bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complex motivations of Japanese medical students to an online medical English course during the COVID-19 pandemic
Authors: Azuma Miu , Nomura Osamu , Sakuma Takaya , Soma Yuki 
Published: April 2022

Background: In response to globalism, many East-Asian countries now include a Medical English course in their undergraduate medical education syllabus. The purpose of this study was to explore the relationship between the related attribute factors of students' motivation to learn medical English through an online modality. Methods: Of 134 eligible fourth-year medical students who participated in an Online Medical English course at a Japanese medical school, 105 were enrolled in this single cohort study. The participants completed pre- and post-course surveys regarding their motivation during the course, including perceived academic control and task value, and their assignment scores. A structural equation model was used to examine the hypothesized relationship of constructs, based on control-value theory. Results: The model showed a good fit for the data (χ2[df=7] = 1.821, p=0.969, CFI = 1.000, RMSEA < 0.001, SRMR < 0.05, GFI = 0.993, AGFI = 0.980). The latent variables of the perceived course achievement related to the observed variables of academic control and task value scale scores, and negatively predicted willingness for self-study after course completion. In addition, the preference of English as the course language negatively predicted willingness for self-study of medical English. Conclusion: Choice of English as the language of instruction and perceived high course achievement negatively predicted students’ motivation for further English self-study after the class. The importance of incorporating the perspective of lifelong learning into the teaching of medical English was recognized.
The Causal Impact of Distance on Bank Lending
Authors: Herpfer Christoph , Mjøs Aksel , Schmidt Cornelius 
Published: April 2022

We investigate the role of physical distance in corporate lending by exploiting infrastructure improvements as shocks to travel time. Lower travel time increases the likelihood of initiating a new banking relationship, consistent with an economic surplus from lower transaction costs. In existing lending relationships, banks capture part of this surplus by increasing interest rates, in particular, if banks have higher bargaining power. Reductions in travel time to competing banks have the opposite effects. Banks benefit from improved infrastructure through an increase in clients, and lenders that rely more on technology do not exhibit sensitivity to changes in distance. This paper was accepted by Victoria Ivashina, finance. Funding: Financial support from Finans|Bergen is gratefully acknowledged. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4346 .
Acute effects of varying densities of foam roller on hamstring flexibility and eccentric strength
Authors: Rhodes David , Crowie Sean , Alexander Jill 
Published: April 2022

Background/Aims Foam rolling is a popular form of self-administered soft tissue therapy, commonly used in sporting environments. There are several variations in foam roller types including differences in density. No studies have examined the effects of different density type rollers on performance. This study compares the effects of varying foam roller density on hamstring flexibility and eccentric hamstring strength in active men. Methods A total of 28 healthy male participants (height 176.7 ± 5.9 cm; body mass 75.8 ± 9.6 kg; age 21.6 ± 4.0 years) were randomly allocated to receive a low density, medium density or high density foam roller or allocated to a control group. Outcome measures included hamstring flexibility through active knee extension (°) and eccentric hamstring strength pre and immediately-post foam roller application. Results Significant foam roller x time interactions were found for hamstring flexibility (P<0.05). Significant increases in active knee extension were reported post-foam roller application for all foam roller densities (P<0.05). No significant changes in strength parameters (break angle, peak and average force and torque) were found (P>0.05). No significant interactions between strength parameters, limb, type of roller or time were found (P>0.05). Conclusions Foam roller use elicits immediate positive increases in hamstring flexibility through active knee extension assessment, with the lower density foam roller displaying the largest increases in hamstring flexibility. No change in strength parameters were noted with the increases in flexibility; however, this does not denote that injury risk is reduced because of this. Findings provide practitioners with insight to inform decision making for the use of different densities of foam roller in practical settings.
Stigmatization is common in patients with non-alcoholic fatty liver disease and correlates with quality of life
Authors: Carol Marta , Pérez-Guasch Martina , Solà Elsa , Cervera Marta , Martínez Sara , Juanola Adrià , Ma Ann T. , Avitabile Emma , Napoleone Laura , Pose Elisa , Graupera Isabel , Honrubia Maria , Korenjak Marko , Torres Ferran , Ginès Pere , Fabrellas Núria ,   for the LiverHope Consortium Investigators
Published: April 2022

Background and aims
Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD.

Methods
One-hundred and ninety-seven patients seen at the liver clinic were included: a study group of 144 patients with NAFLD, 50 with cirrhosis (34 compensated, 16 decompensated), and a control group of 53 patients with alcohol-related cirrhosis. Demographic, clinical, and laboratory data were collected. Quality-of-life was assessed by chronic liver disease questionnaire (CLDQ). Perceived stigma was assessed using a specific questionnaire for patients with liver diseases categorized in 4 domains: stereotypes, discrimination, shame, and social isolation.

Results
Perceived stigma was common in patients with NAFLD (99 patients, 69%) and affected all 4 domains assessed. The frequency was slightly higher, yet not significant, in patients with NAFLD cirrhosis vs those without (72% vs 67%, respectively; p = 0.576). In patients without cirrhosis perceived stigma was unrelated to stage of disease, since frequency was similar in patients with no or mild fibrosis compared to those with moderate/severe fibrosis (66% vs 68%, respectively). There were no differences in perceived stigma between patients with compensated cirrhosis and these with decompensated cirrhosis. Among patients with cirrhosis, stigmatization was more common in alcohol-related vs NAFLD-cirrhosis, yet differences were only significant in two domains. In patients with NAFLD, perceived stigma correlated with poor quality-of-life, but not with demographic or clinical variables.

Conclusions
Perceived stigmatization is common among patients with NAFLD independently of disease stage, is associated with impaired quality-of-life, and may be responsible for stereotypes, discrimination, shame, and social isolation, which may affect human and social rights of affected patients.
Blood pressure response to commonly administered antihypertensives for severe inpatient hypertension
Authors: Ghazi Lama , Li Fan , Chen Xinyuan , Simonov Michael , Yamamoto Yu , Biswas Aditya , Hanna Jonathan , Shah Tayyab , Peixoto Aldo J. , Wilson F. Perry 
Published: April 2022

Background
Blood pressure (BP) elevations are commonly treated in hospitalized patients; however, treatment is not guideline directed. Our objective was to assess BP response to commonly prescribed antihypertensives after the development of severe inpatient hypertension (HTN).

Methods
This is a cohort study of adults, excluding intensive care unit patients, within a single healthcare system admitted for reasons other than HTN who developed severe HTN (systolic BP>180 or diastolic BP >110 mmHg at least 1 hour after admission). We identified the most commonly administered antihypertensives given within 6 hours of severe HTN (given to >10% of treated patients). We studied the association of treatment with each antihypertensive vs. no treatment on BP change in the 6 hours following severe HTN development using mixed-effects model after adjusting for demographics and clinical characteristics.

Results
Among 23,147 patients who developed severe HTN, 9,166 received antihypertensive treatment. The most common antihypertensives given were oral metoprolol (n = 1991), oral amlodipine (n = 1812), oral carvedilol (n = 1116), IV hydralazine (n = 1069) and oral hydralazine (n = 953). In the fully adjusted model, treatment with IV hydralazine led to 13 [-15.9, -10.1], 18 [-22.2, -14] and 11 [-14.1, -8.3] mmHg lower MAP, SBP, and DBP in the 6 hours following severe HTN development compared to no treatment. Treatment with oral hydralazine and oral carvedilol also resulted in significantly lower BPs in the 6 hours following severe HTN development (6 [-9.1, -2.1 and -7 [-9.1, -4.2] lower MAP, respectively) compared to no treatment. Receiving metoprolol and amlodipine did not result in a drop in BP compared to no treatment.

Conclusion
Among commonly used antihypertensives, IV hydralazine resulted in the most significant drop in BP following severe HTN, while metoprolol and amlodipine did not lower BP. Further research to assess the effect of treatment on clinical outcomes and if needed which antihypertensives to administer are necessary.
The epidemiology of multimorbidity in France: Variations by gender, age and socioeconomic factors, and implications for surveillance and prevention
Authors: Coste Joël , Valderas José M. , Carcaillon-Bentata Laure 
Published: April 2022

BackgroundRobust public health and health system response to the increasing burden of multimorbidity worldwide requires detailed epidemiological examination of its key sociodemographic and geographic determinants. We investigated the role of gender, age and socioeconomic and geographic factors on multimorbidity (i.e., having two or more conditions) in the adult population in France and examined implications for surveillance and prevention.MethodsWe used data from two large nationwide representative surveys with cross-sectional and longitudinal health and socio-demographic indicators, conducted in France between 2008 and 2014. Morbidity counts and frequent dyads/triads of conditions independently impacting mortality, activity limitations, and perceived health were investigated with regard to differences in gender, age, socioeconomic (education, occupation and income) and geography (size of the urban unit and region).ResultsThe component conditions of multimorbidity varied with gender and age. Women experienced multimorbidity 23–31% more frequently and at a younger age (5–15 years earlier) than men. Multimorbidity increased with age while its associations with most health indicators weakened with it. Multimorbidity was strongly and independently associated with socioeconomic indicators, with a strong inverse dose-response relationship with education, but less consistently with geographic factors.ConclusionsMultimorbidity has diverse and variable components and impacts across gender and age. It is strongly associated with socioeconomic factors, notably educational level, for which causality appears likely. Consideration of this diversity and variability, its common occurrence in dyads and triads, and its impact on health outcomes according to age and gender may contribute to efficient surveillance and support the identification of prevention strategies targeting middle-aged men and women.
E-scooter related injuries: Using natural language processing to rapidly search 36 million medical notes
Authors: Ioannides Kimon L. H. , Wang Pin-Chieh , Kowsari Kamran , Vu Vu , Kojima Noah , Clayton Dayna , Liu Charles , Trivedi Tarak K. , Schriger David L. , Elmore Joann G. 
Published: April 2022

Background
Shareable e-scooters have become popular, but injuries to riders and bystanders have not been well characterized. The goal of this study was to describe e-scooter injuries and estimate the rate of injury per e-scooter trip.

Methods and findings
Retrospective review of patients presenting to 180 clinics and 2 hospitals in greater Los Angeles between January 1, 2014 and May 14, 2020. Injuries were identified using a natural language processing (NLP) algorithm not previously used to identify injuries, tallied, and described along with required healthcare resources. We combine these tallies with municipal data on scooter use to report a monthly utilization-corrected rate of e-scooter injuries. We searched 36 million clinical notes. Our NLP algorithm correctly classified 92% of notes in the testing set compared with the gold standard of investigator review. In total, we identified 1,354 people injured by e-scooters; 30% were seen in more than one clinical setting (e.g., emergency department and a follow-up outpatient visit), 29% required advanced imaging, 6% required inpatient admission, and 2 died. We estimate 115 injuries per million e-scooter trips were treated in our health system.

Conclusions
Our observed e-scooter injury rate is likely an underestimate, but is similar to that previously reported for motorcycles. However, the comparative severity of injuries is unknown. Our methodology may prove useful to study other clinical conditions not identifiable by existing diagnostic systems.
Surface conjugation of antibodies improves nanoparticle uptake in bronchial epithelial cells
Authors: Luks Valerie L. , Mandl Hanna , DiRito Jenna , Barone Christina , Freedman-Weiss Mollie R. , Ricciardi Adele S. , Tietjen Gregory G. , Egan Marie E. , Saltzman W. Mark , Stitelman David H. 
Published: April 2022

Background
Advances in Molecular Therapy have made gene editing through systemic or topical administration of reagents a feasible strategy to treat genetic diseases in a rational manner. Encapsulation of therapeutic agents in nanoparticles can improve intracellular delivery of therapeutic agents, provided that the nanoparticles are efficiently taken up within the target cells. In prior work we had established proof-of-principle that nanoparticles carrying gene editing reagents can mediate site-specific gene editing in fetal and adult animals in vivo that results in functional disease improvement in rodent models of β-thalassemia and cystic fibrosis. Modification of the surface of nanoparticles to include targeting molecules (e.g. antibodies) holds the promise of improving cellular uptake and specific cellular binding.

Methods and findings
To improve particle uptake for diseases of the airway, like cystic fibrosis, our group tested the impact of nanoparticle surface modification with cell surface marker antibodies on uptake in human bronchial epithelial cells in vitro. Binding kinetics of antibodies (Podoplanin, Muc 1, Surfactant Protein C, and Intracellular Adhesion Molecule-1 (ICAM)) were determined to select appropriate antibodies for cellular targeting. The best target-specific antibody among those screened was ICAM antibody. Surface conjugation of nanoparticles with antibodies against ICAM improved cellular uptake in bronchial epithelial cells up to 24-fold.

Conclusions
This is a first demonstration of improved nanoparticle uptake in epithelial cells using conjugation of target specific antibodies. Improved binding, uptake or specificity of particles delivered systemically or to the luminal surface of the airway would potentially improve efficacy, reduce the necessary dose and thus safety of administered therapeutic agents. Incremental improvement in the efficacy and safety of particle-based therapeutic strategies may allow genetic diseases such as cystic fibrosis to be cured on a fundamental genetic level before birth or shortly after birth.
Individual and healthcare supply-related HIV transmission factors in HIV-positive patients enrolled in the antiretroviral treatment access program in the Centre and Littoral regions in Cameroon (ANRS-12288 EVOLCam survey)
Authors: Coulaud Pierre-julien , Sow Abdourahmane , Sagaon-Teyssier Luis , Ndiaye Khadim , Maradan Gwenaëlle , Laurent Christian , Spire Bruno , Vidal Laurent , Kuaban Christopher , Boyer Sylvie ,   for the EVOLCam Group
Published: April 2022

Background
Despite great progress in antiretroviral treatment (ART) access in recent decades, HIV incidence remains high in sub-Saharan Africa. We investigated the role of individual and healthcare supply-related factors in HIV transmission risk in HIV-positive adults enrolled in 19 HIV services in the Centre and Littoral regions of Cameroon.

Methods
Factors associated with HIV transmission risk (defined as both unstable aviremia and inconsistent condom use with HIV-negative or unknown status partners) were identified using a multi-level logistic regression model. Besides socio-demographic and behavioral individual variables, the following four HIV-service profiles, identified using cluster analysis, were used in regression analyses as healthcare supply-related variables: 1) district services with large numbers of patients, almost all practicing task-shifting and not experiencing antiretroviral drugs (ARV) stock-outs (n = 4); 2) experienced and well-equipped national reference services, most practicing task-shifting and not experiencing ARV stock-outs (n = 5); 3) small district services with limited resources and activities, almost all experiencing ARV stock-outs (n = 6); 4) small district services with a wide range of activities and half not experiencing ARV stock-outs (n = 4).

Results
Of the 1372 patients (women 67%, median age [Interquartile]: 39 [33–44] years) reporting sexual activity in the previous 12 months, 39% [min-max across HIV services: 25%-63%] were at risk of transmitting HIV. The final model showed that being a woman (adjusted Odd Ratio [95% Confidence Interval], p-value: 2.13 [1.60–2.82], p<0.001), not having an economic activity (1.34 [1.05–1.72], p = 0.019), having at least two sexual partners (2.45 [1.83–3.29], p<0.001), reporting disease symptoms at HIV diagnosis (1.38 [1.08–1.75], p = 0.011), delayed ART initiation (1.32 [1.02–1.71], p = 0.034) and not being ART treated (2.28 [1.48–3.49], p<0.001) were all associated with HIV transmission risk. Conversely, longer time since HIV diagnosis was associated with a lower risk of transmitting HIV (0.96 [0.92–0.99] per one-year increase, p = 0.024). Patients followed in the third profile had a higher risk of transmitting HIV (1.71 [1.05–2.79], p = 0.031) than those in the first profile.

Conclusions
Healthcare supply constraints, including limited resources and ARV supply chain deficiency may impact HIV transmission risk. To reduce HIV incidence, HIV services need adequate resources to relieve healthcare supply-related barriers and provide suitable support activities throughout the continuum of care.
International consultation on incontinence questionnaire – Urinary incontinence short form ICIQ-UI SF: Validation of its use in a Danish speaking population of municipal employees
Authors: Grøn Jensen Lærke Cecilie , Boie Sidsel , Axelsen Susanne 
Published: April 2022

Introduction
Worldwide, the estimated prevalence of urinary incontinence is 8.7%. Urinary incontinence is more frequent in women than in men. Posing the right questions is crucial, when diagnosing urinary incontinence, but also to evaluate the need of treatment and treatment effect. Therefore, reliable and validated questionnaires within this area are needed. Even though the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) has been used on a daily basis in the Danish Urogynaecological Database since 2006, it has not yet been validated in a Danish population of both men and women.

Objective
To test the reliability and validity of the Danish version of the ICIQ-UI SF in a Danish speaking population of men and women among municipal employees.

Methods
Content validity was evaluated with semi-structured interviews. A quantitative field test was performed, in which the questionnaire was distributed electronically to municipal workers by E-mail. Statistical methods included item characteristics (missings, kurtosis and skewness), internal consistency (Chronbach’s alfa), test-retest (ICC), construct validity (known group validation), and floor and ceiling effect.

Results
A number of 1814 Danish municipal workers completed the questionnaire. Of the total number of responders, 426 were invited to complete the questionnaire twice (for test-retest) and 215 (50.5%) of these completed the questions again two weeks later. Statistical analyses of the ICIQ-UI SF demonstrated no floor and ceiling effects, skewness was zero and kurtosis 0.00–0.49. Cronbach’s alfa was 0.87 and intraclass correlation coefficient 0.73. Two out of three hypotheses were accepted in the known-groups validation.

Conclusion
This study offers an adaptation of the ICIQ-UI SF to a Danish setting. The Danish ICIQ-UI SF demonstrated acceptable reliability and validity. However, clinicians should consider the relatively high measurement error.
ABORDAGENS DO CONTEÚDO DE GEOGRAFIA FÍSICA PRESENTES NO SIMPÓSIO BRASILEIRO DE GEOGRAFIA FÍSICA APLICADA (SBGFA): SESSÃO ENSINO DE GEOGRAFIA - EDIÇÕES 2003-2019
Authors: Pereira Alicia de Oliveira Moreira , Souza Carla Juscélia de Oliveira 
Published: April 2022

Esta pesquisa investigou os artigos da sessão Ensino de Geografia Física nos anais do Simpósio Brasileiro de Geografia Física Aplicada, edições 2017 e 2019. O objetivo foi verificar as abordagens e tendências presentes em seus conteúdos. A discussão considerou os resultados de pesquisas realizadas anteriormente e autores que abordam a trajetória da Geografia Física no Brasil e a questão dos conteúdos da Geografia Física no contexto da Geografia Escolar. A pesquisa investigou 60 artigos da edição de 2017 e 143 do evento de 2019, considerando: origem institucional do trabalho; subáreas da Geografia; tipo de trabalho, entre outros aspectos. A pesquisa adotou a classificação proposta por Clemente e Souza (2014) para a análise e classificação de seus conteúdos. Nos textos, os assuntos referem-se ao conteúdo de Geomorfologia, Climatologia, Biogeografia, Pedologia, Hidrologia, à questões relacionadas com a Cartografia, Geotecnologia, Análise Ambiental e Educação Ambiental. A questão ambiental permanece evidente nas propostas pedagógicas. Mas, começam a aparecer as abordagens Geodiversidade, Cartografia tátil e Riscos, não identificados nas edições anteriores.