4 and 7.5 km, whereas the maximum thickness reaches 8 km in some areas. This depth range suggests a promising prospect for source-facies maturation and expulsion. We expect that areas in the study area with these appreciable sediment thicknesses, good preservation of graben fill, and suitable areal closures or fault structures would be favorable for hydrocarbon prospectivity.
The Impact of the COVID-19 Pandemic on Self-Reported Outcomes in Patients With Adrenal Insufficiency
Authors: Li Dingfeng , Suresh Malavika , Abbondanza Tiffany , Vaidya Anand , Bancos Irina 
Published: May 2021

AbstractContextThe COVID-19 pandemic has impacted healthcare environment.ObjectiveTo determine the impact of the pandemic on self-reported outcomes in patients with adrenal insufficiency (AI).Design and settingProspective longitudinal survey study at 2 tertiary centers.ParticipantsPatients with AI.InterventionPatient-centered questionnaire.Main outcome measuresDepression Anxiety Stress Scales-21, Short Form-36, and AI self-management.ResultsOf 342 patients, 157 (46%) had primary AI, 109 (32%) had secondary AI, and 76 (22%) had glucocorticoid-induced AI. When compared to prepandemic, daily glucocorticoid dose and number of adrenal crises did not change. However, patients reported a higher financial impact from AI (34% vs 23%, P = 0.006) and difficulty accessing medical care (31% vs 7%, P &lt; 0.0001) during the pandemic. A third of patients reported difficulty managing AI during the pandemic. After adjusting for duration and subtypes of AI, younger patients [odds ratio (OR) 2.3, CI 95% 1.3-4.1], women (OR 3.7, CI 95% 1.9-7.1), poor healthcare access(OR 4.2, CI 95% 2.3-7.7), lack of good insurance support (OR 2.8, CI 95% 1.3-5.9), and those with a higher financial impact (OR 2.3, CI 95% 1.3-4.3) reported greater difficulties managing AI. Patients were more likely to report a higher anxiety score (≥8) if they found managing AI challenging during the pandemic (OR 3.0, CI 95% 1.3-6.9), and had lower Physical Component Summary (OR 4.9, CI 95% 2.2-11.0) and Mental Component Summary (OR 4.1, CI 95% 1.8-9.5) scores prior to the pandemic.ConclusionsA third of patients with AI reported difficulties with management of AI during the pandemic, particularly in younger patients, women, and those with poor healthcare access.
Cranial Neuralgias
Authors: Robertson Carrie 
Published: May 2021

ABSTRACT

PURPOSE OF REVIEW
This article discusses the differential diagnosis, evaluation, and management of trigeminal neuralgia and reviews other neuralgias of the head and neck, including those that contribute to neuralgic ear pain.

RECENT FINDINGS
Most cases of trigeminal neuralgia are related to vascular compression, a demyelinating plaque, or a compressive mass affecting the trigeminal nerve. However, recent studies have shown that up to 11% of patients have a family history of trigeminal neuralgia, suggesting that some patients may have a genetic predisposition to demyelination or nerve hyperexcitability. In these patients, trigeminal neuralgia may occur at a younger age, on both sides of the face, or in combination with other neuralgias.

SUMMARY
When a patient presents with neuralgic pain, the diagnosis is made by careful history and neurologic examination, with attention to the dermatome involved, the triggers, and the presence of any associated sensory deficit. All patients with new neuralgia or neuropathic facial pain warrant a careful evaluation for a secondary cause. The presence of sensory deficit on bedside examination is particularly concerning for an underlying secondary etiology.
Spontaneous Intracranial Hypotension
Authors: Wang Shuu-Jiun 
Published: May 2021

ABSTRACT

PURPOSE OF REVIEW
Spontaneous intracranial hypotension is a disorder caused by spinal CSF leakage. This article reviews the clinical presentation, diagnosis, and treatment of spontaneous intracranial hypotension.

RECENT FINDINGS
The hallmark symptom of spontaneous intracranial hypotension is acute orthostatic headache; however, clinical presentations can be heterogeneous. New evidence shows that lumbar puncture is not always necessary or sufficient to establish the diagnosis. Some patients may have normal opening pressure, which suggests that insufficiency of CSF volume (hypovolemia) rather than CSF pressure might be the underlying mechanism. Several neuroimaging modalities can aid in diagnosis and localization of the CSF leakage, including brain MRI, spinal MRI, CT myelography, digital subtraction myelography, and radionuclide cisternography. Complications, such as subdural hematoma, can lead to a change in the headache pattern and potentially life-threatening consequences. Conservative treatments, such as fluid supplementation, can provide temporary relief; however, epidural blood patches, especially targeted ones, are more effective and definitive. For patients with refractory spontaneous intracranial hypotension, surgical repair of spinal CSF leakages should be considered.

SUMMARY
Brain and spinal MRIs are important for the diagnosis and treatment of patients with spontaneous intracranial hypotension. Early treatment with epidural blood patches may be considered to shorten the disease duration and minimize the potential risk of complications.
The Earnings Expectations Game and the Dispersion Anomaly
Authors: Veenman David , Verwijmeren Patrick 
Published: May 2021

This study examines the role of differences in firms’ propensity to meet earnings expectations in explaining why firms with high analyst forecast dispersion experience relatively low future stock returns. We first demonstrate that the negative relation between dispersion and returns is concentrated around earnings announcements. Next, we show that this relation disappears when we control for ex ante measures of firms’ propensity to meet earnings expectations and that the component of dispersion explained by these measures drives the return predictability of dispersion. We further demonstrate that firms with low analyst dispersion are substantially more likely to achieve positive earnings surprises and provide new evidence consistent with both expectations management and strategic forecast pessimism explaining this result. Overall, we conclude that investor mispricing of firms’ participation in the earnings-expectations game provides a viable explanation for the dispersion anomaly. This paper was accepted by Brian Bushee, accounting.
Turn Your Online Weight Management from Zero to Hero: A Multidimensional, Continuous-Time Evaluation
Authors: Zhou Tongxin , Yan Lu (Lucy) , Wang Yingfei , Tan Yong 
Published: May 2021

Online weight-loss communities (OWCs) provide individuals with various tools to support their weight management, such as weight recorders and weight-loss journals. These tools enable individuals to focus on different aspects of their self-regulation, including weight-loss outcomes and behavioral routines. Prior research, however, has not fully incorporated individuals’ self-regulation focuses; thus, there is limited understanding of individuals’ online weight-management dynamics as well as the operating mechanisms of OWCs. This gap in the literature motivates us to develop a framework that is able to account for individuals’ multiple self-regulation focuses, termed self-regulatory dimensions in this study. We propose a multidimensional, continuous-time hidden Markov model, which can not only capture individuals’ self-regulatory dimensions jointly as a multidimensional vector, but also can incorporate a hidden layer of dynamics that depicts individuals’ cognitive states in producing weight-management behaviors. By investigating a leading noncommercial OWC in the United States, we find that individuals tend to increase their journal-recording behaviors while decreasing self-weighing behaviors after they have participated in online social activities. Given that individuals usually expend limited effort toward weight management, this result suggests that individuals may shift their focus from weight-loss outcomes (i.e., changes in weight) to weight-management behavioral routines. Therefore, neglecting either self-regulatory dimension would result in an underestimation of individuals’ engagement in conducting self-management in OWCs. Our results also provide insight into social influence on individuals’ weight-management behaviors. This study contributes to the extant literature on individuals’ engagement in online healthcare communities and the functionality of OWCs. This paper was accepted by Anandhi Bharadwaj, information systems.
Functional electrical stimulation as a promising intervention for polymyositis-related weakness: a case report
Authors: Morgan Marie Vazquez , Tinsley Suzanne , Henderson Rachael 
Published: May 2021

Background/aims Polymyositis is an inflammatory myopathy characterised by chronic and progressive muscle weakness. This case report discusses a 61-year-old African-American man with polymyositis. Even though pharmacological and physical therapy interventions had previously been prescribed, they had not been beneficial. This case report examined the effects of a functional electric stimulation-assisted exercise programme. Methods The patient was treated in an outpatient clinic two times a week and performed exercises three times a week on alternating days for 36 weeks. In the clinic, he received functional electrical stimulation-assisted strengthening to quadriceps, hamstrings and gluteus maximus while performing activities such as sit to stand, squats, bridging and cycling. For endurance training, he ambulated on the clinic track with a neuroprosthetic to assist with dorsiflexion in the swing phase of gait. At home, he performed lower extremity and core strengthening exercises. Measures to evaluate the intervention included the Manual Muscle Test, functional mobility (Timed Up and Go Test), balance (Berg Balance Scale, Activities of Balance Confidence Scale), endurance (Six-Minute Walk Test with a modified Borg scale) and gait speed (10-Metre Walk Test). Results After 36 weeks of treatment, the patient had made gains in strength in all muscle groups in his bilateral lower extremities except hip extensors. Timed Up and Go time decreased by 14.01 seconds. The patient changed from a medium fall risk to low fall risk on the Berg Balance Scale and his confidence increased by 46.2% on the Activities of Balance Confidence Scale. Furthermore, he gained endurance as exhibited by his increased distance of 289 feet on the Six-Minute Walk Test and his modified Borg score decreased from 4 out of 10 to 2 out of 10. The patient made subjective and objective gains in gait speed, increasing from 0.18 metres per second at his initial examination to 0.50 metres per second. Conclusions This case study demonstrates that functional electrical stimulation-assisted exercise, conducted in an outpatient setting, can improve strength and functional mobility in an individual with polymyositis without detrimental effects.
Impact of inspiratory muscle training on diaphragmatic mobility and arterial blood gases in patients undergoing haemodialysis
Authors: Aboelmagd Fatma , Ismail Samah M 
Published: May 2021

Background/aims Impairment of respiratory muscle function is common in patients with chronic kidney disease undergoing haemodialysis, and is manifested by decreased oxygenation and physical function. The purpose of this study was to analyse the impact of training with incentive spirometer on mobility of the diaphragm, arterial blood gases and functional capacity in patients with chronic kidney disease undergoing haemodialysis. Methods A pre–post research design was implemented. A total of 30 patients undergoing haemodialysis for chronic kidney disease received incentive spirometer training intradialysis three sessions a week for 8 weeks. Outcome measures were the amount of diaphragmatic mobility measured by ultrasonography, the levels of arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, oxygen saturation percentages and the distance walked in 6 minutes. Results Significant improvement from pre-treatment to post-treatment measurements occurred in all outcome measures, with P<0.05. Conclusions Incentive spirometer training should be recommended to be a part of daily routine of patients with chronic kidney disease who are undergoing haemodialysis to decrease respiratory and physical function impairments.
Association of SMAD4 loss with drug resistance in clinical cancer patients: A systematic meta-analysis
Authors: Xu Wei , Lee Sau Har , Qiu Fengjun , Zhou Li , Wang Xiaoling , Ye Tingjie , Hu Xudong 
Published: May 2021

Background
Drug resistance frequently led to the failure of chemotherapy for malignant cancers, hence causing cancer relapse. Thus, understanding mechanism of drug resistance in cancer is vital to improve the treatment efficacy. Here, we aim to evaluate the association between SMAD4 expression and the drug resistance in cancers by performing a meta-analysis.

Method
Relevant studies detecting SMAD4 expression in cancer patients treated with chemo-drugs up till December 2020 were systematically searched in four common scientific databases using selected keywords. The pooled hazard ratio (HR) was the ratio of hazard rate between SMAD4neg population vs SMAD4pos population. The HRs and risk ratios (RRs) with 95% confidence intervals (CIs) were used to explore the association between SMAD4 expression losses with drug resistance in cancers.

Result
After an initial screening according to the inclusion and exclusion criteria, eleven studies were included in the meta-analysis. There were a total of 2092 patients from all the included studies in this analysis. Results obtained indicated that loss of SMAD4 expression was significantly correlated with drug resistance with pooled HRs (95% CI) of 1.23 (1.01–1.45), metastasis with pooled RRs (95% CI) of 1.10 (0.97–1.25) and recurrence with pooled RRs (95% CI) of 1.32 (1.06–1.64). In the subgroup analysis, cancer type, drug type, sample size and antibody brand did not affect the significance of association between loss of SMAD4 expression and drug resistance. In addition, there was no evidence of publication bias as suggested by Begg’s test.

Conclusion
Findings from our meta-analysis demonstrated that loss of SMAD4 expression was correlated with drug resistance, metastasis and recurrence. Therefore, SMAD4 expression could be potentially used as a molecular marker for cancer resistance.
Nursing supervisors’ perspectives on student preparedness before clinical placements- a focus group study
Authors: Leonardsen Ann-Chatrin L. , Brynhildsen Siri E. , Hansen Mette T. , Grøndahl Vigdis A. 
Published: May 2021

Clinical placements and supervision is an integral part of nursing education internationally. There are significant differences between students’ expectations of clinical learning and their fulfillment. Few studies have focused on supervisors’ perspectives on clinical placements. The objective of this study was to explore nursing supervisors’ perspectives on students’ preparedness for clinical placements.

Methods
The study was conducted in a county in Southeastern-Norway, with 317.000 inhabitants, and within one hospital and one university college catchment area. Focus group interviews were conducted in the periode August to December 2018. Data were analyzed using Hsieh and Shannon’s conventional content analysis.

Results
34 nursing supervisors participated, three intellectual disability nurses and 31 registered nurses, working in four different primary healthcare wards and four different hospital wards. Participants’ age ranged from 23 to 58 years, one male only. Through the analysis we derived the category ‘Shared responsibility for preparation’ with subcategories a) Individual initiative, and b) University college facilitation.

Conclusions
Findings indicate that there is a gap between nursing supervisors’ expectations and reality regarding students’ preparedness for clinical placements. Moreover, nursing supervisors did not seem to focus on their own role in student preparedness.
Examination of the proximodistal patellar position in small dogs in relation to anatomical features of the distal femur and medial patellar luxation
Authors: Murakami Sawako , Shimada Masakazu , Harada Yasuji , Hara Yasushi 
Published: May 2021

Objective
To determine the influence of anatomical features of the distal femur on the proximodistal patellar position and compare the proximodistal patellar position between dogs with and without medial patellar luxation (MPL).

Study design
Retrospective case series (n = 71).

Methods
Mediolateral-view radiographs of clinical cases of dogs weighing less than 15 kg were obtained. The stifle joint angle, patellar ligament length, patellar length, size of the femoral condyle, trochlear length, and trochlear angle were measured and included in multiple linear regression analyses to ascertain their effects on the proximodistal patellar position. Radiographs were divided into MPL and control groups. The effects of MPL on the proximodistal patellar position and morphological factors were also examined.

Results
The final model for the proximodistal patellar position revealed that the patella became distal as the ratio of the patellar ligament length to patellar length decreased, the trochlear angle relative to the femur increased, the trochlear length relative to the patellar length increased, or the trochlear length relative to the femoral condyle width decreased. The proximodistal patellar position in the MPL group was not significantly different from that in the control group despite the trend towards a distally positioned patella (p = 0.073). The MPL group showed a significantly shorter trochlea (p<0.001) and greater trochlear angle relative to the femur (p = 0.029) than the control group.

Conclusion
The proximodistal patellar position depends on multiple factors, and its determination based on PLL/PL alone may not be appropriate. Dogs with MPL did not have a proximally positioned patella compared with dogs without MPL. Although hindlimbs with MPL had a shorter trochlea than those without patellar luxation, this difference did not appear to be sufficient to displace the patellar position proximally in small dogs, possibly compensated by increased trochlear angle relative to the femur.
Evaluation of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda
Authors: Kwizera Richard , Bongomin Felix , Olum Ronald , Worodria William , Bwanga Freddie , Meya David B. , Kirenga Bruce J. , Gore Robin , Denning David W. , Fowler Stephen J. 
Published: May 2021

Background
Diagnosis of fungal allergies in asthma remains problematic in low-and middle-income countries due to non-availability of point-of-care testing. In this study, we aimed to evaluate the performance of an Aspergillus immunochromatographic technology (ICT) IgG/M lateral flow device (LFD) for the serological diagnosis of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitisation (SAFS) among Ugandan adult asthmatics.

Methods
374 adult (aged ≥18years) asthmatics in the African Severe Asthma Program study, Ugandan site constituted the study population. ABPA and SAFS were diagnosed according to standard criteria. Asthmatics who did not meet the above criteria constituted a control group. The LFD tests were performed and read according to manufacturer’s instructions.

Results
ABPA was found in 12/374 (3.2%) and SAFS in 60/374 (16%) participants. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Aspergillus ICT for the diagnosis of ABPA were 0.0%, 96.4%, 0.0% and 96.7% respectively, and for SAFS 6.7%, 97.1%, 30.8% and 84.5% respectively. False positive and negative rates were 3.5% and 3.2% for ABPA and 2.4% and 14.9% for SAFS, respectively. Patients with a positive LFD significantly had higher median Aspergillus fumigatus-specific IgE levels compared to those with negative LFD (median: 0.06 kUA/l VS 0.03 kUA/L, P = 0.011).

Conclusion
The Aspergillus ICT IgG/M LFD had a poor diagnostic performance for the diagnosis of both ABPA and SAFS. Its greatest value may be in distinguishing chronic and allergic aspergillosis in Africa.