bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testing telediagnostic obstetric ultrasound in Peru: a new horizon in expanding access to prenatal ultrasound
Authors: Toscano Marika , Marini Thomas J. , Drennan Kathryn , Baran Timothy M. , Kan Jonah , Garra Brian , Dozier Ann M. , Ortega Rafael L. , Quinn Rosemary A. , Zhao Yu T. , Egoavil Miguel S. , Tamayo Lorena , Carlotto Claudia , Castaneda Benjamin 
Published: April 2021

Abstract
Background
Ninety-four percent of all maternal deaths occur in low- and middle-income countries, and the majority are preventable. Access to quality Obstetric ultrasound can identify some complications leading to maternal and neonatal/perinatal mortality or morbidity and may allow timely referral to higher-resource centers. However, there are significant global inequalities in access to imaging and many challenges to deploying ultrasound to rural areas. In this study, we tested a novel, innovative Obstetric telediagnostic ultrasound system in which the imaging acquisitions are obtained by an operator without prior ultrasound experience using simple scan protocols based only on external body landmarks and uploaded using low-bandwidth internet for asynchronous remote interpretation by an off-site specialist.

Methods
This is a single-center pilot study. A nurse and care technician underwent 8 h of training on the telediagnostic system. Subsequently, 126 patients (68 second trimester and 58 third trimester) were recruited at a health center in Lima, Peru and scanned by these ultrasound-naïve operators. The imaging acquisitions were uploaded by the telemedicine platform and interpreted remotely in the United States. Comparison of telediagnostic imaging was made to a concurrently performed standard of care ultrasound obtained and interpreted by an experienced attending radiologist. Cohen’s Kappa was used to test agreement between categorical variables. Intraclass correlation and Bland-Altman plots were used to test agreement between continuous variables.

Results
Obstetric ultrasound telediagnosis showed excellent agreement with standard of care ultrasound allowing the identification of number of fetuses (100% agreement), fetal presentation (95.8% agreement, κ =0.78 (p < 0.0001)), placental location (85.6% agreement, κ =0.74 (p < 0.0001)), and assessment of normal/abnormal amniotic fluid volume (99.2% agreement) with sensitivity and specificity > 95% for all variables. Intraclass correlation was good or excellent for all fetal biometric measurements (0.81–0.95). The majority (88.5%) of second trimester ultrasound exam biometry measurements produced dating within 14 days of standard of care ultrasound.

Conclusion
This Obstetric ultrasound telediagnostic system is a promising means to increase access to diagnostic Obstetric ultrasound in low-resource settings. The telediagnostic system demonstrated excellent agreement with standard of care ultrasound. Fetal biometric measurements were acceptable for use in the detection of gross discrepancies in fetal size requiring further follow up.
The relationship between sexual function and mental health in Iranian pregnant women during the COVID-19 pandemic
Authors: Effati-Daryani Fatemeh , Jahanfar Shayesteh , Mohammadi Azam , Zarei Somayeh , Mirghafourvand Mojgan 
Published: April 2021

Abstract
Background
Sexual function, a significant contributor to quality of life, is affected by various factors, including overall mental health. COVID-19 is a current pandemic that influences the mental health of various populations, especially pregnant women. Despite the importance of sexual health, the specific nature of its relationship to overall mental health during the COVID-19 pandemic is not clearly defined. Thus, this study investigates the relationship between sexual function and mental health during the COVID-19 pandemic in Iranian pregnant women.

Methods
This descriptive-analytical, cross-sectional study was carried out among 437 pregnant women using the sociodemographic and obstetrics characteristics questionnaire, Female Sexual Function Inventory, Stress, Depression, and Anxiety Scales. Random sampling was employed to select pregnant women who had a medical record in Health Centers of Tabriz city, Iran. The questionnaires were sent to the participants’ cell phones via WhatsApp or text messages, including links of questionnaires and the participants completed these questionnaires. Spearman correlation test was used to determine the relationship between sexual function and stress, anxiety, and depression. Generalized linear modeling was used to estimate each of the independent variables (sociodemographic characteristics, stress, anxiety, and depression) on the dependent variable (sexual function).

Results
The mean (Standard Deviation) sexual functioning (total) score was 20.0 (8.50) from the available range of 2 to 36. The mean (SD) of depression, stress, and anxiety scale was 4.81 (5.22), 5.13 (4.37), and 7.86 (4.50) (possible score ranging from 0 to 21), respectively. Based on Spearman’s correlation test, there was a significant reverse correlation between the total sexual function score and stress, anxiety, and depression, indicating that all three variables negatively impacted sexual functioning. Variables such as mild stress, spouse type of job, sufficient household income, living with parents, higher marital satisfaction, and higher gestational age had a significant, positive impact on sexual function and could predict 35.8% of the variance model.

Conclusions
Sexual functioning was significantly impacted by stress, anxiety, and depression – all of which are heightened during a pandemic. This topic warrants further study, and the general public should be educated on the protective influence of safe sex/intimacy on overall mental health.
Effect of cognitive-behavioral therapy on domestic violence and its consequences in transgender youth: a randomized clinical trial, parallel group study
Authors: Damanpak-Rizi Mahdieh , Farnam Farnaz , Khodakhah Parisa 
Published: April 2021

AbstractBackgroundFamily violence against transgender people is a common issue and affects their mental health. Very few if any interventions have been designed to reduce family violence against transgender youths. This RCT will evaluate the effect of cognitive-behavioral therapy on the violent behaviors towards transgender people.MethodsThis study is a randomized controlled trial conducted on 50 transgender youths with selected inclusion criteria in Iran. The intervention will be undertaken on the parents or guardians of these transgender youths in eight 1-h online sessions for the intervention group to increase their knowledge of gender dysphoria, to help control their anger regarding their offspring’s gender dysphoria and learn to manage stressful situations. The primary outcomes include frequency of family violence towards transgender youths and also parental conflict resolution tactics. Depression, anxiety, stress, self-esteem, suicidal thoughts, and suicide attempts in transgender youth are the secondary outcomes.DiscussionTo the best of our knowledge, this is one of the first RCT on family violence against transgender youth in the world. Findings will help to provide better education and intervention for transgender parents to reduce violence against their children.Results: N/A.Conclusion: N/A.Trial registrationIRCT20120609009975N7(08/03/2020).
Association between supportive attitude and adoptive practice of control strategy against COVID-19 amosng college students in China: a cross-sectional study
Authors: Shen Dong , Liu Dan , Cai Miaochun , Chen Peiliang , Wang Zhenghe , Zhang Yujie , Li Zhihao , Zhang Xiru , Wu Xianbo , Yang Xingfen , Mao Chen 
Published: April 2021

Abstract
Background
We investigated college students’ attitude and compliance towards a prevention strategy involving use of non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19).

Methods
We conducted a cross-sectional online survey in four universities in Guangdong Province (China) based on purposive sampling. A self-administered questionnaire was given to College students (CSs) to measure the supportive attitude towards an outbreak control strategy and adoption of NPIs in respondents.

Results
A total of 44,446 CSs participated between 31 January and 10 February 2020; 92.7% of respondents supported the outbreak control strategy. The proportion of respondents who avoided public places, wore a facemask, avoid gatherings, and washed hands more frequently than usual was 94.8, 92.8, 91.2 and 86.9%. respectively. A total of 76.5% respondents adopted all four measures. A supportive attitude was associated with NPI adoption. Students who were female, postgraduate, anxious, and not depressed tended to have a higher supportive attitude and higher chance of NPI adoption.

Conclusions
Higher supportiveness towards the disease control strategy for the Chinese public may lead to higher adoption rate of NPIs. Psychosocial factors were related to a supportive attitude and adoption of the NPI. We believe that our findings could aid policymakers to create NPIs to prevent and control emerging infectious diseases such as COVID-19.
Trans-bronchial lung cryobiopsy in patients at high-risk of complications
Authors: Bondue Benjamin , Schlossmacher Pascal , Allou Nathalie , Gazaille Virgile , Taton Olivier , Gevenois Pierre Alain , Vandergheynst Frederic , Remmelink Myriam , Leduc Dimitri 
Published: April 2021

Abstract
Background
The surgical lung biopsy (SLB) is the recommended sampling technique when the pathological analysis of the lung is required in the work-up of an interstitial lung disease (ILD) but trans-bronchial lung cryobiopsy (TBLC) is increasingly recognized as an alternative approach. As TBLCs have lower mortality and morbidity risks than SLB, this study aimed to investigate the safety of TBLCs in patients at higher risk of complications and for whom SLB was not considered as an alternative.

Method
This prospective study was conducted in two hospitals in which TBLCs were performed in patients with body mass index (BMI) > 35, and/or older than 75 years, and/or with severely impaired lung function (FVC < 50% or DLCO < 30%), and/or systolic pulmonary artery pressure > 45 mmHg, and/or a clinically significant cardiac disease. Patients with any of these risk factors constituted the high-risk group. Clinical outcomes were compared with those obtained in patients without these risk factors (low-risk group).

Results
Ninety-six patients were included between April 2015 and April 2020, respectively 38 and 58 in the high-risk or the low-risk group. No statistically significant difference was observed between both groups in terms of severity and rate of bleeding, pneumothorax, or duration of hospital stay (p value ranging from 0.419 to 0.914).

Conclusion
This preliminary study on a limited number of patients suggests that TBLC appears safe in those in whom lung biopsy is at high-risk of complications according to their age, BMI, lung impairment, and cardiac comorbidities.
A lattice topology optimization of cervical interbody fusion cage and finite element comparison with ZK60 and Ti-6Al-4V cages
Authors: Sun Jun , Wang Qiuan , Cai Dazhao , Gu Wenxiang , Ma Yiming , Sun Yang , Wei Yangyang , Yuan Feng 
Published: April 2021

Abstract
Background
In current clinical practice, the most commonly used fusion cage materials are titanium (Ti) alloys. However, titanium alloys are non-degradable and may cause stress shielding. ZK60 is a bio-absorbable implant that can effectively avoid long-term complications, such as stress shielding effects, implant displacement, and foreign body reactions. In this study, we aimed at investigating the biomechanical behavior of the cervical spine after implanting different interbody fusion cages.

Methods
The finite element (FE) models of anterior cervical disc removal and bone graft fusion (ACDF) with a ZK60 cage and a Ti cage were constructed, respectively. Simulations were performed to evaluate their properties of flexion, extension, lateral bending, and axial rotation of the cervical spine. Moreover, a side-by-side comparison was conducted on the range of motion (ROM), the deformation of cages, the stress in the cages, bone grafts, and cage-end plate interface. Simultaneously, according to the biomechanical analysis results, the microporous structure of the ZK60 cage was improved by the lattice topology optimization technology and validation using static structure.

Results
The ROMs in the current study were comparable with the results reported in the literature. There was no significant difference in the deformation of the two cages under various conditions. Moreover, the maximum stress occurred at the rear of the cage in all cases. The cage’s and endplate-cage interface’s stress of the ZK60 group was reduced compared with the Ti cage, while the bone graft stress in the ZK60 fusion cage was significantly greater than that in the Ti fusion cage (average 27.70%). We further optimized the cage by filling it with lattice structures, the volume was decreased by 40%, and validation showed more significant biomechanical properties than ZK60 and Ti cages.

Conclusion
The application of the ZK60 cage can significantly increase the stress stimulation to the bone graft by reducing the stress shielding effect between the two instrumented bodies. We also observed that the stress of the endplate-cage interface decreased as the reduction of the cage’s stiffness, indicating that subsidence is less likely to occur in the cage with lower stiffness. Moreover, we successfully designed a porous cage based on the biomechanical load by lattice optimization.
A pilot study of aquatic prehabilitation in adults with knee osteoarthritis undergoing total knee arthroplasty – short term outcome
Authors: Kim Sunghye , Hsu Fang-Chi , Groban Leanne , Williamson Jeff , Messier Stephen 
Published: April 2021

Abstract
Background
Knee osteoarthritis (KOA) is increasingly more prevalent and significant number of patients require knee arthroplasty. Although knee arthroplasty is generally successful, it takes months to recover physical function. Preoperative physical function is known to predict postoperative outcomes and exercise can improve preoperative physical function. However, patients with KOA have difficulty exercise on land due to pain and stiffness, while water exercise can be better tolerated. We hypothesized that preoperative water exercise to improve preoperative physical function will improve postoperative outcomes after total knee arthroplasty (TKA).

Methods
We enrolled 43 participants who were scheduled for elective TKA in 4–8 weeks and scored at or below 50th percentile in mobility assessment tool-sf (MAT-sf). All enrolled participants were assessed on 1) clinical osteoarthritis symptom severity using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 2) physical function using Short Physical Performance Battery (SPPB), 3) self-reported mobility using Mobility Assessment Tool-short form (MAT-sf), 4) depression using Geriatric Depression Scale-short form (GDS-sf), 5) cognitive function using Montreal Cognitive Assessment (MoCA). Blood samples for high-sensitivity-C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were stored at − 80 °C then all samples were analyzed together. All the enrolled participants were randomly assigned to the aquatic exercise intervention (AEI) or usual care group. Sixty minute sessions of AEI was conducted three times a week for 4–8 weeks. Participants in both groups were evaluated within 1 week before their scheduled surgery, as well as 4 weeks after the surgery.

Results
The mean age was 67.1 (±6.2), 44% were female, 74% were White. There is no statistically significant difference in combined outcome of any complication, unscheduled ER visit, and disposition to nursing home or rehab facility by AEI. However, AEI was associated with more favorable outcomes: WOMAC scores (p < 0.01), chair-stand (p = 0.019), MAT-sf as well as improved depression (p = 0.043) and cognition (p = 0.008).

Conclusion
4–8 weeks of aquatic exercise intervention resulted in improved functional outcomes as well as improved depression and cognition in elderly patients undergoing TKA. A larger study is warranted to explore the role of water exercise in clinical and functional outcomes of TKA.
“Snapping” of the extensor carpi ulnaris tendon in asymptomatic population
Authors: Erpala Firat , Ozturk Tahir 
Published: April 2021

AbstractBackgroundExtensor carpi ulnaris tendinopathy (ECU) can be one cause of ulnar side wrist pain and it is more prominent in pronation-supination movements against resistance. In supination, flexion, and ulnar deviation within the ulnar groove, the tendon is tense and becomes predisposed to subluxation or dislocation. Snapping occurs during this dislocation and relocation. As a result of this friction between the tendon sheath and ulnar groove, tendinopathy and pain occur. ECU tendon is an important structure that contributes to the dynamic stability of wrist therefore resulting degeneration contributes disruption of distal radioulnar joint and causes wrist instability.MethodsParticipants without active wrist complaints who presented to the outpatient clinic between 2019 and 2020 were included. Provocation test was performed and participants with snapping were evaluated with ultrasound to determine subluxation or dislocation. Participants asked to indicate approximately how much time they spent daily on the phone, computer and game console. The distribution of data was evaluated with the Kolmogorov-Smirnov test. Quantitative data that were not normally distributed were evaluated using the Mann-Whitney U test, and Student’s t-test was used for normally distributed data. The Chi-square test was used to compare categorical variables. For all tests,p < 0.05 was considered statistically significant.ResultsFour hundred and fifteen women and 340 men were included in the study. Fifty of the 755 participants (6.6 %) had snapping. 22 of the 755 participants (2.9 %) had dislocation or subluxation on ultrasound. Three (13.6 %) participants had dislocation and 19 (%86.4) participants had subluxation on ultrasound. All 50 of the participants with snapping had significant repetitive trauma and sports activities. It was determined that 21 of the 22 participants who were found to have subluxation or dislocation by ultrasound had more than two hours of hobby activity and significantly more participants had more than two hours of activity compared to the group without subluxation or dislocation.ConclusionsThis study with a large number of participants will contribute to the literature in terms of evaluating the contribution of technological devices, such as computers, smartphones, and consoles to chronic wrist pain and the prevalence of ECU snapping in the asymptomatic population.Trial registrationDate of Approval; 19.02.2019, Approval Number; 19-KAEK-045.
Urinary pentosidine level is associated with grip strength and gait speed in community-dwelling adults: a cross-sectional study
Authors: Moriwaki Kenta , Matsumoto Hiromi , Tanimura Chika , Osaki Mari , Nagashima Hideki , Hagino Hiroshi 
Published: April 2021

Abstract
Background
Muscle and bone interactions might be associated with osteoporosis and sarcopenia. Urinary pentosidine and serum 25-hydroxyvitamin D (25(OH)D) might affect muscle and bone interactions. It is unclear whether these biomarkers are affected by age and sex or play a role in muscle and physical functions. We aimed to investigate the association between urinary pentosidine and serum 25(OH)D levels with muscle mass, muscle strength, and physical performance in community-dwelling adults.

Methods
Two-hundred and fifty-four middle-aged and elderly adults were enrolled. There was no significant difference in age between 97 men (75.0 ± 8.9 years) and 157 women (73.6 ± 8.1 years). The skeletal muscle mass index (SMI), grip strength, and gait speed were assessed. The urinary pentosidine level was measured. We evaluated the association of urinary pentosidine and serum 25(OH)D levels with age and sex (student’s t-test) and correlations between biomarker and each variable (Pearson’s correlation coefficients). Multiple regression analysis was performed with grip strength and gait speed as dependent variables and with age, height, weight, body mass index (BMI), speed of sound (SOS), SMI, glycated hemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), 25(OH)D, and pentosidine as independent variables using the stepwise method.

Results
The urinary pentosidine level was negatively correlated with grip strength, gait speed, eGFR, and insulin-like growth factor-1 (IGF-1) in men and with SOS, grip strength, and gait speed in women. The serum 25(OH)D level was positively correlated with IGF-1 in women and grip strength in men. Grip strength was associated with age, height, and pentosidine in men and height and pentosidine in women. Gait speed was associated with age, BMI, and pentosidine in men and age, height, and pentosidine in women.

Conclusion
Urinary pentosidine levels are significantly associated with grip strength and gait speed and may serve as a biomarker of muscle and bone interactions.
Lumbar spinal stenosis combined with obesity-induced idiopathic spinal epidural lipomatosis treated with posterior lumbar fusion: case report
Authors: Han Xiao , Xu Derong , Ren ZhiNan , Chen Xin , Li Zheng , Li Shugang 
Published: April 2021

AbstractBackgroundSpinal epidural lipomatosis is a rare cause of lumbar spinal stenosis. While conservative therapy is applicable for most of cases, surgical intervention is necessary for severe ones. This is the first time we apply this modified technique to this disease.Case presentationThe case is a 53-year-old man. He is 175 cm tall and weighs 102 kg (body mass index 33.3 kg/cm2), presenting with low back pain and bilateral legs pain and numbness. Radiological examination showed severe lumbar spinal stenosis resulting from adipose hyperplasia, combined with hyperosteogeny and hypertrophy of ligaments, which are common etiological factors. Posterior decompression, internal fixation and a modified articular fusion technique was performed on this patient, and regular follow-up that up o 22 months showed outstanding clinical outcomes.ConclusionsA suitable style of posterior lumbar fusion should be considered to especially severe case with lumbar spinal stenosis and idiopathic spinal epidural lipomatosis.
EPDR1 is related to stages and metastasize in bladder cancer and can be used as a prognostic biomarker
Authors: Yang Yue , Zhang Hanchao , Liu Zhengdao , Zhao Faliang , Liang Guobiao 
Published: April 2021

AbstractBackgroundBladder cancer (BLCA) is a malignant urothelial carcinoma and has a high mortality rate. EPDR1 (ependymin related 1) is a type II transmembrane protein and related to calcium-dependent cell adhesion.MethodsWe explored the potential oncogenic roles of EPDR1 in BLCA basing on the multiple public datasets.ResultsWe found that EPDR1 expression had a significant difference in BLCA and adjacent normal bladder tissues, and the level of EPDR1was up-regulated with advanced tumor stage and metastasis in BLCA. Meanwhile, the high expression group of EPDR1 had a shorter OS compared to the low or medium expression-group. Furthermore, EPDR1 expression was associated with tumor-infiltrating immune cells (TIICs), including NK cells, CD8 + T cells, CD4 + T cells, Macrophages cells, and so on. Moreover, EPDR1 also involved in several signaling pathways as well as PI3K/AKT pathway, Cytokine receptor interaction, and apoptosis.ConclusionEPDR1 can be used as a novel prognostic biomarker as well as an effective target for diagnosis and treatment in BLCA.