bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy and usability of a diagnostic decision support system in the diagnosis of three representative rheumatic diseases: a randomized controlled trial among medical students
Authors: Knitza Johannes , Tascilar Koray , Gruber Eva , Kaletta Hannah , Hagen Melanie , Liphardt Anna-Maria , Schenker Hannah , Krusche Martin , Wacker Jochen , Kleyer Arnd , Simon David , Vuillerme Nicolas , Schett Georg , Hueber Axel J. 
Published: September 2021

Abstract
Background
An increasing number of diagnostic decision support systems (DDSS) exist to support patients and physicians in establishing the correct diagnosis as early as possible. However, little evidence exists that supports the effectiveness of these DDSS. The objectives were to compare the diagnostic accuracy of medical students, with and without the use of a DDSS, and the diagnostic accuracy of the DDSS system itself, regarding the typical rheumatic diseases and to analyze the user experience.

Methods
A total of 102 medical students were openly recruited from a university hospital and randomized (unblinded) to a control group (CG) and an intervention group (IG) that used a DDSS (Ada – Your Health Guide) to create an ordered diagnostic hypotheses list for three rheumatic case vignettes. Diagnostic accuracy, measured as the presence of the correct diagnosis first or at all on the hypothesis list, was the main outcome measure and evaluated for CG, IG, and DDSS.

Results
The correct diagnosis was ranked first (or was present at all) in CG, IG, and DDSS in 37% (40%), 47% (55%), and 29% (43%) for the first case; 87% (94%), 84% (100%), and 51% (98%) in the second case; and 35% (59%), 20% (51%), and 4% (51%) in the third case, respectively. No significant benefit of using the DDDS could be observed. In a substantial number of situations, the mean probabilities reported by the DDSS for incorrect diagnoses were actually higher than for correct diagnoses, and students accepted false DDSS diagnostic suggestions. DDSS symptom entry greatly varied and was often incomplete or false. No significant correlation between the number of symptoms extracted and diagnostic accuracy was seen. It took on average 7 min longer to solve a case using the DDSS. In IG, 61% of students compared to 90% in CG stated that they could imagine using the DDSS in their future clinical work life.

Conclusions
The diagnostic accuracy of medical students was superior to the DDSS, and its usage did not significantly improve students’ diagnostic accuracy. DDSS usage was time-consuming and may be misleading due to prompting wrong diagnoses and probabilities.

Trial registration
DRKS.de, DRKS00024433. Retrospectively registered on February 5, 2021.
Economical and preferred walking speed using body weight support apparatus with a spring-like characteristics
Authors: Abe Daijiro , Sakata Shunsuke , Motoyama Kiyotaka , Toyota Naoki , Nishizono Hidetsugu , Horiuchi Masahiro 
Published: September 2021

Abstract
Background
A specific walking speed minimizing the U-shaped relationship between energy cost of transport per unit distance (CoT) and speed is called economical speed (ES). To investigate the effects of reduced body weight on the ES, we installed a body weight support (BWS) apparatus with a spring-like characteristics. We also examined whether the 'calculated' ES was equivalent to the 'preferred' walking speed (PWS) with 30% BWS.

Methods
We measured oxygen uptake and carbon dioxide output to calculate CoT values at seven treadmill walking speeds (0.67–2.00 m s− 1) in 40 healthy young males under normal walking (NW) and BWS. The PWS was determined under both conditions on a different day.

Results
A spring-like behavior of our BWS apparatus reduced the CoT values at 1.56, 1.78, and 2.00 m s− 1. The ES with BWS (1.61 ± 0.11 m s− 1) was faster than NW condition (1.39 ± 0.06 m s− 1). A Bland-Altman analysis indicated that there were no systematic biases between ES and PWS in both conditions.

Conclusions
The use of BWS apparatus with a spring-like behavior reduced the CoT values at faster walking speeds, resulting in the faster ES with 30% BWS compared to NW. Since the ES was equivalent to the PWS in both conditions, the PWS could be mainly determined by the metabolic minimization in healthy young males. This result also derives that the PWS can be a substitutable index of the individual ES in these populations.
A neonate with Klippel–Trénaunay syndrome: a case report
Authors: Sikakulya Franck Katembo , Egesa Walufu Ivan , Kiyaka Sonye Magugu , Anyama Philip 
Published: September 2021

Abstract
Background
Klippel–Trénaunay syndrome is a rare congenital capillary–lymphatic–venous condition characterized by the clinical triad of capillary malformations (port wine stains), varicose veins with or without venous malformations, and bony and/or soft-tissue hypertrophy. It has a very low incidence of about 1:100,000.

Case presentation
We report the case of 21-day-old neonate Black African female (born in Uganda) with Klippel–Trénaunay syndrome who presented with macrodactyly and ectrodactyly on the left foot, as well as numerous port wine stains on the left thoracoabdominal region and anteroposterior left lower limb. Color Doppler ultrasound examination of the left lower limb and abdomen revealed varicose veins without signs of arteriovenous fistula.

Conclusion
The report presents the case of a neonate with a rare congenital vascular disorder type Klippel–Trénaunay syndrome.
Modeling the health impact of water and sanitation service deficits on waterborne disease transmission
Authors: Chaysiri Rujira , Louis Garrick E. , Chinviriyasit Wirawan 
Published: September 2021

AbstractCholera is a waterborne disease that continues to pose serious public health problems in many developing countries. Increasing water and sanitation coverage is a goal for local authorities in these countries, as it can eliminate one of the root causes of cholera transmission. The SIWDR (susceptible–infected–water–dumpsite–recovered) model is proposed here to evaluate the effects of the improved coverage of water and sanitation services in a community at risk of a cholera outbreak. This paper provides a mathematical study of the dynamics of the water and sanitation (WatSan) deficits and their public health impact in a community. The theoretical analysis of the SIWDR model gave a certain threshold value (known as the basic reproductive number and denoted $\mathcal{R}_{0}$

R
0

) to stop the transmission of cholera. It was found that the disease-free equilibrium was globally asymptotically stable whenever $\mathcal{R}_{0} \leq 1$

R
0

≤
1
. The unique endemic equilibrium was globally asymptotically stable whenever $\mathcal{R}_{0} >1$

R
0

>
1
. Sensitivity analysis was performed to determine the relative importance of model parameters to disease transmission and prevention. The numerical simulation results, using realistic parameter values in describing cholera transmission in Haiti, showed that improving the drinking water supply, wastewater and sewage treatment, and solid waste disposal services would be effective strategies for controlling the transmission pathways of this waterborne disease.
Clinical leaders and providers’ perspectives on delivering medications for the treatment of opioid use disorder in Veteran Affairs’ facilities
Authors: Hawkins Eric J. , Danner Anissa N. , Malte Carol A. , Blanchard Brittany E. , Williams Emily C. , Hagedorn Hildi J. , Gordon Adam J. , Drexler Karen , Burden Jennifer L. , Knoeppel Jennifer , Lott Aline , Sayre George G. , Midboe Amanda M. , Saxon Andrew J. 
Published: September 2021

AbstractBackgroundImproving access to medication treatment of opioid use disorder (MOUD) is a national priority, yet common modifiable barriers (e.g., limited provider knowledge, negative beliefs about MOUD) often challenge implementation of MOUD delivery. To address these barriers, the VA launched a multifaceted implementation intervention focused on planning and educational strategies to increase MOUD delivery in 18 medical facilities. The purpose of this investigation was to determine if a multifaceted intervention approach to increase MOUD delivery changed providers’ perceptions about MOUD over the first year of implementation.MethodsCross-disciplinary teams of clinic providers and leadership from primary care, pain, and mental health clinics at 18 VA medical facilities received invitations to complete an anonymous, electronic survey prior to intervention launch (baseline) and at 12- month follow-up. Responses were summarized using descriptive statistics, and changes over time were compared using regression models adjusted for gender and prescriber status, and clustered on facility. Responses to open-ended questions were thematically analyzed using a template analysis approach.ResultsSurvey response rates at baseline and follow-up were 57.1% (56/98) and 50.4% (61/121), respectively. At both time points, most respondents agreed that MOUD delivery is important (94.7 vs. 86.9%), lifesaving (92.8 vs. 88.5%) and evidence-based (85.2 vs. 89.5%). Over one-third (37.5%) viewed MOUD delivery as time-consuming, and only 53.7% affirmed that clinic providers wanted to prescribe MOUD at baseline; similar responses were seen at follow-up (34.5 and 52.4%, respectively). Respondents rated their knowledge about OUD, comfort discussing opioid use with patients, job satisfaction, ability to help patients with OUD, and support from colleagues favorably at both time points. Respondents’ ratings of MOUD delivery filling a gap in care were high but declined significantly from baseline to follow-up (85.7 vs. 73.7%, p < 0.04). Open-ended responses identified implementation barriers including lack of support to diagnose and treat OUD and lack of time.ConclusionsAlthough perceptions about MOUD generally were positive, targeted education and planning strategies did not improve providers’ and clinical leaders’ perceptions of MOUD over time. Strategies that improve leaders’ prioritization and support of MOUD and address time constraints related to delivering MOUD may increase access to MOUD in non-substance use treatment clinics.
Intermittent face cooling reduces perceived exertion during exercise in a hot environment
Authors: Miyazawa Taiki , Mizutani Mirai , Sheahan John Patrick , Ichikawa Daisuke 
Published: September 2021

Abstract
Background
Facial cooling (FC) is effective in improving endurance exercise performance in hot environments. In this study, we evaluated the impact of intermittent short-lasting FC on the ratings of perceived exertion (RPE) during exercise.

Methods
Ten healthy men performed 40 continuous minutes of ergometric cycle exercise at 65% of the peak heart rate in a climatic chamber controlled at an ambient temperature of 35 °C and a relative humidity of 50%. In the control (CONT) trial, the participants performed the exercise without FC. In two cooling trials, each participant underwent 10 s of FC at 2- (FC2) and 4-min (FC4) intervals while continuing to exercise. FC was achieved by applying two soft-gel packs (cooled to 0 °C) directly and bilaterally on the forehead, eyes, and cheeks. In another cooling trial, 10 s of FC was performed at 2-min intervals using two soft-gel packs cooled to 20 °C (FC2-20).

Results
The RPE values in the FC4 trial were significantly lower than those in the CONT trial at 20 min (FC4, 11.6 ± 2.2 points; CONT, 14.2 ± 1.3 points; P < 0.01). Further, significant differences in the RPE values were observed between the FC4 and CONT trials at 5–15 min and 25–40 min (P < 0.05). RPE values were also significantly lower in the FC2 trial than in the CONT trial (5–40 min). Although the RPE values in the FC2-20 trial were significantly lower (5–10 min; 15–20 min) than those in the CONT trial, there were no significant differences in the RPE between the FC2-20 and CONT trials at 25–40 min. At 35 min, the RPE values were significantly higher in the FC2-20 trial than in the FC2 trial (P < 0.05).

Conclusion
Intermittent short-lasting FC was associated with a decrease in RPE, with shorter intervals and lower temperatures eliciting greater attenuation of increase in the RPE.
Corrosion of Longquan celadons in the marine environment: study on the celadons from the Dalian Island shipwreck of the Yuan Dynasty
Authors: He Yan , Li Weidong , Li Jianan , Xu Changsong , Lu Xiaoke 
Published: September 2021

Abstract
The Dalian ("Image missing") Island shipwreck of the Yuan Dynasty (1271–1368 CE) was located in the sea area of Pingtan ("Image missing"), Fujian ("Image missing") Province, China. A total of 603 Longquan ("Image missing") celadon wares were excavated, some of which have been severely corroded. In this study, two celadon specimens with severe corrosion were selected to investigate the corrosion mechanism in the marine environment. Optical microscopy (OM), scanning electron microscopy equipped with energy dispersive X-ray spectrometry (SEM–EDS), X-ray diffraction analysis (XRD), Micro-Raman spectroscopy, and thermal expansion analysis were applied to analyze the microstructure of the glaze, corrosion morphology, and composition of corrosion products, and the corrosion mechanism was discussed in depth. The results showed that these two celadon wares are opaque matt glaze, in which the anorthite crystallization-phase separation structure with low chemical stability was found, which was more likely to be corroded. There are three possible stages in the corrosion process of the glaze. The first stage is mainly the long-term cation exchange reaction. Then, because of the corrosion of the CaO-rich droplet phase and the crystal-glass phase interface layer, the porous structure and many microcracks may be formed, promoting the corrosion process. Finally, many corrosion craters, caused by the shedding of anorthite crystals, may appear on the glaze surface. The quintinite group minerals in the glaze were probably formed during the corrosion process, which may be related to the marine buried environment and the corrosion of the glaze. This study discussed the influencing factors of the corrosion process of celadon wares in the marine environment from the perspective of microstructure for the first time, which is of great significance to the study of the corrosion mechanism of ancient ceramics.
Demethylzeylasteral (T-96) initiates extrinsic apoptosis against prostate cancer cells by inducing ROS-mediated ER stress and suppressing autophagic flux
Authors: Yang Dong-lin , Zhang Ya-jun , He Liu-jun , Hu Chun-sheng , Gao Li-xia , Huang Jiu-hong , Tang Yan , Luo Jie , Tang Dian-yong , Chen Zhong-zhu 
Published: September 2021

Abstract
Background
Demethylzeylasteral (T-96) is a pharmacologically active triterpenoid monomer extracted from Tripterygium wilfordii Hook F (TWHF) that has been reported to exhibit anti-neoplastic effects against several types of cancer cells. However, the potential anti-tumour effects of T-96 against human Prostate cancer (CaP) cells and the possible underlying mechanisms have not been well studied.

Results
In the current study, T-96 exerted significant cytotoxicity to CaP cells in vitro and induced cell cycle arrest at S-phase in a dose-dependent manner. Mechanistically, T-96 promoted the initiation of autophagy but inhibited autophagic flux by inducing ROS-mediated endoplasmic reticulum (ER) stress which subsequently activated the extrinsic apoptosis pathway in CaP cells. These findings implied that T-96-induced ER stress activated the caspase-dependent apoptosis pathway to inhibit proliferation of CaP cells. Moreover, we observed that T-96 enhances the sensitivity of CaP cells to the chemotherapeutic drug, cisplatin.

Conclusions
Taken together, our data demonstrated that T-96 is a novel modulator of ER stress and autophagy, and has potential therapeutic applications against CaP in the clinic.
Microstructural and mechanical studies of feedstock material in continuous extrusion process
Authors: Desta Tariku , Sinha Devendra Kumar , Ramulu Perumalla Janaki , Tufa Habtamu Beri 
Published: September 2021

AbstractThe challenge encountered in continuous forming process is the variation in mechanical strength of product formed with respect to process variables like extrusion wheel speed and diameter of product. In this research article, the micro-structural investigation of the aluminum (AA1100) feedstock material of 9.5-mm diameter has been carried out at various extrusion wheel speeds and diameter of product before and after deformation on commercial continuous extrusion setup TBJ350. The mechanical properties like yield strength as well as percentage elongation have been estimated and optimized using two variables with 3 levels through central composite rotatable design (CCRD) method. The mathematical modeling has been carried out to predict the optimum combination of process parameters for obtaining maximum value of yield strength and percentage elongation. The statistical significance of mathematical model is verified through analysis of variance (ANOVA). The optimum value of yield strength is found to be 70.939 MPa at wheel velocity of 8.63 rpm and product diameter of 9 mm respectively, whereas the maximum percentage elongation recorded is 46.457 at wheel velocity of 7.06 rpm and product diameter of 7.18 mm. The outcome may be useful in obtaining the best parametric combination of wheel speed and extrusion ratio for best strength of the product.
Specificity and incremental predictive validity of implicit attitudes: studies of a race-based phenotype
Authors: Kurdi Benedek , Carroll Timothy J. , Banaji Mahzarin R. 
Published: September 2021

AbstractFour studies involving 2552 White American participants were conducted to investigate bias based on the race-based phenotype of hair texture. Specifically, we probed the existence and magnitude of bias in favor of Eurocentric (straight) over Afrocentric (curly) hair and its specificity in predicting responses to a legal decision involving the phenotype. Study 1 revealed an implicit preference, measured by an Implicit Association Test (IAT), favoring Eurocentric over Afrocentric hair texture among White Americans. This effect was not reducible to a Black/White implicit race attitude nor to mere perceptual preference favoring straight over curly hair. In Study 2, the phenotype (hair) IAT significantly and uniquely predicted expressions of support in response to an actual legal case that involved discrimination on the basis of Afrocentric hair texture. Beyond replicating this result, Studies 3 and 4 (the latter preregistered) provided further, and even more stringent, evidence for incremental predictive validity: in both studies, the phenotype IAT was associated with support for a Black plaintiff above and beyond the effects of two parallel explicit scales and, additionally, a race attitude IAT. Overall, these studies support the idea that race bias may be uniquely detected by examining implicit attitudes elicited by group-based phenotypicality, such as hair texture. Moreover, the present results inform theoretical investigations of the correspondence principle in the context of implicit social cognition: they suggest that tailoring IATs to index specific aspects of an attitude object (e.g., by decomposition of phenotypes) can improve prediction of intergroup behavior.
Swedish translation and cross-cultural adaptation of eight pediatric item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS)®
Authors: Blomqvist Ida , Chaplin John Eric , Nilsson Evalill , Henje Eva , Dennhag Inga 
Published: September 2021

Abstract
Background
This study is part of the Swedish initiative for the establishment of standardized, modern patient-reported measures for national use in Swedish healthcare. The goal was to translate and culturally adapt eight pediatric Patient-Reported Outcomes Measurement Information System (PROMIS®) item banks (anger, anxiety, depressive symptoms, family relationships, fatigue, pain interference, peer relationships and physical activity) into Swedish.

Methods
Authorization to translate all currently available pediatric PROMIS item banks (autumn, 2016) into Swedish was obtained from the PROMIS Health Organization. The translation followed the Functional Assessment of Chronic Illness Therapy translation recommendations with one major modification, which was the use of a bilingual multi-professional review workshop. The following steps were applied: translation, reconciliation, a two-day multi professional reviewer workshop, back translation, and cognitive debriefing with eleven children (8–17 years) before final review. The bilingual multi-professional review workshop provided a simultaneous, in-depth assessment from different professionals. The group consisted of questionnaire design experts, researchers experienced in using patient-reported measures in healthcare, linguists, and pediatric healthcare professionals.

Results
All item banks had translation issues that needed to be resolved. Twenty-four items (20.7%) needed resolution at the final review stage after cognitive debriefing. The issues with translations included 1. Lack of matching definitions with items across languages (6 items); 2. Problems related to language, vocabulary, and cultural differences (6 items); and 3. Difficulties in adaptation to age-appropriate language (12 items).

Conclusions
The translated and adapted versions of the eight Swedish pediatric PROMIS item banks are linguistically acceptable. The next stage will be cross-cultural validation studies in Sweden. Despite the fact that there are cultural differences between Sweden and the United States, our translation processes have successfully managed to address all issues. Expert review groups from already-established networks and processes regarding pediatric healthcare throughout the country will facilitate the future implementation of pediatric PROMIS item banks in Sweden.
Fatal rectus sheath hematoma: a rare autopsy phenomenon
Authors: Mahamad Arif Akma Nurain Fairuz , Syed Alwee Al’Aidrus Sharifah Safoorah 
Published: September 2021

Abstract
Background
Rectus sheath hematoma is a condition where blood is accumulated within the sheath of the rectus abdominis muscle. It is caused by the rupture of either the superior or inferior epigastric artery or from a direct tear of the rectus muscle itself. This condition is usually self-limiting and most of the time, the hematoma is small, non-expanding and can be reabsorbed spontaneously over time. However, certain underlying pathology may lead to the expansion of the hematoma or even a recurrence, and without any medical treatment or intervention, this condition can even be fatal. Due to its rarity, only a few published cases of fatality associated with rectus sheath hematoma are reported worldwide.

Case presentation
We present a case of non-traumatic fatal rectus sheath hematoma in the presence of underlying lung infection. The deceased complained of abdominal pain 2 days prior to death with a history of prolonged cough. The autopsy revealed the presence of a hematoma within the rectus sheath of the left lower quadrant of the abdomen extending down into the left pelvis and a multitude of small yellow-tan firm lesions scattered throughout the parenchyma of the right lung, suggestive of a lung infection which was later confirmed histologically.

Conclusions
The case serves to increase awareness of fatal rectus sheath hematoma as a cause of death given its rarity in forensic medicine practice. The importance of a thorough post-mortem examination is the key to noticing the fatal hematoma since its enclosed location within the rectus sheath may be obscured to the eye of an inexperienced prosector.