bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Intervention Approaches of Emotion Regulation and Learning Strategies on Students’ Learning and Mental Health
Authors: Charbonnier Elodie , Le Vigouroux Sarah , Puechlong Cécile , Montalescot Lucile , Goncalves Aurélie , Baussard Louise , Gisclard Beatrice , Philippe Antony G. , Lespiau Florence 
Published: March 2023

University students are a vulnerable population, and many recent studies show that anxiety, depressive symptoms, and academic burnout have been on the increase since the beginning of the COVID-19 pandemic. These findings point to a need for interventions to reduce these difficulties. The purpose of the present study was to assess the effects of 2 formats of an innovative program on students’ mental health (anxiety, depressive symptoms, and academic burnout), intolerance of uncertainty, learned helplessness, and learning. Our sample was composed of 105 university students, recruited on a voluntary basis. They were divided into 3 groups: online intervention group (n = 36), face-to-face intervention group (n = 32), and control group (n = 37). The following variables were measured through online questionnaires: anxiety and depressive symptoms, academic burnout, intolerance of uncertainty, learned helplessness, perceived social support, learning strategies, and beliefs. There were 2 assessments 10 weeks apart (ie, before and after the program in the case of the 2 intervention groups). We performed nonparametric analyses to run comparisons between the 2 assessment timepoints in each group. Results showed that participants in the 2 intervention groups had lower levels of learned helplessness and intolerance of uncertainty at the end of the program. Furthermore, participants in the face-to-face group reported higher levels of perceived social support, academic self-efficacy, and help-seeking strategies. The present study highlighted the benefits of our innovative program, especially its face-to-face format. Clinical Trial - ID: NCT04978194.
Exploring hydrogen fuel cell and battery freight locomotive options using train dynamics simulation
Authors: Cole Colin , Sun Yan , Wu Qing , Spiryagin Maksym 
Published: March 2023

As efforts are being made to quickly adopt zero carbon technologies and replace fossil fuel powered trains, the design requirements are explored using train dynamics simulations to establish energy needs. The test case was a freight train of 3030 gross tonnes consisting of two locomotives and thirty wagons operating on a relatively flat coastal rail route. Then, assuming rapid deployment of existing and near market technologies, speculative locomotive designs are proposed for both battery only and hydrogen-battery systems. Batteries were assumed as rack mounted systems and hydrogen assumed at 250 bar gaseous. The results showed that full recovery of dynamic braking required only a very small amount of storage to capture and allow re-use, requiring a battery of only 6% of the trip total of recovered energy. The haulage task was found to require traction energy of 10.7 MWh per locomotive but reduced to a net requirement of 7.6 MWh per locomotive with recovery of dynamic braking energy. The large mass of batteries needed for the operating trip, however, limits the practical operating range. The results showed that, although hydrogen storage and equipment occupy considerable space and the containment systems have large mass, the space and mass requirements for a hydrogen system in this case study could be as low as half that required for batteries, while higher pressure or cryogenic approaches to hydrogen storage will allow the scaling for longer range.
Association of Talar Neck Fractures With Body Extension and Risk of Avascular Necrosis
Authors: Mechas Charles A. , Aneja Arun , Nazal Mark R. , Pectol Richard W. , Sneed Chandler R. , Foster Jeffrey A. , Kinchelow Daria L. , Kavolus Matthew W. , Landy David C. , Srinath Arjun , Moghadamian Eric S. 
Published: March 2023

Background: The objective of this study was to determine whether talar neck fractures with proximal extension (TNPE) into the talar body are associated with higher rates of avascular necrosis (AVN) compared to isolated talar neck (TN) fractures. Methods: A retrospective review of patients sustaining talar neck fractures at a level I trauma center from 2008 to 2016 was performed. Demographic and clinical data were collected from the electronic medical record. Fractures were characterized as TN or TNPE based on initial radiographs. TNPE was defined as a fracture that originates on the talar neck and extends proximal to a line subtended from the junction of the neck and the articular cartilage dorsal to the anterior portion of the lateral process of the talus. Fractures were classified according to the modified Hawkins classification for analysis. The primary outcome was the development of AVN. Secondary outcomes included nonunion and collapse. These were measured on postoperative radiographs. Results: There were 137 fractures in 130 patients, with 80 (58%) fractures in the TN group and 57 (42%) in the TNPE group. Median follow-up was 10 months (interquartile range, 6-18 months). The TNPE group was more likely to develop AVN as compared to the TN group (49% vs 19%, P < .001). Similarly, the TNPE group had a higher rate of collapse (14% vs 4%, P = .03) and nonunion (26% vs 9%, P = .01). Even after adjusting for open fracture, Hawkins fracture type, smoking, and diabetes, AVN still remained significant for the TNPE group as compared to the TN group with an odds ratio of 3.47 (95% CI, 1.51-7.99). Conclusion: We found a higher rate of AVN, subsequent collapse, and nonunion in patients with TNPE compared to isolated TN fractures. Level of Evidence: Level III, retrospective cohort study.
Association of Dopamine Transporter Gene (DAT1) 40 bp 3′ UTR VNTR Polymorphism (rs28363170) and Cannabis Use Disorder
Authors: Olasore Holiness SA , Osuntoki Akinniyi A , Magbagbeola Olubunmi A , Awesu Abdur-Rasheed B , Olashore Anthony A 
Published: March 2023

Introduction: Cannabis remains the most widely used illicit drug among Nigerians, often associated with psychiatric disorders. Since genetic predisposition has been implicated in substance use disorders, we, therefore, aimed at finding out the relationship between dopamine transporter gene (DAT1) polymorphism and cannabis use disorder. Methods: We recruited 104 patients from a tertiary psychiatric facility in Lagos, Nigeria, who were diagnosed with cannabis use disorder according to ICD-10 and 96 non-smokers as a comparative group. The smokers were screened with Cannabis Use Disorder Identification Test (CUDIT), and cannabis dependence was assessed with the Severity of Dependence Scale (SDS). Genotyping was carried out for the 40 bp 3′ UTR VNTR of the DAT1 (rs28363170). Results: The frequencies of 9R/9R, 9R/10R, 10R/10R among non-smokers and smokers were 14 (14.3%), 25 (26.2%), 57 (59.5%) and 17 (16.3%), 54 (51.9%), 33 (31.7%) respectively. The genotype distribution was in Hardy Weinberg equilibrium (HWE) only in the smokers’ population (χ² = 1.896, P = .166). Individuals with the 10R allele were almost twice as likely as the 9R carriers to smoke cannabis (OR = 1.915, 95% CI: 1.225-2.995). However, this polymorphism was not associated with the quantity of cannabis smoked, age at onset of smoking, CUDIT, and SDS scores. Conclusion: The DAT VNTR polymorphism was associated with cannabis smoking but not cannabis use disorder.
Finite Element Model-Computed Mechanical Behavior of Femurs with Metastatic Disease Varies Between Physiologic and Idealized Loading Simulations
Authors: Johnson Joshua E , Brouillette Marc J , Miller Benjamin J , Goetz Jessica E 
Published: March 2023

Background and objectives: Femurs affected by metastatic bone disease (MBD) frequently undergo surgery to prevent impending pathologic fractures due to clinician-perceived increases in fracture risk. Finite element (FE) models can provide more objective assessments of fracture risk. However, FE models of femurs with MBD have implemented strain- and strength-based estimates of fracture risk under a wide variety of loading configurations, and “physiologic” loading models typically simulate a single abductor force. Due to these variations, it is currently difficult to interpret mechanical fracture risk results across studies of femoral MBD. Our aims were to evaluate (1) differences in mechanical behavior between idealized loading configurations and those incorporating physiologic muscle forces, and (2) differences in the rankings of mechanical behavior between different loading configurations, in FE simulations to predict fracture risk in femurs with MBD. Methods: We evaluated 9 different patient-specific FE loading simulations for a cohort of 54 MBD femurs: strain outcome simulations—physiologic (normal walking [NW], stair ascent [SA], stumbling), and joint contact only (NW contact force, excluding muscle forces); strength outcome simulations—physiologic (NW, SA), joint contact only, offset torsion, and sideways fall. Tensile principal strain and femur strength were compared between simulations using statistical analyses. Results: Tensile principal strain was 26% higher ( R2 = 0.719, P < .001) and femur strength was 4% lower ( R2 = 0.984, P < .001) in simulations excluding physiologic muscle forces. Rankings of the mechanical predictions were correlated between the strain outcome simulations (ρ = 0.723 to 0.990, P < .001), and between strength outcome simulations (ρ = 0.524 to 0.984, P < .001). Conclusions: Overall, simulations incorporating physiologic muscle forces affected local strain outcomes more than global strength outcomes. Absolute values of strain and strength computed using idealized (no muscle forces) and physiologic loading configurations should be used within the appropriate context when interpreting fracture risk in femurs with MBD.
Addressing the Gap Between Academic Research and Grassroots Public Health Practice: Supporting Policy, Systems, and Environmental Changes in Rural Communities
Authors: Gabbert Kerry Darr , Tompkins Nancy O’Hara , Murphy Emily 
Published: March 2023

Public health practice continues to expand beyond traditional partners to increase reach and impact in communities. This is particularly important in rural communities, who face inequities in the social determinants of health and increased chronic disease burden. However, the capacity for non-traditional community organizations to understand and implement public health work varies widely. Promoting policy, systems, and environmental change strategies (PSE’s) is a promising method to support public health in rural communities, due to their variety, flexibility, and potential impact. Using a mixed methods approach to data analysis, we explore the barriers, challenges, and lessons learned from efforts in two rural Appalachian counties to stimulate use of PSE strategies through micro-funding. Several significant barriers were identified: challenges with evaluation and reporting, and lack of understanding and limited utilization of PSE strategies. Successful approaches to overcome these barriers included (1) changing reporting processes to reduce reliance on technology and shift reporting burden from community partners to researchers, (2) adapting data collection to capitalize on strengths of project partners, and (3) abandoning scientific language to embrace more common terminology used in communities. Policy changes were the least utilized strategy. This strategy may be less relevant in rural grassroots organizations with a small staff. Additional research into barriers to policy change is recommended. Enhanced training and support for grassroots, local-level PSE interventions could expand public health promotion in rural areas, reducing rural health disparities.
Optimising the delivery of breast cancer risk assessment for women aged 30–39 years: A qualitative study of women’s views
Authors: Hindmarch Sarah , Gorman Louise , Hawkes Rhiannon E , Howell Sacha J , French David P 
Published: March 2023

Background: Identifying women aged 30–39 years at increased risk of developing breast cancer could allow them to consider screening and preventive strategies. Research is underway to determine the feasibility of offering breast cancer risk assessment to this age group. However, it is unclear how best to deliver and communicate risk estimates to these women, in order to avoid potential harms such as undue anxiety and increase benefits such as informed decision-making. Objectives: This study aimed to investigate women’s views on, and requirements for, this proposed novel approach to risk assessment. Design: A cross-sectional qualitative design was used. Methods: Thirty-seven women aged 30–39 years with no family history or personal history of breast cancer participated in seven focus groups (n = 29) and eight individual interviews. Data were analysed thematically using a framework approach. Results: Four themes were developed. Acceptability of risk assessment service concerns the positive views women have towards the prospect of participating in breast cancer risk assessment. Promoting engagement with the service describes the difficulties women in this age group experience in relation to healthcare access, including mental load and a lack of cultural awareness, and the implications of this for service design and delivery. Impact of receiving risk results focuses on the anticipated impacts of receiving different risk outcomes, namely, complacency towards breast awareness behaviours following low-risk results, an absence of reassurance following average-risk results and anxiety for high-risk results. Women’s information requirements highlights women’s desire to be fully informed at invite including understanding why the service is needed. In addition, women wanted risk feedback to focus on plans for management. Conclusion: The idea of breast cancer risk assessment was received favourably among this age group, providing that a risk management plan and support from healthcare professionals is available. Determinants of acceptability of a new service included minimising effort required to engage with service, co-development of invitation and risk feedback materials and the importance of educational campaigning about the potential benefits of participation in risk assessment.
Perspectives of Singaporean Chinese patients with mild dementia and their family caregivers towards end-of-life care: Results from a qualitative study
Authors: Seow Dennis , Pang Amanda , Ho Suzanna , Malhotra Chetna 
Published: March 2023

Background Currently, there is little understanding of how patients with dementia and their caregivers view end-of-life (EOL) care. We thus aimed to study and understand the perception of EOL care by patients with mild dementia and their family caregivers. Methods We conducted qualitative in-depth interviews with 25 patients with mild dementia and their family caregivers belonging to Chinese ethnicity in Singapore. Patients’ and family caregivers’ understanding of illness, patients’ preferences for EOL care and caregiver concerns for the patients were discussed. Thematic analysis was conducted on the transcribed results of the interviews. Results We identified three main themes of person-centred EOL care: planning for cognitive decline and death, supporting patients to die peacefully at home, and supporting family caregivers to cope with patient’s condition. Most patients wanted to die peacefully and be cared for at their home. However, they were reluctant to initiate discussions regarding their future health care and seemed to be in denial that they may decline cognitively in future. Caregiver burden was noticeable for all family caregivers interviewed. Conclusion . Results highlight three important components that would enhance the delivery of patient-centred EOL care in patients with mild dementia. Strategies based on these components can enable family caregivers and health care providers to plan for and provide patient-centred EOL care concordant with patients’ wishes.
Community pharmacists’ measurement of health-related quality of life for breast cancer with positive hormone receptors: A prospective observational study
Authors: Ichimura Takenori , Nomura Hisanaga , Shimizu Hisanori 
Published: March 2023

Objectives: Many patients with hormone-receptor positive breast cancer undergo prolonged treatment. However, the long-term patient quality of life assessment has not been examined. Using community pharmacists’ assistance is one method for assessing long-term quality of life. Thus, this study aimed to understand the ongoing health-related quality of life and quality-adjusted life year among breast cancer patients so that community pharmacists may contribute to their pharmacotherapy. Methods: We conducted a prospective observational study with 22 breast cancer patients who had health-related quality of life at the initial measurement and 6 months later. Results: Regarding the health-related quality of life, quality-adjusted life year concerning all patients was 0.890 (95% confidence interval: 0.846–0.935). Quality-adjusted life year concerning those younger than 65 years was 0.907 (95% confidence interval: 0.841–0.973), and that for individuals older than 65 years was 0.874 (95% confidence interval: 0.804–0.943). The adjuvant chemotherapy group had a lower health-related quality of life at the initial measurement (0.887; 95% confidence interval: 0.833–0.941) but showed a higher quality of life 6 months later (0.951; 95% confidence interval: 0894–1.010). Quality-adjusted life year for individuals regarding adjuvant chemotherapy was 0.919 (95% confidence interval: 0.874–0.964). In contrast, the life-prolonged group had a higher health-related quality of life at the initial measurement, which was lower 6 months later. Conclusions: As a result of measuring quality of life using the EuroQol 5-dimensions-5-levels, this study revealed a decline in health-related quality of life in patients undergoing hormonal therapy for breast cancer. The study is expected to assist community pharmacists in managing outpatients.
Incidence Rates and Pathology Types of Boxing-Specific Injuries: A Systematic Review and Meta-analysis of Epidemiology Studies in the 21st Century
Authors: Mao Yunhe , Zhao Dongmei , Li Jian , Fu Weili 
Published: March 2023

Background: To the best of our knowledge, an evidence-based investigation into 21st-century boxing-specific injury rates and types has yet to be performed. Purpose: To provide an overview and quantitative synthesis of the incidence rates (IRs) and pathological categorizations of boxing-specific injuries in the 21st century. Study Design: Systematic review; Level of evidence, 3. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched literature published from January 2000 to November 2021 in PubMed and the Cochrane Library systematically for qualifying epidemiology studies of organized boxing activities across the world. Two independent reviewers completed the literature review, data extraction, and quality assessment. The IRs of injuries per 1000 boxers (IRN), per 1000 competition exposures (IRE), and per 1000 minutes of competition (IRC) or training (IRT) were subsequently calculated. Single-arm meta-analyses were performed for the subgroups of different types of boxing. Sample size weighted means were calculated using a random-effects model in all studies with 95% CIs. Results: Out of an initial 9584 articles, 14 studies were included, with most (11/14) having a moderate level of quality. The pooled IRN in overall injuries was 223.9 (95% CI, 157.5-290.4), the IRE was 233.3 (95% CI, 161.3-305.2), and the IRC was 13.0 (95% CI, 8.9-17.1). In professional boxing, the IRN (399.8), IRE (379.8), and IRC (23.9) were all significantly higher than in the amateur and female groups. The IRE (76.6 vs 250.6; P < .000) and IRC (9.2 vs 15.4; P < .000) in amateur boxing were significantly lower in studies between 2010 and 2019 than in earlier studies. For pathology categorization, the pooled frequencies were 12.3% (95% CI, 8.7%-15.9%) for concussion, 21.4% (95% CI, 14.1%-28.6%) for skin laceration, 30.2% (95% CI, 22.1%-38.2%) for soft tissue contusion, 15.3% (95% CI, 7.7%-22.9%) for sprain and muscle/ligament injury, and 11.4% (95% CI, 2.7%-20.1%) for fracture. Conclusion: IRs of injury remain high in professional boxing, although they have decreased in the past 10 years in amateur boxing. Soft tissue contusion was the most common injury type. Better exposure measurements and epidemiologic indicators should be applied in future studies. Registration: CRD42021289993 (PROSPERO).
New Method of Tibio-calcaneal-Navicular Arthrodesis After Talectomy
Authors: Ali-Zade Chingiz , Aliyev Huseyn , Alizada Farhad 
Published: March 2023

Background: After astragalectomy, patients still have a shortening of the limb, which can require various reconstructive manipulations. We have developed a simple and versatile tibio-calcaneal-navicular arthrodesis (TCNA) technique to reduce limb shortening. Methods: The main difference from the standard method of arthrodesis between the tibia and calcaneus is that in our method after astragalectomy, the tibia rests with the anterior edge against the os navicularis, and the posterior edge against the calcaneus. We have observed 14 patients (2 were female, 12 were male) operated by a new method of tibio-calcaneal-navicular arthrodesis (TCNA) from 2003 to 2020 years with various forms of osteomyelitis, fractures, and septic necrosis of the talus. The average age of the patients was 42.2 (ranged 20-75) years. Observation results will be assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score 1-1.5 years after surgery and treatment time in the Ilizarov apparatus. Results: In all patients, the wounds healed by primary intention. The average time of immobilization in the apparatus was 4.9 (ranged 3.5-6) months. The average limb shortening 2.0 ± 0.5 cm. AOFAS ankle-hindfoot score (n = 14) in all patients came up to 77.9 ± 6.8 (min 68, max 86) SD 12.8. Nonunion was noted in the region of the anterior edge of the tibia in 1 patient (7.1%), and in another patient a painless nonunion was formed (7.1%). Patients wore ordinary footwear without arch supporter and with heels up to 2 cm. Conclusion: Good and satisfactory results were obtained in all patients. The new TCNA method allows restoring the supporting ability of a limb, reduces shortening, and improves the quality of life for patients. Level of Evidence: Level IV, case series, low-quality cohort or case- control studies.
Sparse clusterability: testing for cluster structure in high dimensions
Authors: Laborde Jose , Stewart Paul A. , Chen Zhihua , Chen Yian A. , Brownstein Naomi C. 
Published: March 2023

AbstractBackgroundCluster analysis is utilized frequently in scientific theory and applications to separate data into groups. A key assumption in many clustering algorithms is that the data was generated from a population consisting of multiple distinct clusters. Clusterability testing allows users to question the inherent assumption of latent cluster structure, a theoretical requirement for meaningful results in cluster analysis.ResultsThis paper proposes methods for clusterability testing designed for high-dimensional data by utilizing sparse principal component analysis. Type I error and power of the clusterability tests are evaluated using simulated data with different types of cluster structure in high dimensions. Empirical performance of the new methods is evaluated and compared with prior methods on gene expression, microarray, and shotgun proteomics data. Our methods had reasonably low Type I error and maintained power for many datasets with a variety of structures and dimensions. Cluster structure was not detectable in other datasets with spatially close clusters.ConclusionThis is the first analysis of clusterability testing on both simulated and real-world high-dimensional data.