bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inter-examinerreliability study of physical examination procedures to assess the cervical spine
Authors: Hariharan Karthik V. , Timko Michael G. , Bise Christopher G. , Sundaram Meenakshi , Schneider Michael J. 
Published: June 2021

Abstract
Objective
The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine.

Materials:
Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure.

Results
When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test.

Conclusions
Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.
Reasonable suspicion in reporting child maltreatment: a survey among German healthcare professionals
Authors: Berthold Oliver , Jud Andreas , Jarczok Marion , Fegert Jörg M. , Clemens Vera 
Published: June 2021

Abstract
Background
With regular contacts to the general child population, healthcare professionals could play an important role in the detection of child maltreatment. However, a majority of child maltreatment cases go unnoticed by the healthcare system. Child protection legislations usually offer terms like “reasonable suspicion” to corner a threshold that warrants reporting to child protection services (CPS) is defined as. The indistinct legal terminology leads to marked differences in the interpretation of this threshold. Therefore, we aimed to systematically assess the understanding of reasonable suspicion and subsequent handling of cases in the German context.

Methods
A cross-sectional online survey was conducted among 2485 physicians and psychotherapists working with children and adolescents. Field access was gained by German professional associations. Via case vignettes, predictors of thresholds for reporting were assessed.

Results
The probability of a report to CPS increased positively with the degree of suspicion for maltreatment. However, even if participants were certain that child maltreatment occurred, 20% did not chose to report to CPS. Training in child protection lowered the professionals’ threshold for reasonable suspicion; experience with child protection cases and good knowledge of the legal framework increased the likelihood to report an alleged situation of child maltreatment to CPS.

Conclusion
Our data show that a significant proportion of health care professionals are uncertain about estimating reasonable suspicion and on how to proceed when there are strong indications for child maltreatment Therefore, data point towards the relevance of training in child protection among healthcare professionals in order to improve detection and adequate handling of cases of child maltreatment.
Landscape and selection of vaccine epitopes in SARS-CoV-2
Authors: Smith Christof C. , Olsen Kelly S. , Gentry Kaylee M. , Sambade Maria , Beck Wolfgang , Garness Jason , Entwistle Sarah , Willis Caryn , Vensko Steven , Woods Allison , Fini Misha , Carpenter Brandon , Routh Eric , Kodysh Julia , O’Donnell Timothy , Haber Carsten , Heiss Kirsten , Stadler Volker , Garrison Erik , Sandor Adam M. , Ting Jenny P. Y. , Weiss Jared , Krajewski Krzysztof , Grant Oliver C. , Woods Robert J. , Heise Mark , Vincent Benjamin G. , Rubinsteyn Alex 
Published: June 2021

AbstractBackgroundEarly in the pandemic, we designed a SARS-CoV-2 peptide vaccine containing epitope regions optimized for concurrent B cell, CD4+T cell, and CD8+T cell stimulation. The rationale for this design was to drive both humoral and cellular immunity with high specificity while avoiding undesired effects such as antibody-dependent enhancement (ADE).MethodsWe explored the set of computationally predicted SARS-CoV-2 HLA-I and HLA-II ligands, examining protein source, concurrent human/murine coverage, and population coverage. Beyond MHC affinity, T cell vaccine candidates were further refined by predicted immunogenicity, sequence conservation, source protein abundance, and coverage of high frequency HLA alleles. B cell epitope regions were chosen from linear epitope mapping studies of convalescent patient serum, followed by filtering for surface accessibility, sequence conservation, spatial localization near functional domains of the spike glycoprotein, and avoidance of glycosylation sites.ResultsFrom 58 initial candidates, three B cell epitope regions were identified. From 3730 (MHC-I) and 5045 (MHC-II) candidate ligands, 292 CD8+and 284 CD4+T cell epitopes were identified. By combining these B cell and T cell analyses, as well as a manufacturability heuristic, we proposed a set of 22 SARS-CoV-2 vaccine peptides for use in subsequent murine studies. We curated a dataset of ~ 1000 observed T cell epitopes from convalescent COVID-19 patients across eight studies, showing 8/15 recurrent epitope regions to overlap with at least one of our candidate peptides. Of the 22 candidate vaccine peptides, 16 (n = 10 T cell epitope optimized; n = 6 B cell epitope optimized) were manually selected to decrease their degree of sequence overlap and then synthesized. The immunogenicity of the synthesized vaccine peptides was validated using ELISpot and ELISA following murine vaccination. Strong T cell responses were observed in 7/10 T cell epitope optimized peptides following vaccination. Humoral responses were deficient, likely due to the unrestricted conformational space inhabited by linear vaccine peptides.ConclusionsOverall, we find our selection process and vaccine formulation to be appropriate for identifying T cell epitopes and eliciting T cell responses against those epitopes. Further studies are needed to optimize prediction and induction of B cell responses, as well as study the protective capacity of predicted T and B cell epitopes.
Prevalence and risk factors of hemodynamic instability associated with preload-dependence during continuous renal replacement therapy in a prospective observational cohort of critically ill patients
Authors: Chazot Guillaume , Bitker Laurent , Mezidi Mehdi , Chebib Nader , Chabert Paul , Chauvelot Louis , Folliet Laure , David Guillaume , Provoost Judith , Yonis Hodane , Richard Jean-Christophe 
Published: June 2021

Abstract
Background
Hemodynamic instability is a frequent complication of continuous renal replacement therapy (CRRT). Postural tests (i.e., passive leg raising in the supine position or Trendelenburg maneuver in the prone position) combined with measurement of cardiac output are highly reliable to identify preload-dependence and may provide new insights into the mechanisms involved in hemodynamic instability related to CRRT (HIRRT). We aimed to assess the prevalence and risk factors of HIRRT associated with preload-dependence in ICU patients.
We conducted a single-center prospective observational cohort study in ICU patients with acute kidney injury KDIGO 3, started on CRRT in the last 24 h, and monitored with a PiCCO® device. The primary endpoint was the rate of HIRRT episodes associated with preload-dependence during the first 7 days after inclusion. HIRRT was defined as the occurrence of a mean arterial pressure below 65 mmHg requiring therapeutic intervention. Preload-dependence was assessed by postural tests every 4 h, and during each HIRRT episode. Data are expressed in median [1st quartile–3rd quartile], unless stated otherwise.

Results
42 patients (62% male, age 69 [59–77] year, SAPS-2 65 [49–76]) were included 6 [1–16] h after CRRT initiation and studied continuously for 121 [60–147] h. A median of 5 [3–8] HIRRT episodes occurred per patient, for a pooled total of 243 episodes. 131 episodes (54% [CI95% 48–60%]) were associated with preload-dependence, 108 (44%, [CI95% 38–51%]) without preload-dependence, and 4 were unclassified. Multivariate analysis (using variables collected prior to HIRRT) identified the following variables as risk factors for the occurrence of HIRRT associated with preload-dependence: preload-dependence before HIRRT [odds ratio (OR) = 3.82, p < 0.001], delay since last HIRRT episode > 8 h (OR = 0.56, p < 0.05), lactate (OR = 1.21 per 1-mmol L−1 increase, p < 0.05), cardiac index (OR = 0.47 per 1-L min−1 m−2 increase, p < 0.001) and SOFA at ICU admission (OR = 0.91 per 1-point increase, p < 0.001). None of the CRRT settings was identified as risk factor for HIRRT.

Conclusions
In this single-center study, HIRRT associated with preload-dependence was slightly more frequent than HIRRT without preload-dependence in ICU patients undergoing CRRT. Testing for preload-dependence could help avoiding unnecessary decrease of fluid removal in preload-independent HIRRT during CRRT.
Surgery school—who, what, when, and how: results of a national survey of multidisciplinary teams delivering group preoperative education
Authors: Fecher-Jones I. , Grimmett C. , Carter F. J. , Conway D. H. , Levett D. Z. H. , Moore J. A. 
Published: June 2021

Abstract
Background
Group education is increasing in popularity as a means of preparing patients for surgery. In recent years, these ‘surgery schools’ have evolved from primarily informing patients of what to expect before and after surgery, to providing support and encouragement for patients to ‘prehabilitate’ prior to surgery, through improving physical fitness, nutrition and emotional wellbeing.

Method
A survey aimed at clinicians delivering surgery schools was employed to capture a national overview of activity to establish research and practice priorities in this area. The survey was circulated online via the Enhanced Recovery after Surgery UK Society and the Centre for Perioperative Care mailing lists as well as social media.

Results
There were 80 responses describing 28 active and 4 planned surgery schools across the UK and Ireland. Schools were designed and delivered by multidisciplinary teams, contained broadly similar content and were well attended. Most were funded by the National Health Service. The majority included aspects of prehabilitation most commonly the importance of physical fitness. Seventy five percent of teams collected patient outcome data, but less than half collected data to establish the clinical effectiveness of the school. Few describe explicit inclusion of evidence-based behavior change techniques, but collaboration and partnerships with community teams, gyms and local charities were considered important in supporting patients to make changes in health behaviors prior to surgery.

Conclusion
It is recommended that teams work with patients when designing surgery schools and use evidence-based behavior change frameworks and techniques to inform their content. There is a need for high-quality research studies to determine the clinical effectiveness of this type of education intervention.
Effects of supplements differing in fatty acid profile to late gestational beef cows on cow performance, calf growth performance, and mRNA expression of genes associated with myogenesis and adipogenesis
Authors: Shao Taoqi , Ireland Frank A. , McCann Joshua C. , Shike Daniel W. 
Published: June 2021

Abstract
Background
Maternal nutrition during gestation affects fetal development, which has long-term programming effects on offspring postnatal growth performance. With a critical role in protein and lipid metabolism, essential fatty acids can influence the development of muscle and adipose tissue. The experiment investigated the effects of late gestation supplements (77 d prepartum), either rich in saturated and monounsaturated fatty acids (CON; 155 g/cow/d EnerGII) or polyunsaturated fatty acids (PUFA; 80 g/cow/d Strata and 80 g/cow/d Prequel), on cow performance and subsequent calf growth performance as well as mRNA expression in longissimus muscle (LM) and subcutaneous adipose tissue at birth and weaning.

Results
There was no difference (P ≥ 0.34) in cow body weight (BW) or body condition score from pre-supplementation through weaning. Relative concentrations of C18:3n-3 and C20:4n-6 decreased (P ≤ 0.05) to a greater extent from mid-supplementation to calving for PUFA compared with CON cows. Cow plasma C20:0, C20:5n-3, and C22:6n-3 were increased (P ≤ 0.01) in PUFA during supplementation period. At birth, PUFA steers had greater (P = 0.01) plasma C20:5n-3. No differences (P ≥ 0.33) were detected in steer birth BW or dam milk production, however, CON steers tended (P = 0.06) to have greater pre-weaning average daily gain and had greater (P = 0.05) weaning BW compared with PUFA. For mRNA expression in steers: MYH7 and C/EBPβ in LM increased (P ≤ 0.04) to a greater extent from birth to weaning for PUFA compared with CON; MYF5 in LM and C/EBPβ in adipose tissue tended (P ≤ 0.08) to decrease more from birth to weaning for CON compared with PUFA; SCD in PUFA adipose tissue tended (P = 0.08) to decrease to a greater extent from birth to weaning than CON. In addition, maternal PUFA supplementation tended (P = 0.08) to decrease MYOG mRNA expression in LM and decreased (P = 0.02) ZFP423 in adipose tissue during the pre-weaning stage.

Conclusions
Late gestation PUFA supplementation decreased pre-weaning growth performance of the subsequent steer progeny compared with CON supplementation, which could have been a result of downregulated mRNA expression of myogenic genes during pre-weaning period.
Apply machine learning techniques to detect malicious network traffic in cloud computing
Authors: Alshammari Amirah , Aldribi Abdulaziz 
Published: June 2021

AbstractComputer networks target several kinds of attacks every hour and day; they evolved to make significant risks. They pass new attacks and trends; these attacks target every open port available on the network. Several tools are designed for this purpose, such as mapping networks and vulnerabilities scanning. Recently, machine learning (ML) is a widespread technique offered to feed the Intrusion Detection System (IDS) to detect malicious network traffic. The core of ML models’ detection efficiency relies on the dataset’s quality to train the model. This research proposes a detection framework with an ML model for feeding IDS to detect network traffic anomalies. This detection model uses a dataset constructed from malicious and normal traffic. This research’s significant challenges are the extracted features used to train the ML model about various attacks to distinguish whether it is an anomaly or regular traffic. The dataset ISOT-CID network traffic part uses for the training ML model. We added some significant column features, and we approved that feature supports the ML model in the training phase. The ISOT-CID dataset traffic part contains two types of features, the first extracted from network traffic flow, and the others computed in specific interval time. We also presented a novel column feature added to the dataset and approved that it increases the detection quality. This feature is depending on the rambling packet payload length in the traffic flow. Our presented results and experiment produced by this research are significant and encourage other researchers and us to expand the work as future work.
Examining engineering students’ participation in entrepreneurship education programs: implications for practice
Authors: Shekhar Prateek , Huang-Saad Aileen 
Published: June 2021

Abstract
Background
Recent research has demonstrated the importance of entrepreneurship education programs (EEPs) in the professional development of engineering students. Numerous universities have adopted various forms of EEPs which are typically offered as elective programs. To create suitable programs that will encourage students to seek out EEPs, it is critical to understand the factors that influence student participation in EEPs. Using qualitative research methods, we examined the question “What influences engineering students’ participation in entrepreneurship education programs?” The purpose of our work is to identify and understand the factors impacting engineering student participation in EEPs.

Results
Analysis of 20 semi-structured interviews of undergraduate engineering students was conducted using the first and second cycle coding methods to determine key factors that inform students’ participation in EEPs. We found that student decisions to participate in EEPs are influenced by several factors: entrepreneurial self-efficacy, entrepreneurial intent, attitude, subjective norm, goals, academic transitions, information and resources, social capital, opportunities and challenges, and past participation in EEPs.

Conclusions
Findings demonstrate that students’ non-compulsory participation is not a result of a single act, but is regulated by multiple factors. Explication of these factors using our qualitative results provides actionable guidance for EEPs to encourage engineering students’ participation and offers directions for future research.
Automation of 3D average human body shape modeling using Rhino and Grasshopper Algorithm
Authors: Lee Kyu Sun , Song Hwa Kyung 
Published: June 2021

AbstractThe aim of this study is to develop an automated process for modeling average 3D human body according to body types using both NUBRS-based modeling software Rhinoceros 3D® (Rhino) and Grasshopper as an algorithm editor. First, we categorized men aged 36 to 55 years included in SizeUSA 3D data into the three body types (normal, overweight, and obese), and selected seven samples in each body type. To execute the automated process of generating an average 3D model of their lower bodies in a step-by-step manner, the following procedures were performed: (1) Determine the main reference lines on the 3D-scanned lower bodies, including six horizontal reference lines and six vertical reference lines; (2) Create horizontal and vertical line grids and intersection points (3) Generate an average 3D model in a position that corresponds to the average coordinates of the intersection points (vertex coordinates) of seven samples for each body type. A Grasshopper algorithm was formulated to automatically execute all procedures that had to be repeatedly performed. As a way to verify the average model’s size and shape, the girth measurements of the samples for each body type were averaged, and the results were compared with those of the 3D average body shape. It was found that the deviation was less than 1 cm, which indicates the validity of the 3D modeling approach applied in the present study. Each process was incorporated into commands available in the Rhino interface, and this automation allowed a number of 3D body shape modeling operations to be implemented in a significantly reduced time period.
Editors-in-chief perceptions of patients as (co) authors on publications and the acceptability of ICMJE authorship criteria: a cross-sectional survey
Authors: Cobey Kelly D. , Monfaredi Zarah , Poole Evelyn , Proulx Laurie , Fergusson Dean , Moher David 
Published: June 2021

Abstract
Background
Access to, and awareness of, appropriate authorship criteria is an important right for patient partners. Our objective was to measure medical journal Editors-in-Chief’ perceptions of including patients as (co-)authors on research publications and to measure their views on the application of the ICMJE (International Committee of Medical Journals Editors) authorship criteria to patient partners.

Methods
We conducted a cross-sectional survey co-developed with a patient partner. Editors-in-Chief of English-language medical journals were identified via a random sample of journals obtained from the Scopus source list. The key outcome measures were whether Editors-in-Chief believed: 1) patient partners should be (co-)authors and; 2) whether they felt the ICMJE criteria for authorship required modification for use with patient partners. We also measured Editors-in-Chief description of how their journal’s operations incorporate patient partner perspectives.

Results
One hundred twelve Editors-in-Chief responded to our survey (18.7% response rate; 66.69% male). Participants were able to skip any questions they did not want to answer, so there is missing data for some items. 69.2% (N = 74) of Editors-in-Chief indicated it was acceptable for patient partners to be authors or co-authors on published biomedical research articles, with the remaining 30.8% (N = 33) indicating this would not be appropriate. When asked specifically about the ICMJE authorship criteria, and whether this should be revised to be more inclusive of patient partners, 35.8% (N = 39) indicated it should be revised, 35.8% (N = 39) indicated it should not be revised, and 28.4% (N = 31) were unsure about a revision. 74.1% (N = 80) of Editors-in-Chief did not think patients should be required to have an academic affiliation to published while 16.7% (N = 18) and 9.3% (N = 10) indicated they should or were unsure. 3.6% (N = 4) of Editors-in-Chief indicated their journal had a policy that specifies how patients or patient partners should be considered as authors.

Conclusions
Our findings highlight gaps that may act as barriers to patient partner participation in research. A key implication is the need for education and for consensus building within the biomedical community to establish processes that will facilitate equitable patient partners inclusion.