bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled trial investigating effects of an individualized pedometer driven walking program on chronic low back pain
Authors: Lang Angelica E. , Hendrick Paul A. , Clay Lynne , Mondal Prosanta , Trask Catherine M. , Bath Brenna , Penz Erika D. , Stewart Samuel A. , Baxter G. David , Hurley Deidre A. , McDonough Suzanne M. , Milosavljevic Stephan 
Published: February 2021

Abstract
Background
Walking is an easily prescribed physical activity for people with low back pain (LBP). However, the evidence for its effectiveness to improve pain and disability levels for people with chronic low back pain (CLBP) within a community setting has not been evaluated. This study evaluates the effectiveness of a clinician guided, pedometer-driven, walking intervention for increasing physical activity and improving clinical outcomes compared to education and advice.

Methods
Randomized controlled trial recruiting N = 174 adults with CLBP. Participants were randomly allocated into either a standardized care group (SG) or pedometer based walking group (WG) using minimization allocation with a 2:1 ratio to the WG. Prior to randomization all participants were given a standard package of education and advice regarding self-management and the benefits of staying active. Following randomization the WG undertook a physiotherapist guided pedometer-driven walking program for 12 weeks. This was individually tailored by weekly negotiation of daily step targets. Main outcome was the Oswestry Disability Index (ODI) recorded at baseline, 12 weeks, 6 and 12 months. Other outcomes included, numeric pain rating, International Physical Activity Questionnaire (IPAQ), Fear-Avoidance Beliefs Questionnaire (FABQ), Back Beliefs questionnaire (BBQ), Physical Activity Self-efficacy Scale, and EQ-5D-5L quality of life estimate.

Results
N = 138 (79%) participants completed all outcome measures at 12 weeks reducing to N = 96 (55%) at 12 months. Both observed and intention to treat analysis did not show any statistically significant difference in ODI change score between the WG and the SG at all post-intervention time points. There were also no significant between group differences for change scores in all secondary outcome measures. Post hoc sensitivity analyses revealed moderately disabled participants (baseline ODI ≥ 21.0) demonstrated a greater reduction in mean ODI scores at 12 months in the WG compared to SG, while WG participants with a daily baseline step count < 7500 steps demonstrated a greater reduction in mean ODI scores at 12 weeks.

Conclusions
Overall, we found no significant difference in change of levels of (ODI) disability between the SG and WG following the walking intervention. However, ODI responses to a walking program for those with moderate levels of baseline disability and those with low baseline step count offer a potential future focus for continued research into the benefit of walking as a management strategy for chronic LBP.

Trial registration
United States National Institutes of Health Clinical Trails registry (http://ClinicalTrials.gov/) No. NCT02284958 (27/10/2014).
Preoperative transarterial embolization of a recurrent orbital solitary fibrous tumor with significant hypervascularity: a case report
Authors: Wang Xiawei , Shen Jianqin , Cui Hongguang , Pan Jianwei , Teng Xiaodong , Yan Min , Feng Shi , Ding Wei 
Published: February 2021

Abstract
Background
Orbital solitary fibrous tumors (SFTs) are rare neoplasms. Recurrent, hypervascular, malignant variations of orbital SFTs have recently been noted and can present a surgical challenge.

Case presentation
We describe a case of a 53-year-old Chinese woman with a history of a resected orbital SFT. She presented with proptosis, limited eyeball movement, and visual loss in the right eye, suggestive of a recurrent SFT. Ocular examination with multimodal imaging revealed a large, nonpulsatile, noncompressible, hypervascular mass behind the eyeball. The patient underwent preoperative transarterial embolization of the main blood supply to the tumor in order to control intraoperative blood loss, followed by ocular enucleation to optimize exposure and enable complete resection of the tumor. Embolization of the right ophthalmic artery and the distal branch of the right internal maxillary artery caused an immediate, substantial reduction of vascular flow, which allowed us to enucleate the eyeball and resect the tumor with minimal blood loss and no complications.

Conclusions
Our case is so far the first Chinese case of successful preoperative embolization of the main blood supply to a large, recurrent, hypervascular orbital SFT. This case also described a different surgical approach to achieve total removal of an orbital SFT without osteotomy.
The efficacy of convenient cleaning methods applicable for customized abutments: an in vitro study
Authors: Kim Sunjai , Choi Changhun , Cha Yunsu , Chang Jae-Seung 
Published: February 2021

Abstract
Background
The demand for implant dentistry, which includes customized abutments, is increasing. A lot of pollutions are generated on the customized abutment surface following milling procedure. This study evaluated the surface topography and cleanliness of customized abutments after cleaning procedures, which are simply applicable in the dental clinic.

Methods
Thirty computer-aided design and computer-aided manufacturing internal connection type titanium abutments were produced, milled, and randomly divided into 3 groups: steam cleaning (control group), chlorhexidine (CHX) scrubbing (test group 1), and ultrasonic cleaning with CHX solution, acetone, and ethyl alcohol (test group 2). Each group was evaluated using microscopic and microbial analysis.

Results
Foreign bodies were observed on the abutment surfaces in control group and test group 1, but not in test group 2. Bacteria were observed on 40% of the agar plates following steam cleaning; most of the colonies consisted of Bacillus cereus and Staphylococcus warneri. Colony growth was absent following test group 1 and 2.

Conclusion
For customized abutments, cleaning with steam is ineffective. CHX scrubbing effectively eliminates only bacteria. Ultrasonic cleaning with CHX solution, acetone, and ethyl alcohol successfully removes both foreign bodies and bacteria. Thus, the ultrasonic cleaning method is conveniently applicable in the dental clinic for eliminating contamination of the customized abutment surface.
“It was like nobody cared about what I said?” Iranian women committed self-immolation: a qualitative study
Authors: Aghakhani Nader , Lopez Violeta , Parizad Naser , Baghaei Rahim 
Published: February 2021

Abstract
Background
Suicide-attempts have increased across the world and have become higher among females. There has been a high prevalence of self-immolation in Iran, mostly young married women admitted to the burn centers. This study aimed to explore the factors and experiences of self-immolation in Iranian married women to develop prevention strategies to prevent the personal, social, and economic impacts of suicide and suicide attempts.

Methods
A qualitative descriptive approach using open-ended, in-depth, face-to-face interviews was conducted in a purposive sample of 16 married Iranian women aged 16–40 years in the burn centers in Urmia city, a place in northwest Iran. Conventional content analysis was used to analyze the data.

Results
Three themes emerged from the data, including (1) antecedents of self-immolation, (2) suicidal ideation method, and (3) pathway to recovery. Each of these themes is supported by sub-themes.

Conclusions
The study highlights the demand for health professionals to support self-immolation survivors to continue their normal lives. According to survivors’ needs, a comprehensive supportive program is recommended to support their pathways to recovery in all its complexities. Health professionals should also not forget that the survivors’ family also will need help to overcome this trauma. A family counseling program may also be provided.
Relationship between vitamin D receptor gene polymorphisms (BsmI, TaqI, ApaI, and FokI) and calcium intake on bone mass in young Japanese women
Authors: Sakamoto Yuri , Oono Fumi , Iida Kaoruko , Wang Pao-Li , Tachi Yoichi 
Published: February 2021

Abstract
Background
The high prevalence of low bone mass in young women in Japan has emerged as a serious health issue in recent years. Therefore, the aim of the present study was to reevaluate the relationship between genetic and dietary factors, as well as its influence on bone mass in young Japanese women, with particular emphasis on vitamin D receptor (VDR) gene polymorphisms and calcium intake.

Methods
A total of 499 Japanese women aged 20–24 years were enrolled in the study. The bone mass of the calcaneus was assessed using the quantitative ultrasound method and expressed as the osteo sono-assessment index (OSI). VDR gene polymorphisms (BsmI, TaqI, ApaI, and FokI) were analyzed using DNA extracted from saliva. Calcium intake was assessed using the Food Frequency Questionnaire based on food groups (FFQg) and adjusted with the energy intake. Participants were divided into two groups based on the median calcium intake (250 mg/1000 kcal).

Results
Consequently, bone mass was significantly different among the BsmI and TaqI genotypes after adjusting for body mass index (BMI) (p = 0.030 and 0.019, respectively). In addition, the BsmI AA and ApaI GT genotypes showed significant differences in bone mass between the calcium-intake groups, with low OSI in the low-calcium intake group and high OSI in the high-calcium intake group, respectively, even after adjusting for BMI (p = 0.020 and 0.038, respectively).

Conclusions
These findings may prove instrumental in developing a logical approach towards preventing bone loss in young Japanese women.
Porcine placenta extract improves high-glucose-induced angiogenesis impairment
Authors: Nensat Chatchai , Songjang Worawat , Tohtong Rutaiwan , Suthiphongchai Tuangporn , Phimsen Suchada , Rattanasinganchan Panthip , Metheenukul Pornphimon , Kumphune Sarawut , Jiraviriyakul Arunya 
Published: February 2021

Abstract
Background
High glucose (HG)-induced reactive oxygen species (ROS) overproduction impairs angiogenesis that is one pivotal factor of wound healing process. Angiogenesis impairment induces delayed wound healing, whereby it eventually leads to amputation in cases of poorly controlled diabetes with diabetic ulceration. Porcine placenta extract (PPE) is a natural waste product that comprises plenty of bioactive agents including growth factors and antioxidants. It was reported as an effective compound that prevents ROS generation. The goal of this study was to investigate the in vitro effect of PPE on HG-induced ROS-mediated angiogenesis impairment.

Methods
Primary endothelial cells (HUVECs) and endothelial cell line (EA.hy926) were treated with HG in the presence of PPE. The endothelial cells (ECs) viability, intracellular ROS generation, migration, and angiogenesis were determined by MTT assay, DCFDA reagent, wound healing assay, and tube formation assay, respectively. Additionally, the molecular mechanism of PPE on HG-induced angiogenesis impairment was investigated by Western blot. The angiogenic growth factor secretion was also investigated by the sandwich ELISA technique.

Results
HG in the presence of PPE significantly decreased intracellular ROS overproduction compared to HG alone. HG in the presence of PPE significantly increased ECs viability, migration, and angiogenesis compared to HG alone by showing recovery of PI3K/Akt/ERK1/2 activation. HG in the presence of PPE also decreased ECs apoptosis compared to HG alone by decreasing p53/Bax/cleaved caspase 9/cleaved caspase 3 levels and increasing Bcl 2 level.

Conclusion
PPE attenuated HG-induced intracellular ROS overproduction that improved ECs viability, proliferation, migration, and angiogenesis by showing recovery of PI3K/Akt/ERK1/2 activation and inhibition of ECs apoptosis. This study suggests PPE ameliorated HG-induced ROS-mediated angiogenesis impairment, whereby it potentially provides an alternative treatment for diabetic wounds.
Traditional medicine among the community of Gash-Barka region, Eritrea: attitude, societal dependence, and pattern of use
Authors: Tesfamariam Sirak , Tesfai Filmon , Hussien Lemlem , Ateshim Yonatan , Yemane Dawit , Russom Mulugeta , Ahmed Hagos , Bahta Iyassu , Kidane Solyana Ngusbrhan , Namboze Josephine , Kasilo Ossy Muganga Julius 
Published: February 2021

AbstractBackgroundDespite the growing conventional healthcare coverage in Eritrea, traditional medicine (TM) remains an essential source of healthcare service to the population. This study, therefore, aims at exploring the attitude, societal dependence, and pattern of TM use of the Gash-Barka community.MethodsA cross-sectional study was conducted between December 2018 and January 2019 in Gash-Barka region, one of the six regions of Eritrea. Two-stage stratified cluster sampling design was used to provide representative sample of households. The data collected through face-to-face interview using a structured questionnaire was entered twice and analyzed using CSPro7.2 and SPSS 23, respectively. Both descriptive and analytical analyses were performed to test statistical significance.ResultsOf the total 210 participants, 202 completed the interview with a response rate of 96.2%. Almost 97% of the respondents were aware of the general existence of TM. About half of the respondents (47.4%) had visited traditional health practitioners (THPs) at least once in their lifetime. The majority of the respondents claimed their medical condition had been improved (63.2%), were satisfied with the outcome (76.8%), and had not encountered complications (95.2%) due to TM use. Around 40% of the respondents admitted they do not disclose previous TM use to conventional health practitioners. Females are more likely to have had ever visited THPs (AOR = 1.85, CI: 1.01, 3.38) and use TM in the future (AOR = 2.26, CI: 0.92, 5.14) than males. Moreover, those who had visited THPs before (COR = 8.30, CI: 3.25, 21.20) are more likely to use TM as a primary treatment choice and prefer to use TM in the future (AOR = 4.40, CI: 1.97, 9.83) than those who had never visited THPs. About 61% of the total families claimed they had circumcised at least one female child, and 96.8% disclosed they had circumcised at least one male child. Out of which, 89.2% of the circumcisions were done by THPs.ConclusionTM is popular and widely relayed upon by Gash-Barka residents with exposure of children to harmful TM practices. Since the reliance of the community on TM is expected to continue, further representative studies are recommended to inform regulatory interventions and integrate TM into the health system.
Implementation of an educational module on nosocomial infection control measures: a randomised hospital-based trial
Authors: Alrubaiee Gamil Ghaleb , Baharom Anisah , Faisal Ibrahim , Shahar Hayati Kadir , Daud Shaffe Mohd , Basaleem Huda Omer 
Published: February 2021

Abstract
Background
Previous cross-sectional studies have reported limited knowledge and practices among nurses regarding controlling nosocomial infections (NIs). Even though health institutions offer many irregular in-service training courses to solve such issues, a three year-nursing educational programme at institutions is not adequate to enable nurses to handle NIs. Therefore, this study aims to evaluate the implementation of an educational module on NIs control measures among Yemeni nurses.

Methods
A single-blinded randomised hospital-based trial was undertaken involving 540 nurses assigned to two intervention groups and a waitlist group. Intervention group-1 received a face-to-face training course comprising 20 h spread over six weeks and a hard copy of the module, while intervention group-2 only received the hard copy of the module “without training”. In contrast, the waitlist group did not receive anything during the period of collecting data. A self-administered NI control measures-evaluation questionnaire was utilised in collecting the data from the participants; before the intervention, at six weeks and 3 months after the end of the intervention. The period of data collection was between 1st May and 30th October 2016.

Results
The results from collecting and analysing the data showed a statistically significant difference in the mean knowledge scores between the intervention groups that were detectable immediately post-intervention with a mean difference (MD) of 4.31 (P < 0.001) and 3 months after the end of the intervention (MD = 4.48, P < 0.001) as compared to the waitlist group. Similarly, the results showed a statistically significant difference in the mean practice scores between the intervention groups immediately post-intervention (MD = 2.74, P < 0.001) and 3 months after the intervention (MD = 2.46, P < 0.001) as compared to the waitlist group. Intervention-1 (face-to-face training + module) was more effective than intervention-2 (module only) in improving Yemeni nurses’ knowledge and practices regarding NI control measures compared to the waitlist group.

Conclusion
The findings of this study found that intervention-1 could be offered to nurses in the form of an in-service training course every six months. The NI course should also be included in nursing curricula, particularly for the three-year-nursing diploma in Yemen.

Trial registration
Nosocomial infection educational module for nurses ISRCTN19992640, 20/6/2017. The study protocol was retrospectively registered.
The burden of waiting to access pain clinic services: perceptions and experiences of patients with rheumatic conditions
Authors: Deslauriers Simon , Roy Jean-Sébastien , Bernatsky Sasha , Blanchard Nathan , Feldman Debbie E. , Pinard Anne Marie , Fitzcharles Mary-Ann , Desmeules François , Perreault Kadija 
Published: February 2021

Abstract
Background
Extensive waiting times before receiving services is a major barrier to adequate pain management. Waiting times may have a detrimental impact on patients’ conditions and quality of life. However, there remains a lack of knowledge on the actual experiences of patients waiting to receive services, especially for those with rheumatic conditions. The present study aimed to gain an in-depth understanding of perceptions and experiences of patients with rheumatic conditions regarding access to pain clinic services. The secondary objective was to identify possible solutions to improve this access according to patients’ perspectives.

Methods
This qualitative study based on semi-structured interviews was conducted with adults with rheumatic conditions waiting to access pain clinics in the province of Quebec, Canada. Interviews were transcribed verbatim and analyzed using thematic content analysis.

Results
Twenty-six participants were interviewed (22 women and 4 men; mean age 54 ± 10 years). Four main themes were identified: 1) the perception that waiting time is unacceptably long; 2) how the lack of information affects patients’ experiences of waiting; 3) patients’ various expectations towards the pain clinic, from high hopes to disillusionment and 4) carrying an emotional, physical and financial burden resulting from the wait. Participants reported several solutions to improve the experience of waiting, including providing information to patients, increasing resources, improving prioritization processes and care coordination, and providing alternative interventions to patients during the wait.

Conclusions
For patients with rheumatic conditions, access to pain clinic services is challenging due to extensive waiting times. The burden it imposes on them adds to the existing challenge of living with a chronic rheumatic condition. The solutions identified by participants could serve as building blocks to develop and implement measures to improve patients’ experience of accessing pain-related services.
Personalized genealogical history of UK individuals inferred from biobank-scale IBD segments
Authors: Naseri Ardalan , Tang Kecong , Geng Xin , Shi Junjie , Zhang Jing , Shakya Pramesh , Liu Xiaoming , Zhang Shaojie , Zhi Degui 
Published: February 2021

AbstractBackgroundThe genealogical histories of individuals within populations are of interest to studies aiming both to uncover detailed pedigree information and overall quantitative population demographic histories. However, the analysis of quantitative details of individual genealogical histories has faced challenges from incomplete available pedigree records and an absence of objective and quantitative details in pedigree information. Although complete pedigree information for most individuals is difficult to track beyond a few generations, it is possible to describe a person’s genealogical history using their genetic relatives revealed by identity by descent (IBD) segments—long genomic segments shared by two individuals within a population, which are identical due to inheritance from common ancestors. When modern biobanks collect genotype information for a significant fraction of a population, dense genetic connections of a person can be traced using such IBD segments, offering opportunities to characterize individuals in the context of the underlying populations. Here, we conducted an individual-centric analysis of IBD segments among the UK Biobank participants that represent 0.7% of the UK population.ResultsWe made a high-quality call set of IBD segments over 5 cM among all 500,000 UK Biobank participants. On average, one UK individual shares IBD segments with 14,000 UK Biobank participants, which we refer to as “relatives.” Using these segments, approximately 80% of a person’s genome can be imputed. We subsequently propose genealogical descriptors based on the genetic connections of relative cohorts of individuals sharing at least one IBD segment and show that such descriptors offer important information about one’s genetic makeup, personal genealogical history, and social behavior. Through analysis of relative counts sharing segments at different lengths, we identified a group, potentially British Jews, who has a distinct pattern of familial expansion history. Finally, using the enrichment of relatives in one’s neighborhood, we identified regional variations of personal preference favoring living closer to one’s extended families.ConclusionsOur analysis revealed genetic makeup, personal genealogical history, and social behaviors at the population scale, opening possibilities for further studies of individual’s genetic connections in biobank data.
Sustained CHK2 activity, but not ATM activity, is critical to maintain a G1 arrest after DNA damage in untransformed cells
Authors: García-Santisteban Iraia , Llopis Alba , Krenning Lenno , Vallejo-Rodríguez Jon , van den Broek Bram , Zubiaga Ana M. , Medema René H. 
Published: February 2021

AbstractBackgroundThe G1 checkpoint is a critical regulator of genomic stability in untransformed cells, preventing cell cycle progression after DNA damage. DNA double-strand breaks (DSBs) recruit and activate ATM, a kinase which in turn activates the CHK2 kinase to establish G1 arrest. While the onset of G1 arrest is well understood, the specific role that ATM and CHK2 play in regulating G1 checkpoint maintenance remains poorly characterized.ResultsHere we examine the impact of ATM and CHK2 activities on G1 checkpoint maintenance in untransformed cells after DNA damage caused by DSBs. We show that ATM becomes dispensable for G1 checkpoint maintenance as early as 1 h after DSB induction. In contrast, CHK2 kinase activity is necessary to maintain the G1 arrest, independently of ATM, ATR, and DNA-PKcs, implying that the G1 arrest is maintained in a lesion-independent manner. Sustained CHK2 activity is achieved through auto-activation and its acute inhibition enables cells to abrogate the G1-checkpoint and enter into S-phase. Accordingly, we show that CHK2 activity is lost in cells that recover from the G1 arrest, pointing to the involvement of a phosphatase with fast turnover.ConclusionOur data indicate that G1 checkpoint maintenance relies on CHK2 and that its negative regulation is crucial for G1 checkpoint recovery after DSB induction.