bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females
Authors: Szilagyi Ingrid A , Waarsing Jan H , Schiphof Dieuwke , van Meurs Joyce B J , Bierma-Zeinstra Sita M A 
Published: April 2021

Abstract

Objectives
The aim of this study was to identify sex-specific prevalence and strength of risk factors for the incidence of radiographic knee OA (incRKOA).

Methods
Our study population consisted of 10 958 Rotterdam Study participants free of knee OA in one or both knees at baseline. One thousand and sixty-four participants developed RKOA after a median follow-up time of 9.6 years. We estimated the association between each available risk factor and incRKOA using sex stratified multivariate regression models with generalized estimating equations. Subsequently, we statistically tested sex differences between risk estimates and calculated the population attributable fractions (PAFs) for modifiable risk factors.

Results
The prevalence of the investigated risk factors was, in general, higher in women compared with men, except that alcohol intake and smoking were higher in men and high BMI showed equal prevalence. We found significantly different risk estimates between men and women: high level of physical activity [relative risk (RR) 1.76 (95% CI: 1.29–2.40)] or a Kellgren and Lawrence score 1 at baseline [RR 5.48 (95% CI: 4.51–6.65)] was higher in men. Among borderline significantly different risk estimates was BMI ≥27, associated with higher risk for incRKOA in women [RR 2.00 (95% CI: 1.74–2.31)]. The PAF for higher BMI was 25.6% in women and 19.3% in men.

Conclusion
We found sex-specific differences in both presence and relative risk of several risk factors for incRKOA. Especially BMI, a modifiable risk factor, impacts women more strongly than men. These risk factors can be used in the development of personalized prevention strategies and in building sex-specific prediction tools to identify high risk profile patients.
Distinct morpho-physiological and biochemical features of arid and hyper-arid ecotypes of Ziziphus nummularia under drought suggest its higher tolerance compared with semi-arid ecotype
Authors: Sivalingam P N , Mahajan Mahesh M , Satheesh Viswanathan , Chauhan Sarita , Changal Harish , Gurjar Karun , Singh Dhurendra , Bhan Chander , Sivalingam Anandhan , Marathe Ashish , Ram Chet , Dokka Narasimham , More T A , Padaria J C , Bhat K V , Mohapatra T 
Published: April 2021

Abstract
Tree species in the arid and semi-arid regions use various strategies to combat drought stress. Ziziphus nummularia (Burm. f.) Wight et Arn., native to the Thar Desert in India, is highly drought-tolerant. To identify the most drought-tolerant ecotype of Z. nummularia, one ecotype each from semi-arid (Godhra, annual rainfall &gt;750 mm), arid (Bikaner, 250–350 mm) and hyper-arid (Jaisalmer, &lt;150 mm) regions was selected along with two other Ziziphus species, Ziziphus mauritiana Lamk. and Ziziphus rotundifolia Lamk., and screened for parameters contributing to drought tolerance. Among these, Z. nummularia (Jaisalmer) (CIAHZN-J) was the most drought - tolerant. The tolerance nature of CIAHZN-J was associated with increased membrane stability, root length and number, length of hairs and thorns, root dry/fresh weight ratio, seed germination (at −0.5 MPa), proline content (31-fold), catalase and sugar content (two- to three-fold). Apart from these characteristics, it also exhibited the longest duration to reach highest cumulative drought stress rating, maintained higher relative water content for a longer period of time with reduced leaf size, leaf rolling and falling of older leaves, and displayed sustained shoot growth during drought stress. To determine drought tolerance in Ziziphus, we developed a morphological symptom-based screening technique in this study. Additionally, transcriptome profiling of CIAHZN-J in response to drought revealed the up-regulation of genes involved in sugar metabolism and transport, abscisic acid biosynthesis, osmoregulation, reactive oxygen species homeostasis and maintaining water potential. Expression profiles and semi-quantitative reverse transcription PCR results further correlated with the physiological and biochemical mechanisms. In conclusion, CIAHZN-J is an excellent genetic stock for the identification of drought-responsive genes and can also be deployed in crop improvement programs for drought tolerance.
Evolution of nuptial-gift-related male prosomal structures: taxonomic revision and cladistic analysis of the genus Oedothorax (Araneae: Linyphiidae: Erigoninae)
Authors: Lin Shou-Wang , Lopardo Lara , Uhl Gabriele 
Published: April 2021

Abstract
Sexual selection has been shown to drive speciation. In dwarf spiders (erigonines), males possess diverse, sexually selected prosomal structures with nuptial-gift-producing glands. The genus Oedothorax is suitable for investigating the evolution of these features due to high structural variation. We have re-delimited this genus based on a phylogenetic analysis. Ten species are Oedothorax s.s.; five are transferred back to their original generic placement; 25 remain unplaced as ‘Oedothorax’. Four junior synonymies are proposed: Callitrichia simplex to Ca. holmi comb. nov.; Gongylidioides kougianensis to G. insulanus comb. nov.; Ummeliata ziaowutai to U. esyunini comb. nov.; Oe. kathmandu to Mitrager unicolor comb. nov. Oedothorax seminolus is a junior synonym of Soulgas corticarius and the transfer of Oe. alascensis to Halorates is confirmed. The replacement name Ca. hirsuta is proposed for Ca. pilosa. The male of Callitrichia longiducta comb. nov. and the female of ‘Oedothorax’ nazareti are newly described. Thirty-eight Oedothorax species are transferred to other genera. Callitrichia spinosa is transferred to Holmelgonia. Three genera are erected: Cornitibia, Emertongone and Jilinus. Ophrynia and Toschia are synonymized with Callitrichia. Character optimization suggests multiple origins of different prosomal modification types. Convergent evolution in these traits suggests that sexual selection has played an important role in erigonine diversification.
Measuring Auditory Fitness in Locomotive Engineers: Development and Validation of a Signal Detection Test
Authors: van der Hoek-Snieders Hanneke E.M. , Houben Rolph , Dreschler Wouter A. 
Published: April 2021

Objectives:
To perform their job safely and effectively, locomotive engineers are required to detect auditory warning signals in the noisy work setting of a train cabin. Based on audio recordings of Dutch train cabins, we have developed a task and job-specific test for assessing the engineer’s ability to detect the two acoustic warning signals for the Dutch situation. The aim of this study was to evaluate the reliability, agreement, and construct validity of this test.

Design:
Two experiments were performed. In the first experiment, reliability and agreement of the signal detection test were assessed. Normally hearing individuals (N = 12) completed a signal detection test twice in 12 driving conditions. In the second experiment, construct validity was assessed. We retrospectively identified locomotive engineers, suspected of being hearing impaired, who were referred to the Amsterdam UMC for an auditory fitness for job assessment. All included engineers (N = 83) performed the signal detection test in four driving conditions, underwent tone audiometry and two speech perception in noise tests, and rated the effort and concentration it takes to detect the auditory signals. Seven a priori formulated hypotheses were tested.

Results:
In the first experiment, sufficient reliability and agreement were found in nine driving conditions (ICC = 0.54–0.81; standard error of measurement = 1.15–1.92), poor reliability in two driving conditions (ICC < 0.50), and poor agreement in one driving condition (standard error of measurement = 2.67 dBA). In the second experiment, the results of the signal detection test correlated moderately with the pure-tone thresholds, speech reception threshold in fluctuating noise, and engineer’s subjective rating of effort and concentration, but not with the speech reception threshold in continuous noise. According to the hypotheses, poorer test scores were obtained by hearing aid users compared with nonhearing aid users.

Conclusions:
The signal detection test has sufficient reliability and agreement in all but three driving conditions. This study provides evidence supporting the construct validity of the signal detection test in locomotive engineers. The moderate associations with conventional hearing tests show that the conventional hearing tests did not cover the whole construct measured with the signal detection test. The results, therefore, underpin the importance of evaluating the ability to detect auditory warning signals separately from other hearing-critical job tasks.
Bone Metabolism in the Healing Process of Lumbar Interbody Fusion: Temporal Changes of Bone Turnover Markers
Authors: Hyakkan Ryota , Kanayama Masahiro , Takahata Masahiko , Oha Fumihiro , Hashimoto Tomoyuki , Iwasaki Norimasa 
Published: April 2021

Study Design.
Prospective longitudinal study.

Objective.
The aim of this study was to evaluate temporal changes of bone turnover markers (BTMs) after lumbar spinal fusion in patients without osteoporosis.

Summary of Background Data.
Radiological studies are the standard method to monitor bony fusion, but they do not allow a timely assessment of bone healing. BTMs react rapidly to changes in bone metabolism during fusion process and could be an additional tool to monitor this process.

Methods.
A total of 78 nonosteoporosis patients who had undergone one- or two-level transforaminal lumbar interbody fusion were included. Fusion status was assessed using computed tomography sagittal and coronal images. Serum levels of bone-specific alkaline phosphatase (BAP), procollagen type 1 amino-terminal propeptide (P1NP), and osteocalcin (OC) were measured to assess bone formation, and tartrate-resistant acid phosphatase 5b (TRACP-5b) was measured to assess bone resorption. Serum samples were obtained before surgery and at 1, 2, 4, 8, 13, 26, 39, and 52 weeks after surgery.

Results.
A solid fusion was achieved in 71 of 78 patients (91%), and seven patients resulted in pseudarthrosis. In the fusion group, the level of all BTMs once decreased at 1 postoperative week. Then, BAP and P1NP reached a peak at 4 weeks after surgery, and TRACP-5b and OC peaked at 8 weeks. Thereafter, the level of P1NP and TRACP-5b gradually got closer to the baseline over a year, and BAP kept high until 52 postoperative weeks. In the pseudarthrosis group, peak level of BTMs was significantly higher and the increased level of BAP and P1NP was kept until 52 weeks.

Conclusion.
The present study demonstrated dynamics of BTMs after lumbar spinal fusion in patients without osteoporosis. These normal population data contribute as a baseline to evaluate the effect of osteogenic agents on bone metabolism after spinal fusion.

Level of Evidence: 2
Tranexamic Acid in Pediatric Scoliosis Surgery
Authors: Hasan Mohd Shahnaz , Yunus Siti Nadzrah , Ng Ching Choe , Chan Chris Yin Wei , Chiu Chee Kidd , Kwan Mun Keong 
Published: April 2021

Study Design.
Prospective randomized double-blinded trial

Objective.
The objective of this study is to determine the efficacy of high-dose versus low-dose tranexamic acid (TXA) in adolescent idiopathic scoliosis (AIS) corrective surgery.

Summary of Background Data.
Corrective surgery for AIS is associated with significant blood loss. Evidence on the optimum TXA dose to reduce bleeding in pediatric population is scarce.

Methods.
A total of 166 AIS patients aged between 10 and 21 years, of American Society of Anesthesiologists (ASA) physical status I and II, preoperative hemoglobin >10 g/dL, platelet count >150,000 cells/L and Cobb angle of >45° scheduled for elective single-stage posterior spinal fusion (PSF) surgery by two attending surgeons were included between March 2017 and November 2018. Patients were randomized into Group A (High Dose, 30 mg/kg TXA loading dose followed by 10 mg/kg/h infusion) and Group B (Low Dose, 10 mg/kg TXA loading dose followed by 1 mg/kg/h infusion). The primary outcome was total surgical blood loss between both groups. Secondary outcomes were transfusion requirement, perioperative changes in hemoglobin and coagulation profiles, adverse events, and factors that influence total blood loss.

Results.
The mean total surgical blood loss between the two groups was not significant (Group A: 928.8 ± 406.1 mL [range: 348–1857 mL]; Group B: 918.1 ± 406.2 mL [range: 271–2000 mL], P = 0.865). The median duration of surgery was 120 minutes. One patient in each group received allogenic blood transfusion during the perioperative period. There were no significant changes in hemoglobin and coagulation profile at pre-operation, post-operation 0 hour and 48 hours. Sex, number of vertebral levels fused, and duration of surgery were independently associated with total surgical blood loss. No adverse events were observed perioperatively.

Conclusion.
Low-dose TXA was as efficacious as high-dose TXA in reducing blood loss and allogenic blood transfusion for AIS patients undergoing PSF surgery.

Level of Evidence: 1
Anal squamous cell carcinoma: standards of care, new data and ongoing clinical trials
Authors: Giunta Emilio Francesco , Bregni Giacomo , Hendlisz Alain , Sclafani Francesco 
Published: April 2021

Purpose of review
To summarize current standards of care, discuss results of recent studies and present ongoing clinical trials for anal squamous cell carcinoma (ASCC).

Recent findings
Over the last year, no practice changing studies have been reported in the setting of localised ASCC. A number of retrospective analyses, however, have provided practice-informing data, such as those confirming the negative impact of low compliance to chemoradiotherapy (CRT) on patient outcomes. In contrast, and for the first time, randomized evidence has become available to inform the management of advanced tumours. The InterAACT trial represents a key milestone in the evidence-building process for this disease, establishing carboplatin plus paclitaxel as a new standard of care for treatment-naïve advanced ASCC patients. Furthermore, more data have accumulated about the value of triplet chemotherapy in the first-line setting and of immune checkpoint inhibitors (either as single agents or in combination with other agents) in the refractory setting.

Summary
Recent findings have the potential to improve the treatment quality standards and overall outcome of patients with either localised or advanced ASCC. Results from ongoing clinical trials will hopefully provide useful insights into the management of this disease and further shape current treatment paradigms.
Being Simultaneously Curious and Stressed, Precipitants to Methamphetamine Initiation Among Chinese Men Who Have Sex With Men: Findings From a Qualitative Study
Authors: Zhou Jing , Li Xianhong , Li Fei , Shoptaw Steve , Wang Honghong , Heilemann MarySue V. , Koniak-Griffin Deborah 
Published: April 2021

Abstract
The cultural context and precipitants for initiating methamphetamine (MA) using among Chinese men who have sex with men (MSM) are unclear. This qualitative descriptive study, which explores the specific precipitants of MA initiation within a cultural context among MSM in China, was conducted with data from semistructured, face-to-face interviews with 24 MA-using MSM (8 HIV positive). Two themes were identified, internal precipitants included the following: (a) curiosity, (b) desire for maximum sexual pleasure, (c) experience with other drugs, and (d) strong sense of self-control capacity. External precipitants included (a) Xiao [

JOURNAL/janac/04.03/00001782-202110000-00017/17FFU1/v/2023-08-29T005718Z/r/image-tiff

] (filial piety), (b) peer pressure, (c) negative life events, (d) parental emotional neglect, and (e) experiences of homophobia. Internal precipitants to MA initiation for Chinese MSM are consistent with past research. External precipitants were more culture specific. This exacerbates the vulnerability of MSM to MA initiation and keeps it hidden among this population. Future drug use prevention interventions for MSM should address external precipitants and integrate culture-specific strategies.
Pulmonary toxicity associated with occupational and environmental exposure to pesticides and herbicides
Authors: Bast Aalt , Semen Khrystyna O. , Drent Marjolein 
Published: April 2021

Purpose of review
Critical review on the notion that exposure to pesticides and herbicides lead to adverse effects in pulmonary health.

Recent findings
The lung effects of several chemical classes of pesticides and herbicides is biologically plausible. However, the studies that describe the association between exposure and toxic lung effects have numerous limitations. Critical evaluation of the studies that are performed shows that assessment of occupational or environmental exposure to pesticides and herbicides is cumbersome. Moreover, the health effects are not always clearly established due to the use of questionnaires and self-reported data instead of lung function measurements or diagnostic work-up by physicians.
Future studies should preferably better characterize the exposure. Genetic phenotyping should be included to understand and strengthen possible (individual) associations between exposure and health outcome. It should be realized that combined exposure to multiple environmental chemicals may lead to different health effects than exposure to individual chemicals.

Summary
The relation between exposure to pesticides and herbicides and lung toxicity is less clear than generally assumed. Adverse lung effects seem multifactorial and needs further research. Preventive measures remain key.
The role of magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease
Authors: Bonavina Luigi , Boyle Nick , Schoppmann Sebastian F. 
Published: April 2021

Purpose of review
Magnetic sphincter augmentation (MSA) has been designed as a less disruptive and more standardized laparoscopic surgical procedure than fundoplication for patients with early stage gastroesophageal reflux disease (GERD). We analyzed the more recent literature in search of updates regarding indications, technique, perioperative management, and long-term outcomes.

Recent findings
Over the years, the procedure of MSA has evolved to including full hiatus repair rather than relying on the preservation of the phreno-esophageal ligament. Restoring the mechanical synergy between the lower esophageal sphincter and the crural diaphragm has the potential to further enhance the antireflux barrier. The adoption of this approach has led to expand the indications from early stage disease to different scenarios including patients with high esophageal acid exposure, atypical symptoms, large hiatal hernias, Barrett's esophagus, postbariatric surgery, and previously failed fundoplication.

Summary
MSA has a favorable side-effect profile and is highly effective in reducing typical reflux symptoms, medication dependency, and esophageal acid exposure. Excellent outcomes have been confirmed over a 12-year follow-up, indicating that the operation has the potential to prevent GERD progression. Further studies are needed to confirm the cost-effectiveness of this procedure in patients with more advanced disease-stage and prior gastric surgery. A randomized control trial comparing MSA with fundoplication could raise the level of evidence and the strength of recommendation.
Kidney cancer management 3.0: can artificial intelligence make us better?
Authors: Lee Matthew , Wei Shuanzeng , Anaokar Jordan , Uzzo Robert , Kutikov Alexander 
Published: April 2021

Purpose of review
Artificial intelligence holds tremendous potential for disrupting clinical medicine. Here we review the current role of artificial intelligence in the kidney cancer space.

Recent findings
Machine learning and deep learning algorithms have been developed using information extracted from radiomic, histopathologic, and genomic datasets of patients with renal masses.

Summary
Although artificial intelligence applications in medicine are still in their infancy, they already hold immediate promise to improve accuracy of renal mass characterization, grade, and prognostication. As algorithms become more robust and generalizable, artificial intelligence is poised to significantly disrupt kidney cancer care.
An Integrative Review of Organizational Factors Influencing Successful Large-Scale Changes in Healthcare
Authors: Castiglione Sonia Angela , Lavoie-Tremblay Melanie 
Published: April 2021

OBJECTIVE
The aim of this study was to review organizational factors influencing successful large-scale change (LSC) in healthcare.

BACKGROUND
LSC is necessary to achieve sustained and meaningful healthcare improvement. However, organizational readiness needs to be considered to promote successful LSC.

METHODS
Four databases were searched for articles published between 2009 and 2018. Thematic analysis was used to identify enabling or hindering factors to LSC.

RESULTS
Seven organizational factors were consistently described as facilitators of or barriers to successful LSC in healthcare: infrastructure support, organizational culture, leadership, change management approach, roles and responsibilities, networks, and measurement and feedback.

CONCLUSION
The factors that emerged from this review are consistent with concepts of implementation but broadened and highlight learning organizations in successful LSC. The results of this review informed the development of a reflective tool on LSC for nurse leaders.
Assessing Evidence-Based Practice Knowledge: An Innovative Approach by a Nursing Research Council
Authors: Maydick-Youngberg Diane , Gabbe Laura , Simmons Grace , Smith Daniel , Quimson Epifania , Meyerson Elaine , Manley-Cullen Catherine , Rosenfeld Peri 
Published: April 2021

OBJECTIVE
The aim of this study was to describe the structure and processes implemented by nursing research councils to conduct a nurse-led research study at an urban community teaching hospital.

BACKGROUND
We assessed nurses' knowledge, skills, and attitudes toward evidence-based practice (EBP) to inform development plans.

METHODS
This is an institutional review board–approved single-site cross-sectional anonymous online survey (Evidence-Based Practice Questionnaire [EBPQ]) emailed to 850 participants. Data were analyzed using SPSS v25 (Armonk, New York).

RESULTS
Initial response rate was 11%. Deployment of new strategies achieved an overall response rate of 57.5%. EBPQ subscale scores were highest for “attitude,” followed by “knowledge/skills,” and “practice.” Lowest-scoring items included critical appraisal of literature, converting information needs into a question, time for new evidence, information technology, and research skills.

CONCLUSIONS
Our EBPQ scores were consistent with prior findings. Our strategies provide a framework for other institutions in similar stages of implementing EBP and nurse-led research initiatives.