bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and factors associated with low back pain among health care providers in public hospitals of Gamo zone, Southern Ethiopia
Authors: Gashawbeza Biruk , Ezo Elias 
Published: July 2022

Objectives: To assess prevalence and factors associated with low back pain among health care providers in public hospitals of Gamo zone, Southern Ethiopia, 2021. Methods: An institution-based cross-sectional study design was employed from August 1 to September 10, 2021. The total sample size was 470 and a multi-stage sampling technique was used. Data were collected through face-to-face interviews and taking Anthropometric measurements. Epi data version 3.1 for data entry and SPSS version 25 for analysis were used. The fitness of the model was checked using the Hosmer–Lemeshow goodness of fit test. A binary logistic regression analysis was done, and variables with a p-value of less than .025 in univariate analysis were taken to bivariate analysis. Statistically significant was declared at a p-value of less than .05 with an adjusted odds ratio and 95% confidence interval. Results: The 1-year prevalence of low back pain among health care providers was 44.2% (95% CI 39.5–48.3). Past medical history of systemic illness, most commonly adopted posture, a job never requiring repeating motions within 60 s difference, belief that working health profession activities at night aggravate low back pain, and job satisfaction were significantly associated with low back pain, believing that working at night aggravated low back pain, (often lift, push, pull carry or move) more than 10 kg alone, and job satisfaction were important risk factors for low back pain. Conclusion: About four in 10 health care providers in public hospitals in the Gamo zone were suffering from low back pain. Therefore, using ergonomic equipment and lifting techniques and alternating posture while caring for patients may reduce the burden.
A personalized mobile app for physical activity: An experimental mixed-methods study
Authors: Tong Huong Ly , Quiroz Juan C , Kocaballi Ahmet Baki , Ijaz Kiran , Coiera Enrico , Chow Clara K , Laranjo Liliana 
Published: July 2022

Objectives To investigate the feasibility of the be.well app and its personalization approach which regularly considers users’ preferences, amongst university students. Methods We conducted a mixed-methods, pre-post experiment, where participants used the app for 2 months. Eligibility criteria included: age 18–34 years; owning an iPhone with Internet access; and fluency in English. Usability was assessed by a validated questionnaire; engagement metrics were reported. Changes in physical activity were assessed by comparing the difference in daily step count between baseline and 2 months. Interviews were conducted to assess acceptability; thematic analysis was conducted. Results Twenty-three participants were enrolled in the study (mean age = 21.9 years, 71.4% women). The mean usability score was 5.6 ± 0.8 out of 7. The median daily engagement time was 2 minutes. Eighteen out of 23 participants used the app in the last month of the study. Qualitative data revealed that people liked the personalized activity suggestion feature as it was actionable and promoted user autonomy. Some users also expressed privacy concerns if they had to provide a lot of personal data to receive highly personalized features. Daily step count increased after 2 months of the intervention (median difference = 1953 steps/day, p-value <.001, 95% CI 782 to 3112). Conclusions Incorporating users’ preferences in personalized advice provided by a physical activity app was considered feasible and acceptable, with preliminary support for its positive effects on daily step count. Future randomized studies with longer follow up are warranted to determine the effectiveness of personalized mobile apps in promoting physical activity.
Steady-state visual evoked potentials in children with neurofibromatosis type 1: associations with behavioral rating scales and impact of psychostimulant medication
Authors: Lalancette Eve , Charlebois-Poirier Audrey-Rose , Agbogba Kristian , Knoth Inga Sophia , Jones Emily J. H. , Mason Luke , Perreault Sébastien , Lippé Sarah 
Published: July 2022

Abstract
Background
Neurofibromatosis type 1 (NF1) is a genetic disorder often associated with cognitive dysfunctions, including a high occurrence of deficits in visuoperceptual skills. The neural underpinnings of these visuoperceptual deficits are not fully understood. We used steady-state visual evoked potentials (SSVEPs) to investigate possible alterations in the synchronization of neural activity in the occipital cortex of children with NF1.

Methods
SSVEPs were measured using electroencephalography and compared between children with NF1 (n = 28) and neurotypical controls (n = 28) aged between 4 and 13 years old. SSVEPs were recorded during visual stimulation with coloured icons flickering at three different frequencies (6 Hz, 10 Hz, and 15 Hz) and analyzed in terms of signal-to-noise ratios. A mixed design ANCOVA was performed to compare SSVEP responses between groups at the three stimulation frequencies. Pearson’s correlations with levels of intellectual functioning as well as with symptoms of ADHD, ASD and emotional/behavioral problems were performed. The impact of psychostimulant medication on the SSVEP responses was analyzed in a subset of the NF1 group (n = 8) with paired t-tests.

Results
We observed reduced signal-to-noise ratios of the SSVEP responses in children with NF1. The SSVEP responses were negatively correlated with symptoms of inattention and with symptoms of emotional/behavioral problems in the NF1 group. The SSVEP response generated by the lowest stimulation frequency (i.e., 6 Hz) was rescued with the intake of psychostimulant medication.

Conclusions
Impaired processing of rhythmic visual stimulation was evidenced in children with NF1 through measures of SSVEP responses. Those responses seem to be more reduced in children with NF1 who exhibit more symptoms of inattention and emotional/behavioral problems in their daily life. SSVEPs are potentially sensitive electrophysiological markers that could be included in future studies investigating the impact of medication on brain activity and cognitive functioning in children with NF1.
Italian reference rivers under the Water Framework Directive umbrella: do natural factors actually depict the observed nutrient conditions?
Authors: Erba Stefania , Buffagni Andrea , Cazzola Marcello , Balestrini Raffaella 
Published: July 2022

AbstractBackgroundDespite the efforts made in the last century to counteract the nutrient enrichment from diffuse and point-sources, the excess of nitrogen and phosphorous is among the main causes of degradation of European rivers. In this context, determining natural background concentrations of nutrients in rivers is crucial for a correct definition of their ecological status. In the most anthropized regions, this is a difficult task. This study provides a nation-wide assessment of the nutrient concentration variability between Italian river reference sites.ResultsWe applied the Affinity Propagation technique to identify groups of river sites classified as reference based on measured nutrients and oxygen water saturation. The role of natural and anthropogenic factors determining differences in nutrients concentration between groups of sites was explored. Nitrate concentrations varied from 0.01 mg N l−1to more than 5 mg N l−1. Ammonia and total phosphorous varied between 0.001 and 0.12 mg l−1. Observed nutrient levels, although in line with those identified for reference sites in other countries, largely exceed the ranges reported for natural basins. Atmospheric deposition of inorganic N and artificial and/or high-impact agricultural land use are the major factors determining differences in nutrient concentration. Factors like, e.g. catchment size, precipitation amount and altitude do not play a relevant role in explaining nutrient differences between groups of reference sites.ConclusionsWe especially focused on (i) major causes of failure in the selection of appropriate reference sites in Italy; (ii) the potential of setting higher NO3-N thresholds for the classification of ecological status in specific areas, and (iii) the prospective of a regionalization approach, in which human effects are accepted to a low degree for reference site selection or when setting thresholds for peculiar geographical areas.
ccImpute: an accurate and scalable consensus clustering based algorithm to impute dropout events in the single-cell RNA-seq data
Authors: Malec Marcin , Kurban Hasan , Dalkilic Mehmet 
Published: July 2022

Abstract
Background
In recent years, the introduction of single-cell RNA sequencing (scRNA-seq) has enabled the analysis of a cell’s transcriptome at an unprecedented granularity and processing speed. The experimental outcome of applying this technology is a $$M \times N$$

M
×
N

matrix containing aggregated mRNA expression counts of M genes and N cell samples. From this matrix, scientists can study how cell protein synthesis changes in response to various factors, for example, disease versus non-disease states in response to a treatment protocol. This technology’s critical challenge is detecting and accurately recording lowly expressed genes. As a result, low expression levels tend to be missed and recorded as zero - an event known as dropout. This makes the lowly expressed genes indistinguishable from true zero expression and different than the low expression present in cells of the same type. This issue makes any subsequent downstream analysis difficult.

Results
To address this problem, we propose an approach to measure cell similarity using consensus clustering and demonstrate an effective and efficient algorithm that takes advantage of this new similarity measure to impute the most probable dropout events in the scRNA-seq datasets. We demonstrate that our approach exceeds the performance of existing imputation approaches while introducing the least amount of new noise as measured by clustering performance characteristics on datasets with known cell identities.

Conclusions
ccImpute is an effective algorithm to correct for dropout events and thus improve downstream analysis of scRNA-seq data. ccImpute is implemented in R and is available at https://github.com/khazum/ccImpute.
Poly(a) selection introduces bias and undue noise in direct RNA-sequencing
Authors: Viscardi Marcus J. , Arribere Joshua A. 
Published: July 2022

Abstract
Background
Genome-wide RNA-sequencing technologies are increasingly critical to a wide variety of diagnostic and research applications. RNA-seq users often first enrich for mRNA, with the most popular enrichment method being poly(A) selection. In many applications it is well-known that poly(A) selection biases the view of the transcriptome by selecting for longer tailed mRNA species.

Results
Here, we show that poly(A) selection biases Oxford Nanopore direct RNA sequencing. As expected, poly(A) selection skews sequenced mRNAs toward longer poly(A) tail lengths. Interestingly, we identify a population of mRNAs (> 10% of genes’ mRNAs) that are inconsistently captured by poly(A) selection due to highly variable poly(A) tails, and demonstrate this phenomenon in our hands and in published data. Importantly, we show poly(A) selection is dispensable for Oxford Nanopore’s direct RNA-seq technique, and demonstrate successful library construction without poly(A) selection, with decreased input, and without loss of quality.

Conclusions
Our work expands the utility of direct RNA-seq by validating the use of total RNA as input, and demonstrates important technical artifacts from poly(A) selection that inconsistently skew mRNA expression and poly(A) tail length measurements.
Living with frailty and haemodialysis: a qualitative study
Authors: Young Hannah M. L. , Ruddock Nicki , Harrison Mary , Goodliffe Samantha , Lightfoot Courtney J. , Mayes Juliette , Nixon Andrew C. , Greenwood Sharlene A. , Conroy Simon , Singh Sally J. , Burton James O. , Smith Alice C. , Eborall Helen 
Published: July 2022

Abstract
Background
Frailty is highly prevalent in people receiving haemodialysis (HD) and is associated with poor outcomes. Understanding the lived experiences of this group is essential to inform holistic care delivery.

Methods
Semi-structured interviews with N = 25 prevalent adults receiving HD from 3 HD units in the UK. Eligibility criteria included a Clinical Frailty Scale (CFS) score of 4–7 and a history of at least one fall in the last 6 months. Sampling began guided by maximum variation sampling to ensure diversity in frailty status; subsequently theoretical sampling enabled exploration of preliminary themes. Analysis was informed by constructivist grounded theory; later we drew upon the socioecological model.

Results
Participants had a mean age of 69 ± 10 years, 13 were female, and 13 were White British. 14 participants were vulnerable or mildly frail (CFS 4–5), and 11 moderately or severely frail (CFS 6–7). Participants characterised frailty as weight loss, weakness, exhaustion, pain and sleep disturbance arising from multiple long-term conditions. Participants’ accounts revealed: the consequences of frailty (variable function and psychological ill-health at the individual level; increasing reliance upon family at the interpersonal level; burdensome health and social care interactions at the organisational level; reduced participation at the community level; challenges with financial support at the societal level); coping strategies (avoidance, vigilance, and resignation); and unmet needs (overprotection from family and healthcare professionals, transactional health and social care exchanges).

Conclusions
The implementation of a holistic needs assessment, person-centred health and social care systems, greater family support and enhancing opportunities for community participation may all improve outcomes and experience. An approach which encompasses all these strategies, together with wider public health interventions, may have a greater sustained impact.

Trial registration
ISRCTN12840463.
The effects of synbiotics on indoxyl sulphate level, constipation, and quality of life associated with constipation in chronic haemodialysis patients: a randomized controlled trial
Authors: Lydia Aida , Indra Tities Anggraeni , Rizka Aulia , Abdullah Murdani 
Published: July 2022

Abstract
Background
Gut microbiota dysbiosis in patients with chronic kidney disease on haemodialysis (CKD-HD) creates an increase in proteolytic bacteria activity, leading to an increase in the production of uraemic toxins, such as indoxyl sulphate, worsening of constipation symptoms and reducing patients’ quality of life. Improving gut microbiota dysbiosis is expected to improve this condition. This study aimed to evaluate the effect of synbiotics on indoxyl sulphate levels, constipation symptoms, and constipation-related quality of life in haemodialysis patients.

Methods
This was a double-blinded randomized controlled clinical trial with a parallel design involving haemodialysis patients. We included chronic haemodialysis patients with gastrointestinal complaints, difficulty defecating, faeces with hard consistency, or a bowel movement frequency of fewer than three times per week. Patients were randomly divided into two groups (synbiotics (Lactobacillus acidophilus and Bifidobacterium longum 5x109 CFU) and placebo) for 60 days of oral intervention. All participants, caregivers, and outcome assessors were blinded to group assignment. The primary outcome was a decrease in indoxyl sulphate toxin levels. Meanwhile, improvement in constipation symptoms (measured using the Patient Assessment of Constipation: Symptoms (PAC-SYM) questionnaire) and improvement in constipation-related quality of life (measured using the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire) were assessed as secondary outcomes.

Results
We included 60 patients (30 intervention; median age of 51.23 (13.57) years, 33.3% male; 30 control; median age of 52.33 (11.29) years, 36.7% male). There was no significant difference in terms of pre- and postintervention indoxyl sulphate toxin levels in the synbiotics group compared to the placebo group (p=0.438). This study found an improvement in constipation symptoms (p = 0.006) and constipation-related quality of life (p=0.001) after synbiotic administration.

Conclusion
Two months of synbiotic supplementation did not lower indoxyl sulphate toxin levels. Nevertheless, it had a major effect in improving constipation and quality of life affected by constipation in patients undergoing chronic haemodialysis.

Trial registration
NCT04527640 (date of first registration: 26/08/2020)
A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients
Authors: Privitera Claudio M. , Neerukonda Sanjay V. , Aiyagari Venkatesh , Yokobori Shoji , Puccio Ava M. , Schneider Nathan J. , Stutzman Sonja E. , Olson DaiWai M. ,   the END PANIC Investigators, Hill Michelle , DeWitt Jessica , Atem Folefac , Barnes Arianna , Xie Donglu , Kuramatsu Joji , Koehn Julia , Swab Stefan 
Published: July 2022

AbstractBackgroundAutomated infrared pupillometry (AIP) and the Neurological Pupil index (NPi) provide an objective means of assessing and trending the pupillary light reflex (PLR) across a broad spectrum of neurological diseases. NPi quantifies the PLR and ranges from 0 to 5; in healthy individuals, the NPi of both eyes is expected to be ≥ 3.0 and symmetric. AIP values demonstrate emerging value as a prognostic tool with predictive properties that could allow practitioners to anticipate neurological deterioration and recovery. The presence of an NPi differential (a difference ≥ 0.7 between the left and right eye) is a potential sign of neurological abnormality.MethodsWe explored NPi differential by considering the modified Rankin Score at discharge (DC mRS) among patients admitted to neuroscience intensive care units (NSICU) of 4 U.S. and 1 Japanese hospitals and for two cohorts of brain injuries: stroke (including subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, and aneurysm, 1,200 total patients) and 185 traumatic brain injury (TBI) patients for a total of more than 54,000 pupillary measurements.ResultsStroke patients with at least 1 occurrence of an NPi differential during their NSICU stay have higher DC mRS scores (3.9) compared to those without an NPi differential (2.7;P < .001). Patients with TBI and at least 1 occurrence of an NPi differential during their NSICU stay have higher discharge modified Rankin Scale scores (4.1) compared to those without an NPi differential (2.9;P < .001). When patients experience both abnormalities, abnormal (NPi < 3.0) and an NPi differential, the latter has an anticipatory relationship with respect to the former (P < .001 for z-score skewness analysis). Finally, our analysis confirmed ≥ 0.7 as the optimal cutoff value for the NPi differential (AUC = 0.71,P < .001).ConclusionThe NPi differential is an important factor that clinicians should consider when managing critically ill neurological injured patients admitted to the neurocritical care units.Trial registrationNCT02804438, Date of Registration: June 17, 2016.
Metabolic activity via 18F-FDG PET/CT is predictive of microsatellite instability status in colorectal cancer
Authors: Song Jinling , Li Zhongwu , Yang Lujing , Wei Maomao , Yang Zhi , Wang Xuejuan 
Published: July 2022

Abstract
Purpose
Identification of microsatellite instability high (MSI-H) colorectal cancer (CRC) is crucial for screening patients most likely to benefit from immunotherapy. We aim to investigate whether the metabolic characteristics is related to MSI status and can be used to predict the MSI-H CRC.

Methods
A retrospective analysis was conducted on 420 CRC patients who were identified via [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography(CT) prior to therapy. Maximum standardized uptake (SUVmax), mean standardized uptake (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary tumor were calculated and compared between MSI-H and microsatellite stability (MSS). Predictive factors of MSI status were selected from metabolic parameters and clinicopathological profiles via a multivariate analysis.

Results
Of 420 colorectal cancers, 44 exhibited a high incidence of MSI. Both MTV and TLG were significantly higher in MSI-H group compared with the MSS group (P = 0.004 and P = 0.010, respectively). Logistic regression analysis indicated that CRC with MSI-H were related to younger age (P = 0.013), primary lesion located at right hemi-colon (P < 0.001) and larger MTV on PET/CT imaging (P = 0.019). MTV more than 32.19 of colorectal cancer was linked to the presence of MSI (P = 0.019).

Conclusion
Tumor metabolic burden were higher in MSI-H CRC which may be useful for predicting the MSI status of CRC patient and thus aid in determination of immunotherapy for patients with CRC.
Mycobacterium chimaera chorioretinitis preceding central nervous system lesions: a case report and review of the literature
Authors: Veenis Aaron , Haghnegahdar Megan , Ajlan Radwan 
Published: July 2022

Abstract
Background
Mycobacterium chimaera ocular infection is a rare disease that is linked to bypass devices used during cardiothoracic surgeries. Reported cases in the literature of ocular involvement preceding CNS involvement are based on clinical exam with no neuroimaging. Here we present a case of M. chimaera ocular infection with no CNS M. chimaera lesions on brain magnetic resonance imaging (MRI).

Case presentation
A 59-year-old female presented with altered mental status and blurred vision in February 2021. Her past medical history was significant for aortic valve replacement and ascending aortic aneurysm repair in 2017 complicated by known M. chimaera infection. She had been receiving azithromycin, ethambutol, rifampin, and amikacin as systemic anti-mycobacterium treatment. Her dilated fundus exam showed numerous yellow placoid circular lesions scattered throughout the macula and peripheral retina in both eyes with associated vitritis. Systemic workup, including brain MRI showed no acute infectious lesions. Her infections workup was unremarkable except for a positive toxoplasma IgM, for which she was treated with sulfamethoxazole/trimethoprim. One month later, a head computed tomography showed new numerous scattered round foci of hyperdensity throughout the cerebrum and brainstem thought to be foci of M. chimaera infection. Clofazimine was added per culture and sensitivity. MRI brain 1 month later showed mild decrease in conspicuity and number of these intensities while on anti-mycobacterium treatment. Her cognition had improved at that time as well. She was seen in retina clinic 2 months later where her exam showed similar retinal lesions with no associated vitritis or anterior chamber cell in bilateral eyes, suggesting a lack of active infection. Optical coherence tomography macula showed parafoveal cystoid macular edema bilaterally. She was started on steroidal and non-steroidal anti-inflammatory eye drops.

Conclusions
To the best of our knowledge, this is the first case in the literature to report M. chimaera chorioretinitis with concomitant negative neuroimaging. Chorioretinal M. chimaera lesions should motivate high suspicion of CNS involvement prompting early neurological work up.