bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective cohort study examining exposure to incarceration and cardiovascular disease (Justice-Involved Individuals Cardiovascular Disease Epidemiology – JUSTICE study): a protocol paper
Authors: Howell Benjamin A. , Puglisi Lisa B. , Aminawung Jenerius , Domingo Kirsten Bibbins- , Elumn Johanna , Gallagher Colleen , Horton Nadine , Kazi Dhruv S. , Krumholz Harlan M. , Lin Hsiu-Ju , Roy Brita , Wang Emily A. 
Published: February 2022

Abstract
Background
People who have been incarcerated have high rates of cardiovascular risk factors, such as hypertension and smoking, and cardiovascular disease (CVD) is a leading cause of hospitalizations and mortality in this population. Despite this, little is known regarding what pathways mediate the association between incarceration exposure and increased rates of CVD morbidity and especially what incarceration specific factors are associated with this risk. The objective of this study is to better understand CVD risk in people exposed to incarceration and the pathways by which accumulate cardiovascular risk over time.

Methods and Analysis
The Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study is a prospective cohort study of individuals released from incarceration with known cardiovascular risk factors. We are recruiting 500 individuals within three months after release from jail/prison. At baseline we are assessing traditional risk factors for CVD, including diet, exercise, and smoking, and exposure to incarceration-related policies, psychosocial stress, and self-efficacy. Cardiovascular risk factors are measured at baseline through point of care testing. We are following these individuals for the 12 months following the index release from incarceration with re-evaluation of psychosocial factors and clinical risk factors every 6 months. Using these data, we will estimate the direct and indirect latent effects of incarceration on cardiovascular risk factors and the paths via which these effects are mediated. We will also model the anticipated 10-year burden of CVD incidence, health care use, and mortality associated with incarceration.

Discussion
Our study will identify factors associated with CVD risk factor control among people released from incarceration. Our measurement of incarceration-related exposures, psychosocial factors, and clinical measures of cardiovascular risk will allow for identification of unique targets for intervention to modify CVD risk in this vulnerable population.
The predictive power of geographic health care utilization for unintentional fatal fall rates
Authors: Crowson Matthew Gordon , Beyea Jason A. , Cottrell Justin , Karmali Faisal , Lampasona Giovanni , Saunders James E. , Lewis Richard F. 
Published: February 2022

Abstract
Background
Falls are the leading cause of fatal and nonfatal injuries among adults over 65 years old. The increase in fall mortality rates is likely multifactorial. With a lack of key drivers identified to explain rising rates of death from falls, accurate predictive modelling can be challenging, hindering evidence-based health resource and policy efforts. The objective of this work is to examine the predictive power of geographic utilization and longitudinal trends in mortality from unintentional falls amongst different demographic and geographic strata.

Methods
This is a nationwide, retrospective cohort study using the United States Centers for Disease Control (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS) database. The exposure was death from an unintentional fall as determined by the CDC. Outcomes included aggregate and trend crude and age-adjusted death rates. Health care utilization, reimbursement, and cost metrics were also compared.

Results
Over 2001 to 2018, 465,486 total deaths due to unintentional falls were recorded with crude and age-adjusted rates of 8.42 and 7.76 per 100,000 population respectively. Comparing age-adjusted rates, males had a significantly higher age-adjusted death rate (9.89 vs. 6.17; p <  0.00001), but both male and female annual age-adjusted mortality rates are expected to rise (Male: + 0.25 rate/year, R2= 0.98; Female: + 0.22 rate/year, R2= 0.99). There were significant increases in death rates commensurate with increasing age, with the adults aged 85 years or older having the highest aggregate (201.1 per 100,000) and trending death rates (+ 8.75 deaths per 100,000/year, R2= 0.99). Machine learning algorithms using health care utilization data were accurate in predicting geographic age-adjusted death rates.

Conclusions
Machine learning models have high accuracy in predicting geographic age-adjusted mortality rates from health care utilization data. In the United States from 2001 through 2018, adults aged 85+ years carried the highest death rate from unintentional falls and this rate is forecasted to accelerate.
Using Facebook to promote the uptake of colorectal cancer screening
Authors: Ruco Arlinda , Baxter Nancy N. , Jacobson Jenna , Tinmouth Jill , Llovet Diego 
Published: February 2022

AbstractBackgroundThe use of social media presents a unique opportunity for cancer screening programs to motivate individuals to get screened. However, we need a better understanding of what types of social media messages for colorectal cancer (CRC) screening are preferred. The objective of this study was to develop social media messages promoting CRC screening uptake to identify messages preferred by the target audience.MethodsWe conducted a qualitative descriptive study and collected data through focus groups with Facebook users of screen-eligible age. Participants were presented with social media messages and asked to provide feedback. Messages were informed by the Health Belief Model, current evidence regarding screening communication and health communication and social media best practices. Focus groups were audio-recorded and transcribed and analysis was completed by two independent coders. If messages generated sufficient discussion, we developed a recommendation regarding the use of the message in a future social media campaign. Recommendations included: strongly consider using this message, consider using this message, proceed with caution, and do not use this message. General considerations about social media campaigns were also noted.ResultsA total of 45 individuals participated in six focus groups. We developed recommendations for 7 out of the 18 messages tested; 1 was classified as strongly consider using this message, 4 as consider using this message and 2 as proceed with caution. The data suggest that participants preferred social media messages that were believed to be credible, educational, and with a positive or reassuring tone. Preferred messages tended to increase awareness about CRC risk and screening and prompted participants to ask questions, and to want to learn more about what they could do to lower their risk. Messages that were viewed as humorous, strange or offensive or that had a negative or excessively fearful tone were less well received by study participants.ConclusionsFacebook users prefer social media messages for CRC that have a positive or reassuring tone, are educational, and that have a credible ad sponsor. Campaign planners should proceed with caution when considering messages that use humor or a fearful tone to avoid undermining their campaign objectives.
Stakeholders’ hopes and concerns about the COVID-19 vaccines in Southeastern Nigeria: a qualitative study
Authors: Chukwuocha Uchechukwu Madukaku , Emerole Chiagoziem Ogazirilem , Iwuoha Greg Ndubeze , Dozie Ugonma Winnie , Njoku Princewill Ugochukwu , Akanazu Chidinma Onyebuchi , Eteike Precious Okechukwu , Hemingway Charlotte 
Published: February 2022

Abstract
Background
Equitable access and high uptake of safe and effective vaccines is critical to ending the COVID-19 pandemic. To ensure the success of these vaccines, particularly in many developing and under-developed parts of the world, the concerns of local communities including fears, potency, and levels of acceptance should be addressed. This study assessed community stakeholders’ perceptions in parts of Southeastern Nigeria about COVID-19 vaccine, towards engaging them effectively to ensure the success of the vaccination campaigns.

Methods
A qualitative study was conducted involving fourteen stakeholders from the Southeastern geo-political zone of Nigeria selected using purposive sampling. In-depth semi-structured individual interviews lasting about 30 min were used to collect data. Data analysis was informed by a general inductive approach.

Results
Stakeholders hoped that the development and roll out of the vaccines will bring COVID -19 to an end, will help to maintain good health and allow people get back to normal life. On the other hand, stakeholders expressed their concerns and worries about the “speed” with which the vaccines are being produced, possibility of future adverse effects from vaccination, misinformation, and level of preparedness in the health system to implement the vaccine campaign.

Conclusions
This study identified that more needs to be done to improve perceptions of those who influence health decisions in communities towards COVID-19 vaccines. This includes firstly, the involvement of the community and religious leaders in vaccine promotion. Secondly, it is imperative to develop and disseminate persuasive messaging on vaccine effectiveness and safety targeted at both health professionals, policymakers, and the community which are culturally sensitive and address identified concerns among health workers. Thirdly, the health systems should be strengthened and system-level interventions that directly target one or more of the WHO’s six health system building blocks: service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance.
Head kinematics in patients with neck pain compared to asymptomatic controls: a systematic review
Authors: Franov Esther , Straub Matthias , Bauer Christoph M. , Ernst Markus J. 
Published: February 2022

Abstract
Background
Neck pain is one of the most common musculoskeletal disorders encountered by healthcare providers. A precise assessment of functional deficits, including sensorimotor control impairment, is regarded necessary for tailored exercise programmes. Sensorimotor control can be measured by kinematic characteristics, such as velocity, acceleration, smoothness, and temporal measures, or by assessing movement accuracy. This systematic review aims to identify movement tasks and distinct outcome variables used to measure kinematics and movement accuracy in patients with neck pain and present their results in comparison to asymptomatic controls.

Methods
Electronic searches were conducted in MEDLINE, PEDro, Cochrane Library and CINAHL databases from inception to August 2020. Risk of bias of included studies was assessed. Movement tasks and specific outcome parameters used were collated. The level of evidence for potential group differences in each outcome variable between patients with neck pain and controls was evaluated.

Results
Twenty-seven studies examining head kinematics and movement accuracy during head-aiming, functional and unconstrained movement tasks of the head were included. Average Risk of Bias of included studies was moderate. In total, 23 different outcome variables were assessed. A strong level of evidence for an increased movement time in idiopathic neck pain, and for an increased number of errors during head aiming tasks in both idiopathic and traumatic neck pain was found. Moderate evidence was found in traumatic neck pain for a decreased mean velocity, and peak acceleration, and for an increased reaction time, further for a decreased time on target and increased point deviation during head aiming tasks. Moderate evidence was found for decreased acceleration during unconstrained movements, too.
Results on the remaining movement task and outcome variables showed only limited, very limited or even conflicting level of evidence for patients with neck pain to differ from controls.

Conclusions
Sensorimotor control in NP in the way of kinematic and movement accuracy characteristics of head motion was examined in head aiming, functional or unconstrained movement tasks.
The results from this review indicate that for some characteristics that describe sensorimotor control, patients with NP differ from healthy controls.

Systematic review registration
PROSPERO registration number: CRD42020139083.
The dynamic rotation axis of ulnohumeral joint during active flexion-extension: an in vivo 4-dimensional computed tomography analysis
Authors: Liu Hua , Kholinne Erica , Sun Yucheng , Liu Tingting , Tan Jun 
Published: February 2022

Abstract
Background
As the collateral ligament reconstruction becomes more common to perform, the knowledge between the collateral ligament reconstruction and the elbow rotation axis is still ambiguous. The purpose of this study was to investigate the location of the intersections between the elbow rotation axis and medial and lateral aspect of the humerus.

Methods
Four-dimensional computed tomography (4D CT) scan was designed to obtain the images from 8 participants. The instantaneous rotation axis was created according to the trochlea notch of the ulna in the Rapidform XO software. Then the intersections between the instantaneous rotation axis and the medial and lateral aspect of the humerus were identified in the Geomagic Wrap software. Landmark coordinate systems of the distal humerus was created.

Result
The intersections in the medial aspect of the humerus were mostly located in the superior and posterior quadrant and showed the trend from anterior-superior to posterior-superior with the increment of the elbow flexion. The intersections in the lateral aspect of the humerus were mostly located in the middle half of the anterior quadrant and showed the trend from posterior-inferior to anterior-superior with the increment of the elbow flexion.

Conclusion
There’s no isometric point for medial collateral ligament (MCL) and lateral ulnar collateral ligament (LUCL) reconstruction. The isometric area for MCL reconstruction should be considered at the superior and posterior quadrant of the medial aspect of the humerus. The isometric area for LUCL reconstruction should be considered at the middle half of the anterior quadrant of the lateral aspect of the humerus.

Trial registration
This work was supported by the National Natural Science Foundation of China [No.81911540488] in 07/01/2019.
Urethrocutaneous fistula following VMMC: a case series from March 2013 to October 2019 in ZAZIC’s voluntary medical male circumcision program in Zimbabwe
Authors: Murenje Vernon , Omollo Victor , Gonouya Paidemoyo , Hove Joseph , Munyaradzi Tinashe , Marongwe Phiona , Tshimanga Mufuta , Chitimbire Vuyelwa , Xaba Sinokuthemba , Mandisarisa John , Balachandra Shirish , Makunike-Chikwinya Batsirai , Holec Marrianne , Mangwiro Tonderayi , Barnhart Scott , Feldacker Caryl 
Published: February 2022

Abstract
Background
Urethrocutaneous fistula (subsequently, fistula) is a rare adverse event (AE) in voluntary medical male circumcision (VMMC) programs. Global fistula rates of 0.19 and 0.28 per 100,000 VMMCs were reported. Management of fistula can be complex and requires expert skills. We describe seven cases of fistula in our large-scale VMMC program in Zimbabwe. We present fistula rates; provide an overview of initial management, surgical interventions, and patient outcomes; discuss causes; and suggest future prevention efforts.

Results
Case details are presented on fistulas identified between March 2013 and October 2019. Among the seven fistula clients, ages ranged from 10 to 22 years; 6 cases were among boys under 15 years of age. All clients received surgical VMMC by trained providers in an outreach setting. Clients presented with fistulae 2–42 days after VMMC. Secondary infection was identified in 6 of 7 cases. Six cases were managed through surgical repair. The number of repair attempts ranged from 1 to 10. One case healed spontaneously with conservative management. Fistula rates are presented as cases/100,000 VMMCs.

Conclusion
Fistula is an uncommon but severe AE that requires clinical expertise for successful management and repair. High-quality AE surveillance should identify fistula promptly and include consultation with experienced urologists. Strengthening provider surgical skills and establishment of standard protocols for fistula management would aid future prevention efforts in VMMC programs.
Ovarian steroid cell tumor causing isosexual pseudoprecocious puberty in a young girl: an instructive case and literature review
Authors: Chu Chun-Hao , Wang Wei-De , Wang Shuo-Yu , Chao Tai-Kuang , Su Ruei-Yu , Lin Chien-Ming 
Published: February 2022

Abstract
Background
Steroid cell tumors (SCTs) are very rare sex cord-stromal tumors and account only for less than 0.1% of ovarian neoplasms. SCTs might comprise diverse steroid-secreting cells; hence, the characteristic clinical features were affected by their propensity to secrete a variety of hormones rather than mass effect resulting in compression symptoms and signs. To date, ovarian SCTs have seldom been reported in children, particularly very young children; and pseudoprecocious puberty (PPP) as its unique principal manifestation should be reiterated.

Case presentation
We reported a 1-year-8-month-old girl presenting with rapid bilateral breast and pubic hair development within a 2-month period. Undetectable levels of LH and FSH along with excessively high estradiol after stimulation with gonadotropin-releasing hormone (GnRH), as well as a heterogeneous mass inside left ovary shown in pelvic sonography indicate isosexual PPP. Her gonadal hormones returned remarkably to the prepubertal range the day after surgery, and histology of the ovary mass demonstrated SCTs containing abundant luteinized stromal cells.

Conclusion
The case highlighted that SCTs causing isosexual PPP should be taken into consideration in any young children coexistent with rapidly progressive puberty given a remarkable secretion of sex hormones. This article also reviewed thoroughly relevant reported cases to enrich the clinical experience of SCTs in the pediatric group.
Why do students struggle in their first year of medical school? A qualitative study of student voices
Authors: Picton Aled , Greenfield Sheila , Parry Jayne 
Published: February 2022

Abstract
Background
Struggling at medical school incorporates academic failure, course disruption and early course exit. Struggling is usually multi-factorial involving academic, personal, financial and health factors. Struggling students may fail to engage with available support. First year students are particularly susceptible as they transition to university and a professional career.

Methods
The study aim was to explore medical students’ own voices on struggling and assess how they match up to existing literature. During one academic year, all first year medical students at the University of Birmingham (UK) who opted to leave or were required to withdraw (n = 52) were asked to participate in an individual exit interview. Fifteen students responded and fourteen (27%) agreed to be interviewed. Interviews were face to face (n = 10), telephone (n = 3) and via email (n = 1). Interviews were unstructured and led by a general open question. Framework analysis identified key data themes.

Results
Students described year one of medical school as a critical transition. They simultaneously needed to adapt to being a university student, a medical student and a doctor. A six-group typology of students emerged, each of which struggled with one or more of these adaptations. The groups were: wrong degree choice, mental health problems, acute crisis, at capacity, slow starter and family rock. Some students experienced an isolated problem from within this typology. Most had a multi-factorial story of struggling. Mental health problems and acute crises were the most common issues. Early professional identity formation was a key hurdle. Help-seeking behaviours were varied.

Conclusions
This study explores the narratives of medical students who struggled from an early stage and presents a data-driven typology of their issues. It advances existing qualitative understanding of this topic, which to date is predominantly derived from educator perceptions and not specific to early course issues. Although our results broadly cohere with existing knowledge, we also present novel findings which may reflect our focus on first year students. Issues around early professional identity formation may reflect the increasing emphasis on professionalism in medical school curricula. Listening to these narratives could help university staff to identify students at risk of struggling for targeted support.
Deep learning model for multi-classification of infectious diseases from unstructured electronic medical records
Authors: Wang Mengying , Wei Zhenhao , Jia Mo , Chen Lianzhong , Ji Hong 
Published: February 2022

Abstract
Purpose
Predictively diagnosing infectious diseases helps in providing better treatment and enhances the prevention and control of such diseases. This study uses actual data from a hospital. A multiple infectious disease diagnostic model (MIDDM) is designed for conducting multi-classification of infectious diseases so as to assist in clinical infectious-disease decision-making.

Methods
Based on actual hospital medical records of infectious diseases from December 2012 to December 2020, a deep learning model for multi-classification research on infectious diseases is constructed. The data includes 20,620 cases covering seven types of infectious diseases, including outpatients and inpatients, of which training data accounted for 80%, i.e., 16,496 cases, and test data accounted for 20%, i.e., 4124 cases. Through the auto-encoder, data normalization and sparse data densification processing are carried out to improve the model training effect. A residual network and attention mechanism are introduced into the MIDDM model to improve the performance of the model.

Result
MIDDM achieved improved prediction results in diagnosing seven kinds of infectious diseases. In the case of similar disease diagnosis characteristics and similar interference factors, the prediction accuracy of disease classification with more sample data is significantly higher than the prediction accuracy of disease classification with fewer sample data. For instance, the training data for viral hepatitis, influenza, and hand foot and mouth disease were 2954, 3924, and 3015 respectively and the corresponding test accuracy rates were 99.86%, 98.47%, and 97.31%. There is less training data for syphilis, infectious diarrhea, and measles, i.e., 1208, 575, and 190 respectively and the corresponding test accuracy rates were noticeably lower, i.e., 83.03%, 87.30%, and42.11%. We also compared the MIDDM model with the models used in other studies. Using the same input data, taking viral hepatitis as an example, the accuracy of MIDDM is 99.44%, which is significantly higher than that of XGBoost (96.19%), Decision tree (90.13%), Bayesian method (85.19%), and logistic regression (91.26%). Other diseases were also significantly better predicted by MIDDM than by these three models.

Conclusion
The application of the MIDDM model to multi-class diagnosis and prediction of infectious diseases can improve the accuracy of infectious-disease diagnosis. However, these results need to be further confirmed via clinical randomized controlled trials.