bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the enhancing nutrition and antenatal infection treatment (ENAT) intervention on birth weight in Ethiopia: a cluster randomized controlled trial
Authors: Mekonnen Y , Wolde E , Bekele A , Mehari Z , Abebe S , Hagos T , Tadesse Y , Taye T , Asire G , Nigatu T , Kumar S , Girma S , Salasibew M 
Published: August 2023

Abstract
Background
The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) intervention was implemented in Ethiopia to improve newborn birth weight (BW) by strengthening the contents and quality of antenatal care (ANC), especially point-of-care testing for maternal infections. This study examined the effect of the ENAT intervention on birth weight.

Methods
We conducted a cluster randomized controlled trial of 22 clusters (health centers), randomized equally between 11 intervention and 11 control clusters. This study enrolled and followed pregnant women from ANC booking to the end of pregnancy or loss to follow-up. The primary outcome was mean BW, and the incidence of low birth weight (LBW) was the secondary outcome. We presented univariate comparisons of outcomes between the intervention and control arms for mean BW and LBW. Multilevel analyses using random effects models were performed to adjust for clustering and individual-level covariates.

Results
We enrolled and followed up 4,868 and 4,821 pregnant women in the intervention and control arms, respectively, from March 2021-July 2022. During follow-up, 3445 pregnant women in the intervention and 3192 in the control delivered in the health centers, and BW measurements of their babies were recorded within 48 h. The mean BW was 3,152 g (standard deviation (SD) = 339.8 g) in the intervention and 3,044 g (SD = 353.8 g) in the control arms (mean difference, 108 g; 95% confidence interval (CI): 91.3-124.6; P = 0.000). Adjusting for clustering and several covariates, the mean BW remained significantly higher in the intervention arm than in the control arm (adjusted ß coef., 114.3; p = 0.011). The incidence of LBW was 4.7% and 7.3% in the intervention and control arms, respectively. The adjusted risk of LBW was significantly lower by 36% in the intervention arm than in the control arm (adjusted relative risk, 0.645; p = 0.027).

Conclusion
This study provided sufficient evidence of the effectiveness of the ENAT intervention in improving birth weight in the study population. The intervention demonstrated that an increase in birth weight can be attained by availing point-of-care testing, strengthening infection prevention, and maternal nutrition within the ANC platform of public health facilities in a low-income setting.

Trial Registration
Registered at Pan African Clinical Trial Registry (PACTR) database dated 09/05/2023, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25493. The unique identification number for the registry is PACTR202305694761480.
Diagnostic accuracy of Panbio™ rapid antigen test for SARS-CoV-2 in paediatric population
Authors: Gallardo-Alfaro Laura , Lorente-Montalvo Patricia , Cañellas Margarita , Carandell Eugenia , Oliver Antonio , Rojo Estrella , Riera Beatriz , Llobera Joan , Bulilete Oana ,   on behalf of Balearic COVID-19 Pediatric Primary Care Research Group, Leiva Alfonso , Obieta Anaida , Pascual Victoria , Pericas Pau , Radúan Carlos , Segura Elsa , Vega Verónica 
Published: August 2023

Abstract
Background
Rapid antigen-detection tests (Ag-RDTs) are used to diagnose SARS-CoV-2 infection. Real-world studies of Ag-RDTs are necessary to evaluate their diagnostic yield in paediatric patients. Our aim was to evaluate the accuracy of the Panbio™ Rapid Antigen Test for SARS-CoV-2 in the setting of a primary health care centre (PHC), with use of the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) as gold standard.

Methods
This prospective diagnostic study was conducted at PHCs in Mallorca, Spain. Patients were ≤ 18 years-old that attended sites for RT-PCR testing due to symptoms suggestive of infection (fever, headache, nasal congestion and dry cough, among others) or epidemiological exposure (close contacts). Two samples were collected: a nasal mid-turbinate sample for Ag-RDTs and a nasopharyngeal swab for RT-PCR testing. The sensitivity, specificity, and predictive values of the AgRDT were calculated using the RT-PCR results as the reference.

Results
We examined 1142 participants from 0 to 18 years (47.5% female, mean age 8.9 ± 4.8 years, median 9.0 [5.0–13.0]). There were 84 positive RT-PCR results (pre-test probability of 7.3%) and 52 positive Ag-RDT results. The sensitivity of the Ag-RDT was 59.5% (95% Confidence Interval (CI): 48.2–69.9%), the specificity was 99.8% (95%CI: 99.2–99.9%), the positive predictive value was 96.1% (95%CI: 85.6–99.4%), and the negative predictive value was 96.8% (95%CI: 95.6–97.7%). The sensitivity for individuals referred by a general practitioner (GP) or paediatrician due to symptoms was 71.4% (95%CI: 51.5–86.0%) and for asymptomatic individuals was 50.0% (95%CI: 9.1–90.8%). The specificity was greater than 98.9% overall and in all subgroups. The sensitivity was 73.0% (95%CI: 52.0–87.5%) for referred patients due to symptoms and who were tested within 5 days since symptom onset. No significant statistical differences between any groups were found. There were 34 false-negative Ag-RDT results (40.5%) and 2 false-positive Ag-RDT results (0.2%).

Conclusion
The sensitivity of the Panbio™ Test in paediatric individuals is below the minimum of 80% recommended by the World Health Organization for Ag-RDTs. This test had better accuracy in individuals referred by a GP or paediatrician due to symptoms, rather than those who were asymptomatic or referred due to epidemiological exposure. The RT-PCR test using a nasopharyngeal swab is accurate, but a less invasive alternative that has better sensitivity than the Panbio™ Test is needed for paediatric populations.
Factors associated with physical activity policy and practice implementation in British Columbia’s childcare settings: a longitudinal study
Authors: Tugault-Lafleur Claire N. , Naylor Patti-Jean , Carson Valerie , Faulkner Guy , Lau Erica Y. , Wolfenden Luke , Mâsse Louise C. 
Published: August 2023

Abstract
Background
In 2016–17, the government of British Columbia (BC) enacted a mandatory policy outlining Active Play Standards (AP Standards) alongside a capacity building initiative (Appetite to Play) focused on implementing policies and practices to support physical activity in childcare centres. We aimed to identify factors at the provider and organizational levels as well as attributes of the Standards hypothesized to influence implementation (i.e., changes in policies and practices).

Methods
We conducted surveys before (2016–2017) and after (2018–2019) enforcement of the AP Standards among 146 group childcare centres across BC. The 2018–19 surveys measured theoretically based constructs associated with implementation of policies and practices (9 childcare- and 8 provider- level characteristics as well as 4 attributes of the licensing standards). Characteristics that were associated in simple regression models were entered in multivariable regression models to identify factors associated with policy and practice changes related to fundamental movement skills (FMS), screen time, total amount of active play (AP) and total amount of outdoor AP from baseline to follow-up.

Results
In multivariable analyses, higher staff capacity (OR = 2.1, 95% 1.2, 3.7) and perceived flexibility of the standards (OR: 3.3, 95% 1.5, 7.1) were associated with higher odds of a policy change related to FMS. Higher staff commitment to the AP standards was associated with a higher odds of policy changes related to screen time (OR = 1.6, 95% CI: 1.1, 2.4) and amount of AP (OR: 1.5, 95% 1.0, 2.3). Higher institutionalization of PA policies was associated with a higher odds of policy changes related to the amount of AP (OR: 5.4, 95% CI: 1.5, 20). Higher self-efficacy was associated with a higher odds of policy changes related to outdoor AP (OR = 2.9, 95% 1.1, 7.8). Appetite to Play training was a positively associated with practice changes related to FMS (β = 0.5, 95% CI: 0.1, 0.9).

Conclusions
A hierarchy of theoretically defined factors influenced childcare providers’ implementation of the AP Standards in BC. Future research should test the feasibility of modifying these factors to improve the implementation of PA policy and practice interventions in this setting.
Translation and psychometric evaluation of the Persian version of Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS)
Authors: Minoonejad Hooman , Henteh Mohammad Amin , Keshavarz Roshanak , Safarzadeh Mehdi , Montazeri Ali 
Published: August 2023

Abstract
Background
The present study aimed to translate and validate the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) in Iran.

Methods
Following standard forward and backward translation procedure, content and face validity were tested by specialists and a sample of 32 patients. Then, in a cross sectional study, a sample of patients with knee disorders, recruited through simple sampling, completed the KOS-ADLS and the Short-Form Health Survey (SF-36) in their first visit to physiotherapy clinics in Tehran. Regarding construct validity, the Spearman’s correlation (rs) and one-way ANOVA were employed to evaluate the correlations between the Persian KOS-ADLS and SF-36 subscales (convergent validity) and known groups comparison, respectively. Test-retest reliability and internal consistency were evaluated by intraclass correlation coefficient (ICC) and the Cronbach’s α coefficient.

Results
In total 101 patients were included in the study. The mean age of patients was 42.39 (SD = 9.2). The finding indicated that the KOS-ADLS had strong correlations with SF-36 physical functioning, bodily pain subscales, and also physical component summary while it had lower correlations with other subscales of the SF-36 as expected. The KOS-ADLS was able to differentiate between the subgroups of patients who differed in BMI. The acceptable level of intraclass correlation coefficient (ICC = 0.91) and Cronbach’s α coefficient (α = 0.91) was obtained for the Persian KOS-ADLS. Also no floor and ceiling effects were observed for the questionnaire.

Conclusions
The Persian version of KOS-ADLS was found to be a reliable and valid outcome measure for assessing daily living activities in patients who suffer from knee pathological conditions.
Endodontic management of maxillary first molar with protostylid: a rare case report
Authors: Zhou Yang , Tao Ye 
Published: August 2023

Abstract
Background
A protostylid is a relatively rare dental developmental aberration characterized as an extra cusp located on the mesial half of the buccal surface of the molars. A protostylid is rarely to be reported due to its low rate of occurrence. This case report describes a patient referred for endodontic treatment due to the presence of a protostylid on the buccal surface of the maxillary first molar that induced apical periodontitis.

Case presentation
A 53-year-old female reported a 3-month history of pain of chewing with her upper left posterior teeth over 3 months. In the clinical examination, an abraded anomalous cusp-like structure was found on the buccal surface of tooth 26, Cone beam computed tomography (CBCT) revealed a supernumerary cusp with an intact root canal inside, which was fused with the mesiobuccal (MB) root canal in the middle of the root. In addition, extensive periapical radiolucency was observed around tooth 26. The tooth was diagnosed as apical periodontitis, and endodontic treatment was performed. The initial lesion in tooth 26 gradually healed over 1 year of observation.

Conclusions
To our knowledge, this case is the first to describe the endodontic management of a maxillary first molar with a protostylid and advances our understanding of supernumerary cusps. This case provides a reference for the treatment of protostylid.
Differences in the effects of orthodontic treatment on airway-craniocervical functional environment in adult and adolescent patients with skeletal class II high-angle: a retrospective pilot study
Authors: Shen Yiyang , Li Xin , Feng Xiaoyan , Yu Lan , Weng Luxi , Zhang Chenxing , Shang Yufeng , Lin Jun 
Published: August 2023

Abstract
Introduction
This retrospective cohort study aimed to compare the change in upper airway and craniocervical posture after orthodontic treatment between adolescent and adult patients with Class II high-angle malocclusion.

Methods
A total of 12 adolescent (mean ± standard deviation age = 13.0 ± 2.0 years) and 12 adult patients with Class II high-angle malocclusion (mean ± standard deviation age = 23.7 ± 6.4 years) were selected in this study. The lateral cephalograms and cone beam computed tomography images of adolescent and adult patients were taken before and after treatment, which can be employed to evaluate the variables of craniofacial morphology, upper airway, and craniocervical posture through paired t tests, respectively. An independent sample t test was performed to observe the differences between two groups after orthodontic intervention. For adults and adolescents, the correlation between craniofacial morphology, upper airway, and craniocervical posture was determined through Pearson correlation analysis.

Results
In all subjects, the improvements in vertical and sagittal facial morphology after treatment were observed. Anterior and inferior movements of the hyoid bone, an increase of upper airway dimension, posterior tipping of the head and a reduction of cervical inclination in the lower and middle segments post-treatment were identified in adolescence (P < 0.05). Adults displayed anterior movements of the hyoid bone, whereas no significant difference was observed in upper airway dimension and craniocervical posture (P < 0.05). Notable differences were identified in the change of hyoid position and airway volume between two groups (P > 0.05). Mandibular plane inclination, growth pattern, occlusal plane inclination, and chin position were all significantly correlated with craniocervical posture in adolescent patients. Besides, the mandibular growth pattern and chin position in adult patients were significantly correlated with craniocervical posture (P < 0.05).

Conclusions
Orthodontic treatment is capable of enhancing the facial profile of patients with skeletal class II high-angle while improving their upper airway morphology and craniocervical posture, where adolescents and adults differ substantially in that the former exhibit a more favorable alteration in the airway-craniocervical functional environment.
Interpretable machine-learning model for Predicting the Convalescent COVID-19 patients with pulmonary diffusing capacity impairment
Authors: Ma Fu-qiang , He Cong , Yang Hao-ran , Hu Zuo-wei , Mao He-rong , Fan Cun-yu , Qi Yu , Zhang Ji-xian , Xu Bo 
Published: August 2023

Abstract
Introduction
The COVID-19 patients in the convalescent stage noticeably have pulmonary diffusing capacity impairment (PDCI). The pulmonary diffusing capacity is a frequently-used indicator of the COVID-19 survivors’ prognosis of pulmonary function, but the current studies focusing on prediction of the pulmonary diffusing capacity of these people are limited. The aim of this study was to develop and validate a machine learning (ML) model for predicting PDCI in the COVID-19 patients using routinely available clinical data, thus assisting the clinical diagnosis.

Methods
Collected from a follow-up study from August to September 2021 of 221 hospitalized survivors of COVID-19 18 months after discharge from Wuhan, including the demographic characteristics and clinical examination, the data in this study were randomly separated into a training (80%) data set and a validation (20%) data set. Six popular machine learning models were developed to predict the pulmonary diffusing capacity of patients infected with COVID-19 in the recovery stage. The performance indicators of the model included area under the curve (AUC), Accuracy, Recall, Precision, Positive Predictive Value(PPV), Negative Predictive Value (NPV) and F1. The model with the optimum performance was defined as the optimal model, which was further employed in the interpretability analysis. The MAHAKIL method was utilized to balance the data and optimize the balance of sample distribution, while the RFECV method for feature selection was utilized to select combined features more favorable to machine learning.

Results
A total of 221 COVID-19 survivors were recruited in this study after discharge from hospitals in Wuhan. Of these participants, 117 (52.94%) were female, with a median age of 58.2 years (standard deviation (SD) = 12). After feature selection, 31 of the 37 clinical factors were finally selected for use in constructing the model. Among the six tested ML models, the best performance was accomplished in the XGBoost model, with an AUC of 0.755 and an accuracy of 78.01% after experimental verification. The SHAPELY Additive explanations (SHAP) summary analysis exhibited that hemoglobin (Hb), maximal voluntary ventilation (MVV), severity of illness, platelet (PLT), Uric Acid (UA) and blood urea nitrogen (BUN) were the top six most important factors affecting the XGBoost model decision-making.

Conclusion
The XGBoost model reported here showed a good prognostic prediction ability for PDCI of COVID-19 survivors during the recovery period. Among the interpretation methods based on the importance of SHAP values, Hb and MVV contributed the most to the prediction of PDCI outcomes of COVID-19 survivors in the recovery period.
Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report
Authors: Zhou Ying , Wang Xiaoxue , Lin Xuyong , Wang Jun , Yan Xiaojing , Wen Ying 
Published: August 2023

Abstract
Background
Despite increasing effort for treating primary central nervous system lymphoma (PCNSL), the prognosis of human immunodeficiency virus (HIV) -related PCNSL was still unsatisfactory. There is currently a lack of clinical evidence for the application of Bruton tyrosine kinase (BTK) inhibitor in HIV-related PCNSL. We reported two HIV-related PCNSL patients, who achieved sustained remission by application of BTK inhibitor based treatment. This protocol had not been previously reported for the treatment of HIV-related PCNSL.

Case presentation
The two cases were characterized by the treatment choice of Bruton tyrosine kinase (BTK) inhibitor. Rituximab was not recommended for them due to their very low CD4+ T cell counts. They both took MTX as the first-line therapy and got a relief in initial phase. For the first case, ibrutinib was kept both in the first-line therapy and in the maintenance therapy. When the second case underwent a progressive disease, we continued to use orelabrutinib as one of the salvage treatment, in combination with programmed cell death-1 (PD-1) inhibitor plus lenalidomide. They both achieved a continuous response of up to 20 months without opportunistic infection.

Conclusions
This report highlights the safety and effectiveness of BTK inhibitors, as well as lenalidomide and PD-1 inhibitor in HIV-related PCNSL patients. Both the new therapeutic approaches and a multidisciplinary team authentically contributed to improved survival outcome among HIV-positive PCNSL patients.
Development and validation of core entrustable professional activities for abdominal radiology
Authors: Paisant Anita , Skehan Stephen , Colombié Mathilde , David Arthur , Aubé Christophe 
Published: August 2023

Abstract
Objectives
To develop and validate European entrustable professional activities (EPAs) for sub-specialised hepatobiliary and gastrointestinal (HB/GI) diagnostic imaging.

Materials and methods
Both European Society of Radiology and national curricula in HB/GI diagnostic radiology were thoroughly reviewed, resulting in preliminary EPAs drafted by a pilot group of expert radiologists in 2 different countries. Each EPA was fully described with 7 components (Specification/limitations; Potential risks of failing; Relevant domains of competence; Required experience, knowledge, skills, attitude and behaviour; Assessment information sources to assess progress and ground a summative entrustment decision; Entrustment for which level of supervision is to be reached; and Expiration date). The modified Delphi method with 3 Delphi rounds was chosen for validation. Content validity index (CVI) and median values were used for validation.

Results
There were 15 preliminary EPAs, some of them divided according to 2 levels: resident and fellow level. The 37 members of the Delphi group were based in 2 different European countries with a background experience of 10 represented countries. Subsequent to the first Delphi round, 6 EPAs were accepted (CVI ≥ 0.8, median ≥ 4), 6 needed major revisions (CVI 0.7–0.79, median ≥ 4), 3 were rejected (CVI < 0.7) and 1 was added. After the second Delphi round, both the 6 revised EPAs and the additional one met the validation criteria (CVI ≥ 0.8, median ≥ 4). Finally, 13 EPAs were validated during the 3rd Delphi round with an agreement percentage of 95–100%.

Conclusion
This study creates and validates EPAs for sub-specialised HB/GI diagnostic imaging.

Critical relevance statement
Thirteen EPAs for sub-specialised hepatobiliary and gastrointestinal diagnostic imaging were created with a strong methodology, and as a first example set in sub-specialised diagnostic imaging, they provide a template for others to be created.

Key points
• The competence-based teaching in medical studies has recently been reintroduced through EPAs.
• Thirteen EPAs have been developed for hepatobiliary and gastrointestinal sub-specialised diagnostic imaging.
• These EPAs were validated using a Delphi modified method and provide a template for other to be created.

Graphical abstract
Nonuniform sampling and reconstruction of Diracs signal associated with linear canonical transform and its application
Authors: Xu Liyun , Li Wei 
Published: August 2023

AbstractSampling and reconstruction play a critical role in signal processing. The non-ideal sampling conditions motivate the development of the sampling theory. In this paper, associated with multiple non-ideal conditions, we discuss the nonuniform sampling and reconstruction of nonbandlimited signal in the linear canonical transform (LCT) domain with finite samples. The Diracs signal is nonbandlimited in the LCT domain but has the finite rate of innovation property. The sampling of the Diracs signal in the LCT domain is analyzed firstly. Secondly, the reconstruction of the signal with finite nonuniform samples is discussed, including two cases where the nonuniform sampling instants are known or unknown. Finally, the numerical experiment verifies the effect of the reconstruction algorithm, and the potential applications and generalized analysis indicate the value of the research.