bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keeping Children Healthy During and After COVID-19 Pandemic: Meeting Youth Physical Activity Needs
Authors: Pavlovic Andjelka , DeFina Laura F. , Natale Breanna L. , Thiele Shelby E. , Walker Timothy J. , Craig Derek W. , Vint Georgina R. , Leonard David , Haskell William L. , III Harold W. Kohl 
Published: January 2021

Abstract
Background: The purpose of this study was to: 1) examine the maintenance of Physical Education and physical activity during the distance learning time, 2) determine the resources educators are utilizing to deliver PE curricula, and 3) understand the challenges experienced by educators during distance learning.Methods: A survey was sent to a cohort of school-based fitness assessment software users. Respondents were largely school-based individuals including PE teachers (n= 1,789), school (n=62), and district administrators (n=64). nurses (n=3), and “other” (n =522). Results: Of 2,440 respondents, most were from a city or suburb (69.7%), elementary or middle school (72.3%), and had Title 1 status, an indicator of low socioeconomic status, (60.4%). Most campuses were closed during the COVID-19 pandemic (97.8%). Of the schools closed during the pandemic, only 2.8% had no prior PE requirements and that increased to 21% during the pandemic. In schools that remained open during the pandemic, 7.7% had no prior PE requirements and this increased to 60.5%. Importantly, 79% of respondents reported that students were either “significantly less” or “somewhat less” physically active during the closure. For closed schools, the most frequently cited challenges included “student access to online learning“, “teacher/student communication” and “teacher remote work arrangements”. For open schools, the most commonly reported challenges included “social distancing”, “access to gymnasium/equipment”, and “concern for personal health and wellbeing”.Conclusion: The COVID-19 pandemic has caused important reductions in PE requirements and time engaged in physical activity. Challenges experienced by teachers were identified for closed and open schools.
Watchful Waiting as a Strategy to Reduce Low-Value Spinal Imaging: Study Protocol for a Randomized Trial
Authors: Fenton Joshua , Jerant Anthony , Franks Peter , Gosdin Melissa , Fridman Ilona , Cipri Camille , Weinberg Gary , Hudnut Andrew , Tancredi Daniel J 
Published: January 2021

Abstract
• Background: Patients with acute low back pain frequently request diagnostic imaging, and clinicians feel pressure to acquiesce to such requests to sustain patient trust and satisfaction. Spinal imaging in patients with acute low back pain poses risks from diagnostic evaluation of false-positive findings, patient labeling and anxiety, and unnecessary treatment (including spinal surgery). Watchful waiting advice has been an effective strategy to reduce some low-value treatments, and some evidence suggests a watchful waiting approach would be acceptable to many patients requesting diagnostic tests. • Methods: We will use key informant interviews of clinicians and focus groups with primary care patients to refine a theory-informed standardized patient-based intervention designed to teach clinicians how to advise watchful waiting when patients request low-value spinal imaging for low back pain. We will test the effectiveness of the intervention in a cluster randomized clinical trial. We will recruit 8-10 primary care and urgent care clinics (~55 clinicians) in Sacramento, CA; clinicians will be randomized 1:1 to intervention and control groups. Over a 3 to 6 month period, clinicians in the intervention group will receive 3 visits with standardized patient instructors (SPIs) portraying patients with acute back pain; SPIs will instruct clinicians in a three-step model emphasizing establishing trust, empathic communication, and negotiation of a watchful waiting approach. Control physicians will receive no intervention. The primary outcome is the post-intervention rate of spinal imaging among actual patients with acute back pain seen by the clinicians adjusted for rate of imaging during a baseline period. Secondary outcomes are: use of targeted communication techniques during a follow-up visit with an SP; clinician self-reported use of watchful waiting with actual low back pain patients; post-intervention rates of diagnostic imaging for other musculoskeletal pain syndromes (to test for generalization of intervention effects beyond back pain); and patient trust and satisfaction with physicians. • Discussion: This trial will determine whether standardized patient instructors can help clinicians develop skill in negotiating a watchful waiting approach with patients with acute low back pain, thereby reducing rates of low-value spinal imaging. The trial will also examine the possibility that intervention effects generalize to other diagnostic tests. • Trial registration: NCT 04255199, ClinicalTrials.gov (January 20, 2020)
Analysis of Factors of Incompliance To Breastfeeding in Hepatitis B Virus-Infected Mothers Taking Nucleos(t)ide Analogs During Pregnancy for Prevention of Mother-To-Child Transmission
Authors: Xiao Li-xin , Mo Zhi-shuo , Gan Wei-qiang , Mei Yong-Yu , Lin Chao-Shuang 
Published: January 2021

Abstract
Background: We encourage Hepatitis B virus-infected mothers to breastfeed postpartum, even when continuing pregnancy category B nucleos(t)ide analogs treatment. However, a large proportion of the Hepatitis B virus-infected mothers were not compliance to the breastfeeding recommendation. This study aimed to investigate the causes and influencing factors of incompliance to breastfeeding recommendation in Hepatitis B virus-infected mothers receiving nucleos(t)ide analogs treatment during pregnancy for preventing mother-to-child transmission.Methods: A total of 155 mothers with chronic hepatitis B receiving nucleos(t)ide analogs treatment for preventing mother-to-child transmission during the late gestational period were included and divided into the exclusive breastfeeding (n=63), mixed feeding (n=34), and artificial feeding (n=58) groups according to the feeding types postpartum. Independent variables associated with feeding types were analyzed by logistic regression analysis.Results: Compared to the breastfeeding and mixed feeding groups, the artificial feeding group had significantly higher parity, later postpartum timing of stopping nucleos(t)ide analogs treatment, and lower proportion of having knowledge of nucleos(t)ide analogs medications (all P<0.05). In addition, multivariate logistic regression analysis confirmed that higher parity, later postpartum timing of stopping nucleos(t)ide analogs treatment, and lacking knowledge of medication were independent factors associated with incompliance to breastfeeding. Conclusion: Hepatitis B virus-infected mothers with later postpartum timing of stopping nucleos(t)ide analogs treatment and less knowledge of medication were more likely to incompliance to breastfeeding recommendation. Strengthening health education may be an important method to improve compliance to breastfeeding.
Reference Values For Intracranial Pressure And Lumbar Cerebrospinal Fluid Pressure: A Systematic Review
Authors: Norager Nicolas Hernandez , Olsen Markus Harboe , Pedersen Sarah Hornshoej , Riedel Casper Schwartz , Czosnyka Marek , Juhler Marianne 
Published: January 2021

Abstract
BackgroundAlthough widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.MethodA systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals.ResultsThirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were -5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. ConclusionsThis systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.
Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) and Seasonal Influenza at Time of Hospital Admission: a Single Center Comparative Study
Authors: Sieber Pablo , Flury Domenica , Güsewell Sabine , Albrich Werner , Boggian Katia , Gardiol Céline , Schegel Matthias , Sieber Robert , Vernazza Pietro , Kohler Philipp 
Published: January 2021

Abstract
BackgroundFor the winter season 2020/2021, co-circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza viruses A/B is expected. From a clinical point of view, differentiation of these two acute respiratory illnesses is crucial for optimal patient management. We therefore aimed to detect clinical differences between Coronavirus Disease 2019 (COVID-19) and seasonal influenza patients at time of hospital admission.MethodsIn this single-center observational study, we included all consecutive patients hospitalized for COVID-19 or influenza between November 2019 and May 2020. Data were extracted from a nationwide surveillance program and from electronic health records. COVID-19 and influenza patients were compared in terms of baseline characteristics, clinical presentation and outcome. We used recursive partitioning to generate a classification tree to discriminate COVID-19 from influenza patients.ResultsWe included 96 COVID-19 and 96 influenza patients. Median age was 68 vs. 70 years (p=0.90), 72% vs. 56% (p=0.024) were males, and median Charlson Comorbidity Index (CCI) was 1 vs. 2 (p=0.027) in COVID-19 and influenza patients, respectively. Time from symptom onset to hospital admission was longer for COVID-19 (median 7 days, IQR 3-10) than for influenza patients (median 3 days, IQR 2-5, p<0.001). Other variables favoring a diagnosis of COVID-19 in the classification tree were higher systolic blood pressure, lack of productive sputum, and lack of headache. The tree classified 86/192 patients (45%) into two subsets with ≥80% of patients having influenza or COVID-19, respectively. In-hospital mortality was higher for COVID-19 patients (16% vs. 5%, p=0.018).ConclusionDiscriminating COVID-19 from influenza patients based on clinical presentation is challenging. Time from symptom onset to hospital admission is considerably longer in COVID-19 than in influenza patients and showed the strongest discriminatory power in our classification tree. Although they had fewer comorbidities, in-hospital mortality was higher for COVID-19 patients.
Sex differences in association between cognitive impairment and clinical correlates in Chinese patients with first-episode drug-naïve schizophrenia
Authors: Zhao Na , Wang Xiao Hong , Kang Chuan Yi , Zheng Yue , Yang Li Ying , Guan Tie Feng , Bai Yun Xia , Wei Ran , Hinman Hunter C , Zhang Xiangyang 
Published: January 2021

Abstract
Background
Schizophrenia is a complex mental illness with significant sex differences. Cognitive impairment is common in patients with schizophrenia, even in remission. This study was designed to examine the sex differences in the relationship between cognitive impairment and clinical correlations with first-episode drug-naïve (FEDN) schizophrenia.
Methods
93 FEDN patients (male/female = 45/48) and 160 controls (male/female = 74/86) were enrolled to compare the sex differences in cognitive functions measure by the MATRICS Consensus Cognitive Battery (MCCB). Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Scale (HAMD) were used to evaluated patients' clinical symptoms. We compared cognitive impairment with sociodemographic characteristics and measures of different genders, as well as group-by-sex interactions.
Results
Our results showed that the MCCB total and index score in FEDN were lower than in the control group, except for category fluency and social cognition. Male patients had significantly lower symbol coding, digital sequence, and verbal learning scores than female patients, and the controls showed a similar sex difference. Interestingly, we also found six indexes and MCCB total score that showed diagnosis-by-sex interactions, belonging to the speed of processing, attention, working memory, and verbal learning. The MCCB total score showed correlations with PANSS total score and education for both genders. In female patients, education showed significant positive correlations with MCCB total and all ten index scores. Multiple linear regression analysis confirmed that negative symptoms and general psychopathology of PANSS, HAMD total score, and education were independent contributors to MCCB total score. In male patients, only education was an independent contributor to MCCB total score.
Conclusions
These findings revealed significant sex differences in cognitive impairments and clinical symptoms in FEDN. These results should be considered, which will be worthy of a follow-up study of schizophrenia in the future.
High Expression of CDCA7 Predicts Poor Prognosis in Clear Cell Renal Cell Carcinoma and Its Associations With Immunity
Authors: Liu Shouyong , Wang Yi , Miao Chenkui , Xing Qianwei , Wang Zengjun 
Published: January 2021

Abstract
BackgroundCell division cycle-associated 7 (CDCA7), as a member of the cell division cycle associated family, was reported to be aberrantly expressed in both solid tumors and hematological tumors, suggesting its essential role in promoting tumorigenesis. Hence, we aimed to explore its comprehensive role of overall survival (OS) in clear cell renal cell carcinoma (ccRCC) and emphasis on immunity.MethodsThe RNA sequencing data and corresponding clinical information were downloaded from The Cancer Genome Atlas (TCGA) database. Gene set enrichment analysis (GSEA) was adopted to explore CDCA7 associated signaling pathways. Univariate and multivariate Cox regression analyses were carried out to assess independent prognostic factors. Furthermore, roles of CDCA7 in human immunity were also investigated.ResultsOur results suggested that CDCA7 was overexpressed in ccRCC and its elevated expression was related to shorter OS (P<0.01). Univariate and multivariate Cox regression analyses identified CDCA7 as an independent prognostic factor (both P<0.05). The prognostic nomogram integrating CDCA7 expression level and clinicopathologic variables was constructed to predict 1-, 3- and 5-year OS. GSEA indicated that high CDCA7 expression was related to the apoptosis pathway, cell cycle pathway, JAK-STAT pathway, NOD like receptor pathway, P53 pathway, T cell receptor pathway and toll like receptor pathway, etc. As for immunity, CDCA7 was significantly associated with tumor mutational burden (TMB), immune checkpoint molecules, tumor microenvironment and immune infiltration.ConclusionsCDCA7 could serve as an independent prognostic factor for ccRCC and it was closely related to immunity
Dynamic Predictive Scores for Cardiac Surgery-Associated Agitated Delirium: a single-center retrospective observational study
Authors: Tian Yu , Wang Yuefu , Zhao Wei , Ji Bingyang , Diao Xiaolin , Wang Chunrong , Wang Weiwei , Gao Yuchen , Wang Sudena , Zhou Chun , Zhang Qiaoni , Gao Sizhe , Xu Xinyi , Liu Jia 
Published: January 2021

Abstract
Background
Prevention, screening, and early treatment are the mainstays of postoperative delirium management. Score system is an objective and effective tool to stratify potential delirium risk for patients undergoing cardiac surgery
Methods
Patients undergoing cardiac surgery from January 1, 2012, to January 1, 2019, were enrolled in our retrospective study. The patients were divided into a derivation cohort (n = 45,744) and a validation cohort (n = 11,436). The agitated delirium (AD) predictive systems were formulated using multivariate logistic regression analysis at three time points: preoperation, ICU admittance, and 24 hours after ICU admittance.
Results
The prevalence of AD after cardiac surgery in the whole cohort was 3.6% (2,085/57,180). The dynamic scoring system included preoperative LVEF ≤ 45%, serum creatinine > 100 umol/L, emergency surgery, coronary artery disease, hemorrhage volume > 600 mL, intraoperative platelet or plasma use, and postoperative LVEF ≤ 45%. The area under the receiver operating characteristic curve (AUC) values for AD prediction of 0.68 (preoperative), 0.74 (on the day of ICU admission), and 0.75 (postoperative). The Hosmer-Lemeshow test indicated that the calibration of the preoperative prediction model was poor (P = 0.01), whereas that of the pre- and intraoperative prediction model (P = 0.49) and the pre-, intra- and postoperative prediction model (P = 0.35) was good.
Conclusions
Using perioperative data, we developed a dynamic scoring system for predicting the risk of AD following cardiac surgery. The dynamic scoring system may improve early recognition of and interventions for AD.
Predictive Value of Lactate Dehydrogenase to Albumin Ratio (LAR) in Patients With Coronavirus Disease 2019 (COVID-19)
Authors: Liu Mingqing , Zhang Luping , Zhang Yingli , Xu Xiaoming , Ma Tantan , Ni Fengming , Xu Hong , Zhang Nan 
Published: January 2021

Abstract
BackgroundCoronavirus Disease-2019 (COVID-19) is an emerging acute infectious disease that was first discovered in Wuhan, Hubei Province, China. Since then, it has quickly spread to over one hundred cities around the world. Therefore, it is crucial to identify the risk factors of in-hospital mortality and disease severity for COVID-19 patients. MethodsWe firstly proposed a biomarker ratio, lactate dehydrogenase(LDH) to albumin ratio (LAR) may be more reliable to assess the predictive value of LAR for in-hospital mortality and early identification of critical COVID-19 patients. A retrospective study was conducted including patients (≥18 years old) with laboratory-confirmed COVID-19 infection who had been discharged or had died from 1 February to 29 February, 2020. ResultsThe study included 321 patients with COVID-19. The median age of the 321 patients was 63.0 (IQR 51.0-70.0), ranging from 19 to 95 years old and 180 (56.1%) patients were male. 142 (44.2%) patients had 1 or more coexisting comorbidity. The most common symptoms on admission were fever(289[90%]) and cough(258[80.4%]). In multivariable logistic regression, only older age (OR, 1.11; 95% CI, 1.05-1.16), WBC count (OR, 1.26; 95% CI, 1.11-1.44), lymphocyte count (OR, 0.78; 95% CI, 0.62-0.99) and LAR (OR, 1.29; 95% CI, 1.18-1.40) were found to be significantly associated with in-hospital death. ROC analysis showed that LAR had a higher AUC (0.917) and the highest specificity(84.0%) and sensitivity(84.6%). Furthermore, the results showed that LAR had a higher AUC (0.931) to differentiate critical from mild patients and had a sensitivity of 87.7% and a specificity of 82.1%. Besides, LAR had an AUC (0.861) to differentiate critical from severe patients and had a sensitivity of 86.0% and a specificity of 73.8% and the role of LAR to distinguish severe from mild patients was the worst. ConclusionsTo the best of our knowledge, this study is the first for us to explore the predictive value of LAR for in-hospital mortality and disease severity. A high LAR appears to predict higher odds of mortality and differentiate critical patients from mild or severe COVID-19 patients.
Sexualized Drug Use Among Female Sex Workers From Eight Cities in China: a Cross-sectional Study
Authors: Ong Jason , Xiong Mingzhou , Tucker Joseph D. , Wang Yajie , Smith M. Kumi , Tang Weiming , Fu Hongyun , Zheng Heping , Yang Bin , Wang Cheng 
Published: January 2021

Abstract
Background There is rich literature on sexualized drug use (i.e. drug use before or during sex) for men who have sex with men but less data from female sex workers (FSW) particularly from low- and middle-income countries. We describe the sexual and reproductive health outcomes in FSW reporting sexualized drug use.Methods We conducted a cross-sectional study in eight cities from seven provinces in China (2019). We recruited FSW through community organizations working with sex workers, and included those who were age 18 years or above; exchanged sex at least once for money or goods in the past three months. Multivariable logistic regression models were used.Results In total, 1287 women participated: average age was 35.1 years (SD 10.3), 52.4% reported a monthly income over 5000 RMB ($USD 707), and 17.4% completed high school or above. Among participants, 284 (22.1%, 95%CI:19.8-24.4) reported a history of sexualized drug use. Compared to FSW who never reported a history of sexualized drug use, FSW who reported a history of sexualized drug use had greater odds of: reporting inconsistent condom use for vaginal sex (AOR 2.67, 95%CI:1.93-3.69), inconsistent condom use for oral sex (AOR 2.33, 95%CI:1.25-4.37), ever had an unintended pregnancy (AOR 1.43, 95%CI:1.04-1.96), and ever diagnosed with STIs (AOR 5.39, 95%CI:3.92-7.40).Conclusion We recommend routinely asking FSW about sexualized drug use as nearly one in five FSW reported a history of sexualized drug use and these women had an elevated risk profile compared with those who reported no sexualized drug use.
FFT-Based Numerical Method for Non-Linear Elastic Contact
Authors: Guo Fei , Wu Fan , Li Xinyong , Huang Yijie , Wang Zhuo 
Published: January 2021

Abstract
Based on FFT, a numerical method suitable for elastoplastic and hyperelastic frictionless contact is proposed in this paper, which can be used to solve 2D and 3D contact problems. The non-linear elastic contact problem is transformed to linear elastic contact considering residual deformation (or equivalent residual deformation). Numerical simulations for elastic, elastoplastic and hyperelastic contact between hemisphere and rigid plane are compared with the results of finite element method (FEM) to verify the accuracy of the numerical method. Compared with the existing elastoplastic contact numerical methods, the calculation efficiency is improved while ensuring a certain calculation accuracy (pressure error does not exceed 15% while calculation time does not exceed 10 minutes in a 64×64 grid). For hyperelastic contact, the proposed method reduces the dependence of the approximation result on load as in linear elastic approximation. Despite a certain error, the simplified numerical method shows a better approximation result than linear elastic contact approximation, which can be used for the fast solution in engineering applications. Finally, taking the sealing application as an example, the contact and leakage rate between 3D complicated rough surfaces are calculated.