bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence, burden of disease, and lost in health state utilities attributable to chronic musculoskeletal disorders and pain in Chile
Authors: Zitko Pedro , Bilbeny Norberto , Balmaceda Carlos , Abbott Tomas , Carcamo Cesar , Espinoza Manuel 
Published: May 2021

Abstract
Background
Musculoskeletal disorders are a leading cause of disability adjusted life years (DALY) in the world. We aim to describe the prevalence and to compare the DALYs and loss of health state utilities (LHSU) attributable to common musculoskeletal disorders in Chile.

Methods
We used data from the Chilean National Health Survey carried out in 2016–2017. Six musculoskeletal disorders were detected through the COPCOPRD questionnaire: chronic musculoskeletal pain, chronic low back pain, chronic shoulder pain, osteoarthritis of hip and knee, and fibromyalgia. We calculated the DALY for each disorder for 18 sex and age strata, and LHSU following an individual and population level approaches. We also calculated the fraction of LHSU attributable to pain.

Results
Chronic musculoskeletal pain disorder affects a fifth of the adult population, with a significant difference between sexes. Among specific musculoskeletal disorders highlights chronic low back pain with the highest prevalence. Musculoskeletal disorders are a significant cause of LHSU at the individual level, especially in the case of fibromyalgia. Chronic musculoskeletal pain caused 503,919 [283,940 - 815,132] DALYs in 2017, and roughly two hundred thousand LSHU at population level, which represents 9.7% [8.8–10.6] of the total LSHU occurred in that year. Discrepancy in the burden of musculoskeletal disorders was observed according to DALY or LSHU estimation. The pain and discomfort domain of LHSU accounted for around half of total LHSU in people with musculoskeletal disorders.

Conclusion
Chronic musculoskeletal pain is a major source of burden and LHSU. Fibromyalgia should deserve more attention in future studies. Using the attributable fraction offers a straightforward and flexible way to explore the burden of musculoskeletal disorders.
The association of sleep problem, dietary habits and physical activity with weight status of adolescents in Nepal
Authors: Singh Devendra Raj , Sunuwar Dev Ram , Dahal Babita , Sah Rajeeb Kumar 
Published: May 2021

Abstract
Background
Overweight/obesity among adolescents is an emerging public health issue worldwide. However, the evidence on the determinants of body weight status and lifestyle behaviors among Nepalese adolescents is limited. This study aims to explore the sleep characteristics, dietary habits, and physical activity and its association with body mass index (BMI) among Nepalese adolescents.

Methods
A cross-sectional study was conducted between July and November 2019 among 627 randomly selected adolescents from eight schools located in Kathmandu Metropolitan City, Nepal. A self-administrated structure questionnaire was used to collect the data. Anthropometric measurements (adolescent’s BMI), sleep characteristics, dietary habits, and physical activity were assessed using validated tools. Multinomial logistic regression analyses assessed the association between covariates and BMI categories. The statistical significance was considered at p-value < 0.05 and 95% confidence intervals (CIs).

Results
The overall prevalence of underweight and overweight/obesity among adolescents was 9.1% (95% CI: 7.1–11.6) and 23.7% (95% CI: 20.6–27.7) respectively. In multinomial logistic regression, adolescents who reported sleep problem compared to those with no such problem (Relative risk ratio (RRR) = 13.37, 95% CI: 7.14–25.05), adolescents who had obstructive sleep apnea (OSA) symptoms (RRR = 3.21, 95% CI:1.31–7.86), who consumed soft drink ≥1 time/day in past 1 months (RRR = 5.44, 95% CI: 2.93–10.10), consumed high-fat dietary ≥2 times/day (RRR = 2.17, 95% CI: 1.18–3.99), and had a habit of junk food consumptions (RRR = 5.71, 95% CI:2.55–12.82), adolescents who had 5–6 h/day sedentary behavior (RRR = 3.21, 95% CI: 1.14–9.09), adolescents from Terai/Madhesi castes (RRR = 2.81, 95% CI: 1.19–6.64) and adolescents whose father was employed (RRR = 2.04, 95% CI: 1.04–3.98) were at increased risk of being overweight/obesity. In contrast, adolescents aged 14–16 years had 71% lower (RRR = 0.29, 95% CI: 0.16–0.52), and adolescents who consumed less than five food groups had 45% lower (RRR = 0.55, 95% CI: 0.31–0.97) risk of being overweight/obesity compared to 12–14 years age groups and consumed more than five food groups respectively.

Conclusions
The findings of this study warrant immediate interventions to improve the lifestyle to reduce overweight/obesity among Nepalese adolescents. Creating a conducive environment, both at school and home is essential to encourage adolescents for the adoption of healthy lifestyle behaviors.
The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis
Authors: Akhtar Sohail , Nasir Jamal Abdul , Javed Amara , Saleem Mariyam , Sajjad Sundas , Khan Momna , Wadood Abdul , Saeed Khwaja 
Published: May 2021

Abstract
Background
The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis.

Methods
A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines.

Results
Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes.

Conclusions
This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended.

Trial registration
This review was registered on PROSPERO (registration number CRD42020172624).
Comparative evaluation of different molecular methods for DNA extraction from individual Teladorsagia circumcincta nematodes
Authors: Sloan S. , Jenvey C. J. , Piedrafita D. , Preston S. , Stear M. J. 
Published: May 2021

Abstract
Background
The purpose of this study was to develop a reliable DNA extraction protocol to use on individual Teladorsagia circumcincta nematode specimens to produce high quality DNA for genome sequencing and phylogenetic analysis. Pooled samples have been critical in providing the groundwork for T. circumcincta genome construction, but there is currently no standard method for extracting high-quality DNA from individual nematodes. 11 extraction kits were compared based on DNA quality, yield, and processing time.

Results
11 extraction protocols were compared, and the concentration and purity of the extracted DNA was quantified. Median DNA concentration among all methods measured on NanoDrop 2000™ ranged between 0.45–11.5 ng/μL, and on Qubit™ ranged between undetectable – 0.962 ng/μL. Median A260/280 ranged between 0.505–3.925, and median A260/230 ranged − 0.005 – 1.545. Larval exsheathment to remove the nematode cuticle negatively impacted DNA concentration and purity.

Conclusions
A Schistosoma sp. DNA extraction method was determined as most suitable for individual T. circumcincta nematode specimens due to its resulting DNA concentration, purity, and relatively fast processing time.
Efficacy of elastodontic devices in overjet and overbite reduction assessed by computer-aid evaluation
Authors: Ortu Eleonora , Pietropaoli Davide , Cova Samuele , Marci Maria Chiara , Monaco Annalisa 
Published: May 2021

Abstract
Background
This study aimed to verify the efficacy of two elastodontic devices in overjet (OJ) and overbite (OB) reduction during treatment with the Equilibrator Series II (Eptamed) and Occlus-o-Guide (Sweden & Martina) devices.

Method
Sixty patients aged 7–15 years were enrolled in the study, and were divided into test and control groups. The test group included 30 patients (14 males, 16 females; mean age, 10.66 ± 2.12 years) treated with the EQ (Equilibrator) Series II. The control group included 30 patients (15 males, 15 females; mean age, 10.76 ± 2.52 years) treated with the Occlus-o-Guide. The two groups exhibited the same orthodontic features. The orthodontic criteria were: skeletal and dental class II malocclusion (divisions 1 and 2); and the presence of OJ and OB. Evaluation of OJ and OB was performed at two timepoints: T0 (before starting therapy) and T1 (after 1 year).

Results
At T0, OJ and OB were similar for the two groups; however, at T1, both OJ and OB were significantly lower with the Eptamed device compared to the Occlus-o-Guide device (p = 0.0019).

Conclusions
Elastodontic devices improve orthodontic outcomes by aiding orthodontic patient management, diagnosis, and treatment planning, reducing the risk relapse acting on the whole organism and the rehabilitation of the tongue.
Spectral characterization, antioxidant, antimicrobial, cytotoxic, and cyclooxygenase inhibitory activities of Aloysia citriodora essential oils collected from two Palestinian regions
Authors: Jaradat Nidal , Hawash Mohammed , Abualhasan Murad N. , Qadi Mohammad , Ghanim Mustafa , Massarwy Eman , Ammar Suma Abu , Zmero Noor , Arar Mohammad , Hussein Fatima , Issa Linda , Mousa Ahmed , Zarour Abdulraziq 
Published: May 2021

Abstract
Background
Aloysia citriodora Palau (AC) is commonly known as Lemon Verbena and has been utilized as a medicinal tea in folkloric medicine for the treatment of abdominal spasm, anxiety, and fever. The present investigation aimed to identify the chemical ingredients of AC essential oil (EO) collected from two different locations in Palestine and to assess their antioxidant, antimicrobial, cytotoxic, and cyclooxygenase (COX) inhibitory effects.

Methods
Gas chromatography/mass spectroscopy (GC/MS) technique was used to identify the chemical components of the hydro-distilled EO from both regions, while DPPH, MTS, and COX assays were utilized to estimate the antioxidant, cytotoxic, and COX inhibitory activities of the EOs, respectively. Moreover, a broth microdilution assay was used to assess antimicrobial potentials against seven microbial strains.

Results
The GC/MS technique revealed the presence of 17 compounds from the AC collected from the Umm al-Fahm region and 13 compounds from the sample from the Baqa al-Gharbiyye region, while α-citral was the major component of both EOs, representing 47.62 and 43.46%, respectively. The Baqa al-Gharbiyye AC EO exerted more potent antioxidant activity than the Umm al-Fahm EO, with IC50 values of 11.74 ± 0.18 and 35.48 ± 0.14 μg/mL, respectively, while the positive control Trolox had antioxidant IC50 values of 2.45 ± 0.01 μg/mL. Interestingly, both EOs inhibited more potential activity against Methicillin-Resistant Staphylococcus aureus (MRSA) and Proteus vulgaris than Ciprofloxacin and Ampicillin antibiotics and also showed more potent antifungal activity against Candida albicans than Fluconazole. Moreover, the Baqa al-Gharbiyye AC EO had a more potent cytotoxic effect than the Umm al-Fahm EO, with IC50 values of 84.5 ± 0.24 and 33.31 ± 0.01 μg/mL, respectively, compared with Doxorubicin, which had an IC50 dose of 22.01 ± 1.4 μg/mL. The EOs from Baqa al-Gharbiyye showed potent activity against both COX-1 and COX-2 enzymes, with IC50 of 52.93 ± 0.13 and 89.31 ± 0.21 μg/mL, respectively, while the EOs from the Umm al-Fahm region showed weaker activity against these enzymes, with IC50 of 349.99 ± 0.33 and 1326.37 ± 1.13 μg/mL, respectively.

Conclusion
Both characterized EOs have a huge variety of chemical components. The Baqa al-Gharbiyye AC EO has more potent antioxidant and cytotoxic activities than the Umm al-Fahm EO, but both have potential antimicrobial activity against MRSA, P. vulgaris, and C. albicans. These results suggest the use of AC EOs as promising sources of active ingredients in the food, cosmetic, and pharmaceutical industries.
PICU Passport: Pilot study of a handheld resident curriculum
Authors: Zurca Adrian D. , Krawiec Conrad , McKeone Daniel , Solaiman Adil Z. , Smith Brandon M. , Ceneviva Gary D. 
Published: May 2021

AbstractBackgroundTo explore the impact of an educational tool designed to streamline resident learning during their pediatric intensive care (PICU) rotations.MethodsTopics and procedures were chosen for inclusion based on national requirements for pediatric residents. Residents received a PICU Passport at the beginning of their rotations. PICU faculty were provided learning objectives for each topic. Residents and faculty were surveyed before and after starting use of the Passport.ResultsTwenty-two residents pre-Passport and 38 residents post-Passport were compared. Residents were more satisfied with their educational experiences (27 % vs. 79 %;P < 0.001), more likely to report faculty targeted teaching towards knowledge gaps (5 % vs. 63 %;P < 0.001) and felt more empowered to ask faculty to discuss specific topics (27 % vs. 76 %;P = 0.002). The median number of teaching sessions increased from 3 to 10 (Z = 4.2;P < 0.001). Most residents (73 %) felt the Passport helped them keep track of their learning and identify gaps in their knowledge.ConclusionsThe PICU Passport helps residents keep track of their learning and identify gaps in their knowledge. Passport use increases resident satisfaction with education during their PICU rotation and empowers residents to ask PICU faculty to address specific knowledge gaps.
Cultures and cures: neurodiversity and brain organoids
Authors: Barnhart Andrew J. , Dierickx Kris 
Published: May 2021

Abstract
Background
Research with cerebral organoids is beginning to make significant progress in understanding the etiology of autism spectrum disorder (ASD). Brain organoid models can be grown from the cells of donors with ASD. Researchers can explore the genetic, developmental, and other factors that may give rise to the varieties of autism. Researchers could study all of these factors together with brain organoids grown from cells originating from ASD individuals. This makes brain organoids unique from other forms of ASD research. They are like a multi-tool, one with significant versatility for the scope of ASD research and clinical applications. There is hope that brain organoids could one day be used for precision medicine, like developing tailored ASD drug treatments.

Main body
Brain organoid researchers often incorporate the medical model of disability when researching the origins of ASD, especially when the research has the specific aim of potentially finding tailored clinical treatments for ASD individuals. The neurodiversity movement—a developmental disability movement and paradigm that understands autism as a form of natural human diversity—will potentially disagree with approaches or aims of cerebral organoid research on ASD. Neurodiversity advocates incorporate a social model of disability into their movement, which focuses more on the social, attitudinal, and environmental barriers rather than biophysical or psychological deficits. Therefore, a potential conflict may arise between these perspectives on how to proceed with cerebral organoid research regarding neurodevelopmental conditions, especially ASD.

Conclusions
Here, we present these perspectives and give at least three initial recommendations to achieve a more holistic and inclusive approach to cerebral organoid research on ASD. These three initial starting points can build bridges between researchers and the neurodiversity movement. First, neurodiverse individuals should be included as co-creators in both the scientific process and research communication. Second, clinicians and neurodiverse communities should have open and respectful communication. Finally, we suggest a continual reconceptualization of illness, impairment, disability, behavior, and person.
Internationally trained nurses and host nurses’ perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: a cross-sectional study
Authors: Roth Catharina , Berger Sarah , Krug Katja , Mahler Cornelia , Wensing Michel 
Published: May 2021

Abstract
Background
The shortage of qualified nurses is a problem of growing concern in many countries. Recruitment of internationally trained nurses has been used to address this shortage, but successful integration in the workplace is complex and resource intensive. For effective recruitment and retention, it is important to identify why nurses migrate and if their expectations are met to ensure their successful integration and promote a satisfying work climate for the entire nursing team. The aim of this study was to examine the perceptions of safety culture, work-life-balance, burnout and job demand of internationally trained nurses and associated host nurses in German hospitals.

Methods
A multicentric, cross-sectional study was conducted with internationally trained nurses (n = 64) and host nurses (n = 103) employed at two university hospitals in the state of Baden-Wuerttemberg, Germany. An anonymous paper-based survey was conducted between August 2019 and April 2020. The questionnaire included sociodemographic questions, questions regarding factors related to migration, and the German version of the Assessment of your work setting Safety, Communication, Operational Reliability, and Engagement (SCORE) questionnaire. SCORE is divided into three sections: Safety Culture Domains (six subscales), Work-Life-Balance (one subscale), and Engagement Assessment Tool (four subscales).

Results
Nurses who migrated to Germany were primarily seeking better working conditions, a higher standard of living, and professional development opportunities. Internationally trained nurses reported lower work-related burnout climate (Mean 55.4 (SD 22.5)) than host nurses (Mean 66.4 (SD 23.5)) but still at a moderately high degree (Safety Culture Domains). Host nurses indicated a higher workload (Mean 4.06 (SD 0.65)) (Engagement Assessment Tool) and a lower Work-Life-Balance (Mean 2.31 (SD 0.66)) (Work-Life-Balance) compared to nurses who trained abroad (Mean 3.67 (SD 0.81) and Mean 2.02 (SD 0.86), respectively). No differences were detected for the other subscales. The Safety Culture Domains and Engagement Assessment Tool showed room for improvement in both groups.

Conclusion
The study suggest that the expectations migrant nurses had prior to migration may not be met and that in turn could have a negative impact on the integration process and their retention. With increasing recruitment of internationally trained nurses from within Europe but also overseas, it is crucial to identify factors that retain migrant nurses and assist integration.

Trial registration
The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register (DRKS00017465).
Pediatric non-urgent emergency department visits and prior care-seeking at primary care
Authors: Ravi Nithin , Gitz Katherine M. , Burton Danielle R. , Ray Kristin N. 
Published: May 2021

AbstractBackgroundWe aimed to examine how caregiver perceptions of primary care affects care-seeking prior to pediatric non-urgent ED visits.MethodsWe performed a cross-sectional survey of caregivers of children presenting to a pediatric ED during weekday business hours and triaged as low acuity. We first compared caregiver sociodemographic characteristics, perceptions of primary care, and stated preference in care sites (ED vs PCP) for caregivers who had sought care from their child’s PCP office versus had not sought care from their child’s PCP office prior to their ED visit. We then examined odds of having sought care from their PCP office prior to their ED visit using multivariable logistic regression models sequentially including caregiver primary care perceptions and stated care site preferences along with caregiver sociodemographic characteristics.ResultsOf 140 respondents, 64 (46%) sought care from their child’s PCP office prior to presenting to the ED. In unadjusted analysis, children insured by Medicaid or CHIP, caregivers identifying as Black, and caregivers with lower educational attainment were less likely to have sought PCP care before presenting to the ED (p < 0.005, each). Caregivers who had sought PCP care were more likely to prefer their PCP relative to the ED in terms of ease of travel, cost, and wait times (p < 0.001, all). When including these stated preferences in a multivariable model, child insurance, caregiver race, and caregiver education were no longer significantly associated with odds of having sought PCP care prior to their ED visit.ConclusionsDifferential access to primary care may underlie observed demographic differences in non-urgent pediatric ED utilization.
Transitioning from pediatric to adult care and the HIV care continuum in Ghana: a retrospective study
Authors: Abaka Pearl , Nutor Jerry John 
Published: May 2021

Abstract
Background
In Sub-Saharan Africa, there are now a significant number of adolescents living with HIV (ALHIV), due to increased access to effective antiretroviral therapy. However, these adolescents are at high risk of dying during the transition to adult care due to various reasons, including lack of preparation for the transition and poor transition arrangements. More knowledge about this issue will lead to a better planned healthcare transition process and preparation for transition from pediatric care to adult care. The aim of this study was to explore the healthcare transitional experiences of ALHIV as they moved from pediatric to adult care.

Methods
A descriptive exploratory qualitative study was conducted. Purposive sampling method was used to recruit adolescents between 12 and 19 years old. Saturation was realized by the 10th participant. Data were analyzed using thematic content analysis.

Results
Four main themes emerged from the interview data: the transition process, factors facilitating the transition experience, challenges and coping mechanisms of the ALHIV during transition, and suggestions for improvement based on perceptions on the current transitioning approach. A key finding of this study was the sudden preparation for transition, linked to the absence of a structured transition protocol. Even though age was the main reason for transferring the participants from the pediatric to adult clinic, participants’ age did not influence whether they attended clinic appointment on their own or accompanied by a care provider; it was dependent on the availability of their parents or caregivers. Participants’ parents and adult family caregivers were also integrated into the transition process to some extent. We also found that most of the participants had good patient-provider relationship with their health care providers in both pediatric and adult clinics.

Conclusion
Findings support the need to develop a structured healthcare transition policy and age-appropriate transition within the clinic environment. There is also a need for social and community support as ALHIV transition from pediatric to adult care.