bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectories of child cognitive development during ages 0–3 in rural Western China: prevalence, risk factors and links to preschool-age cognition
Authors: Wang Lei , Chen Yifei , Sylvia Sean , Dill Sarah-Eve , Rozelle Scott 
Published: April 2021

AbstractBackgroundCognitive development after age three tends to be stable and can therefore predict cognitive skills in later childhood. However, there is evidence that cognitive development is less stable before age three. In rural China, research has found large shares of children under age three are developmentally delayed, yet little is known about the trajectories of cognitive development between 0 and 3 years of age or how developmental trajectories predict later cognitive skills. This study seeks to describe the trajectories of child cognitive development between the ages of 0–3 years and examine how different trajectories predict cognitive development at preschool age.MethodsWe collected three waves of longitudinal panel data from 1245 children in rural Western China. Child cognitive development was measured by the Bayley Scales of Infant Development when the child was 6–12 months and 22–30 months, and by the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition when the child was 49–65 months. We used the two measures of cognitive development before age three to determine the trajectories of child cognitive development.ResultsOf the children, 39% were never cognitively delayed; 13% were persistently delayed; 7% experienced improving cognitive development; and 41% experienced deteriorating development before age 3. Compared to children who had never experienced cognitive delay, children with persistent cognitive delay and those with deteriorating development before age 3 had significantly lower cognitive scores at preschool age. Children with improving development before age 3 showed similar levels of cognition at preschool age as children who had never experienced cognitive delay.ConclusionsLarge shares of children under age 3 in rural Western China show deteriorating cognitive development from infancy to toddlerhood, which predict lower levels of cognition at preschool age. Policymakers should invest in improving cognitive development before age 3 to prevent long-term poor cognition among China’s rural children.
Spinal pain in pre-adolescence and the relation with screen time and physical activity behavior
Authors: Joergensen Anne Cathrine , Strandberg-Larsen Katrine , Andersen Per Kragh , Hestbaek Lise , Andersen Anne-Marie Nybo 
Published: April 2021

Abstract
Background
To investigate how screen time and physical activity behavior were associated with spinal pain in pre-adolescence.

Methods
This study included 45,555 pre-adolescents who participated in the 11-year follow-up of the Danish National Birth Cohort. The 11-year follow-up included self-reported information on computer and TV behavior, aspects of physical activity, as well as frequency and intensity of spinal pain (neck-, mid back- and low back pain). Data were linked with parental socioeconomic data from Statistics Denmark registers. Associations were estimated using multinomial logistic regression models. To account for sample selection, we applied inverse probability weighting.

Results
Duration of screen time was stepwise associated with the degree of spinal pain. Compared with those spending < 2 h/day in front of a screen, screen time of ≥6 h/day was associated with a substantially increased relative risk ratio (RRR) of severe pain for both girls (RRR: 2.49, 95% CI: 2.13–2.92) and boys (RRR: 1.95, 95% CI: 1.65–2.32). Being physical inactive was likewise associated with higher likelihood of severe spinal pain (RRR: 1.22, 95% CI: 1.10–1.34) relative to those being moderately active. We observed that being physically active was seemingly associated with lower risk of spinal pain among boys with high frequency of screen time.

Conclusion
Findings indicate that both duration of screen time and physical inactivity are correlated with spinal pain in pre-adolescents with the strongest associations for screen time. Reducing screen time or increasing physical activity might help preventing spinal pain in pre-adolescents, particularly among high frequent screen users. Future prospective studies investigating the causal relationship are necessary.
Etiology and surgical management of pediatric acute colon perforation beyond the neonatal stage
Authors: Tan Sarah Siyin , Wang Kai , Pang Wenbo , Wu Dongyang , Peng Chunhui , Wang Zengmeng , Zhang Dan , Chen Yajun 
Published: April 2021

Abstract
Purpose
Acute colon perforation is a pediatric surgical emergency. We aimed to analyze the different etiologies and clinical characteristics of acute non-traumatic colon perforation beyond the neonatal period and to identify surgical management and outcomes.

Methods
This retrospective study included 18 patients admitted with acute colon perforation and who received surgical treatment.

Results
Age of patients ranged between 1 month and 15 years. Five patients swallowed foreign objects (two swallowed magnets), two had colon perforation secondary to a malignant tumor (both colorectal adenocarcinoma) and two were iatrogenic (one prior colonoscopy, one air enema for intussusception). There was one perforation due to chemotherapy and Amyand’s hernia respectively. The remaining seven patients had unknown etiologies; five of them were diagnosed with colitis. Fifteen (83.3 %) patients underwent open laparotomy, among which four attempted laparoscopy first. Three (16.7 %) patients underwent laparoscopic surgery. Fourteen (77.8 %) patients received simple suture repairs and four (22.2 %) received colonic resections and anastomosis. Four (22.2 %) patients received a protective diverting colostomy and three (16.7 %) received an ileostomy.

Conclusions
There is a wide range of etiology besides necrotizing enterocolitis and trauma, but a significant portion of children present with unknown etiology. Type of surgery elected should be dependent on the patient’s etiology, disease severity and experience of surgeons.
Exploring factors associated with research involvement of undergraduate students at the College of Medicine and Health Sciences, University of Rwanda
Authors: Mugabo Eric , Velin Lotta , Nduwayezu Richard 
Published: April 2021

Abstract
Background
Early involvement of students in research processes is an important step in professional development and can increase the academic output of the university. Previous studies indicate low research involvement amongst undergraduate students, however limited research has been done in sub-Saharan Africa. This study aimed to describe the level of research involvement amongst undergraduate students at the College of Medicine and Health Sciences (CMHS) at University of Rwanda (UR) and to assess factors associated with research involvement.

Methods
This cross-sectional study covered the three CMHS campuses. A survey was shared in class WhatsApp groups from July to September 2020. Data were analyzed using Stata IC 16.0 with descriptive statistics and Fisher’s exact test. P-values < 0.05 were considered statistically significant.

Results
In total, 324 students participated with the mean age being 23.3 (standard deviation 2.27). Males constituted 65.1% of respondents vs. 33.3% females. The largest portion of respondents were from the School of Medicine and Pharmacy (46.6%), and Medicine was the most frequent department (33.3%). On a Likert scale from 1 to 10, 60.0% of the respondents thought that research was 10/10 important for undergraduate students, with the mean value being 8.8. Rating their interest in taking part in research during undergraduate studies, 48.2% scored it 10/10, with the mean value being 8.57. 80.3% of respondents had attended a research module, course, or workshop; however, only 48.8% had participated in a research project and 72.0% of them had been involved in data collection. Inadequate knowledge about research processes and lack of mentors were the main barriers to research participation in 48.0 and 40.2% of respondents respectively. Establishment of a UR-Undergraduate research support center (77.2%), and involving students in ongoing UR projects (69.4%) were the most frequent suggestions to improve students’ research participation.

Conclusion
Undergraduate students at the CMHS in the UR have a large research interest, yet their involvement is currently low. Limited knowledge about research processes and shortage of mentors remains potent barriers to participation. Inviting undergraduate students to partake in ongoing projects and establishing a UR undergraduate research support center are recommended to strengthen undergraduate research experience at the UR-CMHS.
Key components influencing the sustainability of a multi-professional obstetric emergencies training programme in a middle-income setting: a qualitative study
Authors: Ghag Kiren , Bahl Rachna , Winter Cathy , Lynch Mary , Bautista Nayda , Ilagan Rogelio , Ellis Matthew , de Salis Isabel , Draycott Timothy J. 
Published: April 2021

Abstract
Background
Multi-professional obstetric emergencies training is one promising strategy to improve maternity care. Sustaining training programmes following successful implementation remains a challenge. Understanding, and incorporating, key components within the implementation process can embed interventions within healthcare systems, thereby enhancing sustainability. This study aimed to identify key components influencing sustainability of PRactical Obstetric Multi-Professional Training (PROMPT) in the Philippines, a middle-income setting.

Methods
Three hospitals were purposively sampled to represent private, public and teaching hospital settings. Two focus groups, one comprising local trainers and one comprising training participants, were conducted in each hospital using a semi-structured topic guide. Focus groups were audio recorded. Data were analysed using thematic analysis. Three researchers independently coded transcripts to ensure interpretation consistency.

Results
Three themes influencing sustainability were identified; attributes of local champions, multi-level organisational involvement and addressing organisational challenges.

Conclusions
These themes, including potential barriers to sustainability, should be considered when designing and implementing training programmes in middle-income settings. When ‘scaling-up’, local clinicians should be actively involved in selecting influential implementation champions to identify challenges and strategies specific to their organisation. Network meetings could enable shared learning and sustain enthusiasm amongst local training teams. Policy makers should be engaged early, to support funding and align training with national priorities.
Efficacy and safety of nintedanib in patients with idiopathic pulmonary fibrosis who are elderly or have comorbidities
Authors: Glaspole Ian , Bonella Francesco , Bargagli Elena , Glassberg Marilyn K. , Caro Fabian , Stansen Wibke , Quaresma Manuel , Orsatti Leticia , Bendstrup Elisabeth 
Published: April 2021

Abstract
Background
Idiopathic pulmonary fibrosis (IPF) predominantly affects individuals aged > 60 years who have several comorbidities. Nintedanib is an approved treatment for IPF, which reduces the rate of decline in forced vital capacity (FVC). We assessed the efficacy and safety of nintedanib in patients with IPF who were elderly and who had multiple comorbidities.

Methods
Data were pooled from five clinical trials in which patients were randomised to receive nintedanib 150 mg twice daily or placebo. We assessed outcomes in subgroups by age < 75 versus ≥ 75 years, by < 5 and ≥ 5 comorbidities, and by Charlson Comorbidity Index (CCI) ≤ 3 and > 3 at baseline.

Results
The data set comprised 1690 patients. Nintedanib reduced the rate of decline in FVC (mL/year) over 52 weeks versus placebo in patients aged ≥ 75 years (difference: 105.3 [95% CI 39.3, 171.2]) (n = 326) and < 75 years (difference 125.2 [90.1, 160.4]) (n = 1364) (p = 0.60 for treatment-by-time-by-subgroup interaction), in patients with < 5 comorbidities (difference: 107.9 [95% CI 65.0, 150.9]) (n = 843) and ≥ 5 comorbidities (difference 139.3 [93.8, 184.8]) (n = 847) (p = 0.41 for treatment-by-time-by-subgroup interaction) and in patients with CCI score ≤ 3 (difference: 106.4 [95% CI 70.4, 142.4]) (n = 1330) and CCI score > 3 (difference: 129.5 [57.6, 201.4]) (n = 360) (p = 0.57 for treatment-by-time-by-subgroup interaction). The adverse event profile of nintedanib was generally similar across subgroups. The proportion of patients with adverse events leading to treatment discontinuation was greater in patients aged ≥ 75 years than < 75 years in both the nintedanib (26.4% versus 16.0%) and placebo (12.2% versus 10.8%) groups. Similarly the proportion of patients with adverse events leading to treatment discontinuation was greater in patients with ≥ 5 than < 5 comorbidities (nintedanib: 20.5% versus 15.7%; placebo: 12.1% versus 10.0%).

Conclusions
Our findings suggest that the effect of nintedanib on reducing the rate of FVC decline is consistent across subgroups based on age and comorbidity burden. Proactive management of adverse events is important to reduce the impact of adverse events and help patients remain on therapy.
Trial registration: ClinicalTrials.gov NCT00514683, NCT01335464, NCT01335477, NCT02788474, NCT01979952.
Codon usage bias regulates gene expression and protein conformation in yeast expression system P. pastoris
Authors: Xu Yichun , Liu Kunshan , Han Yu , Xing Yanzi , Zhang Yuanxing , Yang Qiuying , Zhou Mian 
Published: April 2021

Abstract
Background
Protein synthesis is one of the extremely important anabolic pathways in the yeast expression system Pichia pastoris. Codon optimization is a commonly adopted strategy for improved protein expression, although unexpected failures did appear sometimes waiting for further exploration. Recently codon bias has been studied to regulate protein folding and activity in many other organisms.

Results
Here the codon bias profile of P. pastoris genome was examined first and a direct correlation between codon translation efficiency and usage frequency was identified. By manipulating the codon choices of both endogenous and heterologous signal peptides, secretion abilities of N-terminal signal peptides were shown to be tolerant towards codon changes. Then two gene candidates with different levels of structural disorder were studied, and full-length codon optimization was found to affect their expression profiles differentially. Finally, more evidences were provided to support possible protein conformation change brought by codon optimization in structurally disordered proteins.

Conclusion
Our results suggest that codon bias regulates gene expression by modulating several factors including transcription and translation efficiency, protein folding and activity. Because of sequences difference, the extent of affection may be gene specific. For some genes, special codon optimization strategy should be adopted to ensure appropriate expression and conformation.
Silencing of PSMC2 inhibits development and metastasis of prostate cancer through regulating proliferation, apoptosis and migration
Authors: Chen Qingke , Fu Lingmin , Hu Jieping , Guo Guanghua , Xie An 
Published: April 2021

Abstract
Background
Prostate cancer is the most common malignant tumor of male genitourinary system, molecular mechanism of which is still not clear. PSMC2 (proteasome 26S subunit ATPase 2) is a key member of the 19S regulatory subunit of 26S proteasome, whose relationship with prostate cancer is rarely studied.

Methods
Here, expression of PSMC2 in tumor tissues or cells of prostate cancer was detected by qPCR, western blotting and immunohistochemical analysis. The effects of PSMC2 knockdown on cell proliferation, colony formation, cell migration, cell cycle and apoptosis were assessed by Celigo cell counting assay, colony formation assay, wound-healing assay, Transwell assay and flow cytometry, respectively. The influence of PSMC2 knockdown on tumor growth in vivo was evaluated by mice xenograft models.

Results
The results demonstrated that PSMC2 was upregulated in tumor tissues of prostate cancer and its high expression was significantly associated with advanced Gleason grade and higher Gleason score. Knockdown of PSMC2 could inhibited cell proliferation, colony formation and cell migration of prostate cancer cells, while promoting cell apoptosis and cell cycle arrest. The suppression of tumor growth in vivo by PSMC2 knockdown was also showed by using mice xenograft models. Moreover, the regulation of prostate cancer by PSMC2 may be mediated by Akt/Cyclin D1/CDK6 signaling pathway.

Conclusions
Therefore, our studies suggested that PSMC2 may act as a tumor promotor in the development and progression of prostate cancer, and could be considered as a novel therapeutic target for prostate cancer treatment.
Temporal trends in physical activity levels across more than a decade – a national physical activity surveillance system among Norwegian children and adolescents
Authors: Steene-Johannessen Jostein , Anderssen Sigmund Alfred , Kolle Elin , Hansen Bjørge Herman , Bratteteig Mari , Dalhaug Emilie Mass , Andersen Lars Bo , Nystad Wenche , Ekelund Ulf , Dalene Knut Eirik 
Published: April 2021

Abstract
Background
There is a scarcity of device measured data on temporal changes in physical activity (PA) in large population-based samples. The purpose of this study is to describe gender and age-group specific temporal trends in device measured PA between 2005, 2011 and 2018 by comparing three nationally representative samples of children and adolescents.

Methods
Norwegian children and adolescents (6, 9 and 15-year-olds) were invited to participate in 2005 (only 9- and 15-year-olds), 2011 and 2018 through cluster sampling (schools primary sampling units). A combined sample of 9500 individuals participated. Physical activity was assessed by hip worn accelerometers, with PA indices including overall PA (counts per minute), moderate-to-vigorous intensity PA (MVPA), and PA guideline adherence (achieving on average ≥ 60 min/day of moderate-to-vigorous PA). Random-effects linear regressions and logistic regressions adjusted for school-level clusters were used to analyse temporal trends.

Findings
In total, 8186 of the participating children and adolescents provided valid PA data. Proportions of sufficiently active 6-year-olds were almost identical in 2011 and 2018; boys 95% (95% CI: 92, 97) and 94% (95%CI: 92, 96) and girls 86% (95% CI: 83, 90) and 86% (95% CI: 82, 90). Proportions of sufficiently active 15-year-olds in 2005 and 2018 were 52% (95% CI: 46, 59) and 55% (95% CI: 48, 62) in boys, and 48% (95% CI: 42, 55) and 44% (95% CI: 37, 51) in girls, respectively, resulting from small differences in min/day of MVPA. Among 9-year-old boys and girls, proportions of sufficiently active declined between 2005 and 2018, from 90% (95% CI: 87, 93) to 84% (95% CI: 80, 87)) and 74% (95% CI: 69, 79) to 68% (95% CI: 64, 72), respectively. This resulted from 9.7 min/day less MVPA in boys (95% CI: − 14.8, − 4.7; p < 0.001) and 3.2 min/day less MVPA (95% CI: − 7.0, 0.7; p = 0.106) in girls.

Conclusions
PA levels have been fairly stable between 2005, 2011 and 2018 in Norwegian youth. However, the declining PA level among 9-year-old boys and the low proportion of 15-year-olds sufficiently active is concerning. To evaluate the effect of, and plan for new, PA promoting strategies, it is important to ensure more frequent, systematic, device-based monitoring of population-levels of PA.
Automatic identification of myopic maculopathy related imaging features in optic disc region via machine learning methods
Authors: Du Yuchen , Chen Qiuying , Fan Ying , Zhu Jianfeng , He Jiangnan , Zou Haidong , Sun Dazhen , Xin Bowen , Feng David , Fulham Michael , Wang Xiuying , Wang Lisheng , Xu Xun 
Published: April 2021

AbstractBackgroundMyopic maculopathy (MM) is the most serious and irreversible complication of pathologic myopia, which is a major cause of visual impairment and blindness. Clinic proposed limited number of factors related to MM. To explore additional features strongly related with MM from optic disc region, we employ a machine learning based radiomics analysis method, which could explore and quantify more hidden or imperceptible MM-related features to the naked eyes and contribute to a more comprehensive understanding of MM and therefore may assist to distinguish the high-risk population in an early stage.MethodsA total of 457 eyes (313 patients) were enrolled and were divided into severe MM group and without severe MM group. Radiomics analysis was applied to depict features significantly correlated with severe MM from optic disc region. Receiver Operating Characteristic were used to evaluate these features’ performance of classifying severe MM.ResultsEight new MM-related image features were discovered from the optic disc region, which described the shapes, textural patterns and intensity distributions of optic disc region. Compared with clinically reported MM-related features, these newly discovered features exhibited better abilities on severe MM classification. And the mean values of most features were markedly changed between patients with peripapillary diffuse chorioretinal atrophy (PDCA) and macular diffuse chorioretinal atrophy (MDCA).ConclusionsMachine learning and radiomics method are useful tools for mining more MM-related features from the optic disc region, by which complex or even hidden MM-related features can be discovered and decoded. In this paper, eight new MM-related image features were found, which would be useful for further quantitative study of MM-progression. As a nontrivial byproduct, marked changes between PDCA and MDCA was discovered by both new image features and clinic features.
HIV prevention at drug shops: awareness and attitudes among shop dispensers and young women about oral pre-exposure prophylaxis and the dapivirine ring in Shinyanga, Tanzania
Authors: Tubert Julia , Packel Laura , Hunter Lauren A. , Mfaume Rashid , Njau Prosper , Ramadhani Angela A. , Liu Jenny X. , McCoy Sandra I. 
Published: April 2021

AbstractBackgroundHIV risk remains high among adolescent girls and young women (AGYW, ages 15–24) in Tanzania. Many AGYW experience stigma and provider bias at health facilities, deterring their use of HIV prevention services. Privately-owned drug shops, ubiquitous in many communities, may be an effective and accessible channel to deliver HIV prevention products to AGYW, including oral pre-exposure prophylaxis (PrEP) and the dapivirine vaginal ring.MethodsIn July–August 2019, we enrolled 26 drug shops in Shinyanga, Tanzania in an ongoing study to create “girl-friendly” drug shops where AGYW can access HIV self-testing and contraception. At baseline, all shop dispensers were given basic information about oral PrEP and the dapivirine ring and were asked about their interest in stocking each. During the next 3–5 months, we surveyed AGYW (n = 56) customers about their interest in oral PrEP and the ring.ResultsAmong dispensers, the median age was 42 years and 77% were female. Overall, 42% of dispensers had heard of a medication for HIV prevention. Almost all dispensers reported some interest in stocking oral PrEP (92%) and the dapivirine ring (96%). Most (85%) reported they would provide oral PrEP to AGYW who requested it. Among AGYW customers, the median age was 17 years; 29% of AGYW were married or had a steady partner and 18% had children. Only 20% of AGYW had heard of a medication to prevent HIV, yet 64% and 43% expressed some interest in using oral PrEP and the dapivirine ring, respectively, after receiving information about the products. PrEP interest was higher among AGYW who were partnered and had children.ConclusionsDespite low prior awareness of PrEP among shop dispensers and AGYW, we found high levels of interest in oral PrEP and the dapivirine ring in both groups. Community-based drug shops represent a promising strategy to make HIV prevention more accessible to AGYW.