bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitigating diagnostic performance bias in a skin‐tone balanced dermatology curriculum
Authors: Hardin Jori , Mourad Ahmed , Desy Janeve , Paget Mike , Ma Irene , Traboulsi Danya , Johnson Nicole A. , Ali Asma Amir , Parsons Laurie , Harvey Adrian , Weeks Sarah , McLaughlin Kevin 
Published: August 2023

AbstractIntroductionIndividuals with skin of colour (SoC) have delayed diagnosis and poorer outcomes when presenting with some dermatologic conditions when compared to individuals with light skin (LS). The objective of this study was to determine if diagnostic performance bias can be mitigated by a skin‐tone balanced dermatology curriculum.MethodologyA prospective randomised intervention study occurred over 2 weeks in 2020 at a Canadian medical school. A convenience sample of all first‐year medical students (n = 167) was chosen. In week 1, all participants had access to dermatology podcasts and were randomly allocated to receive non‐analytic training (NAT; online patient ‘cards’) on either SoC cases or LS cases. In week 2, all participants received combined training (CT; NAT and analytic training through workshops on how to apply dermatology diagnostic rules for all skin tones). Participating students completed two formative assessments after weeks 1 and 2.ResultsNinety‐two students participated in the study. After week 1, both groups had a lower diagnostic performance on SoC (p = 0.0002 and p = 0.002 for students who trained on LS ‘cards’ and SoC ‘cards’, respectively). There was a significant decrease in mean skin tone difference in both groups after week 2 (initial training on SoC: 5.8% (SD 12.2) pre, −1.4% (14.7) post, p = 0.007; initial training on LS: 7.8% (15.4) pre, −4.0% (11.8%) post, p = 0.0001). Five students participated in a post‐study survey in 2023, and all found the curriculum enhanced their diagnostic skills in SoC.ConclusionsSoC performance biases of medical students disappeared after CT in a skin tone‐balanced dermatology curriculum.
Validation of the Fatty Liver Index for identifying non‐alcoholic fatty liver disease in a Kenyan population
Authors: Lajeunesse‐Trempe Fannie , Boit Michael K. , Kaduka Lydia U. , De Lucia‐Rolfe Emanuella , Baass Alexis , Paquette Martine , Piché Marie‐Eve , Tchernof André , Christensen Dirk L. 
Published: August 2023

AbstractBackground and AimFatty Liver Index (FLI) is a simple clinical scoring system estimating non‐alcoholic fatty liver disease (NAFLD). It is validated in European‐descent and Asian populations, but not in sub‐Saharan Africans. The aim of this study is to evaluate the validity of the FLI for predicting NAFLD in a population from Kenya.MethodsParticipants were recruited from a community‐based study conducted in Kenya. NAFLD was diagnosed using hepatic ultrasonography. Clinical, anthropometrical, biochemical and lifestyle data were obtained. The accuracy and cut‐off point of the FLI to detect NAFLD were evaluated by area under the receiver operator characteristic curve and the maximum Youden index analysis.ResultsA total of 640 participants (94 with NAFLD) were included. Mean age was 37.4 ± 0.4 years and 58.7% were women. Mean body mass index (BMI) was 22.3 ± 0.2 kg/m2 and waist circumference (WC) 79.1 ± 0.4 cm. A total of 15 (2.3%) participants were diagnosed with type 2 diabetes and 65 (10.2%) with obesity (BMI ≥ 30 kg/m2). AUROC of FLI for predicting NAFLD was 0.80 (95% CI 0.74–0.85), which was significantly higher compared to individual components gamma‐glutamyl transferase and triglycerides (p < 0.05), but not compared to anthropometric parameters BMI (AUROC of 0.83, 95% CI 0.79–0.88) and WC (AUROC of 0.81, 95% CI 0.76–0.87).ConclusionsFLI is a simple valid scoring system to use in rural and urban Kenyan adults. However, this index might not be superior to BMI or WC to predict NAFLD, and those measurements might therefore be more appropriate in limited settings.
Kinematic Modeling and Optimization of a Clustered Tensegrity Mobile Robot
Authors: Yang Qi , Liu Xinyu , Yu Ze , Lian Binbin , Sun Tao 
Published: August 2023

Abstract
Clustered tensegrity mechanisms have elicited extensive attention in recent research due to their easy control system and high stiffness-to-mass ratio. However, modeling and analyzing these mechanisms are still challenging due to the clustering of cables and redundant structural parameters. This article proposes an energy-based kinematic modeling method for a modular clustered tensegrity mobile robot. The design of the clustered tensegrity robot is inspired by the biomechanics of worms, allowing it to achieve two locomotion modes resembling earthworm-like and inchworm-like movements using two motors. Moreover, the clustered and modular structure enables the robot to increase the number of modules as needed without increasing the number of actuators. This feature enhances the robot's terrain adaptability without adding complexity to the control system. The article establishes kinematic models using the energy method and clarifies the motion law of nodes on the sliding cables of the robot, considering multiple structural parameters for both locomotion modes. Based on these models, the article reveals the mapping relationships among various structural parameters (i.e., cable-hole gap, cable-hole friction, stiffness and original length of elastic cables, and ground–robot friction) and locomotion performance (i.e., morphology, displacement, and velocity) of the robot. Furthermore, structural parameter optimization is performed to enhance the kinematic performance of the robot in both locomotion modes simultaneously. To validate the proposed kinematic modeling method, a prototype with two modules is developed, and experiments are conducted to assess the robot's locomotion performance. These experiments demonstrate the effectiveness and rationality of the proposed method.
Loading Rate Effect on the Pullout Capacity of OMNI-Max Anchors in Clay Coupled With Multiple Factors
Authors: Liu Haixiao , Yang Yancheng , Xu Heng 
Published: August 2023

Abstract
As the latest development of gravity installed anchors (GIAs), the OMNI-Max anchor has drawn much attention from worldwide due to its unique behavior in the seabed. The pullout capacity of OMNI-Max anchors is a key index in engineering. However, most of the relevant studies were carried out under a quasi-static condition, which do not actually meet the installation and operation requirements. In practice, the anchor may be subjected to both long-term and short-term sharp loading during mooring. As an important environmental variable, it is essential to evaluate the effect of loading rate on the pullout capacity. Since the bearing capacity of OMNI-Max anchors is affected by many factors, it is also essential to explore systematically the coupling effects of the loading rate and other factors, including the anchor embedment depth, the anchor orientation, the bearing area, the loading angle, and the soil strength. Based on the coupled Eulerian–Lagrangian (CEL) technique, numerous analytical cases are designed and calculated by the large deformation finite element (LDFE) method. The loading rates span four orders of magnitude from the quasi-static velocity to 10 m/s (about one anchor length per second), covering a wider range in pulling out of GIAs. The end-bearing capacity factor changes remarkably with the pullout velocity for OMNI-Max anchors, and the increase can even reach more than twice of that in a quasi-static condition. As a result, a succinct explicit expression is constructed in terms of the loading rate and multiple factors, which can be effectively utilized to calculate the end-bearing capacity factor of OMNI-Max anchors in clay under complex conditions.
Human OTUD6B positively regulates type I IFN antiviral innate immune responses by deubiquitinating and stabilizing IRF3
Authors: Wang Jian , Zheng Hui , Dong Chunsheng , Xiong Sidong 
Published: August 2023

ABSTRACT

Elaborate regulation of innate immunity is necessary for the host to effectively respond to invading pathogens. As an important component of antiviral immunity transcription factors, the stability and activity of interferon (IFN) regulatory factor 3 (IRF3) are tightly controlled via multiple post-translational modifications. Here, we identified a human ovarian tumor domain-containing deubiquitinase OTUD6B as a positive regulator of IRF3 that facilitates type I IFN innate antiviral immune signaling. Mechanically, we found that OTUD6B interacts with IRF3 and directly hydrolyzes both the lysine 11 (K11)- and the lysine 33 (K33)-linked polyubiquitin chain, but only K33-linked polyubiquitin at Lys315 of IRF3 is responsible for IRF3 proteasome degradation. Notably, OTUD6B enhanced cellular antiviral responses
in vivo
, as evidenced by mice that overexpressed human OTUD6B were more resistant to RNA virus infection and had reduced viral load and morbidity. These findings revealed a previously unknown role for OTUD6B in the regulation of innate antiviral immunity and may provide a potential target for enhancing host antiviral defense.

IMPORTANCE
Interferon (IFN) regulatory factor (IRF3) is one of the key factors for type I IFN transcription. To sophisticatedly regulate type I IFN antiviral immune response, IRF3 activity is closely controlled by a variety of post-translational modifications. However, the regulatory mechanisms are still not fully elucidated. In the present study, we found that human deubiquitinase OTUD6B positively regulates IRF3-mediated antiviral immune response. OTUD6B can stabilize the IRF3 protein level via hydrolyzing (Lys33)-linked polyubiquitin at Lys315. More importantly, mice with OTUD6B overexpression exhibited more resistance to RNA virus infection. Thus, unlike the previous report that zebrafish OTUD6B negatively regulates the antiviral response by suppressing K63-linked ubiquitination of IRF3 and IRF7, we demonstrate that human OTUD6B actually enhances type I IFN response and has the potential for antiviral therapy.
Biomechanics and situational patterns associated with anterior cruciate ligament injuries in the National Basketball Association (NBA)
Authors: Gill Vikram S , Tummala Sailesh V , Boddu Sayi P , Brinkman Joseph C , McQuivey Kade S , Chhabra Anikar 
Published: August 2023

ObjectivesPerform a comprehensive video analysis of all anterior cruciate ligament (ACL) injuries in National Basketball Association (NBA) athletes from 2006 to 2022 to determine the associated biomechanics, injury mechanism and game situation.MethodsNBA players diagnosed with an ACL tear from 2006 to 2022 were identified and videos of each injury evaluated by two reviewers. Visual evaluation included assessment of joint kinematics at three time points: initial contact of the injured leg with the ground (IC), 33 milliseconds later (IC+33) and 66 milliseconds later (IC+66). Game situation was assessed qualitatively.ResultsVideos of 38 out of 47 (80.9%) ACL tears were obtained. 9 injuries were non-contact, while 29 involved indirect contact. Between IC and IC+33, average knee valgus increased from 5.1° to 12.0° and knee flexion increased from 12.6° to 32.6°. At all time points, the majority of injuries involved trunk tilt and rotation towards the injured leg, hip abduction and neutral foot rotation. The most common game situations for injury included the first step when attacking the basket following picking up the ball (n=13), landing following contact in the air (n=11) and jump stop (n=5).ConclusionThree major mechanisms predominate ACL tears in NBA players: the first step following picking up the ball when attacking, landing and jump stops. None of the injuries reviewed demonstrated direct contact to the knee, emphasising the importance of body kinematics in this injury pattern. The increase in knee valgus and knee flexion between IC and IC+33 should be noted as a possible precipitant to injury.
Growth and neurodevelopmental outcomes of preterm and low birth weight infants in rural Kenya: a cross-sectional study
Authors: Martin-Herz Susanne P , Otieno Phelgona , Laanoi Grace M , Moshi Vincent , Olieng’o Okoth Geofrey , Santos Nicole , Walker Dilys 
Published: August 2023

ObjectiveData on long-term outcomes of preterm (PT) and low birth weight (LBW) infants in countries with high rates of neonatal mortality and childhood stunting are limited, especially from community settings. The current study sought to explore growth and neurodevelopmental outcomes of PT/LBW infants from a rural community-based setting of Kenya up to 18 months adjusted age.DesignCross-sectional study.SettingMigori County, Kenya.ParticipantsThree hundred and eighty-two PT/LBW infants (50.2% of those identified as eligible) from a cluster randomised control trial evaluating a package of facility-based intrapartum quality of care interventions for newborn survival consented for follow-up.Outcome measuresCaregiver interviews and infant health, growth and neurodevelopmental assessments were completed at 6, 12 or 18 months±2 weeks. Data included sociodemographic information, medical history, growth measurements and neurodevelopmental assessment using the Ten Questions Questionnaire, Malawi Developmental Assessment Tool and Hammersmith Infant Neurological Examination. Analyses were descriptive and univariate regression models. No alterations were made to planned data collection.ResultsThe final sample included 362 PT/LBW infants, of which 56.6% were moderate to late PT infants and 64.4% were LBW. Fewer than 2% of parents identified their child as currently malnourished, but direct measurement revealed higher proportions of stunting and underweight than in national demographic and health survey reports. Overall, 22.7% of caregivers expressed concern about their child’s neurodevelopmental status. Neurodevelopmental delays were identified in 8.6% of infants based on one or more standardised tools, and 1.9% showed neurological findings indicative of cerebral palsy.ConclusionsMalnutrition and neurodevelopmental delays are common among PT/LBW infants in this setting. Close monitoring and access to early intervention programmes are needed to help these vulnerable infants thrive.Trial registration numberNCT03112018.
Mental health of health professionals and their perspectives on mental health services in a conflict-affected setting: a qualitative study in health centres in the Gaza Strip during the COVID-19 pandemic
Authors: Tamming Teisi , Otake Yuko , Aburahma Safa'a , Tan Mengxin , Shishtawi Anas , El-Daour Yahya , Hamad Khalil , Seita Akihiro 
Published: August 2023

ObjectivesTo explore how primary care health professionals perceive their own mental health in a conflict-affected setting during and beyond the COVID-19 pandemic and to explore their perspectives on mental health services.MethodsThe Gaza Strip faces a chronic humanitarian crisis and is suffering from the consequences of the COVID-19 pandemic; United Nations Relief and Works Agency (UNRWA) health centres were used to recruit participants for this study. Semistructured interviews were conducted with 29 health professionals in UNRWA health centres who were sampled using maximum variation sampling. Transcripts were translated, double checked and analysed via thematic analysis.ResultsFrom the analysis, a thematic map was developed showing how health professionals perceive their mental health impacts. This included difficulties due to the COVID-19 pandemic, as well as the socioeconomic processes stemming from the on-going conflict.Another thematic map was developed showing the perceived strengths and challenges of the health services. The strengths included positive impact of the services to the service users and health professionals. In terms of challenges, health professionals identified socioeconomic processes and aspects of remote service provision during COVID-19.ConclusionsBased on the findings, we suggest that an improved signposting mechanism should be developed to address many of the challenges that emergencies bring about; in particular, this could support the health professionals’ mental health, as well as improve the response to patients’ socioeconomic challenges. We further suggest recommendations for improving mental health services when delivered remotely to increase their resiliency during various emergencies.
Testing the validity of a new scale designed to assess beliefs and perceptions about colorectal cancer and colorectal cancer screening in Malaysia: a principal component analysis
Authors: Su Tin Tin , Adekunjo Felix Oluyemi , Schliemann Desiree , Cardwell Christopher R , Htay Mila Nu Nu , Dahlui Maznah , Loh Siew Yim , Champion Victoria L , Donnelly Michael 
Published: August 2023

ObjectiveTo conduct a cultural adaptation and validation of the Champion Health Belief Model Scale (CHBMS) for colorectal cancer (CRC) screening (CHBMS-CRC-M) in order to assess and investigate perceptions and beliefs about CRC screening in Malaysia.Designs and participantsThe results from an evidence synthesis and the outcomes from an expert panel discussion were used to shape CHBMS scale content into an assessment of beliefs about CRC screening (CHBMS-CRC). This questionnaire assessment was translated into the official language of Malaysia. An initial study tested the face validity of the new scale or questionnaire with 30 men and women from various ethnic groups. Factorial or structural validity was investigated in a community sample of 954 multiethnic Malaysians.SettingSelangor state, Malaysia.ResultsThe new scale was culturally acceptable to the three main ethnic groups in Malaysia and achieved good face validity. Cronbach’s alpha coefficients ranged from 0.66 to 0.93, indicating moderate to good internal consistency. Items relating to perceived susceptibility to CRC ‘loaded’ on Factor 1 (with loadings scoring above 0.90); perceived benefits of CRC screening items loaded on factor 2 and were correlated strongly (loadings ranged between 0.63 and 0.83) and perceived barriers (PBA) to CRC screening (PBA) items loaded on factor 3 (range 0.30–0.72).ConclusionThe newly developed CHBMS-CRC-M fills an important gap by providing a robust scale with which to investigate and assess CRC screening beliefs and contribute to efforts to enhance CRC screening uptake and early detection of CRC in Malaysia and in other Malay-speaking communities in the region.
Recruiting historically under-represented individuals into Project ECHO Diabetes: using barrier analysis to understand disparities in clinical research in the USA
Authors: Addala Ananta , Hechavarria Melanie , Figg Lauren , Roque Xanadu , Filipp Stephanie L , Anez-Zabala Claudia , Lal Rayhan , Gurka Matthew J , Haller Michael J , Maahs David M , Walker Ashby F 
Published: August 2023

ObjectivesIndividuals under-recruited in diabetes research studies include those not seen at endocrinology centres and those from rural, low socioeconomic and/or under-represented racial/ethnic groups. The purpose of this descriptive analysis is to detail recruitment and retention efforts of Project ECHO Diabetes clinical sites affiliated with Stanford University and University of Florida.DesignProspective collection of participant engagement and qualitative analysis of barriers and facilitators of research engagement within Project ECHO Diabetes, a virtual tele-education programme for healthcare providers in the management of individuals with insulin-requiring diabetes.SettingData were collected at the patient level, provider level and clinic level between 1 May 2021 and 31 July 2022.ParticipantsParticipants and study personnel were recruited from 33 Project ECHO Diabetes sites in California and Florida.OutcomesWe report study completion rates for participants recruited into 33 Project ECHO Diabetes sites. Using barrier analysis, a methodology designed for the real-time assessment of interventions and system processes to identify barriers and facilitators, study personnel identified significant barriers to recruitment and retention and mapped them to actionable solutions.ResultsIn total, 872 participants (California n=495, Florida n=377) were recruited with differing recruitment rates by site (California=52.7%, Florida=21.5%). Barrier analysis identified lack of trust, unreliable contact information, communication issues and institutional review board (IRB) requirements as key recruitment barriers. Culturally congruent staff, community health centre (CHC) support, adequate funding and consent process flexibility were solutions to address recruitment challenges. Barriers to retention were inconsistent postal access, haemoglobin A1c kit collection challenges, COVID-19 pandemic and broadband/connectivity issues. Additional funding supporting research staff and analogue communication methods were identified as solutions address barriers to retention.ConclusionsFunded partnerships with CHCs, trusted by their local communities, were key in our recruitment and retention strategies. IRB consent process flexibility reduced barriers to recruitment. Recruiting historically under-represented populations is feasible with funding aimed to address structural barriers to research participation.
Assessing disparity in the distribution of HIV and sexually transmitted infections in Australia: a retrospective cross-sectional study using Gini coefficients
Authors: Latt Phyu Mon , Soe Nyi Nyi , Xu Xianglong , Rahman Rashidur , Chow Eric P F , Ong Jason J , Fairley Christopher , Zhang Lei 
Published: August 2023

IntroductionThe risk of HIV and sexually transmitted infections (STIs) varies substantially across population groups in Australia. We examined this disparity in HIV/STI distribution using Gini coefficients, where scores closer to one indicate greater disparity.MethodsWe used demographic and sexual behaviour data from the Melbourne Sexual Health Centre, between 2015 and 2018. We examined 88 642 HIV consultations, 92 291 syphilis consultations, 97 473 gonorrhoea consultations and 115 845 chlamydia consultations. We applied a machine learning-based risk assessment tool, MySTIRisk, to determine the risk scores. Based on individuals’ risk scores and HIV/STIs diagnoses, we calculated the Gini coefficients for these infections for different subgroups.ResultsOverall, Gini coefficients were highest for syphilis (0.60, 95% CI 0.57 to 0.64) followed by HIV (0.57, 95% CI 0.52 to 0.62), gonorrhoea (0.38, 95% CI 0.36 to 0.42) and chlamydia (0.31, 95% CI 0.28 to 0.35). Gay, bisexual and other men who have sex with men (GBMSM) had lower Gini coefficients compared with heterosexual men or women; HIV (0.54 vs 0.94 vs 0.96), syphilis (0.50 vs 0.86 vs 0.93), gonorrhoea (0.24 vs 0.57 vs 0.57) and chlamydia (0.23 vs 0.42 vs 0.40), respectively. The Gini coefficient was lower among 25–34 years than in other age groups for HIV (0.66 vs 0.83–0.90) and gonorrhoea (0.38 vs 0.43–0.47). For syphilis, the oldest age group (≥45 years) had a lower Gini coefficient than 18–24 years (0.61 vs 0.70).ConclusionsOur study demonstrated that HIV/STIs are more evenly distributed among GBMSM, suggesting widely disseminated interventions for GBMSM communities. In contrast, interventions for heterosexual men and women should be more targeted at individuals with higher risk scores.