bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of mode and distance of commuting to school with cardiorespiratory fitness in Slovenian schoolchildren: a nationwide cross-sectional study
Authors: Jurak Gregor , Soric Maroje , Sember Vedrana , Djuric Sasa , Starc Gregor , Kovac Marjeta , Leskosek Bojan 
Published: February 2021

Abstract
Background
It is unclear whether active commuting has the potential to improve children’s health. This study examined the association of commuting mode and distance with children’s cardiorespiratory fitness (CRF).

Methods
We conducted a cross-sectional study, including 713 Slovenian schoolchildren aged 12 to 15 years. Commuting modes were self-reported, and four commuting groups were constructed, while CRF was determined with a 20-m shuttle run test. The distance from home to school was calculated using the Geographic Information System. Effects of commuting mode and distance, controlling for age, gender and amount of total physical activity, were evaluated using general two linear models (one for each direction of commuting to/from school).

Results
The main effect of commuting group on CRF and its interaction with distance were significant in the direction from school to home (P = 0.013 and P = 0.028, respectively), but not in the opposite direction. Predicted differences in CRF between commuting groups were moderate and generally higher in males than in females. When comparing commuting group median distance from home to school, males driven by car had around 4 ml/min/kg lower predicted CRF than those who walked (P = 0.01) or used wheels commuting (e.g., bicycle, skateboard).

Conclusions
The distance of commuting had a small effect on CRF, except in the Car group where children who live close to school had significantly lower CRF than those living further away. Children driven by car who live within wheels or walk distance from school should be targeted by interventions promoting active transport.
Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study
Authors: Nam Bora , Koo Bon San , Lee Tae-Han , Shin Ji-Hui , Kim Jin-Ju , Lee Seunghun , Joo Kyung Bin , Kim Tae-Hwan 
Published: February 2021

Abstract
Background
The purpose of this study was to determine the prevalence of high disease activity as measured using the Ankylosing Spondylitis Disease Activity Score (ASDAS) in ankylosing spondylitis (AS) patients who nonetheless have low Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores after anti-tumor necrosis factor (TNF) treatment. Its clinical impact on anti-TNF survival was also investigated.

Methods
We conducted a single-centre retrospective cohort study of AS patients having low BASDAI scores (< 4) and available ASDAS-C-reactive protein (CRP) data after 3 months of first-line anti-TNF treatment. Patients were grouped into high-ASDAS (≥ 2.1) and low-ASDAS (< 2.1) groups according to the ASDAS-CRP after 3 months of anti-TNF treatment. Their characteristics were compared. And survival analyses were carried out using Kaplan–Meier curves and log-rank test with the event being discontinuation of anti-TNF treatment due to lack/loss of efficacy.

Results
Among 116 AS patients with low BASDAI scores after 3 months of anti-TNF treatment, 38.8% were grouped into the high-ASDAS group. The high-ASDAS group tended to have greater disease activity after 9 months of treatment (BASDAI 2.9 ± 1.1 vs. 2.3 ± 1.4, p=0.007; ASDAS-CRP 1.8 ± 0.6 vs. 1.5 ± 0.7, p=0.079; proportion of high ASDAS-CRP 27.8% vs. 13.8%, p=0.094) and greater risk of discontinuing anti-TNF treatment due to lack/loss of efficacy than the low-ASDAS group (p=0.011).

Conclusions
A relatively high proportion of AS patients with low BASDAI scores had high ASDAS-CRP. These low-BASDAI/high-ASDAS-CRP patients also had a greater risk for discontinuation of anti-TNF treatment due to low/lack of efficacy than the low-ASDAS group. The use of the ASDAS-CRP alone or in addition to the BASDAI may improve the assessment of AS patients treated with anti-TNF agents.
Treatment of the fresh central slip avulsion of the extensor tendon by bone tunnel-tendon suture: a prospective cohort study
Authors: Wang Bin , Lu Yiming , Wang Tianliang , Gu Jiaxiang , Zhang Naichen 
Published: February 2021

Abstract
Background
The current evidence base for the management of central slip avulsions is limited from obtaining a best approach. The purpose of this study was to evaluate the clinical effect and feasibility of repairing the fresh central slip avulsion by bone tunnel-tendon suture.

Methods
Twenty-four cases of open and closed central slip avulsions were prospectively studied. They were treated by suturing the tendon to the pre-holed bone through two parallel bone tunnels. Follow-up was conducted at 1 month, 3 months, 6 months, 12 months and 18 months after the operation. Symptoms, degree of satisfaction with the appearance, complications, Crawford’s evaluation, DASH scores and the total active movement (TAM) were collected.

Results
The follow-up period was 6~18 months (mean 13 months). Finger function was assessed using the Crawford’s evaluation criteria: excellent in 12, good in 10, average in 2, with an excellent and good rate of 91.7%. DASH scores ranged from 37 to 47(mean 39). According to the Chinese Medical Association’s trial criteria for assessing the function of upper limbs, excellent, good and average cases were 9, 14 and 1 respectively. The range of motion gradually improved over time. Conclusions Good prognosis can be achieved through bone tunnel-tendon suture for the treatment of fresh central slip avulsion.
Lessons learned from successful autologous gastrointestinal reconstruction in patients with intestinal failure: a case series
Authors: Ashrafzadeh Kiarash , Shafiekhani Mojtaba , Azadeh Nazanin , Esmaeili Maryam , Nikoupour Hamed 
Published: February 2021

Abstract
Background
Intestinal failure (IF) is a rare but severe form of organ failure. The condition is defined as body’s inability to absorb adequate fluids, macronutrients and minerals for growth and development, so that intravenous supplementation is necessary. A broad spectrum of diseases, trauma and complications of surgery might eventually end up with intestinal failure. Nowadays, intestinal failure patients are preferably cared for in intestinal rehabilitation units (IRU). Autologous gastrointestinal reconstruction (AGIR) refers to non-transplant operative management of IF patients designed to improve enteral tolerance and gut absorptive capacity.

Case presentation
Herein we present five cases with complications of surgeries due to peptic ulcer bleeding, blunt abdominal trauma, obesity and gastric tumor. The surgeries were complicated by anastomotic leak, peritonitis and fistula formation. By adopting multidisciplinary decisions and special care for each complication, all the five patients were successfully managed and discharged.

Discussion and conclusions
As presented, re-anastomosis in presence of abdominal contamination will probably fail. In patients with intestinal failure, PN should start as soon as possible to increase the success rate of future surgeries and prevent potential need for intestinal transplantation. We suggest referring patients with complicated outcomes of gastrointestinal surgeries to the IRUs to reduce morbidity and mortality.
A modified Delphi study to develop a practical guide for selecting patients with prostate cancer for active surveillance
Authors: Merriel Samuel W. D. , Moon Daniel , Dundee Phil , Corcoran Niall , Carroll Peter , Partin Alan , Smith Joseph A. , Hamdy Freddie , Moore Caroline , Ost Piet , Costello Tony 
Published: February 2021

Abstract
Background
Active surveillance (AS) is a management option for men diagnosed with lower risk prostate cancer. There is wide variation in all aspects of AS internationally, from patient selection to investigations and follow-up intervals, and a lack of clear evidence on the optimal approach to AS. This study aimed to provide guidance for clinicians from an international panel of prostate cancer experts.

Methods
A modified Delphi approach was undertaken, utilising two rounds of online questionnaires followed by a face-to-face workshop. Participants indicated their level of agreement with statements relating to patient selection for AS via online questionnaires on a 7-point Likert scale. Factors not achieving agreement were iteratively developed between the two rounds of questionnaires. Draft statements were presented at the face-to-face workshop for discussion and consensus building.

Results
12 prostate cancer experts (9 urologists, 2 academics, 1 radiation oncologist) participated in this study from a range of geographical regions (4 USA, 4 Europe, 4 Australia). Complete agreement on statements presented to the participants was 29.4% after Round One and 69.0% after Round Two. Following robust discussions at the face-to-face workshop, agreement was reached on the remaining statements. PSA, PSA density, Multiparametric MRI, and systematic biopsy (with or without targeted biopsy) were identified as minimum diagnostic tests required upon which to select patients to recommend AS as a treatment option for prostate cancer. Patient factors and clinical parameters that identified patients appropriate to potentially receive AS were agreed. Genetic and genomic testing was not recommended for use in clinical decision-making regarding AS.

Conclusions
The lack of consistency in the practice of AS for men with lower risk prostate cancer between and within countries was reflected in this modified Delphi study. There are, however, areas of common practice and agreement from which clinicians practicing in the current environment can use to inform their clinical practice to achieve the best outcomes for patients.
Levan from Leuconostoc citreum BD1707: production optimization and changes in molecular weight distribution during cultivation
Authors: Han Jin , Feng Huafeng , Wang Xiaohua , Liu Zhenmin , Wu Zhengjun 
Published: February 2021

Abstract
Background
Levan is a well-known homopolymer of fructose composed predominantly of β-(2, 6) fructofuranosyl linkages in the backbone with occasional β-(2, 1) linkages in the branch chains with varied applications. However, high production cost due to low yield of microbial levan has become a bottleneck for its practical applications. Furthermore, factors affecting the molecular mass of the synthesized levan by Leuconostoc spp. during prolonged cultivation is not fully elucidated.

Methods
The cultivation condition for Leuconostoc citreum BD1707 to synthesize levan was optimized by single-factor experiments and subsequently with response surface methodology (RSM). The average molecular weight (Mw) of levan synthesized by the strain L.citreum BD1707 under the optimized cultivation conditions was monitored by high-performance size exclusion chromatography (HPSEC). Finally, the enzyme with levan-degrading activity was determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE).

Results
The levan yield of BD1707 reached 34.86 g/L with a corresponding productivity of 7.47 g/L/d under the optimal cultivation conditions deduced by RSM, i.e., cultivation at 26 °C and 200 rpm for 112 h in tomato juice supplemented with 172 g/L sucrose with an initial pH value of 6.12. The Mw of levan reached a peak value of 2.320 × 107 Da at 6 h of cultivation under the optimized cultivation conditions and then gradually decreased to 8.809 × 106 Da after 120 h of cultivation.

Conclusion
The levan yield of the strain L.citreum BD1707 could be sufficiently enhanced via cultivation condition optimization. The decrease in molecular mass of the synthesized levan was attributed predominantly to the hydrolytic activity of levansucrase secreted by L.citreum BD1707 during cultivation, with an estimated Mw of 130 KD by SDS-PAGE, while the effect of acid hydrolysis could be nearly neglected.
Correlation between microbial host factors and caries among older adults
Authors: Mittal Rakhi , Tan Kai Soo , Wong Mun Loke , Allen Patrick Finbarr 
Published: February 2021

Abstract
Background
There is little knowledge about factors which may affect oral health among older adults. The objective of this study was to determine the relationship between Streptococcus mutans (MS) and Lactobacilli (LB) counts and caries among older adults.

Methods
In this community-based observation study, 141 participants aged 60 years and above were recruited from the west district of Singapore. Alongside the clinical examination, saliva samples were collected to determine Streptococcus mutans (MS) and Lactobacilli (LB) counts, as well as to record salivary flow rate and buffering capacity of saliva.

Results
Of the 141 participants, 63.8% were female and 94.3% were of Chinese ethnicity. The mean DMFT was 11.08 (s.d. 8.27). 9.9% of participants had at least one decayed tooth, 52.5% had minimum one missing tooth and 86.5% had at least one filled tooth. 67.4% had MS counts of ≥ 105 while LB counts were ≥ 105 for 48.2%. 83.7% had normal salivary flow or hypersalivation (> = 1 mL/min), the buffering capacity of the saliva was alkaline in 61% of the participants. Multivariate analysis showed that participants who had high MS counts were less likely to have a DMFT < 12 [OR (95% CI), 0.29 (0.11–0.77)] whereas participants who had high LB counts were less likely to have a DMFT ≤ 14 [OR (95% CI), 0.45 (0.20–1.002)].

Conclusion
Our study showed a positive correlation between MS and LB counts and caries experience in older adults. The mean DMFT was on the low side in our sample despite having a relatively high MS count. This suggests that there are many other factors which vary according to host environment, physiological and biological conditions that may affect MS and LB counts in the oral cavity.

Clinical relevance
Our study supports the knowledge that the aetiology of dental caries among older adults is a complex process and it would be wrong to consider caries as a same problem with the same solution for all age groups.
Assessment of dental anxiety and dental phobia among adults in Lebanon
Authors: Kassem El Hajj Hiba , Fares Youssef , Abou-Abbas Linda 
Published: February 2021

AbstractBackgroundDental anxiety continues to be a widespread problem affecting adult populations. The primary aim of our study was to evaluate the psychometric properties of the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A) and to identify the optimal cut-off for assessing dental anxiety and dental phobia among adults in Lebanon. In addition, we sought to assess dental anxiety and phobia as well as their correlates among Lebanese adult patients.MethodsA cross-sectional study was carried out on a sample of 451 dental adult patients aged between 18 and 65 years old. Information about demographic characteristics, previous bad dental experience, trauma’s experience period, perception of a periodontal problem, sensation of nausea during dental treatment, the MDAS-A scale, and the Visual Analogue Scale for anxiety (VAS-A) were collected.ResultsMDAS-A exhibited evidence of adequate psychometric properties. The optimal cut-off was 12 for dental anxiety and 14 for dental phobia. Out of the total sample, 31.5% suffered from dental anxiety while 22.4% had a dental phobia. Multivariable analysis showed that the odds of dental anxiety and phobia were higher among females compared to males. Also, patients suffering from periodontal problem perceptions, bad dental experiences during childhood and adolescence, and the sensation of nausea during dental treatment were at a higher risk of developing dental anxiety and phobia compared to their counterparts. However, a higher level of education was found to be a protective factor against dental phobia among Lebanese adult patients.ConclusionThe MDAS-A scale is a suitable tool for the routine assessment of dental anxiety and phobia among Lebanese adult patients. Identifying patients with dental anxiety at the earliest opportunity is of utmost importance for delivering successful dental care.
Oral health of aboriginal people with kidney disease living in Central Australia
Authors: Kapellas Kostas , Hughes Jaquelyne T. , Cass Alan , Maple-Brown Louise J. , Skilton Michael R. , Harris David , Askie Lisa M. , Hoy Wendy , Pawar Basant , McKenzie Kirsty , Sajiv Cherian T. , Arrow Peter , Brown Alex , Jamieson Lisa M. 
Published: February 2021

Abstract
Background
Associations between kidney disease and periodontal disease are not well documented among Aboriginal people of Australia. The purpose of this investigation was to report and compare demographic, oral health, anthropometric and systemic health status of Aboriginal Australians with kidney disease and to compare against relevant Aboriginal Australians and Australian population estimates. This provides much needed evidence to inform dental health service provision policies for Aboriginal Australians with kidney disease.

Methods
Sample frequencies and means were assessed in adults represented in six datasets including: (1) 102 Aboriginal Australians with kidney disease residing in Central Australia who participated in a detailed oral health assessment; (2) 312 Aboriginal participants of the Northern Territory’s PerioCardio study; (3) weighted estimates from 4775 participants from Australia’s National Survey of Adult Oral Health (NSAOH); (4) Australian 2016 Census (all Australians); (5) National Health Survey 2017–2018 (all Australians) and; (6) Australian Health Survey: Biomedical Results for Chronic Diseases, 2011–2012 (all Australians). Oral health status was described by periodontal disease and experience of dental caries (tooth decay). Statistically significant differences were determined via non-overlapping 95% confidence intervals.

Results
Aboriginal Australians with kidney disease were significantly older, less likely to have a tertiary qualification or be employed compared with both PerioCardio study counterparts and NSAOH participants. Severe periodontitis was found in 54.3% of Aboriginal Australians with kidney disease, almost 20 times the 2.8% reported in NSAOH. A higher proportion of Aboriginal Australians with kidney disease had teeth with untreated caries and fewer dental restorations when compared to NSAOH participants. The extent of periodontal attachment loss and periodontal pocketing among Aboriginal Australians with kidney disease (51.0%, 21.4% respectively) was several magnitudes greater than PerioCardio study (22.0%, 12.3% respectively) and NSAOH (5.4%, 1.3% respectively) estimates.

Conclusions
Aboriginal Australians with kidney disease exhibited more indicators of poorer oral health than both the general Australian population and a general Aboriginal population from Australia’s Northern Territory. It is imperative that management of oral health among Aboriginal Australians with kidney disease be included as part of their ongoing medical care.
Dignity of informal caregivers of migrant patients in the last phase of life: a qualitative study
Authors: de Voogd X. , Willems D. L. , Torensma M. , Onwuteaka-Philipsen B. D. , Suurmond J. L. 
Published: February 2021

AbstractBackgroundA key aim of palliative care is to improve the quality of life of patients and their families. To help ensure quality of life for the families of patients with migrant backgrounds, this study sought insights into the dignity of informal caregivers in migrant communities. This could improve understanding of family-centered care for migrant patients.MethodsTwenty semi-structured interviews with informal caregivers of Turkish, Moroccan, or Surinamese background living in the Netherlands were analyzed thematically.ResultsThe dignity of the patient and that of their informal caregivers were found to be strongly interrelated. Most important for the dignity of caregivers was ensuring good care for their patients and preserving the patients’ dignity. Ensuring good care involved advocating for good and dignified care and for satisfaction of a patient’s wishes. For many informal caregivers, it also included delivering care to the patient by themselves or together with other family members, despite having to give up part of their own lives. Providing care themselves was part of maintaining a good relationship with the patient; the care was to cater to the patient’s preferences and help preserve the patient’s dignity, and it could be accompanied by valuable aspects such as times for good conversations. Positive interaction between an informal caregiver and a patient positively influenced the informal caregiver’s dignity. Informal caregiver and patient dignity were often compromised simultaneously; when informal caregivers felt healthcare professionals were undermining a patient’s dignity, their own dignity suffered. According to informal caregivers, healthcare professionals can help them preserve dignity by taking seriously their advice about the patient, keeping them informed about the prognosis of the disease and of the patient, and dealing respectfully with differences in values at the end of life.ConclusionThe dignity of migrant patients’ informal caregivers in the last phase of a patient’s life is closely entwined with ensuring good care and dignity for the patient. Healthcare professionals can strengthen the dignity of informal caregivers by supporting their caregiving role.
Nutrition from the kitchen: culinary medicine impacts students’ counseling confidence
Authors: Magallanes Emily , Sen Ahana , Siler Milette , Albin Jaclyn 
Published: February 2021

Abstract
Background
Although a poor diet is the number one risk factor for early death in the United States and globally, physicians receive little to no training in dietary interventions and lack confidence counseling patients about lifestyle modifications. Innovative, interprofessional strategies to address these gaps include the emergence of culinary medicine, a hands-on approach to teaching the role of food in health outcomes. We sought to assess the impact of a culinary medicine elective on counseling confidence, awareness of an evidence-based approach to nutrition, and understanding of the role of interprofessional teamwork in dietary lifestyle change among medical students at one undergraduate medical school.

Methods
We administered pre- and post-course surveys to two cohorts of medical students (n = 64 at pre-test and n = 60 at post-test) participating in a culinary medicine enrichment elective. Chi-square analysis was used to assess the relationship between participation in the course and a positive response to each survey item.

Results
Compared with the baseline, students participating in culinary medicine were more likely to feel confident discussing nutrition with patients (29% vs 92%; p < 0.001), to feel familiar with the Mediterranean diet (54% vs. 97%; p < 0.001), and to understand the role of dietitians in patient care (37% vs. 93%; p < 0.001).

Conclusions
Culinary medicine shows promise as an impactful educational strategy among first-year medical students for increasing counseling confidence, promoting familiarity with evidence-based nutrition interventions, and augmenting understanding of the role of interprofessional engagement to address lifestyle-related disease.