bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stop the Bleed®: Medical Students as Instructors of the Bleeding Control Basics Course
Authors: Evans Kelsey M. , Lake Bryan , Harrell Kelly M. , Longshore Shannon W. , Toschlog Eric A. , Walsh Danielle S. 
Published: April 2021

Background The Bleeding Control Basics (B-Con) Course was developed to teach lifesaving hemorrhage control techniques to the public. Currently, medical students (MS) without prior clinical experience (CE) may not act as autonomous instructors, limiting the instructor pool. Purpose To assess the bleeding control knowledge of MS (phase I) and compare the knowledge of students taught by a certified instructor vs a medical student (phase II). Methods Phase I: 20 MS, 6 with prior CE and 14 without clinical experience (NCE) completed a pre-course and post-course knowledge assessment. Results were assessed by independent sample t-tests. Phase II: 91 first-year MS were taught the B-Con Course by either a third-year MS (n = 45) or certified instructor (n = 46). An analysis of covariance (ANCOVA) was performed to compare scores by instructor type (certified vs MS) using prior CE and pretest scores as confounding variables. Results In Phase I, the CE group scored higher on the pretest assessment compared to the NCE group ( P = .003). All students improved in posttest scoring, and there was no difference in posttest scores between the groups ( P = .597). In Phase II, despite no difference in pretest scores between groups, the MS taught learners scored significantly higher on the posttest compared to the certified instructor group ( P < .01). Prior CE did not correlate to posttest scores ( P = .719). Discussion Medical students are as effective as certified instructors at conveying the B-Con learning objectives. Based on near-perfect assimilation of content by students, MS should be permitted to teach B-Con Courses.
Comparison of four high-throughput, automated immunoassays for the detection of SARS-CoV-2 antibodies
Authors: Oakey Jane , Haslam Shonagh , Brown Andrew , Eglin Janet , Houghton Brittany , Singleton Dawn 
Published: April 2021

Background A number of immunoassays have been developed to measure antibodies specific to SARS-CoV-2. More data is required on their comparability, particularly among those with milder infections and in the general practice population. The aim of this study was to compare four high-throughput automated anti-SARS-CoV-2 assays using samples collected from hospitalized patients and healthcare workers with confirmed SARS-CoV-2 infection. In addition, we collected general practice samples to compare antibody results and determine seroprevalence. Methods Samples were collected from 57 hospitalized patients and nine healthcare workers at 14 days and at 28 days following confirmed SARS-CoV-2 infection. Samples were also collected from 225 patients presenting to general practice. Four assays were used: Abbott Architect IgG, Beckman Coulter DxI 800 IgG, Roche Cobas e801 total antibody and Siemens Advia Centaur XPT total antibody. Results All four assays showed concordance at 14 days in 83.9% of hospitalized patients and in 66.7% of healthcare workers. All four assays showed concordance at 28 days in 88.4% of hospitalized patients and 77.8% of healthcare workers. The sensitivity to detect recent infection was higher for the IgG assays than the total assays. All four assays showed concordance of 95.1% in the general practice population. Seroprevalence ranged from 4.9 to 5.8% depending on the assay used. Conclusions All four assays showed excellent comparability, but it may be possible to obtain a negative result for any of the anti-SARS-CoV-2 assays in patients with confirmed previous SARS-CoV-2 infection. An equivocal range would be useful for all anti-SARS-CoV-2 assays.
‘We are all in this together’: Investigating alignments in intersectoral partnerships dedicated to K-12 food literacy education
Authors: Renwick Kerry , Powell Lisa Jordan , Edwards Gabrielle 
Published: April 2021

Background: Activities to foster food literacy in young people are increasingly common in schools, driven both by the public health sector and by curriculum mandates from education officials in government. In Canada, both Kindergarten–Grade 12 (K-12) classroom teachers and educators from community organisations deliver food literacy education programmes in schools, often framed as partnerships working in the interests of young people. Objective: The study examines the alignment between what both classroom teachers and community educators state are the desired outcomes for students of their food literacy education work and the topics/activities they engage in with students. Design, setting and method: We surveyed and interviewed teachers and community educators in British Columbia, Canada, and utilised participant observation and secondary data from food literacy education network activities. Results: Shared food literacy education goals and topics/activities were evident in the responses of classroom teachers and community educators. Teachers framed their food literacy education programmes around the curriculum-as-plan – in this case, the provincial curriculum known as the BC Curriculum – and then enacted a lived curriculum that students experienced in the classroom. Community educators offered programmes that were initially designed to meet their organisation’s focus, but which varied in terms of how much of the BC Curriculum was addressed. Conclusion: Our results show broad alignment between teachers and community educators in food literacy education goals and practices; however, there is potential to increase this alignment and build stronger partnerships that support teachers in enacting the BC curriculum and meeting the needs of their students.
Presentation and Referral Patterns in Pediatric Closed Hand Fractures
Authors: Walsh Landis R. , Nuzzi Laura C. , Taghinia Amir H. , Labow Brian I. 
Published: April 2021

Background Although pediatric hand fractures are common and generally have good outcomes, they remain a considerable source of anxiety for non–hand surgeons, who are less familiar with these injuries. We hypothesized that this anxiety may manifest as inefficiency in referral patterns. Methods The records of pediatric patients with isolated, closed hand fractures without concurrent trauma seen at our institution by a hand surgeon between January 2017 and December 2018 were retrospectively reviewed. Results There were 454 patients included; 62.1% were men, and the mean age was 9.6 years at initial encounter. Most patients (89.6%) were treated nonoperatively and incurred few complications (0.5%). Roughly half of all cases (n = 262) initially presented to an outside provider. Of these, 24.0% (n = 64 of 262) were evaluated by 2+ providers before a hand surgeon. Most commonly, these patients were referred from an outside emergency department (ED) to our ED before hand surgeon evaluation (n = 45 of 64). Forty-seven patients required surgery; however, none were performed urgently. Although a greater proportion of 7- to 11-year-old patients saw 2+ providers prior to a hand surgeon ( P = .007), fewer required surgery ( P < .001). Conclusions Pediatric closed hand fractures are mainly treated nonoperatively and nonemergently with generally excellent outcomes. Our data suggest that many patients continue to be referred through the ED or multiple EDs/providers for treatment. These inefficient referral patterns demonstrate the need for better education for ED and primary care providers, as well as better communication between these providers and local pediatric hand surgeons. Advancements in these areas are likely to improve efficiency of care and decrease costs.
Safety and feasibility of transradial use of 8F balloon guide catheter Flowgate2 for endovascular thrombectomy in acute ischemic stroke
Authors: Martínez-Galdámez Mario , Schüller Miguel , Galvan Jorge , de Lera Mercedes , Kalousek Vladimir , Ortega-Gutierrez Santiago , Arenillas Juan F 
Published: April 2021

Background While Balloon Guide Catheters (BGC) have been shown to increase the rate of reperfusion during mechanical thrombectomy (MT), its implementation with transfemoral approach is at times limited due to unfavorable vascular anatomy. Objective to determine safety, feasibility and performance of the transradial use of 8 F BGC Flowgate 2 during mechanical thrombectomy procedures in patients with unfavorable vascular anatomies (type 3 or bovine arch) Material/Methods: We performed a retrospective cohort study of consecutive transradial mechanical thrombectomies performed with BGC Flowgate 2 between January and December 2019. Patient demographics, procedural and radiographic metrics, and clinical data were analyzed. Results 20 (8.7%) out of 230 overall thrombectomy procedures underwent transradial approach using an 8 F BGC Flowgate. 2 Successful approach was achieved in 17/20 cases, and in 3 cases radial was switched to femoral, after failure. TICI 2 C/3 was achieved in 18 cases (90%), followed by TICI 2 b and 2a in 1 (5%) case respectively. The average number of passes was 1.8. The average radial puncture-to-first pass time was 22 min. Radial vasospasm was observed in 3/20 cases. The Flowgate 2 was found kinked in 4/20 cases (20%), all of them during right internal carotid procedures. There were no postprocedural complications at puncture site, as hematoma, pseudoaneurysm or local ischemic events Conclusion The use of 8 F Balloon Guide Catheter during MT via transradial approach might represent an alternative in selected cases with unfavorable vascular anatomies. Its use in right ICA catheterizations was associated with a high rate of catheter kinking.
Test Batteries After Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Roe Chelsey , Jacobs Cale , Hoch Johanna , Johnson Darren L. , Noehren Brian 
Published: April 2021

Context: There is a lack of consensus regarding test batteries for return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR). Objective: To report the RTS test batteries for individuals after ACLR and to examine alignment with the American Academy of Orthopaedic Surgeons (AAOS) Appropriate Use Criteria (AUC). Finally, to examine how published RTS batteries prior to the AAOS AUC (2010-2015) compared with those after publication of the AUC (2016-2020). Data Source: A systematic search of PubMed (2010-2020). Study Selection: Studies were included if they were published from 2010 to 2020, patients underwent primary ACLR and were tested between 6 months and 2 years postoperatively and included a minimum of 2 assessments. Studies were excluded if patients were tested outside the designated time; had undergone a revision, contralateral, or multiligament injury; included healthy participants; were level 5 evidence or the study was a systematic review. A total of 1012 articles were reviewed and 63 met the criteria. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Information regarding the RTS batteries and patient demographics were extracted from the included articles. Results: A total of 63 studies met the inclusion and exclusion criteria (22 from 2010-2015 and 41 from 2016-2020). The most common RTS batteries included the hop test, quadriceps strength test, and patient-reported outcome measures. No study met all 7 AUC; the most common criteria met were functional skills (98.4%), followed by confidence (22.2%), then range of motion and knee stability (20.6%). Conclusion: The test batteries in the current literature show high variability and a lack of essential components necessary for RTS. No study met the AUC guidelines, suggesting a disconnect between recommended guidelines and clinical practice. Test battery research has expanded over the past decade; however, standardized, clinically applicable batteries that encompass all criteria are needed.
MicroRNA-21 from bone marrow mesenchymal stem cell-derived extracellular vesicles targets TET1 to suppress KLF4 and alleviate rheumatoid arthritis
Authors: Li Guo-Qing , Fang Yu-Xuan , Liu Ying , Meng Fan-Ru , Wu Xia , Zhang Chun-Wang , Zhang Yu , Liu Yan-Qing , Liu Dan 
Published: April 2021

Background: Accumulating evidence has demonstrated that bone marrow mesenchymal stem cells (BMSCs)-derived extracellular vesicles (EVs) can be used effectively to transfer drugs and biomolecules to target lesions. Meanwhile, BMSCs have been reported to be beneficial in the treatment of rheumatoid arthritis (RA). In this study, we employ gain- and loss-of-function experiments to determine how BMSCs-derived EVs alleviate RA in vitro and in vivo. Methods: We isolated EVs from BMSCs and characterized them by transmission electron microscopy and western blot analysis. The regulatory relationship between miR-21 and TET1 was predicted by bioinformatics analysis and validated by dual luciferase assay. Next, we utilized bisulfite sequencing PCR to decipher how TET1 promoted KLF4 transcription. Then, we established an RA mouse model and determined the role of miR-21 in RA progression. Functional assays were used to validate the role the miR-21-TET1-KLF4 regulatory axis in controlling mouse fibroblast-like synoviocytes (mFLS) cell proliferation and inflammatory cytokines secretion in vitro. Results: RT-qPCR results revealed that miR-21 was highly expressed in BMSCs-derived EVs, and confirmed that BMSCs-derived EVs transferred miR-21 into mFLS cells. Bioinformatic analysis predicted that TET1 was the directly downstream target of miR-21, which was further validated by dual luciferase assay. TET1 promoted KLF4 promoter methylation to increase its expression. Collectively, BMSCs-derived EVs relieved RA by delivering miR-21, while the exosomal miR-21 alleviated RA through targeting the TET1/KLF4 regulatory axis. Conclusion: miR-21 from BMSCs-derived EVs suppresses KLF4 to relive RA by targeting TET1.
Alcohol Consumption in the Australian Mining Industry: The Role of Workplace, Social, and Individual Factors
Authors: James Carole L. , Tynan Ross J. , Bezzina Aaron T. , Rahman Md Mijanur , Kelly Brian J. 
Published: April 2021

Background: Coal miners have been reported to have higher rates of risky/harmful alcohol misuse; however, it is not known if metalliferous mining employees whose working conditions differ in workplace practices, also have increased rates of risky/harmful alcohol misuse. This study aimed to examine alcohol consumption in a sample of Australian metalliferous mining workers and to examine the demographic and workplace factors associated with risky/harmful alcohol use. Methods: All employees from a convenience sample of four Australian mine sites were invited to complete a paper-based cross-sectional survey between June 2015 and May 2017. The survey contained questions relating to social networks, health behaviors, psychological distress, demographic characteristics, and risky/harmful drinking. Current alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated measure of risky and/or harmful drinking. Factors associated with risky/harmful drinking were investigated using univariate and multivariable logistic regression. Findings: A total of 1,799 participants completed the survey (average site response rate 95%). Overall, 94.8% of males and 92.1% of females reported using alcohol in the preceding 12 months. The odds of risky/harmful alcohol use were significantly higher in those who were male, younger, and reported higher psychological distress. Conclusions/Application to Practice: This study identified that metalliferous mining employees engage in at-risk levels of alcohol consumption significantly higher than the national average despite workplace policies and practices that restrict alcohol use. Personal and workplace risk factors that may help target specific employee groups and inform the development of tailored, integrated multicomponent intervention strategies for the industry were identified.
Sonographic Assessment of Human Lumbar Intervertebral Disks: A Cadaveric Study
Authors: Winn Naomi , Balain Birender , Ockendon Matthew , Cassar-Pullicino Victor , Lalam Radhesh 
Published: April 2021

Objectives: The intervertebral disk has traditionally been imaged by magnetic resonance imaging (MRI); however, advances in sonography mean it can now be visualized with this modality. The objectives of this human cadaveric study were to visualize the internal structure of the lumbar intervertebral disks and map any defects. Shear wave sonography was explored as a method for assessing the disks. Materials and Methods: In a human cadaver, L4-L5 and L5-S1 disks were imaged with sonography through the anterior abdominal wall and directly through the anterior longitudinal ligament. Gray-scale images and shear wave elastography velocities were obtained. An MRI was performed for image comparison. Results: Defects in the disks were clearly seen with sonography, imaging through the anterior abdominal wall and also directly through the anterior longitudinal ligament. The defects identified on sonography were less well visualized on MRI. Shear wave velocities could only be obtained from the anterior aspect of the disk and were unreliable, primarily owing to the stiffness of the tissues. Conclusion: Sonography can provide an accurate map of defects within the disk, corresponding with MRI. Shear wave elastography should be used with caution in the human cadaveric intervertebral disk, acknowledging the many confounding factors influencing the measurements.
Extracting knowledge networks from plant scientific literature: potato tuber flesh color as an exemplary trait
Authors: Singh Gurnoor , Papoutsoglou Evangelia A. , Keijts-Lalleman Frederique , Vencheva Bilyana , Rice Mark , Visser Richard G.F. , Bachem Christian W.B. , Finkers Richard 
Published: April 2021

Abstract
Background
Scientific literature carries a wealth of information crucial for research, but only a fraction of it is present as structured information in databases and therefore can be analyzed using traditional data analysis tools. Natural language processing (NLP) is often and successfully employed to support humans by distilling relevant information from large corpora of free text and structuring it in a way that lends itself to further computational analyses. For this pilot, we developed a pipeline that uses NLP on biological literature to produce knowledge networks. We focused on the flesh color of potato, a well-studied trait with known associations, and we investigated whether these knowledge networks can assist us in formulating new hypotheses on the underlying biological processes.

Results
We trained an NLP model based on a manually annotated corpus of 34 full-text potato articles, to recognize relevant biological entities and relationships between them in text (genes, proteins, metabolites and traits). This model detected the number of biological entities with a precision of 97.65% and a recall of 88.91% on the training set. We conducted a time series analysis on 4023 PubMed abstract of plant genetics-based articles which focus on 4 major Solanaceous crops (tomato, potato, eggplant and capsicum), to determine that the networks contained both previously known and contemporaneously unknown leads to subsequently discovered biological phenomena relating to flesh color. A novel time-based analysis of these networks indicates a connection between our trait and a candidate gene (zeaxanthin epoxidase) already two years prior to explicit statements of that connection in the literature.

Conclusions
Our time-based analysis indicates that network-assisted hypothesis generation shows promise for knowledge discovery, data integration and hypothesis generation in scientific research.
Direct modelling of age standardized marginal relative survival through incorporation of time-dependent weights
Authors: Lambert Paul C. , Syriopoulou Elisavet , Rutherford Mark R. 
Published: April 2021

Abstract
Background
When quantifying the probability of survival in cancer patients using cancer registration data, it is common to estimate marginal relative survival, which under assumptions can be interpreted as marginal net survival. Net survival is a hypothetical construct giving the probability of being alive if it was only possible to die of the cancer under study, enabling comparisons between populations with differential mortality rates due to causes other the cancer under study. Marginal relative survival can be estimated non-parametrically (Pohar Perme estimator) or in a modeling framework. In a modeling framework, even when just interested in marginal relative survival it is necessary to model covariates that affect the expected mortality rates (e.g. age, sex and calendar year). The marginal relative survival function is then obtained through regression standardization. Given that these covariates will generally have non-proportional effects, the model can become complex before other exposure variables are even considered.

Methods
We propose a flexible parametric model incorporating restricted cubic splines that directly estimates marginal relative survival and thus removes the need to model covariates that affect the expected mortality rates. In order to do this the likelihood needs to incorporate the marginal expected mortality rates at each event time taking account of informative censoring. In addition time-dependent weights are incorporated into the likelihood. An approximation is proposed through splitting the time scale into intervals, which enables the marginal relative survival model to be fitted using standard software. Additional weights can be incorporated when standardizing to an external reference population.

Results
The methods are illustrated using national cancer registry data. In addition, a simulation study is performed to compare different estimators; a non-parametric approach, regression-standardization and the new marginal relative model. The simulations study shows the new approach is unbiased and has good relative precision compared to the non-parametric estimator.

Conclusion
The approach enables estimation of standardized marginal relative survival without the need to model covariates that affect expected mortality rates and thus reduces the chance of model misspecification.
Validation of the Framingham hypertension risk score in a middle eastern population: Tehran lipid and glucose study (TLGS)
Authors: Koohi Fatemeh , Steyerberg Ewout W. , Cheraghi Leila , Abdshah Alireza , Azizi Fereidoun , Khalili Davood 
Published: April 2021

Abstract
Background
The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population.

Methods
We studied 5423 participants, aged 20–69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models.

Results
Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79–0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision.

Conclusions
The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.