bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults
Authors: Hayashi Chisato , Ogata Soshiro , Okano Tadashi , Toyoda Hiromitsu , Mashino Sonoe 
Published: May 2021

Abstract
Background
The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling.

Methods
We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate.

Results
A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group.

Discussion
Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise.

Conclusion
Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.
Early differences in auditory processing relate to Autism Spectrum Disorder traits in infants with Neurofibromatosis Type I
Authors:   the STAARS and EDEN Teams, Begum-Ali Jannath , Kolesnik-Taylor Anna , Quiroz Isabel , Mason Luke , Garg Shruti , Green Jonathan , Johnson Mark H. , Jones Emily J. H. 
Published: May 2021

AbstractBackgroundSensory modulation difficulties are common in children with conditions such as Autism Spectrum Disorder (ASD) and could contribute to other social and non-social symptoms. Positing a causal role for sensory processing differences requires observing atypical sensory reactivity prior to the emergence of other symptoms, which can be achieved through prospective studies.MethodsIn this longitudinal study, we examined auditory repetition suppression and change detection at 5 and 10 months in infants with and without Neurofibromatosis Type 1 (NF1), a condition associated with higher likelihood of developing ASD.ResultsIn typically developing infants, suppression to vowel repetition and enhanced responses to vowel/pitch change decreased with age over posterior regions, becoming more frontally specific; age-related change was diminished in the NF1 group. Whilst both groups detected changes in vowel and pitch, the NF1 group were largely slower to show a differentiated neural response. Auditory responses did not relate to later language, but were related to later ASD traits.ConclusionsThese findings represent the first demonstration of atypical brain responses to sounds in infants with NF1 and suggest they may relate to the likelihood of later ASD.
Virtual reality in biology: could we become virtual naturalists?
Authors: Morimoto Juliano , Ponton Fleur 
Published: May 2021

AbstractThe technological revolution of past decades has led teaching and learning of evolutionary biology to move away from its naturalist origins. As a result, students’ learning experiences and training on the science of natural history—which entails careful observations and meticulous data curation to generate insight—have been compromised compared with the times of the pioneers in the field. But will technology cause the extinction of natural history in its traditional form? In this essay, we provide a visionary—albeit not yet possible—perspective of the future of natural history in the technological era. We review the main concepts and applications of key state-state-of-the-art technologies to the teaching and learning of Biology including Virtual and Mixed Reality (VMR). Next, we review the current knowledge in artificial life, and describe our visionary model for the future of natural history voyages—the BioVR—which is an immersive world where students can experience evolution in action, and also shape how evolution can occur in virtual worlds. We finish the essay with a cautionary tale as to the known negative sides of using VMR technologies, and why future applications should be designed with care to protect the intended learning outcomes and students’ experience. Our aim is to stimulate debates on how new technologies can revolutionise teaching and learning across scenarios, which can be useful for improving learning outcomes of biological concepts in face-to-face, blended, and distance learning programmes.
Association between doctor-patient familiarity and patient-centred care during general practitioner's consultations: a direct observational study in Chinese primary care practice
Authors: Zhong Chenwen , Zhou Mengping , Luo Zhuojun , Liang Cuiying , Li Lina , Kuang Li 
Published: May 2021

AbstractBackgroundPatient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. This study aimed to explore the association between general practitioner (GP) perceived doctor-patient familiarity and the provision of patient-centred care during GP consultations.MethodsThis is a direct observational study conducted in eight community health centres in China. Level of familiarity was rated by GPs using a dichotomized variable (Yes/No). The provision of patient-centred care during GP consultations was measured by coding audiotapes using a modified Davis Observation Code (DOC) interactional instrument. Eight individual codes in the modified DOC were selected for measuring the provision of patient-centred care, including ‘family information’, ‘treatment effects’, ‘nutrition guidance’, ‘exercise guidance’, ‘health knowledge’, ‘patient question’, ‘chatting’, and ‘counseling’. Multivariate analyses of covariance were adopted to evaluate the association between GP perceived doctor-patient familiarity and patient-centred care.ResultsA total of 445 audiotaped consultations were collected, with 243 in the familiar group and 202 in the unfamiliar group. No significant difference was detected in overall patient-centred care between the two groups. For components of patient-centred care, the number of intervals (1.36 vs 0.88,p = 0.026) and time length (7.26 vs. 4.40 s,p = 0.030) that GPs spent in ‘health knowledge’, as well as time length (13.0 vs. 8.34 s,p = 0.019) spent in ‘patient question’ were significantly higher in unfamiliar group. The percentage of ‘chatting’ (11.9% vs. 7.34%,p = 0.012) was significantly higher in the familiar group.ConclusionsThis study suggested that GP perceived doctor-patient familiarity may not be associated with GPs’ provision of patient-centred care during consultations in the context of China. Not unexpectedly, patients would show more health knowledge and ask more questions when GPs were not familiar with them. Further research is needed to confirm and expand on these findings.
Knowledge, attitudes and practices on African tick bite fever of rural livestock communities living in a livestock-wildlife interface area in the Eastern Cape Province of South Africa
Authors: Katswara Tandiwe , Mukaratirwa Samson 
Published: May 2021

AbstractBackgroundAfrican tick bite fever (ATBF) caused byRickettsia africaeand transmitted byAmblyommaspp. ticks is one of the zoonotic tick-borne fevers from the spotted fever group (SFG) of rickettsiae, which is an emerging global health concern. There is paucity of information regarding the occurrence and awareness of the disease in endemic rural livestock farming communities living in livestock-wildlife interface areas in South Africa.MethodsThe purpose of the study was to assess the level of knowledge, attitudes and practices on ticks and ATBF infection from a community living in livestock-wildlife interface areas in South Africa. A focus group discussion (FGD) was carried out followed by verbal administration of a standardized semi-structured questionnaire a month later to 38 rural livestock farmers (23 from Caquba area and 15 from Lucingweni area whereA. hebraeumwas absent). An FGD was conducted in Caquba (situated at the livestock-wildlife interface whereAmblyomma hebraeumwas prevalent on cattle and infected withRickettsia africae) in the O.R. Tambo district of the Eastern Cape province of South Africa.ResultsResults from the FGD and questionnaire survey showed that participants from the two rural communities were not aware of ATBF and were not aware that ticks are vectors of the disease. Respondents from Caquba reported of having frequent exposure to tick bites (91.3%, 21/23) specifically from the anthropophilicA. hebrauemwhich they were able to identify asQwelagqibein IsiXhosa (their vernacular). Thirteen out of 15 (86.7%) of respondents from Lucingweni reported that they had never been bitten by ticks, which corresponded with the absence ofA. hebraeumfrom their locality as evidenced from results of a concurrent study on prevalence of ticks on livestock in the area. Both communities confirmed to being “very concerned” of tick bites and we presume this was more related to the localized wounds from the bites than to the diseases transmitted by the ticks.ConclusionsWe recommend future studies encompassing seroprevalence of ATBF in Caquba and other communities at risk in South Africa including establishing surveillance systems to monitor the seasonal infection rates in ticks, cattle and humans.
Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center
Authors: Sharma Vinod , Sharma Atul , Raina Vinod , Dabkara Deepak , Mohanti Bidhu Kalyan , Shukla N. K. , Pathy Sushmita , Thulkar Sanjay , Deo S. V. S. , Kumar Sunil , Sahoo Ranjit Kumar 
Published: May 2021

AbstractBackgroundNo data exist for the long-term outcome of metastatic colorectal cancer (mCRC) from the Southern part of Asia. The primary objective of the study is to evaluate the survival outcome of mCRC from an Indian tertiary care center. The study also aims to highlight the treatment pattern practiced and the unique clinico-pathologic characteristics.MethodsThis is a single-center retrospective observational study done at a large referral tertiary care center in North India. All patients with synchronous or metachronous mCRC who received at least one dose of chemotherapy for metastatic disease, registered between 2003 to 2017 were included. Primary outcome measures were overall survival and progression-free survival and prognostic factors of overall survival. Descriptive analysis was done for the clinicopathological characteristics and treatment patterns. Kaplan Meier method for overall survival and progression-free survival. Cox regression analysis was performed for the determination of the prognostic factors for overall survival.ResultOut of 377 eligible patients, 256 patients (68%) had de novo metastatic disease and the remaining 121 (32%) progressed to metastatic disease after initial treatment. The cohort was young (median age, 46 years) with the most common primary site being the rectum. A higher proportion of signet (9%) and mucinous histology (24%). The three common sites of metastasis were the liver, peritoneum, and lung. In the first line, most patients received oxaliplatin-based chemotherapy (70%). Only 12.5% of patients received biologicals in the first-line setting. The median follow-up and median overall survival of study cohort were 17 months and 18.5 months. The factors associated with poor outcome for overall survival on multivariate analysis were ECOG performance status of > 1, high CEA, low albumin, and the number of lines of chemotherapy received (< 2).ConclusionThe outcome of mCRC is inferior to the published literature. We found a relatively higher proportion of patients with the following characteristics; younger, rectum as primary tumor location, the signet, and mucinous histology, higher incidence of peritoneum involvement. The routine use of targeted therapies is limited. Government schemes (inclusion of targeted therapies in the Ayushman scheme), NGO assistance, and availability of generic low-cost targeted drugs may increase the availability.
Health indicators on adolescents reveal disparity and inequality on regional and national levels
Authors: Wang Mengqiao 
Published: May 2021

Abstract
Background
Health status in adolescents is difficult to evaluate and compare horizontally, vertically and longitudinally among different regions and nations of the world.

Methods
With repeated surveys conducted with relatively uniformed standards, the UNICEF Data warehouse compiles and publishes a wide spectrum of health indicators, of which data analysis and visualization would reveal the underlying statuses and trends on global, regional and national levels.

Results
Apparent geographic disparity is present in that sub-Saharan African countries lag far behind their counterparts in other regions with regard to most health indicators on adolescents. Education attendance rates sequentially drop from primary to secondary school levels, and display correlation with youth literacy. Harmful practices of early marriage, early childbearing and female genital mutilation have decreased but the presences of peer violence and sexual violence are worthy of attentions. Although incidence and mortality rates of HIV/AIDS have dropped (most notably in sub-Saharan Africa), adolescents’ HIV/AIDS awareness remains suboptimal in selected countries. Cumulative COVID-19 cases and deaths in the adolescents are comparable to the children but relatively lower than the adult and senior groups.

Conclusions
Findings on the health indicators of adolescents until 2019 reveal the most recent status quo for reference right before the hit of ongoing COVID-19 pandemic. Progresses made on the various health indicators as well as the associated disparity and inequality underlie the remaining gaps to fill for the achievement of the Sustainable Development Goals by 2030.
The association between frequency of eating out with overweight and obesity among children aged 6–17 in China: a National Cross-sectional Study
Authors: Ma Yanning , Gong Weiyan , Ding Caicui , Song Chao , Yuan Fan , Fan Jing , Feng Ganyu , Chen Zheng , Liu Ailing 
Published: May 2021

Abstract
Background
In parallel with the increased prevalence of childhood overweight and obesity, the proportion of eating out in China has increased dramatically in recent years. The purpose of the study was to explore the association between frequency of eating out with overweight and obesity among Chinese children.

Methods
The representative sample was recruited from Chinese National Nutrition and Health Survey (CNNHS) in 2010–2012, which included Chinese children aged 6–17 years (7685 boys and 7576 girls). Frequency of eating out was collected by interview-administered questionnaire and categorized as: 0, 1–2 and ≥ 3 times per week. Height and weight were measured, consequently body mass index was calculated.

Results
The prevalence of eating out among Chinese children aged 6–17 years old was 23.2%. Children who ate out 0, 1–2, ≥3 times per week were accounted for 76.8, 10.9 and 12.3% respectively. Findings revealed that eating out three times per week or more was statistically significant associated with higher prevalence of overweight and obesity among boys (OR = 1.20,95CI:1.04–1.38) compared with those ate out less than three times per week. However, no significantly association was observed among girls (OR = 0.91, 95CI:0.78–1.01). In additional, Younger children, rural children, children from low income family, those with leisure exercises (certain physical activities regularly carried out such as swimming, walking, running, equipment fitness), leisure time sedentary behaviors (LTSB)(> 2 h/d) were relatively more likely to eat out.

Conclusions
The results illustrated that eating out three times or more had a significantly positive effect on overweight and obesity among boys in China.
Duloxetine reduces pain after Total hip arthroplasty: a prospective, randomized controlled study
Authors: Li Hao , Zeng Wei-Nan , Ding Zi-Chuan , Yuan Ming-Cheng , Cai Yong-Rui , Zhou Zong-Ke 
Published: May 2021

Abstract
Background
Previous studies have demonstrated the efficacy of duloxetine in reducing postoperative pain and opioid consumption. However, the effect of duloxetine on total hip arthroplasty (THA) remains unclear. The objective of this study was to assess the efficacy of oral duloxetine in THA.

Methods
We enrolled 96 patients in this randomized controlled trial. These patients were randomized (1,1) to either the duloxetine group or the placebo group and received daily doses of 60 mg duloxetine or placebo, respectively, from 2 d pre-operation to 14 d after surgery. The primary outcome was pain severity upon movement measured by a visual analogue scale (VAS). The secondary outcomes included VAS scores for resting pain, morphine consumption, Harris Hip Score, patient satisfaction at discharge, length of postoperative hospital stay, and adverse events.

Results
Patients in the duloxetine group had significantly lower pain severity scores upon movement within 3 postoperative weeks (p < 0.05) while none of the differences met the minimum clinically important difference (MCID). Moreover, patients in the duloxetine group performed better in terms of resting pain (in 3 weeks after surgery), morphine requirements, and satisfaction level at discharge (all p < 0.05). There was no difference between groups in the prevalence of adverse events.

Conclusions
Although it did not result in a clinically meaning reduction in pain after total hip arthroplasty, perioperative administration of 60 mg of duloxetine daily significantly alleviated pain in the postoperative 3 weeks and morphine requirements during the postoperative 48 h. Therefore, duloxetine still shows promise in optimizing the multimodal pain-management protocols in total hip arthroplasty.

Trial registration
Chinese Clinical Trial Registry, ChiCTR2000033606, 06/06/2020.
Efficacy of the “Eiffel tower” double titanium elastic nailing in combined management of congenital pseudarthrosis of the tibia: preliminary outcomes of 17 cases with review of literature
Authors: Wang Xiaoyu , Shi Li , Zhang Rui , Wang Wenbo , Wang Feng , Wang Mengwei , Xu Ze , Zuo Rongtai , Xu Jia , Kang Qinglin 
Published: May 2021

Abstract
Background
Difficulty in obtaining union, recurrent fractures, and residual deformities remain the problems challenging the management of congenital pseudarthrosis of the tibia (CPT). We applied the “Eiffel Tower” double titanium elastic nails (TENs) in the existing combined approach, which takes advantages of TEN’s mechanical stability with the protection against refracture, Ilizarov’s high fusion rate with alignment control and the biologic environment provided by bone grafting for bony union. The results of this procedure are presented and discussed.

Methods
Seventeen patients with CPT treated by combined surgery including pseudarthrosis resection, the “Eiffel Tower” double TENs technique, autogenous iliac bone grafting, and Ilizarov fixation between 2013 and 2019 were retrospectively investigated. Signs of bone union, limb length discrepancy (LLD), rate of refracture, and degree of residual deformities were reviewed. The AOFAS Ankle Hindfoot scale and measurement of ankle motion were used to evaluate ankle function. The mean follow-up time was 40.5 (11 to 91) months.

Results
The mean age at index surgery was 6.2 (2.5 to 15) years. Union of the pseudarthrosis was achieved in 100% of cases. Among them, 15 (88.2%) patients obtained union of the pseudarthrosis on the first attempt (primary union). The average time to primary union was 3.8 (2 to 6) months. The rest 2 cases achieved union after additional surgeries (secondary union). In terms of complications, refracture occurred in 2 patients (11.8%) and 4 patients (23.5%) developed pin infection. The mean limb length discrepancy at the final follow up was 33.4 (6–141) mm. The average AOFAS score improved from 38.2 (27 to 51) pre-operatively to 77 (63 to 87) post-operatively (p < 0.01).

Conclusions
The “Eiffel Tower” double TENs technique is an ideal intramedullary fixation method in the surgical treatment of CPT. The combination of TENs technique with bone grafting and Ilizarov fixation has the advantages of early bone union, less injury on metaphysis, and early functional recovery.

Level of evidence
Level IV.
Hip arthroscopy has good clinical outcomes in the treatment of osteoid osteoma of the acetabulum
Authors: Gao Guanying , Wu Ruiqi , Liu Rongge , Ao Yingfang , Wang Jianquan , Xu Yan 
Published: May 2021

Abstract
Background
Osteoid osteoma (OO) of the acetabulum is a relatively rare disease. However, the the clinical outcomes of hip arthroscopy for treatment of OO of the acetabulum are still uncertain.

Methods
We evaluated consecutive patients who were diagnosed with OO of the acetabulum and who underwent hip arthroscopy at our hospital between January 2013 and March 2020. All patients underwent a preoperative physical examination. Preoperative supine anteroposterior hip radiography, cross-table lateral radiographs, computed tomography (CT), and magnetic resonance imaging were performed in all patients. The alpha angle and lateral center-edge angle were measured before surgery. Supine anteroposterior hip radiography and CT were performed in all patients postoperatively. Preoperative patient-reported outcomes (PROs), including Visual Analog Scale (VAS), the International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS), and PROs at final follow-up were evaluated.

Results
A total of 6 patients (mean age, 18.7 years; age range, 6–31 years; 5 males and 1 females) were included in this study. The average follow-up period after surgery was 28.3 months (range, 6–90 months). Before surgery, the mean mHHS was 45.2 ± 10.5 (range, 33–56), the mean iHOT-12 was 33.3 ± 14.5 (range, 13–49), and mean VAS was 8.2 ± 1.0 (range, 7–9). At one month after surgery, mean mHHS was 78.7 ± 1.9 (range, 77–81), iHOT-12 was 71.0 ± 4.5 (range, 68–80), and mean VAS was 0. At the final post-operative follow-up, mean mHHS was 89.2 ± 2.1 (range, 86–91), iHOT-12 was 93.5 ± 5.0 (range, 88–98), and mean VAS was 0. All results, except VAS between one month after surgery and at final follow-up, demonstrated statistically significant improvement (P < 0.05). One patient underwent revision surgery.

Conclusions
Hip arthroscopy has good clinical outcomes in the treatment of OO of the acetabulum. Further study on the mechanism of secondary femoroacetabular impingement (FAI) caused by OO of the acetabulum is needed. More cases of arthroscopic excision and longer follow-up are also needed to better prove the clinical outcomes of hip arthroscopy for OO of the acetabulum.