bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Attention Deficit Hyperactivity Disorder in Sri Lankan Children: A School Based Community Study
Authors: Nazeer Nazneen , Rohanachandra Yasodha Maheshi , Prathapan Shamini 
Published: April 2023

Objective: To evaluate potential risk-factors of ADHD among primary school-children (PSC) in state schools in Colombo district of Sri Lanka. Method: A case-control study was conducted with 73 cases and 264 controls selected randomly among 6 to 10-year-old PSC from Sinhala medium state schools in Colombo district. Primary care givers completed the SNAP-IV P/T-S scale to screen for ADHD and an interviewer-administered questionnaire on risk-factors. Children’s diagnostic status was confirmed by a Consultant Child and Adolescent Psychiatrist based on DSM-5 criteria. Results: A binomial regression model identified male sex (aOR = 3.45; 95% CI [1.65, 7.18]), lower educational level of the mother (aOR = 2.99; 95% CI [1.31, 6.48]), birth weight <2,500 g (aOR = 2.83; 95% CI [1.17, 6.81]),a neonatal complications (aOR = 3.82; 95% CI [191, 7.65]) and child having witnessed verbal/emotional aggression between parents (aOR = 2.08; 95% CI [1.01, 4.27])as significant predictors of ADHD. Conclusion: Primary prevention should focus on strengthening neonatal, maternal and child health services within the country.
Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment
Authors: Onsjö Marja , Strand Jennifer , Axberg Ulf 
Published: April 2023

Exposure to adverse childhood experiences is a risk factor for the development of serious psychiatric and somatic illness. Although trauma-focused therapy is effective in reducing symptoms, not all children benefit from it. To improve treatment efficacy, the children’s perspective on what they perceive as helpful versus hindering is necessary. This study aimed, retrospectively, to explore how children exposed to family violence experienced treatment at the Child and Adolescent Mental Health Service. Seventeen children and youths were interviewed 4–5 years after treatment. The thematic analysis resulted in five themes: confusion, the need to feel heard, fear of consequences, feelings of pain, and identifying oneself as an agent. The results emphasize the importance of the therapeutic relationship, and that trust, genuine interest, and reciprocity are necessary for the child to engage in treatment. However, neither the child’s own agency nor external obstacles such as continuous exposure to abuse should be underestimated in terms of the child’s engagement.
Operational performance evaluation of a Passive house residential building in northern China based on long-term monitoring in winter
Authors: Han Fei , Liu Bin , Feist Wolfgang , Pfluger Rainer , Dermentzis Georgios 
Published: April 2023

Passive houses, called nearly zero energy buildings in China, are developing rapidly. These constructions in China are mainly located in cold climate zones. Due to highly efficient energy-saving technology, Passive houses can decrease space heating demand (SHD) by 70%–90% compared to local conventional buildings. However, this energy-saving rate is still a theoretical result and needs to be verified by real data. There is a lack of studies evaluating the performance of residential Passive houses through monitored data in China. This article selects a newly built multi-storey residential Passive house building in Qingdao to accurately quantify its energy performance. Through energy consumption monitoring throughout winter, the average SHD of this building at an occupancy rate of 47% was found to be 28 kWh/(m2·a) and the primary energy consumption was 96.7 kWh/(m2·a), while maintaining a high level of indoor comfort. Compared with local conventional Green Buildings, the SHD of the case building was reduced by 86.3% and the total energy consumption was reduced by 69.2%. The results demonstrate that Passive houses have a great energy-saving potential and provide evidence supporting the use of Passive houses as an option for sustainable building in northern China.
Definition and rationale for placebo composition: Cross-sectional analysis of randomized trials and protocols published in high-impact medical journals
Authors: Hong Kyungwan , Rowhani-Farid Anisa , Doshi Peter 
Published: April 2023

Background/Aims: Inadequate description of trial interventions in publications has been repeatedly reported, a problem that extends to the description of placebo controls. Without describing placebo contents, it cannot be assumed that a placebo is inert. Pharmacologically active placebos complicate accurate estimation and interpretation of efficacy and safety data. In this study, we sought to assess whether placebo contents are described in study protocols and publications of trials published in high-impact medical journals. Methods: We identified all placebo-controlled randomized clinical trials (RCTs) published in 2016 in Annals of Internal Medicine, The BMJ, the Journal of the American Medical Association (JAMA), The Lancet, and the New England Journal of Medicine (NEJM). We included all trials with publicly available study protocols. From journal publications and associated study protocols, we searched and recorded: description of placebo contents; the amount of each placebo ingredient; and investigators’ stated rationale for selection of placebo ingredients. Results: We included 113 placebo-controlled RCTs. Of the 113 trials, placebo content was described in 22 (19.5%) journal publications and 51 (45.1%) study protocols. The amount of each placebo ingredient was described in 15 (13.3%) journal publications and 47 (41.6%) study protocols. None of the journal publications explained the rationale for the choice of placebo ingredients, whereas a rationale was provided in 4 (3.5%) study protocols. The stated rationales were to ensure the placebo was visually indistinguishable from the experimental intervention ( N = 3) and ensure comparability with a previous study ( N = 1). Conclusion: There is no accessible record of the composition of placebos for approximately half of high-impact RCTs, even with access to study protocols. This impedes reproducibility and raises unanswerable questions about what effects—beneficial or harmful—the placebo may have had on trial participants, potentially confounding an accurate assessment of the experimental intervention’s safety and efficacy. Considering that study protocols are unabridged, detailed documents describing the trial design and methodology, the fact that less than half of the study protocols described the placebo contents raises concerns about clinical trial transparency. To improve the reproducibility and potential of placebo-controlled RCTs to provide reliable evidence on the efficacy and safety profile of drugs and other experimental interventions, more detail regarding placebo contents must be included in trial documents.
Quantitative sonoelastography of the uterine cervix in predicting successful outcome of induction of labour
Authors: Agarwal Mukta , Sinha Sudwita , Nitu Nitu , Roy Ria , Kunwar Kajal , Kumar Prem , Kumar Subhash , Prasad Indira 
Published: April 2023

Objectives: The aim of the study was to evaluate the stiffness of cervix and determine its significance in predicting successful outcome of induction of labour. The primary objective was to determine the differences in elastography indices of different areas of cervix between the outcome groups of successful and failed induction of labour. A secondary objective was to find out the correlation of these elastography indices with Bishop’s score and cervical length. Methods: This was a prospective, observational study conducted over a period of 6 months on pregnant women admitted in the labour room for induction of labour. Establishment of adequate regular uterine contractions – at least three contractions lasting 40–45 s in a 10-min period – was taken as end point for successful outcome of induction of labour. Even after 24 h of initiation of induction of labour, regular, adequate and painful uterine contractions were not established, then induction of labour was described as having failed. Prior to induction, cervical length measurement, Bishop’s scoring and elastographic evaluation of the cervix were done by stress–strain elastography. A colour map was produced from purple to red and a five-step scale – the elastography index – was used to describe the various parts of the cervix. The differences between elastography indices of different parts of cervix were estimated using Mann–Whitney U test. Correlation of the indices with cervical length and Bishop’s score was determined by Spearman’s correlation coefficient. Results: A total of 64 women were included in the study. A significant difference ( p < 0.001) was found in the elastography index of internal os between the two outcome groups of success (1.76 ± 0.64) and failure (0.54 ± 0.18). However, the elastography index of central cervical canal, external os, anterior lip and posterior lips did not differ significantly across the outcome groups. A significant positive correlation was found between elastography index of internal os and cervical length (Spearman’s correlation coefficient, r = 0.441, p < 0.001) and between elastography index of external os and cervical length ( r = 0.347, p = 0.005), whereas a negative correlation was seen between elastography index of external os and Bishop’s score ( r = −0.270, p = 0.031). Conclusion: Elastography index of internal os can be used to predict outcome of induction of labour. Cervical elastography is a promising new technique for cervical consistency assessment. Further larger studies are required to determine some cut-off point for elastography index of internal os in prediction of outcome of induction of labour and to strongly establish the usefulness of cervical elastography for pregnancy management, preventing preterm delivery and establishment of cut-off points to determine successful induction.
Features and characteristics of publicly available mHealth apps for self-management in chronic obstructive pulmonary disease
Authors: Quach Shirley , Benoit Adam , Oliveira Ana , Packham Tara L. , Goldstein Roger , Brooks Dina 
Published: April 2023

Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their use and mitigate potential harms. Objective To report the characteristics and features of publicly available apps for COPD self-management. Methods MHealth apps designed for patients’ COPD self-management were searched in the Google Play and Apple app stores. Two reviewers trialed and assessed the eligible apps using the MHealth Index and Navigation Database framework to describe the characteristics, qualities, and features of mHealth apps across five domains. Results From the Google Play and Apple stores, thirteen apps were identified and eligible for further evaluation. All thirteen apps were available for Android devices, but only seven were available for Apple devices. Most apps were developed by for-profit organizations (8/13), non-profit organizations (2/13), and unknown developers (3/13). Many apps had privacy policies (9/13), but only three apps described their security systems and two mentioned compliance with local health information and data usage laws. Education was the common app feature; additional features were medication reminders, symptom tracking, journaling, and action planning. None provided clinical evidence to support their use. Conclusions Publicly available COPD apps vary in their designs, features, and overall quality. These apps lack evidence to support their clinical use and cannot be recommended at this time.
Study of a constrained finite element elbow prosthesis: the influence of the implant placement
Authors: Nalbone Lorenzo , Monac Francesco , Nalbone Luca , Ingrassia Tommaso , Ricotta Vito , Nigrelli Vincenzo , Ferruzza Massimo , Tarallo Luigi , Porcellini Giuseppe , Camarda Lawrence 
Published: April 2023

Abstract
Background
The functional results of total elbow arthroplasty (TEA) are controversial and the medium- to long-term revision rates are relatively high. The aim of the present study was to analyze the stresses of TEA in its classic configuration, identify the areas of greatest stress in the prosthesis–bone–cement interface, and evaluate the most wearing working conditions.

Materials and methods
By means of a reverse engineering process and using a 3D laser scanner, CAD (computer-aided drafting) models of a constrained elbow prosthesis were acquired. These CAD models were developed and their elastic properties, resistance, and stresses were studied through finite element analysis (finite element method—FEM). The obtained 3D elbow-prosthesis model was then evaluated in cyclic flexion–extension movements (> 10 million cycles). We highlighted the configuration of the angle at which the highest stresses and the areas most at risk of implant mobilization develop. Finally, we performed a quantitative study of the stress state after varying the positioning of the stem of the ulnar component in the sagittal plane by ± 3°.

Results
The greatest von Mises stress state in the bone component for the 90° working configuration was 3.1635 MPa, which occurred in the most proximal portion of the humeral blade and in the proximal middle third of the shaft. At the ulnar level, peaks of 4.1763 MPa were recorded at the proximal coronoid/metaepiphysis level. The minimum elastic resistance and therefore the greatest stress states were recorded in the bone region at the apex of the ulnar stem (0.001967 MPa). The results of the analysis for the working configurations at 0° and 145° showed significant reductions in the stress states for both prosthetic components; similarly, varying the positioning of the ulnar component at 90° (− 3° in the sagittal plane, 0° in the frontal plane) resulted in better working conditions with a greater resulting developed force and a lower stress peak in the ulnar cement.

Conclusion
The areas of greatest stress occur in specific regions of the ulnar and humeral components at the bone–cement–prosthesis interface. The heaviest configuration in terms of stresses was when the elbow was flexed at 90°. Variations in the positioning in the sagittal plane can mechanically affect the movement, possibly resulting in longer survival of the implant.
Level of evidence: 5
Association of estimated glomerular filtration rate and all-cause mortality in acute pancreatitis: a retrospective analysis
Authors: Gong Fang , Zhou Quan , Gui Chunmei , Huang Shaohua 
Published: April 2023

Abstract
Background
Our primary objective was to explore the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in acute pancreatitis (AP) admission to intensive care units.

Methods
This study is a retrospective cohort analysis based on the Medical Information Mart for Intensive Care III database. The eGFR was calculated based on Chronic Kidney Disease Epidemiology Collaboration equation. Cox models with restricted cubic spline functions were used to evaluated the association of eGFR with all-cause mortality.

Results
The mean eGFR was 65.93 ± 38.56 ml/min/1.73 m2 in 493 eligible patients. 28-day mortality was 11.97% (59/ 493), which decreased by 15% with every 10 ml/min/1.73 m2 increase in eGFR. The adjusted hazard ratio (95% confidence interval) was 0.85 (0.76–0.96). A non-linear association was proved between eGFR and all-cause mortality. When eGFR < 57 ml/min/1.73 m2, there was a negative correlation between eGFR and 28-day mortality, hazard ratio (95% CI) was 0.97 (0.95, 0.99). The eGFR was also negatively correlated with in-hospital and in-ICU mortality. Subgroup analysis confirmed that the association between eGFR and 28-day mortality in different characteristics was stable.

Conclusions
The eGFR was negatively correlated with all-cause mortality in AP when eGFR is less than the threshold inflection point.
Mixed infection of three nontuberculous mycobacteria species identified by metagenomic next-generation sequencing in a patient with peritoneal dialysis-associated peritonitis: a rare case report and literature review
Authors: Chen Xiangfeng , Zhu Jie , Liu Zhou , Ye Jun , Yang Liqi , Zhang Zhenhua 
Published: April 2023

Abstract
Background
Peritonitis caused by nontuberculous mycobacteria (NTM) is an infrequent but important complication in patients undergoing peritoneal dialysis (PD). There has been no report of mixed infections with multiple NTM. Peritoneal dialysis-associated peritonitis (PDAP) caused by Mycobacterium abscessus is more common than that caused by M. smegmatis and M. goodii.

Case presentation
This case concerns a patient with PDAP caused by gram-positive bacilli, which could not be identified at the species level in successive detections of initial peritoneal effluent. Later, M. smegmatis was detected with no sensitivity results in bacterial culture. However, metagenomic next-generation sequencing (mNGS) and first whole-genome sequences indicated that there were three species coexisting in the culture, including M. smegmatis (24,708 reads), M. abscessus (9224 reads), and M. goodii (8305 reads). This is the first case of PDAP with specific evidence that conventional detection methods isolated a poorly pathogenic NTM, whereas mNGS and first whole-genome sequences identified multiple NTM. Pathogenic bacteria might not be detected using conventional methods due to their lower abundance. This case report is the first description of mixed infections with more than two species of NTM during PDAP.

Conclusions
PDAP caused by multiple NTM is rare, and the diagnosis is difficult. When NTM are isolated by conventional tests in patients who are suspected of infection, clinicians should be vigilant, and further tests should be performed to determine the presence of rare or even previously unknown bacteria, for which the quantity is relatively low, but the pathogenicity is high. The rare pathogen may be a primary agent in causing such complications.
Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain
Authors: Geyer Kristina , Raab Roxana , Hoffmann Julia , Hauner Hans 
Published: April 2023

Abstract
Background
Excessive weight gain during pregnancy is associated with adverse health outcomes for mother and child. Intervention strategies to prevent excessive gestational weight gain (GWG) should consider women’s individual risk profile, however, no tool exists for identifying women at risk at an early stage. The aim of the present study was to develop and validate a screening questionnaire based on early risk factors for excessive GWG.

Methods
The cohort from the German “Gesund leben in der Schwangerschaft”/ “healthy living in pregnancy” (GeliS) trial was used to derive a risk score predicting excessive GWG. Sociodemographics, anthropometrics, smoking behaviour and mental health status were collected before week 12th of gestation. GWG was calculated using the last and the first weight measured during routine antenatal care. The data were randomly split into development and validation datasets with an 80:20 ratio. Using the development dataset, a multivariate logistic regression model with stepwise backward elimination was performed to identify salient risk factors associated with excessive GWG. The β coefficients of the variables were translated into a score. The risk score was validated by an internal cross-validation and externally with data from the FeLIPO study (GeliS pilot study). The area under the receiver operating characteristic curve (AUC ROC) was used to estimate the predictive power of the score.

Results
1790 women were included in the analysis, of whom 45.6% showed excessive GWG. High pre-pregnancy body mass index, intermediate educational level, being born in a foreign country, primiparity, smoking, and signs of depressive disorder were associated with the risk of excessive GWG and included in the screening questionnaire. The developed score varied from 0–15 and divided the women´s risk for excessive GWG into low (0–5), moderate (6–10) and high (11–15). The cross-validation and the external validation yielded a moderate predictive power with an AUC of 0.709 and 0.738, respectively.

Conclusions
Our screening questionnaire is a simple and valid tool to identify pregnant women at risk for excessive GWG at an early stage. It could be used in routine care to provide targeted primary prevention measures to women at particular risk to gain excessive gestational weight.

Trial registration
NCT01958307, ClinicalTrials.gov, retrospectively registered 9 October 2013.
Cervical cancer survival prediction by machine learning algorithms: a systematic review
Authors: Rahimi Milad , Akbari Atieh , Asadi Farkhondeh , Emami Hassan 
Published: April 2023

Abstract
Background
Cervical cancer is a common malignant tumor of the female reproductive system and is considered a leading cause of mortality in women worldwide. The analysis of time to event, which is crucial for any clinical research, can be well done with the method of survival prediction. This study aims to systematically investigate the use of machine learning to predict survival in patients with cervical cancer.

Method
An electronic search of the PubMed, Scopus, and Web of Science databases was performed on October 1, 2022. All articles extracted from the databases were collected in an Excel file and duplicate articles were removed. The articles were screened twice based on the title and the abstract and checked again with the inclusion and exclusion criteria. The main inclusion criterion was machine learning algorithms for predicting cervical cancer survival. The information extracted from the articles included authors, publication year, dataset details, survival type, evaluation criteria, machine learning models, and the algorithm execution method.

Results
A total of 13 articles were included in this study, most of which were published from 2018 onwards. The most common machine learning models were random forest (6 articles, 46%), logistic regression (4 articles, 30%), support vector machines (3 articles, 23%), ensemble and hybrid learning (3 articles, 23%), and Deep Learning (3 articles, 23%). The number of sample datasets in the study varied between 85 and 14946 patients, and the models were internally validated except for two articles. The area under the curve (AUC) range for overall survival (0.40 to 0.99), disease-free survival (0.56 to 0.88), and progression-free survival (0.67 to 0.81), respectively from (lowest to highest) received. Finally, 15 variables with an effective role in predicting cervical cancer survival were identified.

Conclusion
Combining heterogeneous multidimensional data with machine learning techniques can play a very influential role in predicting cervical cancer survival. Despite the benefits of machine learning, the problem of interpretability, explainability, and imbalanced datasets is still one of the biggest challenges. Providing machine learning algorithms for survival prediction as a standard requires further studies.