bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitivity and specificity of modified RUST score using clinical and radiographic findings as a gold standard
Authors: Plumarom Yanin , Wilkinson Brandon G. , Willey Michael C. , An Qiang , Marsh Lawrence , Karam Matthew D. 
Published: September 2021

Aims The modified Radiological Union Scale for Tibia (mRUST) fractures score was developed in order to assess progress to union and define a numerical assessment of fracture healing of metadiaphyseal fractures. This score has been shown to be valuable in predicting radiological union; however, there is no information on the sensitivity, specificity, and accuracy of this index for various cut-off scores. The aim of this study is to evaluate sensitivity, specificity, accuracy, and cut-off points of the mRUST score for the diagnosis of metadiaphyseal fractures healing. Methods A cohort of 146 distal femur fractures were retrospectively identified at our institution. After excluding AO/OTA type B fractures, nonunions, follow-up less than 12 weeks, and patients aged less than 16 years, 104 sets of radiographs were included for analysis. Anteroposterior and lateral femur radiographs at six weeks, 12 weeks, 24 weeks, and final follow-up were separately scored by three surgeons using the mRUST score. The sensitivity and specificity of mean mRUST score were calculated using clinical and further radiological findings as a gold standard for ultimate fracture healing. A receiver operating characteristic curve was also performed to determine the cut-off points at each time point. Results The mean mRUST score of ten at 24 weeks revealed a 91.9% sensitivity, 100% specificity, and 92.6% accuracy of predicting ultimate fracture healing. A cut-off point of 13 points revealed 41.9% sensitivity, 100% specificity, and 46.9% accuracy at the same time point. Conclusion The mRUST score of ten points at 24 weeks can be used as a viable screening method with the highest sensitivity, specificity, and accuracy for healing of metadiaphyseal femur fractures. However, the cut-off point of 13 increases the specificity to 100%, but decreases sensitivity. Furthermore, the mRUST score should not be used at six weeks, as results show an inability to accurately predict eventual fracture healing at this time point. Cite this article: Bone Jt Open 2021;2(10):796–805.
Design of a terahertz dual-channel modulator based on metamaterials
Authors: Pan Wu , Yang Longliang , Ma Yong , Xiao Huiyun , Liu Bowen 
Published: October 2021

In this paper, we propose a terahertz dual-channel modulator by combining a high electron mobility transistor (HEMT) with a metamaterials structure, in which the HEMT is embedded in the opening of the structure metamaterial. The modulator consists of a metamaterial structure, silicon carbide (SiC), HEMT active device, and feeder. The concentration of the two-dimensional electron gas (2DEG) in the HEMT can be controlled by gate voltages, and the change of the concentration can realize the modulation of the intensity and phase of the terahertz wave. The simulation results indicate that when a single channel works, the modulation depth is 90.7% at 0.22 THz and 94.0% at 0.34 THz. When both channels work, the modulation depth is 88.9% at 0.22 THz and 93.3% at 0.34 THz. The terahertz modulator designed in this paper can work in two frequency bands and can be controlled independently, which efficiently uses the spectrum resources and has broad application prospects in the field of terahertz communication.
Characterization of T cell responses to co-administered hookworm vaccine candidates Na-GST-1 and Na-APR-1 in healthy adults in Gabon
Authors: Mouwenda Yoanne D. , Betouke Ongwe Madeleine E. , Sonnet Friederike , Stam Koen A. , Labuda Lucja A. , De Vries Sophie , Grobusch Martin P. , Zinsou Frejus J. , Honkpehedji Yabo J. , Dejon Agobe Jean-Claude , Diemert David J. , van Leeuwen Remko , Bottazzi Maria E. , Hotez Peter J. , Kremsner Peter G. , Bethony Jeffrey M. , Jochems Simon P. , Adegnika Ayola A. , Massinga Loembe Marguerite , Yazdanbakhsh Maria 
Published: October 2021

Two hookworm vaccine candidates, Na-GST-1 and Na-APR-1, formulated with Glucopyranosyl Lipid A (GLA-AF) adjuvant, have been shown to be safe, well tolerated, and to induce antibody responses in a Phase 1 clinical trial (Clinicaltrials.gov NCT02126462) conducted in Gabon. Here, we characterized T cell responses in 24 Gabonese volunteers randomized to get vaccinated three times with Na-GST-1 and Na-APR-1 at doses of 30μg (n = 8) or 100μg (n = 10) and as control Hepatitis B (n = 6). Blood was collected pre- and post-vaccination on days 0, 28, and 180 as well as 2-weeks after each vaccine dose on days 14, 42, and 194 for PBMCs isolation. PBMCs were stimulated with recombinant Na-GST-1 or Na-APR-1, before (days 0, 28 and 180) and two weeks after (days 14, 42 and 194) each vaccination and used to characterize T cell responses by flow and mass cytometry. A significant increase in Na-GST-1 -specific CD4+ T cells producing IL-2 and TNF, correlated with specific IgG antibody levels, after the third vaccination (day 194) was observed. In contrast, no increase in Na-APR-1 specific T cell responses were induced by the vaccine. Mass cytometry revealed that, Na-GST-1 cytokine producing CD4+ T cells were CD161+ memory cells expressing CTLA-4 and CD40-L. Blocking CTLA-4 enhanced the cytokine response to Na-GST-1.
In Gabonese volunteers, hookworm vaccine candidate, Na-GST-1, induces detectable CD4+ T cell responses that correlate with specific antibody levels. As these CD4+ T cells express CTLA-4, and blocking this inhibitory molecules resulted in enhanced cytokine production, the question arises whether this pathway can be targeted to enhance vaccine immunogenicity.
The impact of mating and sugar feeding on blood-feeding physiology and behavior in the arbovirus vector mosquito Aedes aegypti
Authors: League Garrett P. , Degner Ethan C. , Pitcher Sylvie A. , Hafezi Yassi , Tennant Erica , Cruz Priscilla C. , Krishnan Raksha S. , Garcia Castillo Stefano S. , Alfonso-Parra Catalina , Avila Frank W. , Wolfner Mariana F. , Harrington Laura C. 
Published: September 2021

BackgroundAedes aegyptimosquitoes are globally distributed vectors of viruses that impact the health of hundreds of millions of people annually. Mating and blood feeding represent fundamental aspects of mosquito life history that carry important implications for vectorial capacity and for control strategies. Females transmit pathogens to vertebrate hosts and obtain essential nutrients for eggs during blood feeding. Further, because host-seekingAe.aegyptifemales mate with males swarming near hosts, biological crosstalk between these behaviors could be important. Although mating influences nutritional intake in other insects, prior studies examining mating effects on mosquito blood feeding have yielded conflicting results.Methodology/Principal findingsTo resolve these discrepancies, we examined blood-feeding physiology and behavior in virgin and mated females and in virgins injected with male accessory gland extracts (MAG), which induce post-mating changes in female behavior. We controlled adult nutritional status prior to blood feeding by using water- and sugar-fed controls. Our data show that neither mating nor injection with MAG affectAe.aegyptiblood intake, digestion, or feeding avidity for an initial blood meal. However, sugar feeding, a common supplement in laboratory settings but relatively rare in nature, significantly affected all aspects of feeding and may have contributed to conflicting results among previous studies. Further, mating, MAG injection, and sugar intake induced declines in subsequent feedings after an initial blood meal, correlating with egg production and laying. Taking our evaluation to the field, virgin and mated mosquitoes collected in Colombia were equally likely to contain blood at the time of collection.Conclusions/SignificanceMating, MAG, and sugar feeding impact a mosquito’s estimated ability to transmit pathogens through both direct and indirect effects on multiple aspects of mosquito biology. Our results highlight the need to consider natural mosquito ecology, including diet, when assessing their physiology and behavior in the laboratory.
High-intensity interval training versus progressive high-intensity circuit resistance training on endothelial function and cardiorespiratory fitness in heart failure: A preliminary randomized controlled trial
Authors: Turri-Silva Natália , Vale-Lira Amanda , Verboven Kenneth , Quaglioti Durigan João Luiz , Hansen Dominique , Cipriano Gerson 
Published: October 2021

Introduction
Exercise training is strongly recommended as a therapeutic approach to treat individuals with heart failure. High-intensity exercise training modalities still controversial in this population. The study aims to preliminary assess the consequences of high-intensity exercise training modalities, aerobic interval training (HIIT) and progressive high circuit-resistance training (CRT), on primarily endothelial function and cardiorespiratory fitness, and secondly on muscle strength and physical performance in heart failure patients.

Methods
This preliminary multicentric randomized controlled trial comprised 23 heart failure patients, aged 56 ± 10 years old, mainly New York Heart Association classification I and II (%), hemodynamically stable, who compromise at least 36 exercise sessions of a randomly assigned intervention (HIIT, CRT or control group). Endothelial function, cardiopulmonary exercise testing, muscle strength and physical performance were completed at baseline and post-intervention.

Results
Although no effects on endothelial function; both HIIT and CRT modalities were able to produce a positive effect on V˙O2 peak (HIIT = +2.1±6.5, CRT = +3.0±4.2 and control group = -0.1± 5.3 mL/kg/min, time*group p-value<0,05) and METs (HIIT = +0.6±1.8, CRT = +0.9±1.2 and control group = 0±1.6, time*group p-value<0,05). Only HIIT increased isokinetic torque peak (HIIT = +8.8±55.8, CRT = 0.0±60.7 and control group = 1.6±57.6 Nm) matched p-value<0,05. Regarding the physical performance, the CRT modality reduced chair stand test completion time (HIIT = -0.7±3.1, CRT = -3.3±3.2 and control group = -0.3±2.5 s, matched p-value<0,05 and HIIT improved global physical performance(time*group p<0,05).

Conclusion
This preliminary study trends to indicate for the first time that high-intensity interval training promotes a jointly superior effect compared to progressive high intensity circuit-resistance training by improving cardiorespiratory fitness, muscular strength, and physical performance. Further research with larger cohort is necessary.

Clinical trial registration number
ReBEC RBR-668c8v.
Perceived-stigma level of COVID-19 patients in China in the early stage of the epidemic: A cross-sectional research
Authors: Lin Bihua , Zhong Guiqin , Liang Zeyan , Huang Jianying , Wang Xiaofang , Lin Yanjuan 
Published: October 2021

Objective
To investigate the perceived-stigma level of COVID-19 patients in the early stage of the epidemic and analysed related factors and correlations that affected the stigma levels.

Methods
The COVID-19 patients were selected using the convenience sampling method. Perceived-stigma level was evaluated using the Social Impact Scale (SIS). Frequency was used to describe the general information and disease investigation status of COVID-19 patients; mean and standard deviation were used for describing stigma levels, Wilcoxon signed-ranks test (nonparametric test) was applied for pairwise comparison. Kruskal-Wallis non-parametric test for grade data, and Dwass-Steel-Critchlow-Fligner test for multiple comparative analysis. Multiple linear regression analysis was performed, and statistically significant indicators in single-factor analysis were included to investigate the independent factors of stigma. The p<0.05 was considered statistically significant.

Results
SIS score of the 122 COVID-19 patients averaged 57.37±9.99 points. There were statistically significant differences in perceived-stigma levels among patients of different ages (p = 0.008), occupation (p <0.001), marital status (p = 0.009), and disease severity (p = 0.020). Multivariate logistic regression analysis revealed that age was the main influencing factor of stigma (p<0.05).

Conclusions
The overall perceived-stigma level of COVID-19 patients in the early stage of the epidemic was moderate. Younger, unmarried, and severely ill patients had a higher level of perceived-stigma, with age being the main factor. More attention should be given to the young COVID-19 patients.
Initial dose reduction of enzalutamide does not decrease the incidence of adverse events in castration-resistant prostate cancer
Authors: Tsuzuki Shunsuke , Nakanishi Shotaro , Tamaki Mitsuyoshi , Oshiro Takuma , Miki Jun , Yamada Hiroki , Shimomura Tatsuya , Kimura Takahiro , Furuta Nozomu , Saito Seiichi , Egawa Shin 
Published: October 2021

Background
There was no clear evidence whether the initial dose of enzalutamide affects the incidence of adverse events (AEs), and oncological outcome in patients with castration-resistant prostate cancer (CRPC).

Methods
The clinical charts of 233 patients with CRPC treated with enzalutamide were reviewed retrospectively. After 1:3 propensity score matching (PSM), 124 patients were divided into a reduced dose group and a standard dose group, and the prostate specific antigen (PSA) response and the incidence of AEs were compared.

Results
190 patients with CRPC initiated with standard dose enzalutamide were younger and better performance status compared with 43 patients beginning with reduced dose. After PSM, the baseline characteristics were not different between the standard and the reduced dose group. In the PSM cohort, the PSA response rate was significantly lower in the reduced dose group than in the standard dose group (-66.3% and -87.4%, p = 0.02). The incidence rates of AEs were not statistically different between the groups (22.6% and 34.4%, respectively, p = 0.24).

Conclusion
Initiating treatment with a reduced dose of enzalutamide did not significantly decrease the incidence rate of AEs, and it showed poorer PSA response rate. There is no clear rationale for treating with a reduced initial dose of enzalutamide to reduce the incidence of AEs.
Pesquisa ação: Fração e Porcentagem
Authors: Iglesias Ribeiro Alonso Rosa de Lourdes , Erdmann Cibele Nair Rosa , Labiapari Pessoa Carvalho Juliana 
Published: October 2021

O presente artigo busca contribuir com estudos sobre a construção do conceito de porcentagem por alunos do 5º ano do Ensino Fundamental. Investiga-se a hipótese de que o trabalho com representações gráficas, a partir de relações de equivalência entre frações unitárias e centesimais, contribui com a construção do conceito de porcentagem. A metodologia utilizada foi a pesquisa-ação, em uma perspectiva colaborativa, realizada em uma turma de uma escola da rede particular da cidade de São Paulo. A análise dos dados coletados permitiu concluir que as representações gráficas favoreceram a construção do conceito de porcentagem e significativa reflexão acerca da equivalência entre porcentagens e frações.
Instrumentos de avaliação do clima escolar adaptados aos anos iniciais do Ensino Fundamental: evidências de validação
Authors: P. P. Ribeiro Parente Elvira Maria , Unger Raphael Bataglia Patricia , São João Castellini Thais 
Published: October 2021

A avaliação do clima escolar é de grande relevância para o diagnóstico e planejamento das ações que permeiam as relações e aprendizagem na escola, uma vez que contempla as expectativas e percepções dos grupos que a compõem. O presente trabalho apresenta as primeiras evidências de validação dos instrumentos de avaliação do clima escolar adaptados para estudantes, docentes e equipe gestora de instituições do Ensino Fundamental anos iniciais. Para isso, retoma o conceito de clima, aborda a elaboração dos instrumentos para o Ensino Fundamental anos finais e Ensino Médio e, em seguida, discorre sobre a adaptação dos instrumentos e índices de validação qualitativa e quantitativa provenientes da aplicação dos instrumentos em 15 escolas. Conclui sugerindo continuidade no processo de validação.
Impaired Proximal Esophageal Contractility Predicts Pharyngeal Reflux in Patients With Laryngopharyngeal Reflux Symptoms
Authors: Sikavi Daniel R. , Cai Jennifer X. , Leung Ryan , Carroll Thomas L. , Chan Walter W. 
Published: October 2021

OBJECTIVES:
The pathophysiology of laryngopharyngeal reflux (LPR) remains incompletely understood. Proximal esophageal motor dysfunction may impair bolus clearance, increasing the risk of pharyngeal refluxate exposure. We aimed to evaluate the association of proximal esophageal contractility with objective reflux metrics.

METHODS:
We evaluated adults with LPR symptoms undergoing high-resolution manometry (HRM) and combined hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing at a tertiary center between March 2018 and August 2019. Routine parameters per Chicago classification were obtained on HRM. Proximal esophageal contractility was evaluated using proximal contractile integral (PCI), which quantifies contractile pressure >20 mm Hg for the region spanning the distal margin of the upper esophageal sphincter and transition zone. Univariate (Kendall correlation and Student t test) and multivariable (general linear regression and logistic regression) analyses were performed.

RESULTS:
We enrolled 138 patients (66.7% women, mean age 57.1 years) in this study. Lower PCI was associated with an elevated risk of increased pharyngeal reflux (adjusted odds ratio 0.83 per 100 mm Hg-s-cm change in PCI, 95% confidence interval: 0.69–0.98), with a trend toward increased bolus exposure time and total reflux events, after multivariable adjustment. The relationship between PCI and pharyngeal reflux was strongest among participants without a primary motility disorder on HRM (adjusted odds ratio 0.63, 95% confidence interval: 0.42–0.85, P interaction = 0.04). Among continuously expressed reflux parameters, lower PCI was significantly associated with more distal acid reflux events (β = −0.0094, P = 0.03) and total reflux events (β = −0.0172, P = 0.05), after adjusting for confounders.

DISCUSSION:
Reduced proximal esophageal contractility as assessed by decreased PCI on HRM independently predicted increased pharyngeal reflux in patients with LPR symptoms, particularly among those without a coexisting motility disorder.
Analysis of transport path and source distribution of winter air pollution in Shenyang
Authors: Ma Yunfeng , Liu Qiyao , Bian Yushan , Feng Lei , Zhao Di , Wang Shuai , Zhao Huijie , Gao Kunyu , Xu Zhengqing 
Published: October 2021

Abstract
Air pollution is one of the most serious environmental problems faced by mankind. It is regional and highly complex, and it is more prominent in China. With the development of air quality management in China, the research on cross-regional transmission of air pollutants is particularly important. This paper reports on pollution characteristics, transport path, and distribution of pollution sources of major contaminants in Shenyang. For this purpose, pollution-monitoring data were gathered from November 2017 to March 2018. Data were analyzed using the HYSPLIT back trajectory model, the potential source contribution function (PSCF), and the concentration weighted trajectory (CWT) model. Results indicated that PM2.5 was the main pollutant in Shenyang during the study period. Air pollution was mainly affected by coal combustion, traffic emissions, and long-distance transmission. Among the 11 monitoring points, the pollution of Shenliaoxilu was relatively serious. Mongolia, eastern Inner Mongolia, northwestern Jilin, and most of Liaoning were the main potential sources of PM2.5 in Shenyang during the winter.
Examining Internal and External Physical Workloads Between Training and Competitive Matches Within Collegiate Division I Men's Soccer
Authors: Anderson Travis , Adams William M. , Martin Kerry J. , Wideman Laurie 
Published: October 2021

Abstract
Anderson, T, Adams, WM, Martin, KJ, and Wideman, L. Examining internal and external physical workloads between training and competitive matches within collegiate Division I men's soccer. J Strength Cond Res 35(12): 3440–3447, 2021—A direct analysis comparing differences in the demands of competition relative to in-season training in Division I collegiate soccer players has yet to be reported. Thus, the primary purpose of this study was to compare the absolute and relative internal and external workloads measured during training with competitive matches. Twenty-six male college soccer players were monitored over 2 consecutive seasons using a GPS and heart rate (HR) telemetry system. Differences between outdoor training sessions and competitive matches were analyzed for internal and external absolute and relative training workloads. Differences in training workloads between the 3 days before a match were also analyzed. Absolute time in HR zone 4 (80–89% of HRmax) and 5 (90–100% of HRmax); accelerations in zone 1 (0.50–0.99 m·s−2), zone 2 (1.00–1.99 m·s−2), and zone 3 (2.00–2.99 m·s−2); all negative acceleration zones; training load; and estimated energy expenditure were greater in competition than training (p < 0.05). By contrast, when comparing training and competition values using metrics relative to session duration, relative workload in trainings were greater than competition for HR zone 1 (50–59% of HRmax), zone 2 (60–69% of HRmax), zone 3 (70–79% of HRmax), and zone 4 (80–89% of HRmax) and all acceleration and negative acceleration zones. In addition, absolute training workloads were generally greatest 3 days prior (p < 0.01), but not different 2 days before the competitive match. Absolute physical workloads of competition are significantly greater than those achieved during training; however, these differences and impact on the physical condition of players are mitigated by the greater relative workloads achieved during training. These results provide meaningful metrics that may lead to insights into proper conditioning and in-season workload management for Division I collegiate soccer programs.
Pheochromocytomas and paragangliomas in von Hippel–Lindau disease: not a needle in a haystack
Authors: Castro-Teles João , Sousa-Pinto Bernardo , Rebelo Sandra , Pignatelli Duarte 
Published: October 2021

Objective
Pheochromocytomas are a hallmark feature of von Hippel–Lindau disease (vHL). To our knowledge, this is the first systematic review with meta-analysis evaluating the frequency of pheochromocytomas and/or paragangliomas (PPGLs) in patients with vHL, as well as among patients with different vHL subtypes.

Design
Systematic review with meta-analysis.

Methods
We searched on MEDLINE, Scopus, and Web of Science. We included primary studies assessing participants with vHL and reporting on the frequency of PPGL. We performed random-effects meta-analysis to quantitatively assess the frequency of PPGL, followed by meta-regression and subgroup analysis. Risk of bias analysis was performed to assess primary studies’ methodological quality.

Results
We included 80 primary studies. In 4263 patients with vHL, the pooled frequency of PPGL was 19.4% (95% CI = 15.9–23.6%, I2 = 86.1%). The frequency increased to 60.0% in patients with vHL type 2 (95% CI = 53.4–66.3%, I2 = 54.6%) and was determined to be of 58.2% in patients with vHL type 2A (95% CI = 49.7–66.3%, I2 = 36.2%), compared to 49.8% in vHL type 2B (95% CI = 39.9–59.7%, I2 = 42.7%), and 84.1% in vHL type 2C (95% CI = 75.1–93.1%, I2 = 0%). In meta-regression analysis, more recent studies were associated with a higher frequency of PPGL. All studies had at least one internal validity item classified as 'high risk of bias,' with 13% studies having low risk of bias in all external validity items.

Conclusions
PPGLs are a common manifestation of vHL. Despite methodological limitations and differences across primary studies, our results point to the importance of PPGL screening in patients with vHL.