bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of COVID-19 school closures on adolescent sleep duration: an uncontrolled before-after study
Authors: Lian Qiguo , Zuo Xiayun , Zhong Xiangyang , Tu Xiaowen , Zhang Jiashuai , Shu Chang , Yu Chunyan , Lou Chaohua 
Published: August 2021

Abstract
Background
The coronavirus disease 2019 (COVID-19) pandemic affected almost 1.6 billion students or more than 90% of learners globally. However, the effect of school closures during COVID-19 pandemic on adolescent sleep duration remains unclear.

Methods
We undertook a cross-sectional electronic survey in six junior and senior high schools in Shanghai, China from late June to early July 2020. We evaluated the changes of sleep duration on weekdays by comparing sleep duration hours and insufficient sleep (< 9 h for children aged 6–13 years or < 8 h for teenagers aged 14–17 years) in COVID-19 school closures and after school reopening. We also investigated possible sex differences in the changes of sleep duration.

Results
A total of 3265 students completed the survey, the mean age was 14.56 ± 1.99 years, 1567 (47.99%) were girls and 1344 (41.17%) were in grades 10–12. The overall sleep duration decreased from 8.88 h in school closures to 7.77 h after school reopening, and the change (difference: − 1.11 h; 95%CI: − 1.16, − 1.07; P < 0.001) was statistically significant. The prevalence of insufficient sleep increased sharply from 21.10 to 63.98%, and the change (ratio:3.03; 95%CI:2.84, 3.23; P < 0.001) was statistically significant. Besides, the changes were greater in girls than in boys.

Conclusion
Results of this study revealed that sleep duration was longer and percentage of sufficient sleep was higher during COVID-19 school closures in adolescent students.
Self-esteem, job insecurity, and psychological distress among Chinese nurses
Authors: Liu Yun , Yang Chunyan , Zou Guiyuan 
Published: August 2021

AbstractBackgroundMany studies investigate the variables relating to psychological distress among nurses, but little is known about the underlying mechanism(s) among job insecurity, self-esteem, and psychological distress.AimsThis cross-sectional study examines the prevalence of psychological distress among nurses and the relationships among job insecurity, self-esteem, and psychological distress; it also explores how self-esteem might mediate between job insecurity and psychological distress.MethodsQuestionnaires that assess job insecurity, self-esteem, and psychological distress were collected from 462 nurses in a tertiary hospital in Shandong Province, China.ResultsOur results show an 83.3 % prevalence rate for psychological distress among nurses. Regression analysis results show that job insecurity positively correlates with psychological distress, explaining 17.5 % of the variance in psychological distress. Mediation analysis results show that self-esteem partially mediates the effect of the two dimensions of job insecurity on psychological distress.ConclusionsPsychological distress is prevalent among Chinese nurses. Nursing administrators should take effective measures to improve self-esteem and reduce the negative impacts of job insecurity on nurses, including psychological distress.
Barriers to antigen detection and avoidance in chronic hypersensitivity pneumonitis in the United States
Authors: Aronson Kerri I. , O’Beirne Ronan , Martinez Fernando J. , Safford Monika M. 
Published: August 2021

Abstract
Background
Chronic hypersensitivity pneumonitis (CHP) is an interstitial lung disease (ILD) caused by long term exposure to an offending antigen. Antigen avoidance is associated with improved outcomes. We are unable to identify the antigen source in approximately half of patients. When an antigen is successfully identified, patients have difficulty with avoidance.

Methods
We conducted three structured group discussions with US based ILD specialists utilizing the nominal group technique (NGT). Participants listed barriers to antigen detection and avoidance in CHP. Each participant ranked what they perceived to be the top three barriers in the list in terms of importance. The master list of barriers was consolidated across the three groups into themes that were prioritized based on receiving the highest rankings by participants.

Results
Twenty-five physicians participated; 56% had experience caring for CHP patients for ≥ 16 years. Sixty barriers to antigen detection were categorized into seven themes of which the top three were: 1. unclear significance of identified exposures; 2. gaps in clinical knowledge and testing capabilities; 3. there are many unknown and undiscovered antigens. Twenty-eight barriers to antigen avoidance were categorized into five themes of which the top three were: 1. patient limitations, financial barriers and lack of resources; 2. individual patient beliefs, emotions and attachments to the antigen source; and 3. gaps in clinical knowledge and testing capabilities.

Conclusions
This study uncovered challenges at the individual patient, organizational, and societal levels and ranked them in terms of level of importance. These findings provide information to guide development and validation of multidisciplinary support and interventions geared towards antigen identification and avoidance in CHP.
High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score
Authors: Heinsen Laurits Juhl , Pararajasingam Gokulan , Andersen Thomas Rueskov , Auscher Søren , Sheta Hussam Mahmoud , Precht Helle , Lambrechtsen Jess , Egstrup Kenneth 
Published: August 2021

AbstractBackgroundHigh-risk coronary artery plaque (HRP) is associated with increased risk of acute coronary syndrome.We aimed to investigate the prevalence of HRP in asymptomatic patients with type 2 diabetes (T2D), and its relation to patient characteristics including cardiovascular risk factors, diabetes profile, and coronary artery calcium score (CACS).MethodsAsymptomatic patients with T2D and no previous coronary artery disease (CAD) were studied using coronary computed tomography angiography (CCTA) in this descriptive study. Plaques with two or more high-risk features (HRP) defined by low attenuation, positive remodeling, spotty calcification, and napkin-ring sign were considered HRP. In addition, total atheroma volume (TAV), proportions of dense calcium, fibrous, fibrous-fatty and necrotic core volumes were assessed. The CACS was obtained from non-enhanced images by the Agatston method. Cardiovascular and diabetic profiles were assessed in all patients.ResultsIn 230 patients CCTA was diagnostic and 161 HRP were detected in 86 patients (37%). Male gender (OR 4.19, 95% CI 1.99–8.87; p < 0.01), tobacco exposure in pack years (OR 1.02, 95% CI 1.00–1.03; p = 0.03), and glycated hemoglobin (HbA1c) (OR 1.04, 95% CI 1.02–1.07; p < 0.01) were independent predictors of HRP. No relationship was found to other risk factors. HRP was not associated with increased CACS, and 13 (23%) patients with zero CACS had at least one HRP.ConclusionA high prevalence of HRP was detected in this population of asymptomatic T2D. The presence of HRP was associated with a particular patient profile, but was not ruled out by the absence of coronary artery calcium. CCTA provides important information on plaque morphology, which may be used to risk stratify this high-risk population.Trial registrationThis trial was retrospectively registered at clinical trials.gov January 11, 2017 trial identifier NCT03016910.
A smartphone-based online system for fall detection with alert notifications and contextual information of real-life falls
Authors: Harari Yaar , Shawen Nicholas , Mummidisetty Chaithanya K. , Albert Mark V. , Kording Konrad P. , Jayaraman Arun 
Published: August 2021

Abstract
Background
Falls are a leading cause of accidental deaths and injuries worldwide. The risk of falling is especially high for individuals suffering from balance impairments. Retrospective surveys and studies of simulated falling in lab conditions are frequently used and are informative, but prospective information about real-life falls remains sparse. Such data are essential to address fall risks and develop fall detection and alert systems. Here we present the results of a prospective study investigating a proof-of-concept, smartphone-based, online system for fall detection and notification.

Methods
The system uses the smartphone’s accelerometer and gyroscope to monitor the participants’ motion, and falls are detected using a regularized logistic regression. Data on falls and near-fall events (i.e., stumbles) is stored in a cloud server and fall-related variables are logged onto a web portal developed for data exploration, including the event time and weather, fall probability, and the faller’s location and activity before the fall.

Results
In total, 23 individuals with an elevated risk of falling carried the phones for 2070 days in which the model classified 14,904,000 events. The system detected 27 of the 37 falls that occurred (sensitivity = 73.0 %) and resulted in one false alarm every 46 days (specificity > 99.9 %, precision = 37.5 %). 42.2 % of the events falsely classified as falls were validated as stumbles.

Conclusions
The system’s performance shows the potential of using smartphones for fall detection and notification in real-life. Apart from functioning as a practical fall monitoring instrument, this system may serve as a valuable research tool, enable future studies to scale their ability to capture fall-related data, and help researchers and clinicians to investigate real-falls.
Is there an optimal timing for surgical treatment of pediatric supracondylar humerus fractures in the first 24 hours?
Authors: Okkaoglu Mustafa Caner , Ozdemir Fırat Emin , Ozdemir Erdi , Karaduman Mert , Ates Ahmet , Altay Murat 
Published: August 2021

Abstract
Background
We aimed to determine the ideal surgical timing in the first 24 hours after admission to the hospital of pediatric supracondylar humerus fractures (SHF) that do not require emergent intervention.

Materials and Methods
Patients who underwent surgery in our institution between January 2011 and January 2019 due to pediatric Gartland type 3 SHFs were evaluated retrospectively. Open fractures, fractures associated with vascular injury and compartment syndrome, flexion type fractures were excluded. A total of 150 Gartland type 3 were included. The effect of early (<12 hours) or late (>12 hours) surgical interventions, daytime or night-time surgeries, working or non-working hour surgeries on operative parameters (operative duration and open reduction rate, reduction quality on postoperative early radiographs) were evaluated in pediatric SHFs.

Results
Early (<12 hours) or late (>12 hours), daytime or nighttime, working or non-working hour surgeries were found to be similar in Gartland type 3 patients regarding early postoperative reduction quality, duration of surgery, open reduction rate (p>0.05). Mean times passed from first admission to hospital until surgery were longer in working hour, late (>12 hours) and daytime surgery groups than non-working hour, early (<12 hours) and night-time surgery groups (p<0.001).

Conclusion
Although delaying the operation to the working hours seems to prolong the time until surgery in pediatric Gartland type 3 SHF patients who do not require emergent intervention such as open fractures, neurovascular impairment and compartment syndrome, there may not be a time interval that makes a difference for the patients if surgery is performed within the first 24 hours, thus the surgery could be scheduled according to the surgeons’ preference.
Level of Evidence: Level 3, Retrospective cohort study
Traditional growing rod for early-onset scoliosis in high-altitude regions: a retrospective study
Authors: Jiang Haijun , Hai Junrui Jonathan , Yin Peng , Su Qingjun , Zhu Shiqi , Pan Aixing , Wang Yunsheng , Hai Yong 
Published: August 2021

Abstract
Background
Children with early-onset scoliosis living in high-altitude areas have severe deformities and poor nutritional status. However, no reports on early-onset scoliosis treatment using traditional growing rods in such children exist. Thus, we analyzed the outcomes of traditional growing rods treatment in such patients and the effect of altitude on therapy.

Methods
Between September 2007 and December 2017, 59 consecutive patients with EOS underwent systematic surgical correction using traditional growing rods. They were divided into the high-altitude and low-altitude groups, and differences in surgical efficacy and complications between the groups were analyzed pre- and postoperatively. Radiographic measurements, including the Cobb angle, thoracic kyphosis, lumbar lordosis, T1–S1 and T1–T12 heights, sagittal and coronal balance, distance between C7PL and sagittal vertical axis, pelvic incidence, sacral slope, and pelvic tilt were assessed preoperatively, postoperatively, and at the last follow-up. Continuous data were analyzed using paired or independent Student’s t tests, and they were compared preoperatively, postoperatively, and at the last follow-up using a repeated measures analysis of variance. Enumerated data were analyzed using the χ2 test.

Results
The mean patient age at the initial surgery and mean follow-up duration were 8.9 ± 2.4(5–14) years and 51.91 ± 25.23 months, respectively. Altogether, 234 operations were conducted for all patients with an average interval between operations of 11.4 ± 3.0 months. The average Cobb angle was similar in both groups preoperatively and at the last follow-up, it was significantly different postoperatively. TK was significantly different in all three periods. T1–S1 and T1–T12 heights were significantly different only during the preoperative period. The overall rates of complications and implant-related complications did not differ significantly between the groups.

Conclusions
Deformity in patients with EOS in high-altitude areas was more severe, and treatment using TGRs yielded a satisfactory therapeutic effect.
Limited effects on patient outcomes of conjoint tendon release in anterolateral muscle-sparing total hip arthroplasty
Authors: Tanaka Hidetatsu , Yamada Norikazu , Kurishima Hiroaki , Mori Yu , Sakamoto Takashi , Oyama Masamizu , Aizawa Toshimi 
Published: August 2021

Abstract
Background
The anterolateral muscle-sparing total hip arthroplasty (THA) in the supine position is advantageous owing to the very low-dislocation rate and excellent leg length discrepancy control. However, femur exposure is challenging. Although the conjoined external rotators tendon (CERT) release is effective in improving femoral access, the effects on clinical outcomes remain unclear. The purpose of this study was to evaluate the clinical and radiographic results of CERT release in the anterolateral muscle-sparing THA approach.

Methods
The study was performed as a retrospective cohort study and included 85 hips in 85 patients who underwent primary anterolateral THA. Clinical and radiographic outcomes were investigated 6 months and 1 year after THA (CERT-preserved and non-released patients). The Japanese Orthopaedic Association (JOA) hip score, JOA Hip-disease Evaluation Questionnaire (JHEQ), forgotten joint score (FJS), and the 36 short-form questionnaires (SF-36 mental and physical) were evaluated. The leg length discrepancy, cup inclination and stem orientation were evaluated with radiographs.

Results
Among all the included hips, 37 patients (43.5%) retained the CERT, and 48 patients (56.5%) included the released CERT. There were no significant differences in the JOA hip scores, JHEQ, FJF-12 and SF-36 between the released and non-released groups. There were significant differences in sagittal stem alignments between groups.

Conclusion
The CERT release in anterolateral muscle-sparing THA has a limited effect on post-operative clinical outcomes. The CERT release improved the femur exposure and is more invasive than the preserved CERT. We infer that the CERT should be maintained in patients with a wide range of motions, and release the CERT in inadequate femur canal preparation cases.
The GoodHope Ehlers Danlos Syndrome Clinic: development and implementation of the first interdisciplinary program for multi-system issues in connective tissue disorders at the Toronto General Hospital
Authors: Mittal Nimish , Mina Daniel Santa , McGillis Laura , Weinrib Aliza , Slepian P. Maxwell , Rachinsky Maxim , Buryk-Iggers Stephanie , Laflamme Camille , Lopez-Hernandez Laura , Hussey Laura , Katz Joel , McLean Lianne , Rozenberg Dmitry , Liu Louis , Tse Yvonne , Parker Colleen , Adler Arnon , Charames George , Bleakney Robert , Veillette Christian , Nielson Christopher J. , Tavares Sandra , Varriano Stephanie , Guzman Juan , Faghfoury Hanna , Clarke Hance 
Published: August 2021

AbstractEhlers-Danlos Syndrome (EDS) are a heterogeneous group of genetic connective tissue disorders, and typically manifests as weak joints that subluxate/dislocate, stretchy and/or fragile skin, organ/systems dysfunction, and significant widespread pain. Historically, this syndrome has been poorly understood and often overlooked. As a result, people living with EDS had difficulty obtaining an accurate diagnosis and appropriate treatment, leading to untold personal suffering as well as ineffective health care utilization. The GoodHope EDS clinic addresses systemic gaps in the diagnosis and treatment of EDS. This paper describes a leap forward—from lack of awareness, diagnosis, and treatment—to expert care that is tailored to meet the specific needs of patients with EDS. The GoodHope EDS clinic consists of experts from various medical specialties who work together to provide comprehensive care that addresses the multi-systemic nature of the syndrome. In addition, EDS-specific self-management programs have been developed that draw on exercise science, rehabilitation, and health psychology to improve physical and psychosocial wellbeing and overall quality of life. Embedded into the program are research initiatives to shed light on the clinical presentation, underlying mechanisms of pathophysiology, and syndrome management. We also lead regular educational activities for community health care providers to increase awareness and competence in the interprofessional management of EDS beyond our doors and throughout the province and country.
Foot care practice and associated factors among patients with lymphoedema in Boreda district, Gamo zone, southern Ethiopia, 2020. Implications for elimination of podoconiosis and lymphatic filariasis
Authors: Churko Chuchu , Yohanes Tsegaye , Kassahun Alemayehu Bekele , Desalegn Nathan , Endashaw Gesila , Asfaw Mekuria Asnakew 
Published: August 2021

AbstractBackgroundLymphatic filariasis is ranked as the second leading cause of disability world‐wide. The current global programme to eliminate lymphatic filariasis is based on the interruption of transmission and the alleviation of disability and suffering.Objectiveto assess foot care practice and associated factors among lymphoedema patients in Boreda district, Gamo zone Southern Ethiopia.Methodsa community based cross sectional study was employed from December 2020 to June 2021 in Boreda district. Simple random sampling technique was used for selecting participants. Pretested structured interviewer administered questionnaire was prepared in English and translated to local language.Findingsa total of 280 lymphedema patients were involved in this study. More than half 153 (54.6%) had poor practice towards foot care practice with 95% CI (48.7, 60.4%). Patients who fetched 50 l of water or below and wore shoes at the age above 20 years were negatively associated with foot care practice, (AOR = 0.383, 95%CI: 0.155, 0.945) and (AOR = 0.261, 95%CI: 0.107, 0.63), respectively. Patients who owned only one pair and two pairs were negatively associated with foot care practice (AOR = 0.04, 95%CI: 0.009, 0.182) and (AOR = 0.27, 95%CI: 0.087, 0.85), respectively. On the other hand, attending LMMDP service and frequency of adenolymphangitis once and twice or more per month were positively associated with foot care practice (AOR = 3.339, 95%CI: 1.53, 7.285) and (AOR = 8.15, 95% CI: 3.157, 21.058) and (AOR = 9.35, 95% CI: 3.118, 28.059), respectively.Conclusionthis study indicated foot care practice among lymphedema patients in Boreda district was poor. Number of litre of water collected per day, age at which footwear first worn, number of shoes owned, attending LMMDP and frequency of adenolymphangitis were significantly associated with foot care practice. Standard foot care practice should be emphasized to control progression of lymphedema. Foot care practices like skin care, exercise and elevation, washing legs, bandaging and massaging are important factors that influence in reduction of lymphedema volume and acute attacks among people who are suffering from the diseases.
Using single-nucleus RNA-sequencing to interrogate transcriptomic profiles of archived human pancreatic islets
Authors: Basile Giorgio , Kahraman Sevim , Dirice Ercument , Pan Hui , Dreyfuss Jonathan M. , Kulkarni Rohit N. 
Published: August 2021

Abstract
Background
Human pancreatic islets are a central focus of research in metabolic studies. Transcriptomics is frequently used to interrogate alterations in cultured human islet cells using single-cell RNA-sequencing (scRNA-seq). We introduce single-nucleus RNA-sequencing (snRNA-seq) as an alternative approach for investigating transplanted human islets.

Methods
The Nuclei EZ protocol was used to obtain nuclear preparations from fresh and frozen human islet cells. Such preparations were first used to generate snRNA-seq datasets and compared to scRNA-seq output obtained from cells from the same donor. Finally, we employed snRNA-seq to obtain the transcriptomic profile of archived human islets engrafted in immunodeficient animals.

Results
We observed virtually complete concordance in identifying cell types and gene proportions as well as a strong association of global and islet cell type gene signatures between scRNA-seq and snRNA-seq applied to fresh and frozen cultured or transplanted human islet samples.

Conclusions
We propose snRNA-seq as a reliable strategy to probe transcriptomic profiles of freshly harvested or frozen sources of transplanted human islet cells especially when scRNA-seq is not ideal.