bluuebunny/crossref_metadata_2025_split huggingface dataset:
Underrepresentation of women in randomized controlled trials: a systematic review and meta-analysis
Authors: Daitch Vered , Turjeman Adi , Poran Itamar , Tau Noam , Ayalon-Dangur Irit , Nashashibi Jeries , Yahav Dafna , Paul Mical , Leibovici Leonard 
Published: December 2022

Abstract
Background
Although regulatory changes towards correcting the underrepresentation of women in randomized controlled trials (RCTs) occurred (National Institutes of Health 1994), concerns exist about whether an improvement is taking place. In this systematic review and meta-analysis, we aimed to assess the inclusion rates of women in recent RCTs and to explore the potential barriers for the enrollment of women.

Methods
RCTs published in 2017 examining any type of intervention in adults were searched in PubMed and Cochrane Library. The following predefined medical fields were included: cardiovascular diseases, neoplasms, endocrine system diseases, respiratory tract diseases, bacterial and fungal infections, viral diseases, digestive system diseases, and immune system diseases. Studies were screened independently by two reviewers, and an equal number of studies was randomly selected per calendric month. The primary outcome was the enrollment rate of women, calculated as the number of randomized women patients divided by the total number of randomized patients. Rates were weighted by their inverse variance; statistical significance was tested using general linear models (GLM).

Results
Out of 398 RCTs assessed for eligibility, 300 RCTs were included. The enrollment rate of women in all the examined fields was lower than 50%, except for immune system diseases [median enrollment rate of 68% (IQR 46 to 81)]. The overall median enrollment rate of women was 41% (IQR 27 to 54). The median enrollment rate of women decreased with older age of the trials’ participants [mean age of trials’ participants ≤ 45 years: 47% (IQR 30–64), 46–55 years: 46% (IQR 33–58), 56–62 years: 38% (IQR 27–50), ≥ 63 years: 33% (IQR 20–46), p < 0.001]. Methodological quality characteristics showed no significant association with the enrollment rates of women. Out of the 300 included RCTs, eleven did not report on the number of included women. There was no significant difference between these studies and the studies included in the analysis.

Conclusions
Women are being inadequately represented, in the selected medical fields analyzed in our study, in recent RCTs. Older age is a potential barrier for the enrollment of women in clinical trials. Low inclusion rates of elderly women might create a lack of crucial knowledge in the adverse effects and the benefit/risk profile of any given treatment. Factors that might hinder the participation of women should be sought and addressed in the design of the study.
Partial thickness subfoveal hole in a patient treated with tamoxifen: a case report and review of the literature
Authors: Sohn Ashley , Sanchez George , Mantopoulos Dimosthenis 
Published: December 2022

Abstract
Background
We describe a patient presenting with a partial thickness subfoveal hole in the right eye after tamoxifen treatment for breast cancer.

Case presentation
A 76-year-old Caucasian female presented with a 1-day history of acute central scotoma and blurry vision in the right eye. The patient had been receiving oral tamoxifen for 5 years as adjuvant treatment for stage I lobular breast cancer. Her past ocular history was significant for complete, uneventful, and bilateral posterior vitreous detachment. Clinical examination and optical coherence tomography revealed a new, partial thickness subfoveal hole sparing the inner retinal layers. Observation was recommended. At the last follow-up examination, 1 year after the initial presentation, the subfoveal hole remained stable and visual acuity remained stable.

Conclusion
Tamoxifen has been associated with a plethora of ophthalmic adverse events, including macular holes, some of which are partial thickness subfoveal holes. Holes with this almost unique morphology are uncommon, and eye care professionals should be aware of this association given the frequency of tamoxifen use, as well as the low success rate of surgical repair with pars plana vitrectomy.
Single-cell transcriptome reveals core cell populations and androgen-RXFP2 axis involved in deer antler full regeneration
Authors: Ba Hengxing , Wang Xin , Wang Datao , Ren Jing , Wang Zhen , Sun Hai-Xi , Hu Pengfei , Zhang Guokun , Wang Shengnan , Ma Chao , Wang Yusu , Wang Enpeng , Chen Liang , Liu Tianbin , Gu Ying , Li Chunyi 
Published: December 2022

AbstractDeer antlers constitute a unique mammalian model for the study of both organ formation in postnatal life and annual full regeneration. Previous studies revealed that these events are achieved through the proliferation and differentiation of antlerogenic periosteum (AP) cells and pedicle periosteum (PP) cells, respectively. As the cells resident in the AP and the PP possess stem cell attributes, both antler generation and regeneration are stem cell-based processes. However, the cell composition of each tissue type and molecular events underlying antler development remain poorly characterized. Here, we took the approach of single-cell RNA sequencing (scRNA-Seq) and identified eight cell types (mainly THY1+ cells, progenitor cells, and osteochondroblasts) and three core subclusters of the THY1+ cells (SC2, SC3, and SC4). Endothelial and mural cells each are heterogeneous at transcriptional level. It was the proliferation of progenitor, mural, and endothelial cells in the activated antler-lineage-specific tissues that drove the rapid formation of the antler. We detected the differences in the initial differentiation process between antler generation and regeneration using pseudotime trajectory analysis. These may be due to the difference in the degree of stemness of the AP-THY1+ and PP-THY1+ cells. We further found that androgen-RXFP2 axis may be involved in triggering initial antler full regeneration. Fully deciphering the cell composition for these antler tissue types will open up new avenues for elucidating the mechanism underlying antler full renewal in specific and regenerative medicine in general.
Barriers and facilitators of adherence to treatment among women with vulvovaginal candidiasis: a qualitative study
Authors: Erfaninejad Maryam , Salahshouri Arash , Amirrajab Nasrin 
Published: December 2022

Abstract
Background
Non-adherence of patients with vulvovaginal candidiasis (VVC) to treatment recommendations leads to treatment failure and recurrence of infection. Therefore, this qualitative study was conducted to identify barriers and facilitators of observance of treatment among women afflicted with vulvovaginal candidiasis.

Methods
This qualitative study was conducted through 26 in-depth unstructured interviews with 24 patients and 2 gynecologists using purposeful sampling with maximum variation in Ahvaz, southwest Iran. Interviews were conducted in person at health centers and the gynecologist’s offices. MAXQDA 10 software and conventional content analysis were used for data analysis.

Results
The findings showed barriers and facilitator factors of adherence to treatment in women with VVC. Some of these factors lead to an increase in adherence to treatment, and others play the role of hindering factors. These factors were classified into two main categories: patients’ beliefs and patients’ fears and concerns.

Conclusion
The results of this study showed that many of the behaviors of patients from the acceptance of the diagnosis process to treatment are rooted in the patient's beliefs and fears. Therefore, it seems necessary to design and carry out interventions based on the findings of this study, which can be used in the development of appropriate solutions, treatment guidelines, and adopting a policy for treatment adherence.
Are opportunistic captures of neonate ungulates biasing relative estimates of litter size?
Authors: Turnley Matthew T. , Larsen Randy T. , Hughes Tabitha A. , Hinton Morgan S. , Sallee Daniel W. , Lamb Sydney , Hersey Kent R. , McMillan Brock R. 
Published: December 2022

AbstractThe capture of neonate ungulates allows for the collection of valuable ecological data, including estimates of litter size. However, varied methods used to capture neonate ungulates can result in sampling biases. Our objective was to determine if opportunistic captures of neonate ungulates (i.e., locating neonates by visually scanning for adult females displaying postpartum behaviors) bias relative estimates of litter size and investigate potential causes if a bias does exist. We analyzed data from 161 litters of mule deer (Odocoileus hemionus) sampled using three different capture methods during 2019–2021 in Utah, USA. Estimates of litter size derived from opportunistic captures were smaller than estimates derived from movement-based captures or captures completed with the aid of vaginal implant transmitters (VITs). Age at capture was inversely related to estimates of litter size and likely influenced the detection bias associated with opportunistic captures. Neonates captured opportunistically were not older than neonates captured using movement-based methods, but were older than neonates captured with the aid of VITs. Distance between neonates from the same litter did not influence estimates of litter size. Researchers should be aware of the biases associated with different capture methods and use caution when interpreting data among multiple capture methods. Estimates of litter size derived from opportunistic captures should not be compared to estimates of litter size derived from alternative capture methods without accounting for the detection bias we observed.
A comparison of three approaches to covariate effects on latent factors
Authors: Wang Ze 
Published: December 2022

AbstractIn educational and psychological research, it is common to use latent factors to represent constructs and then to examine covariate effects on these latent factors. Using empirical data, this study applied three approaches to covariate effects on latent factors: the multiple-indicator multiple-cause (MIMIC) approach, multiple group confirmatory factor analysis (MG-CFA) approach, and the structural equation model trees (SEM Trees) approach. The MIMIC approach directly models covariate effects on latent factors. The MG-CFA approach allows testing of measurement invariance before latent factor means could be compared. The more recently developed SEM Trees approach partitions the sample into homogenous subsets based on the covariate space; model parameters are estimated separately for each subgroup. We applied the three approaches using an empirical dataset extracted from the eighth-grade U.S. data from the Trends in International Mathematics and Science Study 2019 database. All approaches suggested differences among mathematics achievement categories for the latent factor of mathematics self-concept. In addition, language spoken at home did not seem to affect students’ mathematics self-concept. Despite these general findings, the three approaches provided different pieces of information regarding covariate effects. For all models, we appropriately considered the complex data structure and sampling weights following recent recommendations for analyzing large-scale assessment data.
Parental attitudes, beliefs, and practices related to firearm storage: a qualitative study
Authors: Schenck Christopher , Wilson Meghan , Tiyyagura Gunjan , Bechtel Kirsten 
Published: December 2022

Abstract
Background
Firearm injury is a leading cause of death among children. Safer firearm storage practices are associated with a reduced risk of childhood suicide and unintentional firearm death. However, these practices are underutilized. The objective of this study was to characterize parental attitudes and beliefs related to firearm storage and identify facilitators and barriers to safer storage practices.

Methods
Semi-structured, qualitative interviews were conducted to identify motivations for using different storage methods among parents who kept firearms in southern Connecticut. The constant comparative method was used to code interview transcripts and derive themes directly from the data.

Results
Twenty participants completed the study. 60% were male, 90% were white, and all were between 32 and 53 years old. 85% of participants stored firearms locked, 60% unloaded, 65% kept ammunition locked or did not keep ammunition in their home, and 45% stored ammunition separate from firearms. The following themes were identified: (1) firearm storage must be compatible with a specific context of use; (2) some parents engage in higher-risk storage because they believe it is adequate to reduce the risk of injury; (3) firearm practices are influenced by one’s social network and lived experience; (4) parents who own firearms may be amenable to changing storage practices; and (5) parents’ conceptualization of firearm injury prevention is multimodal, involving storage, education, and legislation.

Conclusions
Parents who keep firearms value convenience and utility, which may be at odds with safer storage practices; however, some may be amenable to adopting safer practices. Family and peer relationships, education, and legislation represent important facilitators of storage practices. Understanding parental attitudes and beliefs on firearm storage may inform future interventions to improve storage practices.
Effects of the COVID-19 pandemic on the pediatric emergency department: a single institution experience
Authors: Masler Isabella V. , Shah Nipam , Duerring Shea A. , Monroe Kathy R. 
Published: December 2022

Abstract
Background
The COVID-19 pandemic resulted in drastic decreases in volume for most pediatric emergency departments (ED). Injuries have persisted and there is concern that injuries may have increased during the pandemic. This study evaluates the impact of the COVID-19 pandemic on ED patient trends at a freestanding children’s hospital.

Results
Despite an average annual increase of 1100 patients per year between 2017 and 2019, this ED saw a decrease of over 25,000 patients in 2020. The number of trauma alerts increased from 341 in 2017 to 571 in 2020 and those numbers remained stable (568–571) in 2020 compared to 2019. The percent of total volume accounted for by trauma alerts increased from 0.65 to 1.2% between 2019 and 2020 (following the trend of 0.48% in 2017 to 0.56% in 2018). Historically, motor vehicle crashes account for the majority of the trauma alerts, though the number of trauma alerts from firearm-related injuries increased from 36 per year in 2018 to 44 in 2019 to 66 (12% of total trauma alerts) in 2020.

Conclusions
While total volumes of patients being seen decreased, the number of trauma alerts remained stable resulting in an increased percentage of trauma alert patients. This indicates that severe injuries requiring trauma alert activation did not diminish during the pandemic. These trends have implications for prevention as well as implications for ED staffing. Changing trends in types of severe injuries are noted.
All-terrain vehicle exposure and the association of certified training on adolescent safety behaviors and crash experiences
Authors: Jennissen Charles A. , Champoux Katharine L. , Hoogerwerf Pamela J. , Wetjen Kristel M. , Mulford Lauren J. , Schaeffer Sienna E. , Okoro Uche E. , Denning Gerene M. 
Published: December 2022

Abstract
Background
Certified training courses in all-terrain vehicle (ATV) operation are recommended, but little has been published regarding how they affect riding behaviors. Our objectives were to determine adolescents’ ATV riding exposures, crashes and injuries, and the association of completing certified ATV training on riding behaviors.

Methods
Respondents completed an anonymous paper survey at 30 school districts approximately one year after participating in the Safety Tips for ATV Riders (STARs) program. Survey data were compiled using Qualtrics™. Frequency, chi-square, Fisher’s exact test, and logistic regression analyses were performed using SAS, V.9.4.

Results
4,891 students completed the survey from Fall 2012–Fall 2019. Respondents were 10–18 years old, and similar numbers of participants were male and female. Fifty-nine percent lived in town, 18% on a farm, and 22% in the country but not on farm. Forty-two percent reported their families owned an ATV. Seventy-seven percent had ridden an ATV, 40% of whom reported riding at least weekly. The vast majority (94%) used ATVs for recreation and 49% used them for work purposes. In the previous year, 22% of riders reported having been in a crash, with 7% of crash victims requiring medical attention for injuries. Greater crash likelihood was seen in males, recreational riders, more frequent riders, competitive racers and those who had ridden with passengers or on roads. Only 8% of riders had completed certified ATV safety training (note, STARs is not a certification program). Those whose families owned ATVs, more frequent riders, and public park users had greater likelihoods of course completion. Relative to their peers, respondents who completed a certification course had higher proportions that always/almost always wore helmets (39% vs. 20%, p < 0.0001) and lower proportions that never/almost never wore helmets (29% vs 58%, p < 0.0001), had ridden with passengers (63% vs. 96%, p < 0.0001), and had driven on public roads (41% vs 50%, p = 0.0065).

Conclusions
ATV safety training certification among Iowa adolescents in the study was infrequent but those that received training reported higher helmet use, less riding with passengers, and less driving on public roads. These data suggest completing safety training certification may promote safer riding behaviors among youth.
Intra- and inter-operator variability in MRI-based manual segmentation of HCC lesions and its impact on dosimetry
Authors: Covert Elise C. , Fitzpatrick Kellen , Mikell Justin , Kaza Ravi K. , Millet John D. , Barkmeier Daniel , Gemmete Joseph , Christensen Jared , Schipper Matthew J. , Dewaraja Yuni K. 
Published: December 2022

Abstract
Purpose
The aim was to quantify inter- and intra-observer variability in manually delineated hepatocellular carcinoma (HCC) lesion contours and the resulting impact on radioembolization (RE) dosimetry.

Methods
Ten patients with HCC lesions treated with Y-90 RE and imaged with post-therapy Y-90 PET/CT were selected for retrospective analysis. Three radiologists contoured 20 lesions manually on baseline multiphase contrast-enhanced MRIs, and two of the radiologists re-contoured at two additional sessions. Contours were transferred to co-registered PET/CT-based Y-90 dose maps. Volume-dependent recovery coefficients were applied for partial volume correction (PVC) when reporting mean absorbed dose. To understand how uncertainty varies with tumor size, we fit power models regressing relative uncertainty in volume and in mean absorbed dose on contour volume. Finally, we determined effects of segmentation uncertainty on tumor control probability (TCP), as calculated using logistic models developed in a previous RE study.

Results
The average lesion volume ranged from 1.8 to 194.5 mL, and the mean absorbed dose ranged from 23.4 to 1629.0 Gy. The mean inter-observer Dice coefficient for lesion contours was significantly less than the mean intra-observer Dice coefficient (0.79 vs. 0.85, p < 0.001). Uncertainty in segmented volume, as measured by the Coefficient of Variation (CV), ranged from 4.2 to 34.7% with an average of 17.2%. The CV in mean absorbed dose had an average value of 5.4% (range 1.2–13.1%) without PVC while it was 15.1% (range 1.5–55.2%) with PVC. Using the fitted models for uncertainty as a function of volume on our prior data, the mean change in TCP due to segmentation uncertainty alone was estimated as 16.2% (maximum 48.5%).

Conclusions
Though we find relatively high inter- and intra-observer reliability overall, uncertainty in tumor contouring propagates into non-negligible uncertainty in dose metrics and outcome prediction for individual cases that should be considered in dosimetry-guided treatment.
A meta-analysis of climatic conditions and whitefly Bemisia tabaci population: implications for tomato yellow leaf curl disease
Authors: Lobin Kanta Kumar , Jaunky Vishal Chandr , Taleb-Hossenkhan Nawsheen 
Published: December 2022

AbstractBackgroundTomato yellow leaf curl disease (TYLCD), which is caused by the genusBegomovirus, is basically transmitted by the vector whitefly,Bemisia tabaci(B. tabaci). It remains a destructive disease of tomato across the world. The disease is present in many tomato growing countries, and it has a broad geographical distribution. The population and distribution of the vector are therefore an important factor in disease spread. This study assesses the determinants of the relationship between climatic factors and whitefly population. A thorough search of relevant papers was first initiated, and eventually 16 articles with 142 estimates were selected. A meta-regression analysis, especially the random-effects model with a restricted maximum likelihood (REML) estimator, was applied.ResultsSummarization of effect sizes revealed a mean effect size for the study ofr = 0.15. The forest plot suggested a significant amount of study heterogeneity. No evidence of significant publication bias was uncovered. The meta-analysis revealed that the population of whiteflies was significantly related to climatic independent variables such as maximum and minimum temperature and rainfall. Other factors such as altitude, number of symptoms, pesticide policy, type of soil, number of references, impact factor and publication status were found to significantly influence the effect sizes.ConclusionsWhiteflies are playing a major role in spreading the TYLCD. Several factors were identified to have a significant impact on the climatic conditions-whitefly population nexus. Since climatic factors, altitude, existing pesticide laws and type of soil were found to have a significant impact on the effect sizes, agricultural management policies could be enacted by specifically considering those factors in a view to minimize the impact of whiteflies. In general, all the above factors could be considered in strategy to manage TYLCD.
CELSIUS: an international project providing integrated, systematic, cost-effective large-scale IoT solutions for improving energy efficiency of medium- and large-sized buildings
Authors: Ma Zheng , Santos Athila Quaresma , Shaker Hamid Reza , Yussof Salman , Eriksen Poul Møller , Hornum Jens , Jørgensen Bo Nørregaard 
Published: December 2022

AbstractWorldwide, buildings consume about 40 percent of the overall energy resources and contribute to an average of 30 percent of the global carbon emission. Hence, technologies for improving the energy efficiency of buildings play an essential role in the global fight against climate change. The CELSIUS project aims to improve the energy efficiency and indoor climate of medium to large sized commercial and public buildings by developing an integrated system solution that consists of (1) an IoT-enabled and cloud-based platform for monitoring and diagnostics of building energy performance and indoor climate quality, (2) a middleware software platform for cost-effective large-scale deployment of wireless sensors and gateways, and (3) an IoT network management platform for cost-efficient life-cycle maintenance of sensors and gateways. The integrated system solution will be deployed and demonstrated in a 6000 m2 building in Aarhus, Denmark, and an 18,000 m2 building in Kuala Lumpur, Malaysia. By choosing buildings located in different climate zones on different continents allows the developed system solution to be tested under realistic conditions for the international export market.