bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal association of maternal weight gain with early-term and preterm birth and low birth weight babies
Authors: Jan Mohamed Hamid Jan , Lim Poh Ying , Loy See Ling , Chang Kah Haw , Abdullah Ahmad Fahmi Lim 
Published: May 2021

Background:
Low birth weight and preterm or early-term babies may have a higher risk of poor health. One of the main factors is the weight gain of a pregnant woman during gestational weeks in the second and third trimesters. Changes in weight over a month in a pregnant woman might also have an impact on infant outcomes. This study aimed to investigate the association between maternal weight at different time points and low birth weight and preterm or early-term babies (premature babies).

Methods:
A total of 156 pregnant women were recruited. Maternal weight was collected at different gestational weeks. Maternal age, body mass index, delivery mode, delivery week, and infant weight were also recorded. Maternal data were restructured into a person-period format before mixed-effects multiple logistic regression was used. Various weight variables with either a fixed effect or time-varying effects were tested in the model.

Results:
Thirty (19.23%) women had delivered low birth weight or premature babies. Multiple logistic regression model demonstrated that mothers with higher increases in weight at 32 weeks of gestation than that in the predelivery stage had a lower probability of having a low birth weight or premature baby (odds ratio [OR] = 0.64; 95% CI, 0.49-0.85; p < 0.001). Women with a weight increase of more than 2 kg in a 4-week gestation period had a higher probability of having a low birth weight or premature baby than those with an increment of <1 kg (OR = 8.43; 95% CI, 2.90-24.54; p < 0.001).

Conclusion:
An increase in weight gain after 32 weeks was shown to reduce the risk of low birth weight and premature babies. Maternal weight monitoring was suggested to be conducted every 4 weeks to minimize the chance of having a low birth weight and premature baby.
Surgical and survival outcomes after robotic and open pancreaticoduodenectomy with positive margins
Authors: Lee Po-Ying , Shyr Bor-Uei , Shyr Bor-Shiuan , Chen Shih-Chin , Shyr Yi-Ming , Wang Shin-E 
Published: May 2021

Background:
Though nowadays a palliative pancreaticoduodenectomy (PD) can be performed safely with relatively low mortality and acceptable morbidity rates in experienced centers, there have been no studies on the routine use of a palliative PD or on the advantages of performing surgical resection as a debulking procedure. Furthermore, the impact of resection margins on survival outcomes has been a matter of controversy. Therefore, this study aimed to clarify the role of robotic PD (RPD) in pancreatic and periampullary adenocarcinomas with positive resection margins.

Methods:
Patients undergoing RPDs and open PDs (OPDs) were included in this study. Based on the resection margins, the patients were divided into the R0, R1, and R2 PD groups. Surgical risks and survival outcomes were analyzed.

Results:
There were 348 PDs, including 29 (8.3%) palliative and 319 (91.7%) curative. Primary tumor origin, tumor sizes, perineural invasions, and abnormal serum carcinoembryonic antigen (CEA) levels were factors leading to palliative resection. The multivariate analysis showed that only pancreatic head adenocarcinomas and abnormal serum CEA levels (>5 ng/mL) were independent predictors. The surgical risks between curative and palliative PD were similar. There were no significant differences in the surgical risks and other surgical parameters between palliative RPDs and OPDs. For curative resection, RPDs resulted in less blood loss, greater harvested lymph nodes yield, less postoperative complications, less delayed gastric emptying, and shorter hospital stays than OPDs. The survival outcome was significantly better following R0 resection in overall periampullary adenocarcinomas, whereas a significant survival difference was shown only between the R0 and R2 resections for pancreatic head adenocarcinomas.

Conclusion:
Compared with R0 PDs, palliative R1 PDs could benefit patients with pancreatic head adenocarcinomas when considering survival outcomes without increasing surgical risks. RPD can be considered for curative purposes and as an alternative for palliative management.
Accurate diagnosis of endoscopic mucosal healing in ulcerative colitis using deep learning and machine learning
Authors: Huang Tien-Yu , Zhan Shan-Quan , Chen Peng-Jen , Yang Chih-Wei , Lu Henry Horng-Shing 
Published: May 2021

Background:
In clinical applications, mucosal healing is a therapeutic goal in patients with ulcerative colitis (UC). Endoscopic remission is associated with lower rates of colectomy, relapse, hospitalization, and colorectal cancer. Differentiation of mucosal inflammatory status depends on the experience and subjective judgments of clinical physicians. We developed a computer-aided diagnostic system using deep learning and machine learning (DLML-CAD) to accurately diagnose mucosal healing in UC patients.

Methods:
We selected 856 endoscopic colon images from 54 UC patients (643 images with endoscopic score 0-1 and 213 with score 2-3) from the endoscopic image database at Tri-Service General Hospital, Taiwan. Endoscopic grading using the Mayo endoscopic subscore (MES 0-3) was performed by two reviewers. A pretrained neural network extracted image features, which were used to train three different classifiers—deep neural network (DNN), support vector machine (SVM), and k-nearest neighbor (k-NN) network.

Results:
DNN classified MES 0 to 1, representing mucosal healing, vs MES 2 to 3 images with 93.8% accuracy (sensitivity 84.6%, specificity 96.9%); SVM had 94.1% accuracy (sensitivity 89.2%, specificity 95.8%); and k-NN had 93.4% accuracy (sensitivity 86.2%, specificity 95.8%). Combined, ensemble learning achieved 94.5% accuracy (sensitivity 89.2%, specificity 96.3%). The system further differentiated between MES 0, representing complete mucosal healing, and MES 1 images with 89.1% accuracy (sensitivity 82.3%, specificity 92.2%).

Conclusion:
Our DLML-CAD diagnosis achieved 94.5% accuracy for endoscopic mucosal healing and 89.0% accuracy for complete mucosal healing. This system can provide clinical physicians with an accurate auxiliary diagnosis in treating UC.
Digital mHealth Interventions for Employees
Authors: Stratton Elizabeth , Jones Nathan , Peters Susan E. , Torous John , Glozier Nicholas 
Published: May 2021

Objectives:
To justify the capital investment, employers require proof of benefit of digital mHealth beyond symptomatic improvement.

Methods:
A systematic review and meta-analysis were conducted to identify studies investigating digital mHealth interventions for employees and their effects on workplace outcomes.

Results:
We identified 28 eligible studies, (8023 employees) comparing digital mHealth interventions to controls. Small significant effects at postintervention in engagement (g = 0.19), and productivity (g = 0.16) were found. Sustained effects were observed, engagement (g = 0.24) and productivity (g = 0.20). There was a wide range of study heterogeneity (I
2 = 16% to 94%).

Conclusion:
In RCTs digital mHealth interventions demonstrate small, potentially sustained efficacy on employee's engagement and productivity. Similar small yet non-significant effect sizes were seen for absenteeism and presenteeism. This supports the need to find ways of enabling employers to deliver these low-cost digital mHealth interventions that can help improve employee's mental health.
Association Between Injury Mechanisms and Magnetic Resonance Imaging Findings in Rectus Femoris Injuries in 105 Professional Football Players
Authors: Geiss Santos Rafael Cristiano , Van Hellemnondt Frank , Yamashiro Eduardo , Holtzhausen Louis , Serner Andreas , Farooq Abdulaziz , Whiteley Rodney , Tol Johannes L. 
Published: May 2021

Objective:
To describe the injury mechanism and its association with magnetic resonance imaging (MRI) injury findings in acute rectus femoris injuries.

Design:
Combined retrospective and prospective descriptive injury study. Retrospective cohort from January 2010 to October 2013 and prospective cohort from October 2013 to January 2019.

Setting:
Specialized sports medicine hospital.

Participants:
Male professional football players older than 18 years playing in a national football league, referred for injury assessment within 7 days after an acute rectus femoris injury, with a positive finding on MRI.

Independent variables:
Rectus femoris muscle injury MRI findings in relation to injury mechanism in male football players.

Main outcome measures:
Rectus femoris injury mechanism (kicking, sprinting, and others), MRI injury location, and grade.

Results:
There were 105 injuries in total, with 60 (57.1%) and 45 (42.8%) injuries from the retrospective and prospective cohorts, respectively. Kicking was the injury mechanism in 57 (54.3%) of all acute rectus femoris injuries, sprinting represented 32 (30.4%), and 16 (15.2%) were classified as others. There were 20 (19.05%) free tendon, 67 (63.8%) myotendinous junction and/or intramuscular tendon, and 18 (17.1%) peripheral myofascial located injuries. All free tendon injuries were related to kicking and graded as a complete tear of at least one of the tendons in 15/20 (75.0%) cases.

Conclusions:
Kicking seems to be an important mechanism related to complete ruptures and injuries occurring at the proximal free tendon. Sprinting was the other most common mechanism but was never associated with injury to the proximal free tendon.
Voiding Dysfunction in Interstitial Cystitis Patients and the Relation to Pelvic Floor Dysfunction
Authors: Crouss Tess , Whitmore Kristene 
Published: May 2021

Background:
A large proportion of patients with interstitial cystitis have concomitant pelvic floor muscle dysfunction.

Objective:
To assess voiding dysfunction in patients with interstitial cystitis who have varying degrees of pelvic floor dysfunction.

Study Design:
A retrospective cohort study.

Methods:
Women with interstitial cystitis who underwent cystoscopy/bladder hydrodistension and urodynamic testing from November 2015 to February 2019 were divided into 2 cohorts based on severity of pelvic floor dysfunction (nonsevere and severe). The primary outcome was voiding dysfunction (bladder outlet obstruction and/or pelvic floor muscle dyssynergia by electromyography during voiding). Symptom severity, cystoscopy findings, and urodynamic findings were compared.

Results:
Fifty-one patients were included—36 in the severe and 15 in the nonsevere cohort. The mean age was 48 years. Those in the severe cohort showed higher rates of voiding dysfunction than those in the nonsevere cohort (89.7% vs 64.3%, respectively, P = .045). Seventy-three percent of subjects had glomerulations and 12% had Hunner's lesions. The presence of Hunner's lesions was associated with a lower first urge volume on urodynamic testing compared with non-Hunner's lesions (75.8 vs 148 mL, P = .046). Modest negative correlations were obtained between interstitial cystitis symptom severity and most urodynamic volumes.

Conclusion:
Patients with interstitial cystitis with more severe pelvic floor dysfunction demonstrated higher rates of dysfunctional voiding than those with nonsevere dysfunction, and may benefit from advanced pelvic floor therapy.
Hospitalized Patients With COVID-19 and Neurological Complications Experience More Frequent Decline in Functioning and Greater Rehabilitation Needs
Authors: Claflin Edward S. , Daunter Alecia K. , Bowman Angeline , Startup Joshua , Reed Eboni , Krishnan Chandramouli , Kratz Anna L. 
Published: May 2021

Abstract
The coronavirus disease 2019 has been reported to cause various serious neurological sequelae. However, there is little information available about the impact of the disease and its complications on patients’ functional status and their postacute needs. Hence, this study was performed to address the current gap in knowledge about the function and postacute needs of those with neurological complications of coronavirus disease 2019. A prospective chart review was completed for 319 patients admitted with coronavirus disease 2019 between March 4 and May 1, 2020. Primary outcomes included rate of new functional decline, discharge location, need for outpatient physical/occupational/speech therapy, need for durable medical equipment at discharge, and presence of dysphagia at discharge. Patients with neurological complications were compared with patients without neurological complications. Two hundred ninety-six cases were included in the final analysis, and 81 (27.4%) of these patients experienced neurological complications. Results indicated that hospitalized coronavirus disease 2019 patients with neurological complications exhibit a significantly longer length of stay, higher frequency of functional decline, higher mortality rate, and more frequent discharge to a subacute rehabilitation facility (all P < 0.0001). The findings of this study are expected to better prepare patients, providers, and health systems for the postacute needs of those with coronavirus disease 2019 and neurological complications.
A Scoping Review of Registered Clinical Studies on Management of Individuals With Acute Spinal Cord Injury (2000–2020)
Authors: Furlan Julio C. , Furlan Daniel T. , Marquez-Chin Cesar 
Published: May 2021

Abstract
This scoping review examined the current trends and characteristics of the clinical research initiatives on the management of acute spinal cord injury. This review included all clinical studies on the acute treatment of spinal cord injury that were registered in the ClinicalTrials.gov website from February 2000 to December 2020. The search strategy combined the terms “acute spinal cord injury” and “treatment.” There has been a gradual increase in the number of registered clinical studies on acute treatment of spinal cord injury over the past two decades. Of the 116 studies, there were 103 interventional studies, 12 observational studies, and 1 registry. While 115 clinical studies recruited male and female participants, most of the registered clinical studies included only adults with an upper age limit after spinal cord injury. Most of the registered clinical studies were interventional studies led by single institutions in North America (n = 70), Europe (n = 29), and Asia (n = 15). Most of the research initiatives were interventional studies on new therapies for management of individuals with spinal cord injury (n = 91). In conclusion, the results of this scoping review suggest that although there has been an increase in the amount and diversity of the research initiatives on treatment of acute spinal cord injury over the past two decades, their generalizability remains relatively limited.
The Effectiveness of Fluoroscopically Guided Genicular Nerve Radiofrequency Ablation for the Treatment of Chronic Knee Pain Due to Osteoarthritis
Authors: Fogarty Alexandra E. , Burnham Taylor , Kuo Keith , Tate Quinn , Sperry Beau P. , Cheney Cole , Walega David R. , Kohan Lynn , Cohen Steven P. , Cushman Daniel M. , McCormick Zachary L. , Conger Aaron 
Published: May 2021

Abstract
The objective was to determine the effectiveness of fluoroscopically guided genicular nerve radiofrequency ablation for painful knee osteoarthritis. Primary outcome measure was improvement in pain after 6 mos. Secondary outcomes included the Oxford Knee Score and Western Ontario and McMaster Universities Osteoarthritis Index. Two reviewers independently assessed publications before October 10, 2020. The Cochrane Risk of Bias Tool and Grades of Recommendation, Assessment, Development, and Evaluation system were used. One hundred ninety-nine publications were screened, and nine were included. Six-month success rates for 50% or greater pain relief after radiofrequency ablation ranged from 49% to 74%. When compared with intra-articular steroid injection, the probability of success was 4.5 times higher for radiofrequency ablation (relative risk = 4.58 [95% confidence interval = 2.61–8.04]). When radiofrequency ablation was compared with hyaluronic acid injection, the probability of treatment success was 1.8 times higher (relative risk = 1.88, 95% confidence interval = 1.38–2.57). The group mean Oxford Knee Score and Western Ontario and McMaster Universities Osteoarthritis Index scores improved in participants receiving genicular radiofrequency ablation compared with intra-articular steroid injection and hyaluronic acid injection. According to Grades of Recommendation, Assessment, Development, and Evaluation, there is moderate-quality evidence that fluoroscopically guided genicular radiofrequency ablation is effective for reducing pain associated with knee osteoarthritis at minimum of 6 mos. Further research is likely to have an important impact on the current understanding of the long-term effectiveness of this treatment.
Standard Psychometric Criteria for Measurements in Physical and Rehabilitation Medicine
Authors: Hassan Samah , Tesio Luigi , Kumbhare Dinesh 
Published: May 2021

Abstract
Measurements of person’s variable, such as behavior, perceptions, or attitudes, are essential to physical and rehabilitation medicine in both clinical practice and research. These measurements are commonly based on cumulative questionnaires and follow special statistical rules, belonging to the domain of psychometrics. Selecting the most appropriate measurement is critical. This article provides an overview of the standard psychometric criteria to consider in measurement selection. The article focuses on the criteria related to the contemporary psychometric approach as it considers the construct, the target population, and the purpose for which measurements are used. Common strategies related to psychometric testing are discussed and applied to critically appraise, as a representative example, one of the most commonly used pain measurements: Brief Pain Inventory. The measurement construct, conceptual framework, target population, purpose, and psychometric properties are highlighted. Observed limitations for its implementation in different settings also are discussed.
Predictors of Psychological Distress and Confidence Negotiating Physical and Social Environments Among Mobility Device Users
Authors: Mortenson W. Ben , Routhier François , Mahmood Atiya , Prescott Mike , Labbé Delphine , Martin Ginis Kathleen A. , Miller William C. 
Published: May 2021

Objective
We conducted an intersectional analysis to explore how demographic characteristics and mobility device use were associated with psychological distress (depression and anxiety) and confidence negotiating physical and social environments.

Design
Cross-sectional data were collected using the Hospital Anxiety and Depression Scale, modified Wheelchair Use Confidence Scale, and self-reported functional independence scale.

Participants
The sample included 105 participants. Primary mobility devices used included mobility scooters (27%), power wheelchairs (26%), manual wheelchairs (25%), walkers (11%), and cane or crutch (12%). The mean age of participants was 58 yrs, 53% were female, and 52% lived alone and were functionally independent with the use of assistive technology.

Results
We were able to explain between 39% and 65% of the variance (adjusted R
2) in the dependent variables with parsimonious regression models. Age was an independent predictor of all outcomes. Women were less confident negotiating the physical environment, and walker use was associated with depression and lower confidence negotiating physical environments, but increased confidence negotiating social environments.

Conclusions
Age is associated with psychosocial outcomes for assistive device users, and those who use walkers may experience increased challenges with depression and negotiating the physical environment. Pending confirmatory research, the findings may have important implications for targeted interventions related to device provision.
How Can We Support the Use of Oral PrEP Among Young Women who Sell Sex? A PrEP Cascade Analysis
Authors: Hensen B. , Machingura F. , Busza J. , Birdthistle I. , Chabata S.T. , Chiyaka T. , Floyd S. , Jamali G. , Mushati P. , Hargreaves J. , Cowan F.M. 
Published: May 2021

Background:
We constructed self-reported pre-exposure prophylaxis (PrEP) cascades and explored factors associated with and barriers to PrEP use to inform efforts to support PrEP use among young women who sell sex.

Methods:
Using self-reported data from HIV-negative young women who sell sex enrolled into a cohort study using respondent-driven sampling in Zimbabwe, we constructed PrEP cascades assessing knowledge of, ever offered, ever used, and current PrEP use in 2017 and 2019. We used logistic regression to examine factors associated with PrEP use by 2019. Through qualitative interviews with 43 women enrolled in the cohort, we investigated barriers to PrEP use.

Results:
At enrollment, 50% of women had heard of PrEP, 12% had ever been offered PrEP, and 7% ever used PrEP. Over time, all cascade domains: 96% of women had heard of and 55% reported an active offer of PrEP. Among women retained in the study in 2019 (56%; n = 538), 34% ever took PrEP by 2019. PrEP use was associated with, at enrollment, reporting more clients in the past month (10+: 45% vs 1–3: 27% adjOR = 1.71 95% CI: 1.06 to 2.76), duration of selling sex (24% <2 years vs 38% 2–3 years; adjOR = 0.51 95% CI: 0.32 to 0.83), and having visited a female sex worker program in the past 12 months (55% vs 27%; adjOR = 2.92 95% CI: 1.91 to 4.46). Qualitative interviews revealed fear of disclosing sex work, HIV-related/ART-related stigma, and (opportunity) costs of accessing PrEP as barriers to use.

Conclusion:
PrEP use was associated with factors known to increase HIV risk. Fear of stigma, disclosure, and supply-side barriers need to be addressed to increase women's ability to use PrEP.
LncRNA RP11-390F4.3 inhibits invasion and migration of glioblastoma cells by downregulating ROCK1
Authors: Fang Zebin , Weng Yuxiang , Xiao Feng , Yu Jianbo 
Published: May 2021

Background
This study aimed to investigate the role of lncRNA RP11-390F4.3 in glioblastoma.

Methods
The expression levels of RP11-390F4.3, miR-148a and ROCK1 in glioblastoma and nontumor tissues were measured by performing quantitative PCR (qPCR) and data were compared using paired t test. Linear regression analysis was performed to analyze the correlations between RP11-390F4.3 and miR-148a/ROCK1 in glioblastoma tissues. The effects of overexpression of RP11-390F4.3, miR-148a and ROCK1 on U-373 MG cell invasion and migration were analyzed by Transwell assay.

Results
RP11-390F4.3 and ROCK1 were both upregulated in glioblastoma, while miR-148a was downregulated in glioblastoma. In glioblastoma, RP11-390F4.3 was positively correlated with ROCK1 but negatively correlated with miR-148a. In glioblastoma cells, overexpression of RP11-390F4.3 led to upregulated ROCK1 and downregulated miR-148a. Cell invasion and migration analysis showed that overexpression of RP11-390F4.3 and ROCK1 resulted in increased, and overexpression of miR-148a resulted in deceased invasion and migration rates of glioblastoma cells.

Conclusion
Therefore, RP11-390F4.3 may upregulate ROCK1 by downregulating miR-148a to promote glioblastoma cell invasion and migration.