bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of factors related to behaviors associated with musculoskeletal pain among elementary students
Authors: Rezapur-Shahkolai Forouzan , Gheysvandi Elham , Karimi-Shahanjarini Akram , Tapak Leili , Heidarimoghadam Rashid , Dianat Iman 
Published: June 2021

AbstractBackgroundMusculoskeletal pains are among evident health problems in children and adolescents. Backpack carrying behaviors and the sitting postures are among behavioral factors associated with musculoskeletal pain in schoolchildren. Therefore, this study aims to identify the factors related to these important musculoskeletal behaviors, using Health Promotion Models.MethodsIn this cross-sectional study, a questionnaire was created based on PRECEDE Model and Health Belief Model and was administered to 673 Iranian students, whom were selected randomly from elementary schools of Hamadan, Iran, in 2018.ResultsThe findings of the study revealed that proper sitting postures and backpack carrying were 42 and 33%, respectively. The findings also showed that predisposing factors including perceived susceptibility (p < 0.05, β = 0.219), perceived severity (p < 0.05, β = 0.166), perceived barriers (p < 0.05, β = − 0.191), perceived self-efficacy (p < 0.05, β = 0.188) and also enabling factors (p < 0.05, β = 0.329) were significantly related to sitting behaviors. Moreover, backpack carrying behaviors had significant relationships with predisposing factors of perceived susceptibility (p < 0.05, β = 0.198), perceived barriers (p < 0.05, β = − 0.258), perceived self-efficacy (p < 0.05, β = 0.185) and reinforcing factors (p < 0.05, β = 0.208).ConclusionsIt seems necessary for future preventive programs to take factors of musculoskeletal pains among children and adolescents into account.
Teaching scripts via smartphone app facilitate resident-led teaching of medical students
Authors: Zessis Nicholas R. , Dube Amanda R. , Sadanand Arhanti , Cole Jordan J. , Hrach Christine M. , Daud Yasmeen N. 
Published: June 2021

AbstractBackgroundPrevious studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app).MethodsPrior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships.Results44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49,p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention.ConclusionsResidency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.
Heparin-binding protein in lower airway samples as a biomarker for pneumonia
Authors: Paulsson Magnus , Thelaus Louise , Riesbeck Kristian , Qvarfordt Ingemar , Smith Margaretha E. , Lindén Anders , Linder Adam 
Published: June 2021

Abstract
Objectives
Ventilator-associated pneumonia (VAP) is difficult to diagnose using clinical criteria and no biomarkers have yet been proved to be sufficiently accurate. The use of the neutrophil-derived Heparin-binding protein (HBP) as a biomarker for pneumonia was investigated in this exploratory case–control study in two intensive care units at a tertiary referral hospital.

Methods
Patients with clinical signs of pneumonia were recruited and bronchoalveolar lavage fluid (BALF) or bronchial wash (BW) samples were collected. Mechanically ventilated and lung healthy subjects were recruited as controls. HBP was measured with enzyme-linked immunosorbent assay.

Results
BALF was collected from 14 patients with pneumonia and 14 healthy controls. Median HBP in BALF pneumonia samples was 14,690 ng/ml and controls 16.2 ng/ml (p < 0.0001). BW was collected from 10 pneumonia patients and 10 mechanically ventilated controls. Median HBP in BW pneumonia was 9002 ng/ml and controls 7.6 ng/ml (p < 0.0001).

Conclusions
These data indicate that HBP concentrations is significantly higher in lower airway samples from patients with pneumonia than control subjects and is a potentially useful biomarker for diagnosis of VAP.
Gaps in evidence for the use of medically authorized cannabis: Ontario and Alberta, Canada
Authors: Lee Cerina , Round Jessica M. , Klarenbach Scott , Hanlon John G. , Hyshka Elaine , Dyck Jason R. B. , Eurich Dean T. 
Published: June 2021

Abstract
Background
With legal access to medical cannabis in Canada since 2001, there is a need to fully characterize its use at both the individual and population levels. We draw on data from Canada’s largest cohort study of medical cannabis to identify the primary reasons for medical cannabis authorization in Canada from 2014 to 2019 in two major provinces: Alberta (AB) and Ontario (ON), and review the extent that evidence supports each indication.

Methods
Self-reported baseline assessments were collected from adult patients in ON (n = 61,835) and AB (n = 3410) who were authorized medical cannabis. At baseline, sociodemographic, primary medical information, and validated clinical questionnaires were completed by patients as part of an individual assessment. Patients’ reasons for seeking medical cannabis were compared to published reviews and guidelines to assess the level of evidence supporting medical cannabis use for each condition.

Results
Medical cannabis use in both AB and ON was similar in both demographic and reason for authorization. The most common reasons for medical cannabis authorization were: (1) pain (AB = 77%, ON = 76%) primarily due to chronic musculoskeletal, arthritic, and neuropathic pain, (2) mental health concerns (AB = 32.9%, ON = 38.7%) due to anxiety and depression, and (3) sleep problems (AB = 28%, ON = 25%). More than 50 other conditions were identified as reasons for obtaining authorization.

Conclusion
In both AB and ON, the majority of reasons for medical cannabis authorization are not substantiated by clinical evidence to fully support its efficacy for long-term use. Ongoing epidemiological studies on medical cannabis on these treatments are warranted to fully outline its treatment benefits or risks.
Individual stiffness optimization of dorsal leaf spring ankle–foot orthoses in people with calf muscle weakness is superior to standard bodyweight-based recommendations
Authors: Waterval Niels F. J. , Brehm Merel-Anne , Harlaar Jaap , Nollet Frans 
Published: June 2021

Abstract
Background
In people with calf muscle weakness, the stiffness of dorsal leaf spring ankle–foot orthoses (DLS-AFO) needs to be individualized to maximize its effect on walking. Orthotic suppliers may recommend a certain stiffness based on body weight and activity level. However, it is unknown whether these recommendations are sufficient to yield the optimal stiffness for the individual. Therefore, we assessed whether the stiffness following the supplier’s recommendation of the Carbon Ankle7 (CA7) dorsal leaf matched the experimentally optimized AFO stiffness.

Methods
Thirty-four persons with calf muscle weakness were included and provided a new DLS-AFO of which the stiffness could be varied by changing the CA7® (Ottobock, Duderstadt, Germany) dorsal leaf. For five different stiffness levels, including the supplier recommended stiffness, gait biomechanics, walking energy cost and speed were assessed. Based on these measures, the individual experimentally optimal AFO stiffness was selected.

Results
In only 8 of 34 (23%) participants, the supplier recommended stiffness matched the experimentally optimized AFO stiffness, the latter being on average 1.2 ± 1.3 Nm/degree more flexible. The DLS-AFO with an experimentally optimized stiffness resulted in a significantly lower walking energy cost (− 0.21 ± 0.26 J/kg/m, p < 0.001) and a higher speed (+ 0.02 m/s, p = 0.003). Additionally, a larger ankle range of motion (+ 1.3 ± 0.3 degrees, p < 0.001) and higher ankle power (+ 0.16 ± 0.04 W/kg, p < 0.001) were found with the experimentally optimized stiffness compared to the supplier recommended stiffness.

Conclusions
In people with calf muscle weakness, current supplier’s recommendations for the CA7 stiffness level result in the provision of DLS-AFOs that are too stiff and only achieve 80% of the reduction in energy cost achieved with an individual optimized stiffness. It is recommended to experimentally optimize the CA7 stiffness in people with calf muscle weakness in order to maximize treatment outcomes.
Trial registration Nederlands Trial Register 5170. Registration date: May 7th 2015. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5170.
Detection of BCOR gene rearrangement in Ewing-like sarcoma: an important diagnostic tool
Authors: Li Lan , Zhang Ming , Chen Shaoyu , Sun Xiaoqi , Xu Hairong , Li Lina , Zhang Tingting , Huang Xiaoyuan , Ye Hongtao , Ding Yi 
Published: June 2021

Abstract
Background
BCOR-CCNB3 sarcoma (BCS) is a group of undifferentiated small round cell sarcomas harboring the BCOR gene rearrangement which shares morphology with the Ewing sarcoma family as well as other malignant round blue cell tumors, thus making them difficult to diagnose. The aim of this study was to explore the role of molecular techniques in the diagnosis of BCS.

Methods
Twenty-three cases of EWSR1 rearrangement-negative undifferentiated small round cell sarcomas (Ewing-like sarcoma) were analyzed for the presence of BCOR gene rearrangement by Fluorescence in situ hybridization (FISH) and Reverse Transcription -Polymerase Chain Reaction (RT-PCR). The clinicopathological features of the positive cases were also reviewed. Fifteen additional cases were used as negative controls.

Results
Eight cases were found with BCOR gene rearrangement by FISH and reappraised as BCS. The patients ranged in age from 8 to 20 years old, with a male predominance (M:F = 6:2). All tumors were located in the lower extremities. The tumor locations were more common in bone (n = 6) than deep soft tissue (n = 2). Histologically, 7 of 8 tumors were predominately composed of spindle or ovoid cells. The tumor cells were usually arranged in solid hypercellular sheets without a distinct architectural pattern. IHC showed expression of TLE1 (100%), CCNB3 (88%), BCOR (71%). RT-PCR for BCOR-CCNB3 fusion transcript was positive in 7 of 8 cases. Pre-operative chemotherapy resulted in eradication of tumors in 5 patients after a follow-up of 7 to 42 months.

Conclusions
Efficient diagnosis of BCOR rearranged sarcomas is achieved by the using a combination of FISH and RT-PCR assays.
Demographics, in-hospital analysis, and prevalence of 33 rare diseases with effective treatment in Shanghai
Authors: Cai Xiaoshu , Genchev Georgi Z. , He Ping , Lu Hui , Yu Guangjun 
Published: June 2021

Abstract
Background
Rare diseases are ailments which impose a heavy burden on individual patients and global society as a whole. The rare disease management landscape is not a smooth one—a rare disease is quite often hard to diagnose, treat, and investigate. In China, the country’s rapid economic rise and development has brought an increased focus on rare diseases. At present, there is a growing focus placed on the importance and public health priority of rare diseases and on improving awareness, definitions, and treatments.

Methods
In this work we utilized clinical data from the Shanghai HIE System to characterize the status of 33 rare diseases with effective treatment in Shanghai for the time period of 2013–2016.

Results and conclusion
First, we describe the total number of patients, year-to-year change in new patients with diagnosis in one of the target diseases and the distribution of gender and age for the top six (by patient number) diseases of the set of 33 rare diseases. Second, we describe the hospitalization burden in terms of in-hospital ratio, length of stay, and medical expenses during hospitalization. Finally, rare disease period prevalence is calculated for the rare diseases set.
Sirolimus in the treatment of kaposiform lymphangiomatosis
Authors: Zhou Jiangyuan , Yang Kaiying , Chen Siyuan , Ji Yi 
Published: June 2021

AbstractBackgroundKaposiform lymphangiomatosis (KLA), which is a new subtype of generalized lymphatic anomaly, is a rare disease with a poor prognosis. Currently, there is no standard treatment due to the poor understanding of KLA. Sirolimus, which is an inhibitor of mammalian target of rapamycin, has been shown to have promising potential in the treatment of complicated vascular anomalies. The aim of this study was to introduce the use of sirolimus for the treatment of KLA and to highlight the challenges of managing this refractory disease.ResultsWe reported seven patients with KLA who received sirolimus therapy in our center. Combined with previously reported cases, 58.3% achieved a partial response, 25.0% had stable disease, and 16.7% experienced disease progression. No severe sirolimus-related adverse events occurred during treatment.ConclusionsThis study suggests that sirolimus is currently an option for the treatment of KLA, and it is hoped that more specific therapies will be developed in the future. Rapid advances in basic science and clinical practice may facilitate the development of important new treatments for KLA.
Delayed diagnosis of Peutz–Jeghers syndrome due to pathological information loss or mistake in family/personal history
Authors: Jiang Yu-Liang , Xu Xiao-Dong , Li Bai-Rong , Yu En-Da , Zhao Zi-Ye , Liu Hong 
Published: June 2021

Abstract
Objective
To report Peutz–Jeghers syndrome (PJS) cases with non-definitive clues in the family or personal history and finally diagnosed through pathological examination and STK11 gene mutation test.

Clinical presentation and intervention
PJS was suspected in 3 families with tortuous medical courses. Two of them had relatives departed due to polyposis or colon cancer without pathological results, and the other one had been diagnosed as hyperplastic polyposis before. Diagnosis of PJS was confirmed by endoscopy and repeated pathological examinations, and the STK11 mutation test finally confirmed the diagnosis at genetic level, during which 3 novel mutation were detected (536C > A, 373_374insA, 454_455insGGAGAAGCGTTTCCCAGTGTGCC).

Conclusion
Early diagnosis of PJS is important and may be based on a family history with selective features among family members, and the pathological information is the key. The novel mutations also expand the STK11 variant spectrum.
Computation offloading strategy based on deep reinforcement learning for connected and autonomous vehicle in vehicular edge computing
Authors: Lin Bing , Lin Kai , Lin Changhang , Lu Yu , Huang Ziqing , Chen Xinwei 
Published: June 2021

AbstractConnected and Automated Vehicle (CAV) is a transformative technology that has great potential to improve urban traffic and driving safety. Electric Vehicle (EV) is becoming the key subject of next-generation CAVs by virtue of its advantages in energy saving. Due to the limited endurance and computing capacity of EVs, it is challenging to meet the surging demand for computing-intensive and delay-sensitive in-vehicle intelligent applications. Therefore, computation offloading has been employed to extend a single vehicle’s computing capacity. Although various offloading strategies have been proposed to achieve good computing performace in the Vehicular Edge Computing (VEC) environment, it remains challenging to jointly optimize the offloading failure rate and the total energy consumption of the offloading process. To address this challenge, in this paper, we establish a computation offloading model based on Markov Decision Process (MDP), taking into consideration task dependencies, vehicle mobility, and different computing resources for task offloading. We then design a computation offloading strategy based on deep reinforcement learning, and leverage the Deep Q-Network based on Simulated Annealing (SA-DQN) algorithm to optimize the joint objectives. Experimental results show that the proposed strategy effectively reduces the offloading failure rate and the total energy consumption for application offloading.
Body mass index, subjective body shape, and suicidal ideation among community-dwelling Korean adults
Authors: Yong Chae Eun , Kim Young Bum , Lyu Jiyoung 
Published: June 2021

Abstract
Background
Previous studies have not investigated in depth the combination of objective body weight and subjective body shape and its association with suicidal ideation among different age groups. Therefore, this study aimed to examine the abovementioned association among Korean adults, stratified by developmental stages.

Methods
We used nationally representative data from the 2017 Korean Community Health Survey, and included 222,037 participants aged 19 years or older in our study. Suicidal ideation was considered as the dependent variable (1 = yes, 0 = no). Along with body mass index (BMI) and subjective body shape measures, seven categories were created (1 = underweight-skinny, 2 = underweight-normal/fat, 3 = healthy weight-skinny, 4 = healthy weight-normal, 5 = healthy weight-fat, 6 = overweight-skinny/normal, 7 = overweight-fat). Multivariate logistic regression was conducted for each age group.

Results
Adjusted for covariates, young adults who were overweight-fat (OR = 1.18, p < .01), middle-aged adults who were underweight-skinny (OR = 1.32, p < .05), and older adults who were healthy weight-fat (OR = 1.19, p < .05) were more likely to have suicidal ideation than their healthy weight-normal counterparts.

Conclusions
The results suggest that the association between the combination of objective body weight and subjective body shape and suicidal ideation differs according to the developmental stage. Therefore, this difference should be considered when developing suicide prevention interventions based on the developmental stages.
Molecular typing, biofilm production, and detection of carbapenemase genes in multidrug-resistant Acinetobacter baumannii isolated from different infection sites using ERIC-PCR in Hamadan, west of Iran
Authors: Hazhirkamal Maryam , Zarei Omid , Movahedi Mahsa , Karami Pezhman , Shokoohizadeh Leili , Taheri Mohammad 
Published: June 2021

Abstract
Background
Acinetobacter baumannii is an opportunistic pathogen that can cause several kinds of nosocomial infections. Increasing antibiotic resistance as well as identifying genetic diversity and factors associated with pathogenicity and prevalence of this bacterium is important. The aim of this study was the investigation of molecular typing, biofilm production, and detection of carbapenemase genes in multidrug-resistant Acinetobacter baumannii isolated from different infection sites using ERIC-PCR in Iran.

Methods
Forty isolates of A. baumannii were obtained from various wards of the central hospital, in the west of Iran. Phenotypic identification and genetic diversity, biofilm production assay, and detection of Carbapenemase genes carried out.

Results
Tracheal samples 26 (61.9 %) are the most frequent isolates, and 95 % of isolates were identified as MDR. 32.5 % of all A. baumannii strains were capable to form a strong biofilm. It was founded that antimicrobial resistance patterns had a significant relationship with strong biofilm formation (P = 0.001). Most frequencies of the studied genes were in the order of VIM (81 %), SPM (45.2 %), and IMP (35.7 %) genes. The VIM gene was the most frequent in all isolates which were significant (P = 0.006). 14 different ERIC-types were observed including 7 common types and 7 unique or single types. F type is the largest common type consisting of nine isolates and B, D, and E types contain two isolates separately.

Conclusions
ERIC-PCR technique was used to genetically classify A. baumannii isolates as one of the most common microorganisms in nosocomial infections.
CSF1R inhibition rescues tau pathology and neurodegeneration in an A/T/N model with combined AD pathologies, while preserving plaque associated microglia
Authors: Lodder Chritica , Scheyltjens Isabelle , Stancu Ilie Cosmin , Botella Lucena Pablo , Gutiérrez de Ravé Manuel , Vanherle Sarah , Vanmierlo Tim , Cremers Niels , Vanrusselt Hannah , Brône Bert , Hanseeuw Bernard , Octave Jean-Noël , Bottelbergs Astrid , Movahedi Kiavash , Dewachter Ilse 
Published: June 2021

AbstractAlzheimer's disease (AD) is characterized by a sequential progression of amyloid plaques (A), neurofibrillary tangles (T) and neurodegeneration (N), constituting ATN pathology. While microglia are considered key contributors to AD pathogenesis, their contribution in the combined presence of ATN pathologies remains incompletely understood. As sensors of the brain microenvironment, microglial phenotypes and contributions are importantly defined by the pathologies in the brain, indicating the need for their analysis in preclinical models that recapitulate combined ATN pathologies, besides their role in A and T models only. Here, we report a new tau-seed model in which amyloid pathology facilitates bilateral tau propagation associated with brain atrophy, thereby recapitulating robust ATN pathology. Single-cell RNA sequencing revealed that ATN pathology exacerbated microglial activation towards disease-associated microglia states, with a significant upregulation of Apoe as compared to amyloid-only models (A). Importantly, Colony-Stimulating Factor 1 Receptor inhibition preferentially eliminated non-plaque-associated versus plaque associated microglia. The preferential depletion of non-plaque-associated microglia significantly attenuated tau pathology and neuronal atrophy, indicating their detrimental role during ATN progression. Together, our data reveal the intricacies of microglial activation and their contributions to pathology in a model that recapitulates the combined ATN pathologies of AD. Our data may provide a basis for microglia-targeting therapies selectively targeting detrimental microglial populations, while conserving protective populations.