bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Decentralized Glucose and Behaviometric Monitoring of Persons with Type 2 Diabetes in the Setting of a Clinical Trial
Authors: Ali Zarqa , Valk Teske Jacqueline , Bjerre-Christensen Theis , Brandt Sigurd , Isberg Ari Pall , Jensen Morten Lind , Helledi Lise Sylvest , Kaas Anne , Thomsen Simon Francis , Andersen Anders Daniel , Robert Zibert John 
Published: September 2021

Background: Clinical trials often suffer from recruitment barriers and poor adherence, which increases costs and affects trial outcomes. Objective: To investigate the feasibility of Decentralized Clinical Trial (DCT) design elements to recruit, enroll, and engage patients with type 2 diabetes mellitus (T2DM). Methods: Patients with T2DM were recruited through a pharmacy and online recruitment using advert on Facebook, to 3 weeks monitoring of glucose and behaviometric parameters. Subjects recruited online could either complete an informed consent conversation in the pharmacy or through live video call managed by the study app. A continuous glucose monitoring (CGM) device to collect glucose data, and a hybrid smartwatch to monitor heart rate, track activity and sleep pattern were delivered by postal service to the participants’ home address. The devices were connected to a study specific app on the participant’s smartphone also capturing GPS data and questionnaire answers. Results: Twenty-six subjects (3 pharmacy, 23 online) with T2DM were recruited, 85% preferred online informed consent conversation. All participants were able to self-apply the CGM device, use the smartwatch, and download the app. GPS location was captured more than 100 times for each participant, and more than 90% completed all 3 questionnaires. All the participants felt safe with the informed consent process and they felt confident in participating from home. Three participants dropped-out during the study period leaving a retention rate at 87%. Conclusions: Use of DCT design elements to conduct a T2DM study is feasible regarding recruitment, data collection from various electronic devices, and participant engagement.
Inclusive Education in Wales: Interpreting Discourses of Values and Practice Using Critical Policy Analysis
Authors: Knight Cathryn , Crick Tom 
Published: September 2021

Purpose This paper provides a detailed analysis of inclusive education policies in the context of major system reform in Wales, United Kingdom. Wales is currently undergoing the most significant changes to its education system since political devolution from the U.K. Government in 1999. Key to these changes is the new Curriculum for Wales and the Additional Learning Needs (ALN) regulations; alongside these and wider system-level reforms, there is an ambition to create an inclusive education system in Wales. This paper explores how inclusion is articulated and communicated within the key policy and guidance documents, using two continuums—“practice” and “values”—to map and interpret these documents. Design/Approach/Methods This paper uses critical policy analysis to make sense of these various inclusive education policy reforms in Wales. Findings The analysis reveals that despite a foregrounded commitment to inclusion, there is disparity both within and between the policy and guidance documents. Originality/Value The paper highlights the lack of coherence of key messages articulated through education policy documentation in Wales, providing insight into the emerging national education system reforms, as well as developing an approach for evaluating inclusive education systems in other jurisdictions.
Qualitative Olfactory Disorders: Patient Experiences and Self-Management
Authors: Philpott Carl , Dixon Joanne , Boak Duncan 
Published: September 2021

Background Qualitative olfactory disorders in the form of parosmia and phantosmia are very subjective and cannot be measured at present. They pose an unpleasant experience for patients and a therapeutic challenge for clinicians. Objective This study aimed to characterise the specific experiences of patients affected by the qualitative symptoms of parosmia and phantosmia including both triggers for symptoms and self-help measures they have tried. Methods A cross-sectional survey questionnaire was developed with the input of patient experts within the charity Fifth Sense. The survey was then open online for 3 months to charity members complaining of qualitative symptoms. The survey captured the frequency and impact of symptoms and self-management undertaken. Reflective feedback was also captured from a patient workshop. Results There were 100 participants; 61% female, age range 13-88. Common self-reported aetiology included sinonasal disease (17%), idiopathic (33%) and post-viral olfactory loss (26%) and post-traumatic olfactory loss (23%). Parosmia was reported as a daily symptom in 67% compared to 31% for phantosmia; 36% complained of suffering with both symptoms. Only 4% of respondents reported having received any successful treatment for their qualitative symptoms and 58% reported having received no treatment whatsoever. Olfactory training was the most common self-management method reported. Conclusion This study illustrates that qualitative disturbances remain problematic for those who experience them due to the duration of symptoms, the relative lack of experience or knowledge amongst medical professionals and the lack of therapeutic options. In future, consideration needs to be given to adaptation and coping strategies to help patients deal with these symptoms.
Association of Body Mass Index With Severity and Lesion Location in Adolescents With Osteochondritis Dissecans of the Knee
Authors: Rogers Davis L. , Klyce Walter , Kajstura Tymoteusz J. , Lee R. Jay 
Published: September 2021

Background: The association between body mass index (BMI) and severity of osteochondritis dissecans (OCD) of the knee at presentation is poorly understood. Hypothesis: We hypothesized that adolescents in higher BMI percentiles for age and sex would have OCD lesions that were more severe at their initial presentation and located more posteriorly on the condyle as compared with adolescents in lower BMI percentiles. Study Design: Cohort study; Level of evidence, 3. Methods: This study included patients aged 10 to 18 years who were treated for knee OCD at a tertiary care hospital from 2006 to 2017. Patients with noncondylar OCD or missing BMI data within 3 months of presentation were excluded. Patients were stratified per the Centers for Disease Control and Prevention guidelines as underweight, normal weight, overweight, or obese, and the groups were compared according to age, side of lesion, 4 markers of lesion severity (cystic changes, loose fragments, subchondral fluid, and subchondral edema), and surgical treatment. Lesion angle was measured in reference to a line parallel to the femoral axis drawn through the center of a best-fit circle covering the distal condyle. Data were analyzed using chi-square tests, relative risk, Student t tests, analysis of variance, and linear regression of cumulative running percentages. Bonferroni correction was performed when applicable. Results: A total of 77 patients met our inclusion criteria (mean age, 14.2 years; range, 10.1-18.8): 2 were underweight, 50 had normal BMI, 13 were overweight, and 12 were obese. We found correlations between BMI percentile and surgical treatment ( R 2 = .732), subchondral fluid ( R 2 = .716), subchondral edema ( R 2 = .63), loose fragments ( R 2 = .835), and the presence of at least 1 marker of lesion severity ( R 2 = .857) ( P < .0001 for all). No correlation was observed for cystic changes ( R 2 = .026). There were significant associations between BMI ≥80th percentile and subchondral edema (risk ratio, 2.5; 95% CI, 1.3-4.8), medial condylar lesions (risk ratio, 1.3; 95% CI, 1.01-1.7), and lesions more anterior on the condyle ( P < .05). Conclusion: Higher BMI in adolescents was strongly correlated with multiple markers of severity of knee OCD at initial presentation as well as with more anterior lesions.
Calcitriol confers neuroprotective effects in traumatic brain injury by activating Nrf2 signaling through an autophagy-mediated mechanism
Authors: Cui Changmeng , Wang Changshui , Jin Feng , Yang Mengqi , Kong Lingsheng , Han Wenxiu , Jiang Pei 
Published: September 2021

AbstractBackgroundThe present study aimed to further explore the potential interaction between oxidative stress and autophagy in the progression of traumatic brain injury (TBI) and therapeutic mechanism of calcitriol, the active form of vitamin D (VitD).MethodsNeuroprotective effects of calcitriol were examined following TBI. We further evaluated the impacts of TBI and calcitriol treatment on autophagic process and nuclear factor E2-related factor 2 (Nrf2) signaling.ResultsWe found that treatment of calcitriol markedly ameliorated the neurological deficits and histopathological changes following TBI. The brain damage impaired autophagic flux and impeded Nrf2 signaling, the major regulator in antioxidant response, consequently leading to uncontrolled and excessive oxidative stress. Meanwhile, calcitriol promoted autophagic process and activated Nrf2 signaling as evidenced by the reduced Keap1 expression and enhanced Nrf2 translocation, thereby mitigating TBI-induced oxidative damage. In support, we further found that chloroquine (CQ) treatment abrogated calcitriol-induced autophagy and compromised Nrf2 activation with increased Keap1 accumulation and reduced expression of Nrf2-targeted genes. Additionally, both CQ treatment and Nrf2 genetic knockout abolished the protective effects of calcitriol against both TBI-induced neurological deficits and neuronal apoptosis.ConclusionsTherefore, our work demonstrated a neuroprotective role of calcitriol in TBI by triggering Nrf2 activation, which might be mediated by autophagy.
CircRNAs as potent biomarkers in ovarian cancer: a systematic scoping review
Authors: Foruzandeh Zahra , Zeinali-Sehrig Fatemeh , Nejati Kazem , Rahmanpour Dara , Pashazadeh Fariba , Seif Farhad , Alivand Mohammad Reza 
Published: September 2021

AbstractMore powerful prognostic and diagnostic tools are urgently needed for identifying and treating ovarian cancer (OC), which is the most fatal malignancy in women in developed countries. Circular RNAs (circRNAs) are conservative and stable looped molecules that can regulate gene expression by competing with other endogenous microRNA sponges. This discovery provided new insight into novel methods for regulating genes that are involved in many disorders and cancers. This review focuses on the dysregulated expression of circRNAs as well as their diagnostic and prognostic values in OC. We found that studies have identified twenty-one downregulated circRNAs and fifty-seven upregulated ones. The results of these studies confirm that circRNAs might be potent biomarkers with diagnostic, prognostic and therapeutic target value for OC. We also consider the connection between circRNAs and OC cell proliferation, apoptosis, metastasis, and chemotherapy resistance and sensitivity.
Impact of a binary triage system and structural reorganization of emergency department on health care workers exposed to suspected COVID-19 patients—a single-centre analysis
Authors: Abd. Wahab Mahathar , Safaai Sufian , Mohd Saiboon Ismail 
Published: September 2021

Abstract
Background
A binary triage system based on infectivity and facilitated by departmental restructuring was developed to manage suspected COVID-19 patients with an aim to provide effective prevention and control of infection among health care workers (HCWs) in the emergency department. This study analyses the effectiveness of the new triage system and structural reorganization in response to the COVID-19 pandemic.

Methods
A cross-sectional observational study was conducted in the Emergency and Trauma Department, Hospital Kuala Lumpur (ETDHKL). The implementation of a binary triage system separates patients with risk of COVID-19 who present with fever and respiratory symptoms from other patients. Data on exposed HCWs to COVID-19 patients were captured pre-restructuring and post-restructuring of the emergency department and analysed using descriptive statistics.

Results
A total of 846 HCWs were involved in this study. Pre-restructuring reported 542 HCWs exposed to COVID-19 patients while post-restructuring reported 122. Using the four categorical exposure risks for HCWs which are no identifiable risk, low risk, medium risk, and high risk, the number of HCWs exposed during pre-restructuring were 15(1.8%), 504 (59.6%), 15 (1.8%), and 8 (0.9%), respectively, while post-restructuring the numbers were 122 (14.4%), 8 (0.9%), 109 (12.9%), and 5 (0.1%), respectively. There was a 77.5% reduction in the number of exposed HCWs after our implementation of the new system (542 vs 122).

Conclusion
A binary triage system based on severity and infectivity and supported with structural reorganization can be effective in reducing HCWs COVID-19 exposure.
Prostate biopsy: a survey of practice among Nigerian urologists
Authors: Mohammed Taofiq O. , Ajape Abdulwahab A. , Kuranga Suleiman A. , Olanipekun Hamid B. , Ogunfowora Tolulope T. 
Published: September 2021

AbstractBackgroundProstate biopsy is a commonly performed outpatient procedure in urology. It is a rapidly changing field with wide variation in practice pattern. The aim of this study is to document the current practice of prostate biopsy among Nigerian urologists.MethodsA prospectively designed, self-administered, 16-item survey questionnaire was distributed among urologists and trainees at the 24th Annual General Meeting and Scientific Conference of the Nigerian Association of Urological Surgeons (NAUS). The survey covers various aspect of prostate biopsy including indications for biopsy, prophylactic antibiotic regimen use, methods of bowel preparation, number of biopsy cores taken, complications among others.ResultsFifty-one completed questionnaires were returned, out of 76 distributed, giving a response rate of 67%. Majority of the respondents were Consultant urologist 47 (92%), most of them practice in the public health system 46 (90.2%), and performed more than 5 prostate needle biopsy per month 37 (72.5%). All respondents administer prophylactic antibiotics prior to biopsy, with intravenous Gentamycin being the most commonly administered prophylactics 14 (27.5%), only a few perform bowel preparations prior to biopsy 8 (15.7%) with Dulcolax suppository being the most commonly employed agents 5 (63%). Most of the biopsy were done under transrectal ultrasound guidance 29 (56.9%). None of the respondents performed MRI-guided transrectal biopsy. Most respondents take 8–12 core biopsy 20 (39.2%), using 18G trucut biopsy needle 31 (60.8%), with the patient in left lateral decubitus position 26 (51%), under 2% intrarectal xylocaine instillation 28 (54.9%). The commonest complication after the procedure was bleeding per rectum 20 (39.2%), followed by haematuria 9 (17.6%), and infection 8 (15.7%).ConclusionThere is universal use of prophylactic antibiotic prior to biopsy. However, bowel preparation prior to biopsy is not common among Nigerian urologist, and MRI-guided biopsy is very rarely done for prostate biopsy. There is need for a prostate biopsy guideline among Nigerian urologists to ensure uniformity of practice, and enhance standardized service delivery.
Using sound to understand protein sequence data: new sonification algorithms for protein sequences and multiple sequence alignments
Authors: Martin Edward J. , Meagher Thomas R. , Barker Daniel 
Published: September 2021

Abstract
Background
The use of sound to represent sequence data—sonification—has great potential as an alternative and complement to visual representation, exploiting features of human psychoacoustic intuitions to convey nuance more effectively. We have created five parameter-mapping sonification algorithms that aim to improve knowledge discovery from protein sequences and small protein multiple sequence alignments. For two of these algorithms, we investigated their effectiveness at conveying information. To do this we focussed on subjective assessments of user experience. This entailed a focus group session and survey research by questionnaire of individuals engaged in bioinformatics research.

Results
For single protein sequences, the success of our sonifications for conveying features was supported by both the survey and focus group findings. For protein multiple sequence alignments, there was limited evidence that the sonifications successfully conveyed information. Additional work is required to identify effective algorithms to render multiple sequence alignment sonification useful to researchers. Feedback from both our survey and focus groups suggests future directions for sonification of multiple alignments: animated visualisation indicating the column in the multiple alignment as the sonification progresses, user control of sequence navigation, and customisation of the sound parameters.

Conclusions
Sonification approaches undertaken in this work have shown some success in conveying information from protein sequence data. Feedback points out future directions to build on the sonification approaches outlined in this paper. The effectiveness assessment process implemented in this work proved useful, giving detailed feedback and key approaches for improvement based on end-user input. The uptake of similar user experience focussed effectiveness assessments could also help with other areas of bioinformatics, for example in visualisation.
Enterococcus hirae bacteremia associated with acute pyelonephritis in a patient with alcoholic cirrhosis: a case report and literature review
Authors: Nakamura Tomoaki , Ishikawa Kazuhiro , Matsuo Takahiro , Kawai Fujimi , Uehara Yuki , Mori Nobuyoshi 
Published: September 2021

Abstract
Background
Infections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. Further, few cases have been reported in humans because of the difficulty in identifying the bacteria. Herein, we report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia.

Case presentation
A 57-year-old male patient with alcoholic cirrhosis and neurogenic bladder presented with fever and chills that had persisted for 3 days. Physical examination revealed tenderness of the right costovertebral angle. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. The patient was treated successfully with intravenous ampicillin followed by oral linezolid for a total of three weeks.

Conclusion
The literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease. However, mortality is not common because of the high antimicrobial susceptibility of E. hirae. With the advancements in MALDI-TOF MS, the number of reports of E. hirae infections has also increased, and clinicians need to consider E. hirae as a possible causative pathogen of urinary tract infections in patients with known risk factors.
Response to Sodium Channel blocking Antiseizure medications and coding polymorphisms of Sodium Channel genes in Taiwanese epilepsy patients
Authors: Lin Chih-Hsiang , Ho Chen-Jui , Lu Yan-Ting , Tsai Meng-Han 
Published: September 2021

Abstract
Background
Many antiseizure medications (ASMs) control seizures by blocking voltage-dependent sodium channels. Polymorphisms of sodium channel genes may affect the response to ASMs due to altering the effect of ASMs on blocking sodium channels.

Methods
We conducted a retrospective study of epilepsy patients followed up at the Neurological Department of Kaohsiung Chang Gung Memorial Hospital, Taiwan between January 2010 and December 2018. We categorized the patients into response, partial response, and failure to sodium channel blocking ASM groups. Sodium channel blocking ASMs included phenytoin, carbamazepine, lamotrigine, oxcarbazepine, lacosamide, zonisamide, topiramate, and valproic acid. A subgroup of predominant sodium channel blocking ASMs included phenytoin, carbamazepine, lamotrigine, oxcarbazepine, and lacosamide. Associations between the response of ASMs and single-nucleotide polymorphisms of SCN1A, SCN1B, SCN2A, and SCN9A were analyzed.

Results
Two hundred Taiwanese patients and 21 single-nucleotide polymorphisms among SCN1A, SCN1B, SCN2A, and SCN9A were evaluated. We found allele C of rs55742440 in SCN1B was statistically significantly associated with not achieving seizure-free with sodium channel blocking ASMs. For the predominant sodium channel blocking ASMs group, no SNPs were associated with the response of ASMs.

Conclusion
Single-nucleotide polymorphism in SCN1B was associated with the response to sodium channel blocking ASMs. This highlights the possibility that beta subunits may affect the function of sodium channels and resulted in different responsiveness to ASMs.
Intergenerational effects of violence on women’s perinatal wellbeing and infant health outcomes: evidence from a birth cohort study in Central Vietnam
Authors: Do Huyen Phuc , Baker Philip R. A. , Van Vo Thang , Murray Aja , Murray Linda , Valdebenito Sara , Eisner Manuel , Tran Bach Xuan , Dunne Michael P. 
Published: September 2021

Abstract
Background
Girls exposed to violence have a high risk of being victimized as adults and are more likely than non-abused women to have children who are treated violently. This intergenerational transmission may be especially serious when women suffer violence during pregnancy and early motherhood, as it impairs maternal wellbeing and infant health and development. This study examined the intergenerational effects of being exposed to childhood maltreatment (CM) and prenatal intimate partner violence (p-IPV) on perinatal mental distress and birth outcomes in central Vietnam.

Methods
A birth cohort study in Hue City, Vietnam was conducted with 150 women in the third trimester of pregnancy (Wave 1) and 3 months after childbirth (Wave 2). Using multivariable logistic regression models, augmented inverse-probability-weighted estimators and structural equation modelling (SEM), we analyzed a theoretical model by evaluating adjusted risk differences and pathways between CM, p-IPV and subsequent perinatal adversity and indicators of infant health problems.

Results
One in two pregnant women experienced at least one form of CM (55.03%) and one in ten pregnant women experienced both CM and p-IPV (10.67%). Mothers who experienced p-IPV or witnessed IPV as a child were approximately twice as likely to experience poor mental health during pregnancy [ARR 1.94, 95% CI (1.20–3.15)]. Infants had a two-fold higher risk of adverse birth outcomes (low birth weight, preterm birth, admission to neonatal intensive care) [ARR 2.45 95% CI (1.42, 4.25)] if their mothers experienced any form of p-IPV, with greater risk if their mothers were exposed to both CM and p-IPV [ARR 3.45 95% CI (1.40, 8.53)]. Notably, significant pathways to p-IPV were found via adverse childhood experience (ACE) events (β = 0.13), neighborhood disorder (β = 0.14) and partner support (β = − 1.3).

Conclusion
These results emphasize the detrimental and prolonged nature of the effect of violence during childhood and pregnancy. Exposure to childhood maltreatment and violence during pregnancy increases the risk of maternal mental health difficulties and adverse birth outcomes. Antenatal care systems need to be responsive to women’s previous experiences of violence and maternal mental health. The significant protective role of partner support and social support should also be considered when designing tailored interventions to address violence during pregnancy.