bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence and assessment of parenchymal patterns of ultrasonography for breast cancer detection among Chinese women: a cross-sectional study
Authors: Bao Zhongtao , Zhao Yanchun , Chen Shuqiang , Chen Xiaoyu , Xu Xiang , Wei Linglin , Chen Ling 
Published: October 2021

Abstract
Background
Screening of breast cancer in asymptomatic women is important to evaluate for early diagnosis. In China ultrasound is a more frequently used method than mammography for the detection of breast cancer. The objectives of the study were to provide evidence and assessment of parenchymal patterns of ultrasonography for breast cancer detection among Chinese women.

Methods
Breast ultrasound examinations including the parenchymatous pattern of cytopathological confirmed breast cancer (n = 541) and age-matched cytopathological not confirmed breast cancer (n = 849) women were retrospectively reviewed by seven sonographer physicians. According to compositions of ducts, the thickness of the breast, diameter of ducts, fat lobules, and fibro glandular tissues, the breast parenchymatous pattern was categorized into heterogeneous (high percentage of fatty tissues), ductal (the inner diameters of ducts > 50% of the thick mass of the breast), mixed (the inner diameters of ducts was 50% of the thick mass of the breast), and fibrous categories (a dense classification of the breast).

Results
Heterogeneous (p < 0.0001, OR = 3.972) and fibrous categories (p < 0.0001, OR = 2.702) were higher among women who have cytopathological confirmed breast cancer than those who have not cytopathological confirmed breast cancer. The heterogeneous category was high-risk ultrasonographic examination category followed by the fibrous category. Agreements between sonographer physicians for categories of ultrasonic examinations were fair to good (Cohen’s k = 0.591).

Conclusions
Breast cancer risk in Chinese asymptomatic women differ according to the ultrasonographic breast parenchymal pattern.
Level of Evidence: III.
Technical efficacy stage: 2.
Variants identified by next-generation sequencing cause endoplasmic reticulum stress in Rhodopsin-associated retinitis pigmentosa
Authors: Wang Yue , Chen Xi , Gao Xiang , Zhao Andi , Zhao Chen , Chen Xuejuan 
Published: October 2021

Abstract
Background
Rhodopsin (RHO) is the most well-known genetic cause of autosomal dominant retinitis pigmentosa (adRP). This study aimed to investigate the genetic cause of a large Chinese adRP family and assess the pathogenicity of the detected RHO mutant.

Methods
Routine ocular examinations were conducted on all participants. Next-generation sequencing with targeted capture was performed to screen mutations in 179 genes associated with hereditary retinal diseases and 10 candidate genes. Variants detected by NGS were validated by Sanger sequencing and evaluated for pathogenicity. Fragments of mutant and wild-type RHO were cloned into the pEGFP-N1 vector and were transfected into different cell lines to observe the cellular localization of the Rhodopsin-GFP fusion protein and evaluate the expression of endoplasmic reticulum (ER) stress markers. RT-PCR analysis was used to detect transfected the splicing of X box-binding protein 1 (XBP1) mRNA, which is a critical factor affecting ER stress.

Results
Genetic analysis identified a heterozygous missense variant, RHO, c.284 T > C (p.L95P) in this adRP family. Another RHO variant (p.P53R) that we reported previously was also included in further functional assessment. Both misfolded mutant proteins accumulated in the ER in a manner similar to that noted for the classic mutant P23H. Spliced XBP1 was observed in cells transfected with mutants, indicating an increase in ER stress.

Conclusions
Although the p.L95P variant is not a novel change, it was the first variant to be functionally evaluated and reported in Chinese RP patients. The results in our study provide significant evidence to classify the p.L95P mutation as a class II mutation.
Correlates of problematic internet use among undergraduate medical students of Delhi
Authors: Dhamnetiya Deepak , Singh Satyavir , Jha Ravi Prakash 
Published: October 2021

Abstract
Background
Globally, due to population diversity, the prevalence of problematic internet use (PIU) varies from 7.3 to 51%. This study aims to assess correlates of problematic internet use among undergraduate medical students of Delhi and derive a model for allocating new subjects among categories of internet users.

Material and methods
A cross-sectional study was conducted on 201 medical-undergraduate students in a medical college of Delhi from April 1st to May 31st, 2019. A semi-structured and pre-tested questionnaire was used to collect demographic information and factors affecting PIU. Dr. Kimberly Young’s Internet Addiction Test (IAT) tool was used to assess PIU. Binary logistic regression has been applied to assess the correlates of PIU, and step-wise discriminant analysis (DA) has been applied to derive a model for allocation of new subjects among categories of internet users. Statistical Package for Social Sciences (Trial version 27.0; SPSS Inc., Chicago, IL) software was used for statistical analysis.

Result
Total 41.3% of the subjects had PIU. Univariate analysis shows that internet use for emotional support, watching adult content, and gambling were significantly associated with PIU; however, in binary logistic regression, chatting, emotional support and watching online adult content were significant risk factors for PIU. The discriminant model correctly classified 66.2% of respondents into average and problematic internet user groups.

Conclusion
We should create awareness among medical students regarding problematic internet use and its potential harms; this could be included in the foundation course of curriculum implementation support program (CISP) for MBBS students.
Parental health risk perceptions and preventive measures related to Children’s second-hand cigarette smoke exposure in Malaysia
Authors: JUNUS Suria , CHEW Chii-Chii , SUGUNAN Pravin , MEOR-AZIZ Nurul-Fazlin , ZAINAL Nurul Ain , HASSAN Husna Mat , ABU-MANSOR Mazetty-Aiza , ABU-ZAMRI Hazirah , HSS Amar-Singh 
Published: October 2021

Abstract
Background
Secondhand smoke (SHS) exposure can affect physical development in children. An understanding of parental risk perception of SHS could guide efforts to develop measures for prevention of SHS exposure among children. This study aimed to assess parental risk perceptions of SHS and action taken by parents to minimise SHS exposure in their children.

Methods
This cross-sectional nationwide study conducted in 2018 recruited convenience sample of 289 parents with children up to age 12 at public areas. Parents were asked to rate the risk level from 1 (no risk) to 5 (extremely high risk) by looking at photographs of an adult smoking in the presence of a child in 8 different situations. The implementation of smoking restriction rules was assessed. Mean scores were calculated with higher scores representing higher risk perception of SHS to child’s health. Linear regression analysis was used to determine factors associated with the level of parental risk perception of SHS exposure to their children’s health.

Results
A total of 246 parents responded. Their mean age was 35 years (SD 6.4). The majority were mothers (75.6%), Malays (72.0%) and had tertiary education level (82.5%), and non-smoker (87.1%). The mean age of respondents’ youngest child was 3 years (SD 3.1). The risk perception level was high [mean scores: 4.11 (SD: 0.82)]. Most parents implemented household (65.0%) and car (68.3%) smoking restriction rules. Lower levels of risk perception were observed among participants who were current smokers (p < 0.001), lived with a smoker (p < 0.001), allowed household smoking with an open window (p = 0.027).

Conclusion
Most parents perceived that risks of SHS exposure to their children were high but only two-thirds of them had set rules prohibiting smoking. Health policymakers should pay attention to factors associated with lower risk perception among parents.

Trial registration
This study was approved by the Medical Research Ethics Committee, Ministry of Health Malaysia (Registration Number: NMRR-18-3299-44967).
Job crafting promotes internal recovery state, especially in jobs that demand self-control: a daily diary design
Authors: Shi Yanwei , She Zhuang , Li Dan , Zhang Hui , Niu Kuihuan 
Published: October 2021

Abstract
Background
Research on how employees recover from work has focused primarily on recovery during non-work hours (external recovery) rather than recovery during work hours (internal recovery). Using the conservation of resources theory as a conceptual framework, we tested whether job crafting promotes an internal recovery state, and examined the processes that explain this association.

Methods
Using the daily diary method, 120 full-time employees provided information before and after work for 5 days by rating job crafting, ego depletion, self-control demands at work, fatigue and vigor.

Results
The results of multilevel modeling showed that after controlling for employees’ fatigue and vigor before work, daily job crafting predicted significantly better internal recovery (greater vigor and lower fatigue at the end of workday), and this association was mediated by lower ego depletion. The links between job crafting and internal recovery were stronger for employees with high self-control demands at work.

Conclusions
This study extends recovery research by examining internal recovery as well as job crafting as its antecedent. Further, the present study suggests that managers may consider encouraging and offering job crafting interventions for employees to achieve internal recovery state.
Cultural contexts during a pandemic: a qualitative description of cultural factors that shape protective behaviours in the Chinese-Canadian community
Authors: Lee Charlotte T. , Kanji Rahim , Wang Angel H. , Mamuji Aaida , Rozdilsky Jack , Chu Terri 
Published: October 2021

Abstract
Background
During the COVID-19 pandemic, there have been significant variations in the level of adoption of public health recommendations across international jurisdictions and between cultural groups. Such variations have contributed to the dissimilar levels of risks associated with this world-changing viral infection and have highlighted the potential role of culture in assigning meaning and importance to personal protective behaviours. The purpose of this study is to describe the cultural factors during the COVID-19 pandemic that shaped protective health behaviours in the Chinese-Canadian community, one of the largest Chinese diasporas outside of Asia.

Methods
A qualitative descriptive design was employed. Content analysis was used to analyze the data from semi-structured virtual interviews conducted with 83 adult Chinese-Canadian participants residing in a metropolitan area in the Province of Ontario, Canada.

Findings
The cultural factors of collectivism, information seeking behaviour, symbolism of masks, and previous experience with severe acute respiratory syndrome (SARS) emerged as themes driving the early adoption of personal protective behaviours within the Chinese-Canadian community during the first wave of COVID-19. These protective behaviours that emerged prior to the first nation-wide lockdown in Canada included physical distancing, mask use, and self-quarantine beyond what was required at the time.

Conclusion
These findings have implications for the development of future public health interventions and campaigns targeting personal protective behaviours in this population and other ethnic minority populations with similar characteristics.
Return to work after subacromial decompression, diagnostic arthroscopy, or exercise therapy for shoulder impingement: a randomised, placebo-surgery controlled FIMPACT clinical trial with five-year follow-up
Authors: Bäck Mathias , Paavola Mika , Aronen Pasi , Järvinen Teppo L. N. , Taimela Simo ,   for the Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators
Published: October 2021

AbstractBackgroundArthroscopic subacromial decompression is one of the most commonly performed shoulder surgeries in the world. It is performed to treat patients with suspected shoulder impingement syndrome, i.e., subacromial pain syndrome. Only few studies have specifically assessed return-to-work rates after subacromial decompression surgery. All existing evidence comes from open, unblinded study designs and this lack of blinding introduces the potential for bias. We assessed return to work and its predictors in patients with shoulder impingement syndrome in a secondary analysis of a placebo-surgery controlled trial.MethodsOne hundred eighty-four patients in a randomised trial had undergone arthroscopic subacromial decompression (n = 57), diagnostic arthroscopy, a placebo surgical intervention, (n = 59), or exercise therapy (n = 68). We assessed return to work, defined as having returned to work for at least two follow-up visits by the primary 24-month time point, work status at 24 and 60 months, and trajectories of return to work per follow-up time point. Patients and outcome assessors were blinded to the assignment regarding the arthroscopic subacromial decompression vs. diagnostic arthroscopy comparison. We assessed the treatment effect on the full analysis set as the difference between the groups in return-to-work rates and work status at 24 months and at 60 months using Chi-square test and the predictors of return to work with logistic regression analysis.ResultsThere was no difference in the trajectories of return to work between the study groups. By 24 months, 50 of 57 patients (88%) had returned to work in the arthroscopic subacromial decompression group, while the respective figures were 52 of 59 (88%) in the diagnostic arthroscopy group and 61 of 68 (90%) in the exercise therapy group. No clinically relevant predictors of return to work were found. The proportion of patients at work was 80% (147/184) at 24 months and 73% (124/184) at 60 months, with no difference between the treatment groups (p-values 0.842 and 0.943, respectively).ConclusionsArthroscopic subacromial decompression provided no benefit over diagnostic arthroscopy or exercise therapy on return to work in patients with shoulder impingement syndrome. We did not find clinically relevant predictors of return to work either.Trial registrationClinicalTrials.gov identifierNCT00428870.
Utilization of complementary and traditional medicine practitioners among middle-aged and older adults in India: results of a national survey in 2017–2018
Authors: Pengpid Supa , Peltzer Karl 
Published: October 2021

Abstract
Background
Lack of information exists about the use of traditional and complementary medicine (TCM) use among middle-aged and older adults in India, which led to studying the estimates of past-12-month Ayurveda/Yoga/Naturopathy/Unani/Siddha/Homeopathy (AYUSH) practitioner and traditional health practitioner (THP) utilization in India.

Methods
The study included 72,262 individuals (45 years and older) from the cross-sectional 2017–2018 Longitudinal Ageing Study in India (LASI) Wave 1.

Results
The prevalence of past 12-month AYUSH practitioner utilization was 6.5%, THP use 7.0%, and AYUSH or THP use 13.0%. The rate of AYUSH practitioner utilization was determined by older age (≥60 years) (Adjusted Odds Ratio-AOR: 1.20, 95% Confidence Interval-CI: 1.07–1.34), having pain (AOR: 1.48, 95% CI: 1.29–1.69), any bone or joint diseases (AOR: 1.57, 95% CI: 1.35–1.82), current tobacco use (AOR: 1.30, 95% CI: 1.12–1.50), male sex (AOR: 0.76, 95% CI: 0.68–0.85), high subjective socioeconomic status (AOR: 0.72, 95% CI: 0.60–0.87), urban residence (AOR: 0.71, 95% CI: 0.57–0.88), diabetes (AOR: 0.66, 95% CI: 0.55–0.81), chronic heart disease (AOR: 0.52, 95% CI: 0.37–0.73), and having a health insurance cover (AOR: 0.36, 95% CI: 0.30–0.44). The rate of THP utilization was determined by depressive symptoms (AOR: 1.17, 95% CI: 1.01–1.35), sleep problems (AOR: 1.28, 95% CI: 1.08–1.51), having pain (AOR: 1.82, 95% CI: 1.55–2.15), current tobacco use (AOR: 1.35, 95% CI: 1.22–1.51), having health insurance cover (AOR: 0.41, 95% CI: 0.33–0.51), hypertension (AOR: 0.82, 95% CI: 0.71–0.95), diabetes (AOR: 0.50, 95% CI: 0.39–0.65), urban residence (AOR: 0.25, 95% CI: 0.19–0.34), and high subjective socioeconomic status (AOR: 0.70, 95% CI: 0.58–0.85).

Conclusion
A moderate prevalence of AYUSH practitioner and THP use among middle-aged and older adults in India was found and several factors associated with AYUSH practitioner and THP use were identified.
A mixed-methods survey of physiotherapists who practice acupuncture and dry needling in Ontario, Canada: practice characteristics, motivations, and professional outcomes
Authors: Ijaz Nadine , Welsh Sandy , Boon Heather 
Published: October 2021

Abstract
Background
Physiotherapists (PTs) across the globe are increasingly incorporating filiform needling techniques (e.g., acupuncture, dry needling) into their clinical toolkits; and, the evidence base for these complementary therapies is becoming progressively more robust. However, to date, little is known about needling PTs themselves.

Methods
Using a cross-sectional survey design, PTs authorized to perform needling therapies in Ontario, Canada were recruited for anonymous participation (n = 2061) in an online survey. The survey asked providers about their demographics and practice characteristics, rationale for and views about therapeutic needling, and their related clinical and professional outcomes. The response rate was 20.7% (n = 426), and 22.3% (n = 95) of respondents provided textual responses to an open-ended qualitative question.

Results
While study respondents’ demographic features appear similar to their broader professional population, Ontario’s needling PTs are less likely to work in public sector settings. Most completed training in medical acupuncture rather than dry needling, and typically used needling in over one-third of patient visits. Almost all endorsed needling as an effective musculoskeletal treatment, the primary factor informing their adoption of the practice. While many viewed traditional Chinese medical theories as a useful explanatory framework, most relied on biomedical epistemology to drive their needling work. A majority of respondents reported that the inclusion of needling within their clinical toolkits had improved their likelihood of achieving excellent clinical results, helped support patient recruitment and retention, and heightened their professional satisfaction. While a few reported earning a higher income as a result, most reported that their clinical use of needling in addition to other PT modalities reduced their physical fatigue after a day’s work.

Conclusions
This study represents a first scholarly investigation into the motivations, training backgrounds and practice patterns of PTs who use acupuncture or dry needling. Additional research from other jurisdictions is needed to evaluate the transferability of study findings.
The information system stress, informatics competence and well-being of newly graduated and experienced nurses: a cross-sectional study
Authors: Kaihlanen Anu-Marja , Gluschkoff Kia , Laukka Elina , Heponiemi Tarja 
Published: October 2021

AbstractBackgroundThe use of information systems takes up a significant amount of nurses’ daily working time. Increased use of the systems requires nurses to have adequate competence in nursing informatics and is known to be a potential source of stress. However, little is known about the role of nursing informatics competence and stress related to information systems (SRIS) in the well-being of nurses. Moreover, the potential impact of nurses’ career stage on this matter is unknown. This study examined whether SRIS and nursing informatics competence are associated with stress and psychological distress in newly graduated nurses (NGNs) and experienced nurses.MethodsA cross-sectional study was conducted in Finland between October and December 2018. The participants were NGNs (n = 712) with less than two years of work experience and experienced nurses (n = 1226) with more than two years of work experience. The associations of nursing informatics and SRIS with nurses’ stress and psychological distress were analyzed with linear regression analysis. Analyses were conducted separately for NGNs and experienced nurses. Models were adjusted for age, gender, and work environment.ResultsSRIS was associated with stress / psychological distress for both NGNs (β = 0.26p < 0.001 / β = 0.22p < 0.001) and experienced nurses (β = 0.21p < 0.001/ β = 0.12p < 0.001). Higher nursing informatics competence was associated with lower stress (β = 0.20p < 0.001) and psychological distress (β = 0.16p < 0.001) in NGNs, but not among experienced nurses.ConclusionsSRIS appears to be an equal source of stress and distress for nurses who are starting their careers and for more experienced nurses, who are also likely to be more experienced users of information systems. However, informatics competence played a more important role among NGNs and a lack of adequate competence seems to add to the strain that is already known to be high in the early stages of a career. It would be important for educational institutions to invest in nursing informatics so that new nurses entering the workforce have sufficient skills to work in increasingly digital health care.
Channel nuclear pore protein 54 directs sexual differentiation and neuronal wiring of female reproductive behaviors in Drosophila
Authors: Nallasivan Mohanakarthik P. , Haussmann Irmgard U. , Civetta Alberto , Soller Matthias 
Published: October 2021

Abstract
Background
Female reproductive behaviors and physiology change profoundly after mating. The control of pregnancy-associated changes in physiology and behaviors are largely hard-wired into the brain to guarantee reproductive success, yet the gene expression programs that direct neuronal differentiation and circuit wiring at the end of the sex determination pathway in response to mating are largely unknown. In Drosophila, the post-mating response induced by male-derived sex-peptide in females is a well-established model to elucidate how complex innate behaviors are hard-wired into the brain. Here, we use a genetic approach to further characterize the molecular and cellular architecture of the sex-peptide response in Drosophila females.

Results
Screening for mutations that affect the sensitivity to sex-peptide, we identified the channel nuclear pore protein Nup54 gene as an essential component for mediating the sex-peptide response, with viable mutant alleles leading to the inability of laying eggs and reducing receptivity upon sex-peptide exposure. Nup54 directs correct wiring of eight adult brain neurons that express pickpocket and are required for egg-laying, while additional channel Nups also mediate sexual differentiation. Consistent with links of Nups to speciation, the Nup54 promoter is a hot spot for rapid evolution and promoter variants alter nucleo-cytoplasmic shuttling.

Conclusions
These results implicate nuclear pore functionality to neuronal wiring underlying the sex-peptide response and sexual differentiation as a response to sexual conflict arising from male-derived sex-peptide to direct the female post-mating response.