bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Cervical Spine Injuries in The Emergency Department at The University Hospital of The West Indies, Jamaica and The Use of Clinical Decision Rules, A Retrospective Review.
Authors: Author) Olsheath Bowen (First , Walters C , Williams Eric Wilson , Graham Leohrandra , author) Jean Williams-Johnson (last 
Published: June 2021

Abstract
Background: Cervical spine injuries are myriad and ubiquitous, however the related demographic information has not been documented for the Jamaican or Caribbean population. These injuries can be life threatening and so it is important for the Emergency Physician to adhere to guidelines which direct management decisions including the need for imaging. This study therefore is an effort to report on the epidemiology of patients with cervical spine injuries presenting to the Emergency Department (ED) at the University Hospital of the West Indies (UHWI) and the use of clinical rules in the diagnosis of these injuries.This was a retrospective study. The log books from the ED at the UHWI were used to identify patients presenting with possible cervical spine injuries from January 1, 2013 to December 31, 2016. Inclusion/exclusion criteria were applied to select study patients. Demographical and clinical information was collected and evaluated.Results: 1,380 charts were identified as possible subjects. Of these, 887 charts were located and 806 (90.9%) were eligible. Ages ranged from 16 to 101 years with an average of 37.5 years. The majority of subjects were male, with a male to female ratio of 3:1. The main causes of these injuries were motor-vehicle collision (46.4%), motor-bike collision (23.8%) and fall from elevation (13.1%). Cervical spine injuries were identified in 20 (2.48%) subjects where motor-vehicle collision (45%) and motor-bike collisions (25%) were the main cause for injuries. Documentation of clinical rules applied to determine the need for radiological testing were present for 37.7% of the study population (NEXUS 36.2%, CCR 0.4% and combination 1.1%)Conclusion: The main source of injuries was due to road traffic accidents. This suggests more needs to be done regarding road safety. There is also room for improvement as it relates to the use of decision rules which may reduce the occurrence of unnecessary imaging.
Preterm-Term Birth Classification Using EMD-Based Time-Domain Features of Single-Channel Electrohysterogram Data
Authors: Janjarasjitt Suparerk 
Published: June 2021

Abstract
The preterm birth anticipation is a crucial task that can reduce the rate of preterm birth and also the complications of preterm birth. Electrohysterogram (EHG) or uterine electromyogram (EMG) data have been evidenced that they can provide an information useful for preterm birth anticipation. Four distinct time-domain features, i.e., mean absolute value, average amplitude change, difference absolute standard deviation value, and log detector, commonly applied to EMG signal processing are applied and investigated in this study. A single-channel of EHG data is decomposed into its constituent components, i.e., intrinsic mode functions, using empirical mode decomposition (EMD) before their time-domain features are extracted. The time-domain features of intrinsic mode functions of EHG data associated with preterm and term births are applied for preterm-term birth classification using support vector machine (SVM) with a radial basis function. The preterm-term classifications are validated using 10-fold cross validation. From the computational results, it is shown that the excellent preterm-term birth classification can be achieved using a single-channel of EHG data. The computational results further suggest that the best overall performance on preterm-term birth classification is obtained when thirteen (out of sixteen) EMD-based time-domain features are applied. The best accuracy, sensitivity, specificity, and F1-score achieved are, respectively, 0.9382, 0.9130, 0.9634, and 0.9366.
Comparison of Forces Applied During Inserting A Cementless Femoral Stem Versus A Test To Failure: A Pilot Trial
Authors: Wendler Toni , Schleifenbaum Stefan , Prietzel Torsten , Möbius Robert , Roth Andreas , Zajonz Dirk 
Published: June 2021

Abstract
Background

The increasing number of total hip arthroplasties (THA) and the more common use of uncemented stems are leading to an increasing incidence of intraoperative proximal femoral fractures (IPFF), making them a clinically relevant complication. When inserting the stem, the surgeon has to find a compromise between sufficient anchorage and the risk of fracture. Only a few biomechanical studies investigated forces that are necessary, or already risky, when inserting a femoral stem. Therefore, the aim of the study was to determine the forces occurring during the insertion of the stem and the forces that lead to IPFF.
Methods

Two female chemically untreated fresh-frozen human cadavers, aged 71 and 83 years and weighed 54 kg and 65 kg respectively, underwent left and right implantation of a THA stem by an experienced orthopaedic surgeon. The insertion of the stem was followed by a failure test, in which the surgeon hit the stem so hard that a fracture occurred. The forces, occurred while insertion and test to failure, were measured using an impulse hammer.
Results

The observed forces varied greatly. Over the four performed implantations, the forces ranged from 1317.7 N to 4347.5 N during insertion, and from 526.5 N to 7383.9 N during the failure test. The comparison between insertion versus failure test showed significantly higher peak forces (P < 0.001, P < 0.001, P = 0.002) in the failure test for implantations 1, 3 and 4. The comparison was not possible for implantation 2 because of a sensor error.
Conclusions

The biomechanical experiments presented in this study have shown that even with the small number of implantations, significantly higher hammering forces were required to cause a visually or acoustically perceptible IPFF than were necessary for adequate seating of the femoral stem. However, as fractures often cannot be perceived intraoperatively, it is important to advance the development of supporting systems for intraoperative use.
Unveiling of Unique Microbiome Resource Having High Antimicrobial Peptide Activity Endowed With Agriculture and Industrial Applications From Pukzing Cave
Authors: Iquebal Mir Asif , Passari Ajit Kumar , Jagannadham Jaisri , Ahmad Farzana , Leo Vincent Vineeth , Singh Garima , Jaiswal Sarika , Rai Anil , Kumar Dinesh , Singh Bhim Pratap 
Published: June 2021

Abstract
Cave ecosystems are considered as a specific niche for the presence of the endemic and extremophilic microorganism. In this study, Pukzing cave documented as the biggest cave of Mizoram, Northeast India was explored for bacterial diversity using both culture-based and culture-independent methods. Culture dependent method revealed 235 bacterial isolates using three different treatments i.e. heat, cold and normal. The highest bacterial population was recovered from heat treatment (n=97; 41.2%) followed by normal (n=79; 33.6%) and cold treatment (n=59; 25.1%) which clearly indicates the dominance of extremophiles. The antimicrobial potential of all the isolates was checked and found that 48 (20.4%) isolates showing antimicrobial ability against all tested pathogens. Phylum Actinobacteria was found to be dominant and showed antimicrobial potential. Modular biosynthetic genes like PKS type II, PKS type I and NRPS genes were detected in 37, 46 and 57 respectively. Similarly, the community-based analysis also predicted the dominance of phylum Actinobacteria using the sequencing of both hyper-variable regions (HVR) i.e. V3 and V4. Subsystem annotation using the V4 region predicted two functions associated with amino acid and its derivatives and cofactors, vitamins, prosthetic groups, pigments functions. A positive strong correlation in relative abundance at the phylum level using Spearman correlation was observed in the V4 region. We conclude that the cave environment harbors unique microbial flora and hypervariable region V4 is more informative as compared to hyper-variable region III. These six microbial pathogens i.e. Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Micrococcus luteus, Bacillus subtilis, and Candida albicans was selected for screening as they are well known for different disease cause organism in various fields such as agriculture, domestic animals and human health. Higher activity of AMP assay against these microbes indicates that cave microbial communities could be a potential source of future genomic resources.
Both E6 and E7 in HPV16 Promote the Glucose Uptake of GLUT1 in Lung Cancer Cells By Repressing NDRG2 Expression and Further Nuclear Translocation of β-Catenin
Authors: Wang Xin , Wu Ming-Zhe , Gu Na-Jin , Wang Shi-Yu , Xu Hong-Tao , Li Qing-Chang , Wu Guang-Ping 
Published: June 2021

Abstract
Background: HPV16 is the most common infection subtype, among which E6 and E7 proteins are the most common carcinogenic proteins. Our previous studies found that E6 and E7 proteins regulated the expression of GLUT1 through multiple molecular signaling pathways in lung cancer. However, whether they can regulate the glucose uptake of GLUT1 and the underlying molecular mechanism has not been identified. Methods: The modulating effects of E6 or E7, NDRG2, β-catenin, and GLUT1 were detected by double directional genetic manipulations in lung cancer cell lines; The immunofluorescence was used to detect the effect of NDRG2 on the nuclear translocation of β-catenin; The glucose uptake level of GLUT1 was observed under the confocal microscope.Results: We demonstrated for the first time that E6 and E7 had inhibitory effects of NDRG2 which further resulted in increased β-catenin expression and promoted β-catenin nuclear translocation, furthermore promoted the expression and glucose uptake of GLUT1. Therefore, we hypothesized both E6 and E7 in HPV16 promoted the expression and glucose uptake of GLUT1 through HPV-NDRG2- β-catenin-GLUT1 axis. Conclusion: Our findings confirmed the regulatory role of tumor suppressor NDRG2 in the pathogenesis of lung cancer, and we further demonstrate the detail relationships among E6 and E7, NDRG2, β-catenin, and GLUT1; which provided a novel therapeutic target for tumor treatment.
The Effect of Aerobic Exercise on Metabolic Parameters of Patients with Non-Alcoholic Fatty Liver Disease: Systematic Review and Meta-Analysis
Authors: Sadeghiyan Sajedeh , Ghafari Mahdi , Faramarzi Mohammad , Moghaddam Masoud , Baghurst Timothy 
Published: June 2021

Abstract
Many studies have investigated the effect of aerobic exercise on factors associated with non-alcoholic fatty liver disease. Aerobic exercise is an essential component in the management and treatment of non-alcoholic fatty liver disease. The aim of this study was to determine and evaluate the effect of aerobic exercise on fasting blood glucose, Insulin, Insulin resistance, Glycosylated hemoglobin (Hemoglobin A1C), Lipid profile as important indicators of non-alcoholic fatty liver disease.Methods: This research is a systematic review and meta-analysis that was conducted in 2021. For the present study, databases, ScienceDirect, PubMed, Scopus, science of Web, SID, Magiran and Google Scholar from 2010 to 2021, were searched along with keywords. After the initial screening, the full text of the articles was evaluated and the articles that met the inclusion criteria were analyzed. A total of 120 articles were reviewed, of which 16 articles met the criteria for entering the systematic review and meta-analysis. Accordingly, 710 people with fatty liver disease were divided into two groups of control and experimental group of 307 and 403 people, respectively. The mean age of the subjects in the present study was 52±10 years. The intervention effects were evaluated using the mean difference (MD) and the random effects model. Data were analyzed using effect size tests, bias analysis and heterogeneity analysis and by STATA software.Results: Meta-analysis results indicated that endurance training in general significantly reduced glucose levels (P = 0.004, SDM = -0.26, SE = 0.09), insulin (P = 0.01, SDM = -0.29, SE = 0.11), HOMA-IR (P = 0.01, SDM = -0.28, SE = 0.11), Hba1c (P = 0.001, SDM = -0.33, SE = 0.12), triglycerides (P = 0.02, SDM = -0.31, SE = 0.13) and LDL (P = 0.03, SDM = -0.21, SE = 0.1). The results of meta-analysis did not show a significant effect on HDL levels after aerobic exercise in patients with fatty liver (P = 0.97, SDM = 0, SE = 0.09).Conclusion: Endurance training improves the levels of glucose, insulin, Hba1c, Homa-IR, triglyceride, and LDL; although, there was no significant change in HDL levels due to endurance training. However, there is still a need for more and higher quality research in this area.
Impact of Infertility Duration on Female Sexual Health
Authors: Dong Meng , Xu Xiaoyan , Li Yining , Wang Yixian , Jin Zhuo , Tan Jichun 
Published: June 2021

Abstract
BackgroundAs an important source of stress, infertility may affect the quality of sexual life, with extensive studies believing that the incidence of sexual dysfunction in infertile women is highly prevalent. As the years of infertility increase, the greater this stress is likely to increase, which may aggravate psychological pain and cause sexual dysfunction. However, the effect of infertility duration on sexual health is unclear.Methods We performed a case-control study, and a total of 715 patients participated in this research between September 1, 2020, and December 25, 2020. Patients diagnosed with infertility (aged between 20 to 45 years) were included. Patients with infertility were divided into four groups according to infertility duration: ≤ 2 years (Group I, n=262), 2< infertility duration ≤5 years (Group II, n=282), 5 < infertility duration ≤8 years (Group III, n=97), and infertility duration > 8 years (Group IV, n=74). A questionnaire survey of female sexual function and psychological depression of patients with infertility was performed. The female sexual function was measured by the Female Sexual Function Index (FSFI), depression status was measured by the Patient Health Questionnaire (PHQ-9).ResultsAnalysis of the relevant factors that affect sexual function using a multivariable logistic regression model revealed that infertility duration of less than 8 years was not a risk factor for sexual dysfunction. However, when infertility duration was greater than 8 years, the incidence of sexual dysfunction (AOR=5.158,95%CI: 1.935-13.746, P=0.001) and 3 domains [arousal disorder (AOR=2.955 ,95%CI: 1.194-7.314, P=0.019, coital pain (AOR=3.811 ,95%CI: 1.045-13.897, P=0.043), and lubrication disorder (AOR=5.077 ,95%CI: 1.340-19.244, P=0.017)] increases. ConclusionsThe multivariate regression equation model reveals that the infertility duration is more than 8 years, which is a risk factor for the occurrence of sexual dysfunction. As the infertility duration increases, the incidence of female sexual dysfunction and psychological distress may increase.
Discontinuation of Azathioprine Could Be Considered in Pediatric Patients with Crohn’s Disease who Have Sustained Clinical and Deep Remission
Authors: Jeong Tae Jong , Kim Eun Sil , Kwon Yiyoung , Kim Seonwoo , Seo Sang Won , Choe Yon Ho , Kim Mi Jin 
Published: June 2021

Abstract
Few studies have demonstrated treatment strategies about the duration and cessation of medications in patients with Crohn’s disease (CD). We investigated factors affecting clinical relapse after infliximab (IFX) or azathioprine (AZA) withdrawal in pediatric patients with CD on combination therapy. Pediatric patients with moderate-to-severe CD receiving combination therapy were analyzed retrospectively and factors associated with clinical relapse were investigated. Discontinuation of IFX or AZA was performed in patients who sustained clinical remission (CR) for at least two years and achieved deep remission. A total of 75 patients were included. Forty-four patients (58.7%) continued with combination therapy and 31 patients (41.3%) discontinued AZA or IFX (AZA withdrawal 10, IFX withdrawal 15, both withdrawal 6). Cox proportional-hazards regression identified four factors associated with clinical relapse: IFX cessation (hazard ratio; HR 2.982, P=0.0081), formation of antibody-to-IFX (ATI) (HR=3.12, P=0.0373), IFX trough level (TL) (HR=0.581, P=0.003) and 6-thioguanine nucleotide (6-TGN) level (HR=0.978, P<0.001). However, AZA cessation was not associated with clinical relapse (P=0.9021). Even when applied in pediatric patients who meet stringent criteria, IFX cessation increased the relapse risk. However, withdrawal of AZA could be contemplated in pediatric patients with CD who have sustained CR for at least two years and achieved deep remission.
Anchoring Copper Single Atoms on Porous Boron Nitride Nanofiber to Boost Selective Reduction of Nitroaromatics
Authors: Liang Jianli , Song Qianqian , Wu Jianghua , Lei Qi , Huang Zhongming , Kang Tianxing , Xu Hui , Wang Peng , Zhou Xingtai , Wong Po Keung , Jiang Zhifeng , Lee Chun-Sing 
Published: June 2021

Abstract
Single atom catalysts have received widespread attention for their fascinating performance in terms of metal atom efficiency as well as their unique catalysis mechanisms comparing to conventional catalysts. Here, we prepared a high-performance catalyst of single-Cu-atom-decorated boron nitride nanofibers (BNNF-Cu) via a facile calcination method for the first time. The as-prepared catalyst shows excellent catalytic activity and good stability for converting different nitro compounds into their corresponding amines both with and without photoexcitation. By combined studies using synchrotron radiation analysis, high-resolution high-angle annular dark-field transmission electron microscopy studies and DFT calculation, dispersion and coordination of Cu atoms as well as their catalytic mechanisms are explored. The BNNF-Cu catalyst is found to have a record high turn-over frequency comparing to previously reported nonprecious-metal-based catalysts. While the performance of the BNNF-Cu catalyst is only of the middle range level among the state-of-the-art precious-metal-based catalysts, due to the much lower cost of the BNNF-Cu catalyst, its cost-efficiency is the highest among these catalysts. This work provides a new choice of support material which can promote the development of single atoms catalysts.
The Association Between Breastfeeding Duration and Language Development Survey (LDS) Score in Children Aged 18 - 35 months
Authors: Faradilah Andi , Rusyaidi Andi Musafir , Jalaluddin Syatirah , Savitri Ary I 
Published: June 2021

Abstract
Background: The World Health Organization (WHO) campaign on breastfeeding as the best source of nourishment for new-born and young children has contributed to increase public’s concern about the practice. Furthermore, several medical studies showed the benefit of breastfeeding on children’s cognitive function, including language development. However, most of the language assessment tools used in such studies had limited ability in identifying children’s language delay. Language Development Survey (LDS), as a recently developed assessment tool, is expected to provide more detailed information in the area especially related to treatment strategy purposes. This study was aimed to examine the association between breastfeeding duration and children’s LDS score. Methods: This cross-sectional study collected data from 286 breastfeeding mothers with children aged 18-35 months old. Children with delayed growth were excluded from the study. Data on breastfeeding duration (BF) and subjects’ characteristics were obtained using a questionnaire. Mother’s Body mass index (BMI) and children’s weight-for-age were measured as proxies for nutritional status. The LDS-word checklist was administered to assess children’s vocabulary and phrase development. Multiple logistic regression analysis was used to examine the association. Results: The findings revealed that 158 children (55.2%) were breastfed for more than 18 months (BF > 18 mos), 78 children (27%) for 7-18 months (BF 7-18 mos) and 50 children (17.5%) for 6 months or less (BF B 6 mos). Language delays were detected in 91 (31.8%) children (scores on LDS-vocabulary) and in 51 (35.7%) children (scores on LDS-phrase). Breastfeeding duration did not associate with the occurrence of language delay based either on LDS-vocabulary or on LDS-phrase score criteria. In comparison with BF a 6 mos, BF 7-18 mos had adjusted OR (aOR) for language delay of 0.86 (0.30 to 2.47, p 0.79) based on vocabulary score and aOR 0.8 (0.18 to 3.55, p 0.78) based on phrase score, while > 18 months had aOR of 0.57 (0.23 to 1.42, p 0.23) and aOR 0.46 (0.14 to 1.67, p 0.25), respectively. Conclusion: Breastfeeding duration was not associated with the occurrence of language delay. This observation merits further investigations on duration in each breastfeeding time and prospective studies to investigate its association with children language development.
Retrospective Analysis of Cancer-Specific Gene Expression Panel for Thyroid Fine Needle Aspiration Specimens.
Authors: Wang Yongchun , McKelvey Brittany Avin , Liu Zhiyang , Rooper Lisa , Cope Leslie M. , Zeiger Martha A. , Umbricht Christopher 
Published: June 2021

Abstract
Background: While molecular testing is a promising strategy for preoperative assessment of cytologically indeterminate thyroid nodules, thyroid fine needle aspiration biopsy (FNA) presents unique challenges for molecular assays, including contaminating peripheral blood mononuclear cells (PBMC) and variable numbers of evaluable epithelial thyroid cells. Moreover, the newly recognized entity, noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), has added an additional challenge to the currently available molecular diagnostic platforms. New diagnostic tools are still needed to correctly distinguish benign and malignant thyroid nodules preoperatively.Methods: Twenty-two transcript splice variants from 12 genes we previously identified as discriminating benign from malignant thyroid nodules were characterized in 80 frozen thyroid tumors from 8 histological subtypes. Isoforms detectable in PBMC were excluded, and the 5 most discriminating isoforms were further validated by real-time quantitative PCR (qPCR) on intraoperative FNA samples from 59 malignant tumors, 55 benign nodules, and 23 NIFTP samples. The qPCR threshold cycle values for each transcript were normalized to the thyrocyte-specific thyroid peroxidase isoform 1 (TPO1) and z-transformed. Receiver operating characteristic (ROC) analyses of the composite transcript scores were used to evaluate classification of thyroid FNAs by the 5-gene isoform expression panel.Results: A molecular signature was developed by combining expression levels of specific isoforms of CDH3, FNDC4, HMGA2, KLK7, and PLAG1. FNAs containing at least 12-36 thyrocytes were sufficient for this assay. The 5-gene composite score achieved an area under the ROC curve (AUC) of 0.86 for distinguishing malignant from benign nodules, with a specificity of 91%, sensitivity of 75%, negative predictive value of 91% and positive predictive value of 74%.Conclusion: Our newly developed 5-gene isoform expression panel distinguishes benign from malignant thyroid tumors and, may help distinguish benign from malignant thyroid nodules in the context of the new NIFTP subtype.