bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological and virological characteristics of respiratory tract infections in children during COVID-19 outbreak
Authors: Zhu Yueling , Li Wei , Yang Binbin , Qian Ruiying , Wu Fang , He Xue , Zhu Qinheng , Liu Jinling , Ni Yan , Wang Jianbing , Mao Shanshan 
Published: April 2021

Abstract
Background
To investigate the impact of protective measures and isolation on respiratory tract infections in children during the COVID-19 outbreak.

Methods
We extracted data on outpatient visits and respiratory infection visits, and tests of respiratory viruses (adenovirus (ADV), influenza A (FluA), influenza B (FluB) and respiratory syncytial virus (RSV)) from electronic healthcare records in Children’s Hospital, Zhejiang University School of Medicine during the COVID-19 outbreak (January–April, 2020), compared with those in 2018 and 2019 during the same periods.

Results
We found that outpatient visits in January, 2020 was comparable with those in 2018 and 2019, but decreased by 59.9% (288,003 vs. 717,983) and 57.4% (288,003 vs. 676,704), respectively during the period of February-April, 2020, as compared with the same periods in 2018 and 2019. The total number of respiratory tract infections from January to April 2020 decreased by 65.7% (119,532 vs.348,762) and 59.0% (119,532 vs.291,557), respectively compared with the same periods in 2018 and 2019. The proportion of respiratory tract infections during the outbreak also dropped compared with the same periods in 2018 and 2019 (P<0.001). We also found significantly decreased number of completed tests for respiratory viruses and positive cases of ADV, FluA, FluB, and RSV during February-April, 2020.

Conclusions
In this study, we found that outpatient visits and respiratory tract infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent respiratory virus infections in children.
Primary pulmonary Ewing’s sarcoma: rare cause of massive hemothorax in a young girl-case report
Authors: Ling Xuefeng , Tong Jianlin , Wang Liangliang , Yao Chuan , Chen Zhiying 
Published: April 2021

Abstract
Background
Ewing’s sarcoma is a common malignant bone tumor in children and young adults. Rarely, extra-skeletal soft tissues and visceral organs can also be the site of origin of Ewing’s sarcoma. Primary pulmonary Ewing’s sarcoma is an extremely rare malignancy.

Case presentation
We report an unusual case of primary pulmonary Ewing’s sarcoma in a 15-year-old girl who initially presented with massive hemothorax. By histopathology evaluation of surgical biopsy specimens, the diagnosis of extraosseous Ewing’s sarcoma was confirmed by both light microscopy and immunohistochemistry. Emergency, open surgery was performed by thoracic surgery at an early stage. After 3 cycles of chemotherapy, the patient was found to be stable at follow-up examination. No more hydrothorax or other symptoms.

Conclusions
We have described an extremely rare case of primary pulmonary Ewing’s sarcoma with massive hemothorax. The patient underwent surgical resection and postoperative chemotherapy, no sign of recurrence to date as an outcome.
Birth cohort-specific trends of sun-related behaviors among individuals from an international consortium of melanoma-prone families
Authors:   on behalf of the GenoMEL Study Group, Lacson John Charles A. , Zamani Shawn A. , Froes Luis Alberto Ribeiro , Mitra Nandita , Qian Lu , Doyle Scarlet H. , Azizi Esther , Balestrini Claudia , Bishop D. Timothy , Bruno William , Carlos-Ortega Blanca , Cuellar Francisco , Cust Anne E. , Elder David E. , Gerdes Anne-Marie , Ghiorzo Paola , Grazziotin Thais C. , Gruis Nelleke A. , Hansson Johan , Hočevar Marko , Höiom Veronica , Holland Elizabeth A. , Ingvar Christian , Landman Gilles , Larre-Borges Alejandra , Mann Graham J. , Molgo Montserrat , Moredo Luciana Facure , Olsson Håkan , Out-Luiting Jacoba J. , Perić Barbara , Pjanova Dace , Puig Susana , Salas-Alanis Julio , Schmid Helen , Wadt Karin A. W. , Newton-Bishop Julia A. , Kanetsky Peter A. 
Published: April 2021

Abstract
Background
Individuals from melanoma-prone families have similar or reduced sun-protective behaviors compared to the general population. Studies on trends in sun-related behaviors have been temporally and geographically limited.

Methods
Individuals from an international consortium of melanoma-prone families (GenoMEL) were retrospectively asked about sunscreen use, sun exposure (time spent outside), sunburns, and sunbed use at several timepoints over their lifetime. Generalized linear mixed models were used to examine the association between these outcomes and birth cohort defined by decade spans, after adjusting for covariates.

Results
A total of 2407 participants from 547 families across 17 centers were analyzed. Sunscreen use increased across subsequent birth cohorts, and although the likelihood of sunburns increased until the 1950s birth cohort, it decreased thereafter. Average sun exposure did not change across the birth cohorts, and the likelihood of sunbed use increased in more recent birth cohorts. We generally did not find any differences in sun-related behavior when comparing melanoma cases to non-cases. Melanoma cases had increased sunscreen use, decreased sun exposure, and decreased odds of sunburn and sunbed use after melanoma diagnosis compared to before diagnosis.

Conclusions
Although sunscreen use has increased and the likelihood of sunburns has decreased in more recent birth cohorts, individuals in melanoma-prone families have not reduced their overall sun exposure and had an increased likelihood of sunbed use in more recent birth cohorts. These observations demonstrate partial improvements in melanoma prevention and suggest that additional intervention strategies may be needed to achieve optimal sun-protective behavior in melanoma-prone families.
Exploring the relationship between life quality and the perceptions of living-environment crises
Authors: Li Xiaoyun , Chen Hongsheng , Zhu Zhenjun 
Published: April 2021

Abstract
Background
Two common consequences of rapid economic development in developing countries are the improvement of residents’ quality of life but also environmental destruction. This study focuses on the relationship between residents’ perceptions on the life quality and their perception of environmental crises in China. The purpose of this study is to answer why people in developing countries have relatively high tolerance for environmental pollution caused by rapid economic development.

Methods
Using ordered logistic regression models and the multi-level mixed effect ordinal regression model, and the data of the 2014 China Labour-force Dynamics Survey, 10,849 responses were analysed to evaluate public perceptions of living-environment crises. Specifically, perceptions relating to the following four living-environment crises were evaluated: (1) (un)employment; (2) public safety; (3) infectious disease; (4) pollution.

Results
We found that respondents with higher levels of subjective well-being, social status, and sense of neighbourhood security expressed a lower level of concern for living-environment crises. The concern of urban residents was also significantly higher than that of rural residents for living-environment crisis. For rural respondents, neighbourhood population density was negatively correlated with the perception of employment, public safety, and infectious disease crises. For urban respondents, neighbourhood population density was positively correlated to the perception of public safety and pollution crises, and neighbourhood average income was positively correlated to the perception of infectious disease and pollution risks.

Conclusions
Rapid economic development has greatly improved people’s well-being, but it has also produced many environmental pollution problems. To a certain extent, the improvement of the well-being will alleviate people’s worries about environmental pollution caused by the development of economy.
Result of cementless total hip arthroplasty in a patient with osteopoikilosis, hip dysplasia and advanced osteoarthritis: a case report
Authors: Chang Yao-Yuan , Lin Wei-Hsin 
Published: April 2021

Abstract
Background
Osteopoikilosis (OPK) is a rare benign sclerosing bone dysplasia and is often incidentally found on plain radiography. OPK generally does not require treatment. Nevertheless, osteonecrosis or degenerative joint disease can occur in the setting of OPK, and little is known with regard to the longevity of arthroplasty prostheses implanted into OPK-bearing bones.

Case presentation
A 55-year-old male presented with progressive right hip pain in 2012. He was diagnosed with coexisting osteopoikilosis and developmental dysplasia of the right hip with advanced osteoarthritis after a series of imaging studies including radiographs, magnetic resonance imaging (MRI), and bone scan. A cementless total hip arthroplasty was performed to treat his right hip pain. Radiographs at eight-year follow-up showed the prosthetic components were well-fixed. Harris hip score of the patient’s right hip was 93. The patient can walk without assistance and work as a construction worker.

Conclusion
Cementless arthroplasty can be considered in patients with hip arthropathies and co-existing osteopoikilosis. Continued follow-up is required to establish the long-term results.
Delayed lumbar plexus palsy due to giant psoas hematoma associated with vertebral compression fracture and direct oral anticoagulants: a case report
Authors: Ishii Chikako , Komatsu Miki , Suda Kota , Takahata Masahiko , Harmon Satoko Matsumoto , Ota Masahiro , Watanabe Takamasa , Asukai Mitsuru , Iwasaki Norimasa , Minami Akio 
Published: April 2021

AbstractBackgroundOsteoporotic vertebral compression fractures (VCFs) are commonly observed in elderly people and can be treated by conservatively with minimal risk of complications in most cases. However, utilization of direct oral anticoagulants (DOACs) increases the risks of secondary hematoma even after insignificant trauma. The use of DOACs increased over the past decade because of their approval and recommendation for both stroke prevention in non-valvular atrial fibrillation and treatment of venous thromboembolism. It is well known that DOACs are safer anticoagulants than warfarin in terms of major and nonmajor bleeding; however, we noted an increase in the number of bleeding events associated with DOACs that required medical intervention. This report describes the first case of delayed lumbar plexus palsy due to DOAC-associated psoas hematoma after VCF to draw attention to potential risk of severe complication associated with this type of common and stable trauma.Case presentationAn 83-year-old man presented with his left inguinal pain and inability to ambulate after falling from standing position and was prescribed DOACs for chronic atrial fibrillation. Computed tomography angiography revealed a giant psoas hematoma arising from the ruptured segmental artery running around fractured L4 vertebra. Because of motor weakness of his lower limbs and expansion of psoas hematoma revealed by contrast computed tomography on day 8 of his hospital stay, angiography aimed for transcatheter arterial embolization was tried, but could not demonstrate any major active extravasation; therefore spontaneous hemostasis was expected with heparin replacement. On day 23 of his stay, hematoma turned to decrease, but dysarthria and motor weakness due to left side cerebral infarction occurred. His pain improved and bone healing was achieved about 2 months later from his admission, however the paralysis of the left lower limb and aftereffects of cerebral infarction remained after 1 year.ConclusionIn patients using DOACs with multiple risk factors, close attention must be taken in vertebral injury even if the fracture itself is a stable-type such as VCF, because segmental artery injury may cause massive psoas hematoma followed by lumbar plexus palsy and other complications.
Risk factors for tooth loss with a mean follow-up period of 13.9 years in supportive periodontal therapy patients
Authors: Kato Tomotaka , Fujiwara Natsuki , Ogawa Tomohisa , Numabe Yukihiro 
Published: April 2021

Abstract
Background
Clinical evidence indicates that there are various risk factors of tooth loss. However, the degree of this risk among other risk factors remains unclear. In this retrospective cohort study, the authors evaluated the hazard ratios of several risk factors for tooth loss.

Methods
Included patients had all been treated for dental disorders, were in the supportive phase of periodontal therapy by dental hygienists, and visited a Japanese dental office continually during a 10-year period. Periodontal parameters, tooth condition, and general status of all teeth (excluding third molars) at the initial visit and at least 10 years later were evaluated by using multiple classification analysis.

Results
The authors evaluated a total of 7584 teeth in 297 patients (average age: 45.3, mean follow-up time: 13.9 years) Non-vital pulp was the most significant predictor of tooth loss according to Cox hazards regression analysis (hazard ratio: 3.31). The 10-year survival rate was approximately 90% for teeth with non-vital pulp and 99% for teeth with vital pulp. Fracture was the most common reason for tooth loss.

Conclusions
Non-vital pulp had the most significant association with tooth loss among the parameters. Therefore, it is very important to minimize dental pulp extirpation.
Epidemiological survey of adult female stress urinary incontinence
Authors: Zhang Rui Qin , Xia Man Cheng , Cui Fan , Chen Jia Wei , Bian Xiao Dong , Xie Hong Jie , Shuang Wei Bing 
Published: April 2021

AbstractBackgroundThe prevalence of stress urinary incontinence (SUI) in adult female in Taiyuan and what are the related risk factors are not clear. The aim of this study was to provide a basis for exploring the prevention and treatment of SUI in adult female in Taiyuan.MethodsA voluntary online questionnaire was used to investigate adult female in the community and surrounding townships of Taiyuan. Most of the questionnaires refer to the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms, and adapt to the specific circumstances of the region. Data were analyzed using SPSS software (version 22.0).ResultsA total of 4004 eligible questionnaires were obtained. The prevalence of SUI in adult female in Taiyuan was 33.5%. Univariate analysis and multivariate logistic regression analysis showed that place of residence, smoking, body mass index, diet, number of deliveries, mode of delivery, dystocia, menopause, oral contraceptives, urinary tract infection, making the bladder empty faster by pushing down and holding urine were risk factors for adult female stress urinary incontinence in Taiyuan.ConclusionThe prevalence of SUI in adult female in Taiyuan was high, and based on risk factors identified in this survey, population-level intervention strategies should be developed for the prevention and treatment of adult female SUI in Taiyuan.
Healthcare student-patient relationship and the quality of the clinical learning environment – a cross-sectional study
Authors: Suikkala Arja , Timonen Leena , Leino-Kilpi Helena , Katajisto Jouko , Strandell-Laine Camilla 
Published: April 2021

Abstract
Background
Relationships with patients are seen as the core component of establishing the quality of patient-centred care and promoting patients’ autonomy and relevant use of services. A clinical learning environment that emphasizes relationship-based healthcare is essential for encouraging future healthcare professionals to work in partnership with patients. There is also broad agreement that the insight of patients should be used actively in healthcare students’ clinical learning. The aim of this study was to describe healthcare students’ perceptions of their relationship with patients and the quality of the clinical learning environment and to identify factors associated with both of these.

Methods
A cross-sectional survey using an electronic questionnaire was applied to collect data from 1644 Finnish healthcare students, mostly nursing students, between January 2018 and May 2018. The data were analysed statistically using descriptive statistics, Spearman’s correlation coefficients, and multifactor analysis of variance.

Results
Students perceived the level of the student-patient relationship and the role of the teacher as good while pedagogical atmosphere, premises of care, premises of learning, and supervisory relationship were perceived to be at very good level. The correlations between the student-patient relationship and all clinical learning environment dimensions were perceived as moderate. Furthermore, a number of student-related factors associated with the student-patient relationship and the quality of the clinical learning environment were detected.

Conclusions
In this study, the rarely explored perspective of the student-patient relationship within the context of the clinical learning environment was included. The student-patient relationship and the quality of the clinical learning environment were perceived as good by the students, with a number of determining factors affecting these perceptions. Giving the student-patient relationship a role in clinical education may be conducive to students’ learning with the patient in focus, and may thus promote the competence needed in the rapidly evolving healthcare environment and the changing scope of clinical practice.
Richer fusion network for breast cancer classification based on multimodal data
Authors: Yan Rui , Zhang Fa , Rao Xiaosong , Lv Zhilong , Li Jintao , Zhang Lingling , Liang Shuang , Li Yilin , Ren Fei , Zheng Chunhou , Liang Jun 
Published: April 2021

Abstract
Background
Deep learning algorithms significantly improve the accuracy of pathological image classification, but the accuracy of breast cancer classification using only single-mode pathological images still cannot meet the needs of clinical practice. Inspired by the real scenario of pathologists reading pathological images for diagnosis, we integrate pathological images and structured data extracted from clinical electronic medical record (EMR) to further improve the accuracy of breast cancer classification.

Methods
In this paper, we propose a new richer fusion network for the classification of benign and malignant breast cancer based on multimodal data. To make pathological image can be integrated more sufficient with structured EMR data, we proposed a method to extract richer multilevel feature representation of the pathological image from multiple convolutional layers. Meanwhile, to minimize the information loss for each modality before data fusion, we use the denoising autoencoder as a way to increase the low-dimensional structured EMR data to high-dimensional, instead of reducing the high-dimensional image data to low-dimensional before data fusion. In addition, denoising autoencoder naturally generalizes our method to make the accurate prediction with partially missing structured EMR data.

Results
The experimental results show that the proposed method is superior to the most advanced method in terms of the average classification accuracy (92.9%). In addition, we have released a dataset containing structured data from 185 patients that were extracted from EMR and 3764 paired pathological images of breast cancer, which can be publicly downloaded from http://ear.ict.ac.cn/?page_id=1663.

Conclusions
We utilized a new richer fusion network to integrate highly heterogeneous data to leverage the structured EMR data to improve the accuracy of pathological image classification. Therefore, the application of automatic breast cancer classification algorithms in clinical practice becomes possible. Due to the generality of the proposed fusion method, it can be straightforwardly extended to the fusion of other structured data and unstructured data.
Plasmodium vinckei genomes provide insights into the pan-genome and evolution of rodent malaria parasites
Authors: Ramaprasad Abhinay , Klaus Severina , Douvropoulou Olga , Culleton Richard , Pain Arnab 
Published: April 2021

Abstract
Background
Rodent malaria parasites (RMPs) serve as tractable tools to study malaria parasite biology and host-parasite-vector interactions. Among the four RMPs originally collected from wild thicket rats in sub-Saharan Central Africa and adapted to laboratory mice, Plasmodium vinckei is the most geographically widespread with isolates collected from five separate locations. However, there is a lack of extensive phenotype and genotype data associated with this species, thus hindering its use in experimental studies.

Results
We have generated a comprehensive genetic resource for P. vinckei comprising of five reference-quality genomes, one for each of its subspecies, blood-stage RNA sequencing data for five P. vinckei isolates, and genotypes and growth phenotypes for ten isolates. Additionally, we sequenced seven isolates of the RMP species Plasmodium chabaudi and Plasmodium yoelii, thus extending genotypic information for four additional subspecies enabling a re-evaluation of the genotypic diversity and evolutionary history of RMPs.
The five subspecies of P. vinckei have diverged widely from their common ancestor and have undergone large-scale genome rearrangements. Comparing P. vinckei genotypes reveals region-specific selection pressures particularly on genes involved in mosquito transmission. Using phylogenetic analyses, we show that RMP multigene families have evolved differently across the vinckei and berghei groups of RMPs and that family-specific expansions in P. chabaudi and P. vinckei occurred in the common vinckei group ancestor prior to speciation. The erythrocyte membrane antigen 1 and fam-c families in particular show considerable expansions among the lowland forest-dwelling P. vinckei parasites. The subspecies from the highland forests of Katanga, P. v. vinckei, has a uniquely smaller genome, a reduced multigene family repertoire and is also amenable to transfection making it an ideal parasite for reverse genetics. We also show that P. vinckei parasites are amenable to genetic crosses.

Conclusions
Plasmodium vinckei isolates display a large degree of phenotypic and genotypic diversity and could serve as a resource to study parasite virulence and immunogenicity. Inclusion of P. vinckei genomes provide new insights into the evolution of RMPs and their multigene families. Amenability to genetic crossing and transfection make them also suitable for classical and functional genetics to study Plasmodium biology.