bluuebunny/crossref_metadata_2025_split huggingface dataset:
The circular RNA circFARSA sponges microRNA-330-5p in tumor cells with bladder cancer phenotype
Authors: Fang Chen , Huang Xin , Dai Jun , He Wei , Xu Le , Sun Fukang 
Published: April 2022

Abstract
Background
Circular RNAs (circRNAs) modulate gene expression in various malignancies. However, their roles in the occurrence of bladder cancer (BC) and their underlying mechanisms of action are currently unclear.

Methods
We measured levels of the circRNA phenylalanyl-tRNA synthetase subunit alpha (circFARSA) and target microRNAs (miRNAs/miRs) in BC tissues and cell lines using quantitative polymerase chain reactions. The functions of circFARSA in tumor formation were examined in mice with BC xenografts in vivo and in BC cells via determination of their proliferation, activity, apoptosis, metastasis, and invasion in vitro using cell counting kit-8 assays, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, flow cytometry, western blotting, Transwell assays, and cell wound healing assays. Interactions between miR-330 and circFARSA were predicted and confirmed by bioinformatic processing and dual-luciferase reporter gene assays, respectively. Expression profiles of miR-330 targets in BC cells were assessed via western blotting.

Results
circFARSA expression was markedly upregulated in BC tissues and cell lines compared with that in normal bladder samples. Silencing circFARSA expression decreased BC cell proliferation, invasion, and migration but induced their apoptosis in vitro. Downregulating circFARSA expression slowed tumor growth in vivo and directly sponged miR-330 and inhibited its function in BC cells in vitro. Inhibiting miR-330 expression abolished the regulatory effects of circFARSA silencing on the tumor phenotypes of BC cells.

Conclusions
circFARSA expression is upregulated and exerts oncogenic functions in BC by sponging miR-330.
The prognostic potential of alkaline phosphatase and lactic acid dehydrogenase in bmCRPC patients without significant PSA response under enzalutamide
Authors: Poteska Renata , Rahbar Kambiz , Semjonow Axel , Schrader Andres Jan , Boegemann Martin , Schlack Katrin 
Published: April 2022

Abstract
Background
In patients with bone metastatic castration-resistant prostate cancer (bmCRPC) on systemic treatment, it is difficult to differentiate between continuous rise of prostate specific antigen (PSA) representing progression, and PSA-surge, which is followed by clinical response or stable disease. The purpose of this study was to evaluate the prognostic value of dynamic changes of alkaline phosphatase (ALP) and lactic acid dehydrogenase (LDH) levels as a predictor of clinical efficacy or therapeutic resistance of patients who do not show a sufficient initial PSA decline of ≥50% from baseline during early therapy with Enzalutamide.

Methods
Forty-eight men with bmCRPC on Enzalutamide 07/2010-09/2019 with initially rising PSA were analyzed. We monitored PSA, LDH and ALP at week 0, 2, 4, and every 4 weeks thereafter and analyzed the correlation between ALP rising at 12 weeks with or without LDH-normalization and the association with survival. For this we used Kaplan Meier analysis and uni- and multivariate cox-regression models.

Results
In Kaplan-Meier analysis, ALP rising at 12 weeks with or without LDH-normalization was associated with significantly worse median progression-free survival (PFS) of 3 months vs. 5 months (Log rank P = 0.02) and 3 months vs. 5 months (P = 0.01), respectively and overall survival (OS) with 8 months vs. 15 months (P = 0.02) and 8 months vs. 17 months (P < 0.01). In univariate analysis of PFS, ALP rising at 12 weeks alone, ALP rising at 12 weeks without LDH-normalization and application of Enzalutamide after chemotherapy showed a statistically significant association towards shorter PFS (hazard ratio (HR): 0.51, P = 0.04; HR: 0.48, P = 0.03; HR: 0.48, P = 0.03). Worse OS was significantly associated with ALP rising at 12 weeks alone, ALP rising at 12 weeks without LDH-normalization, and application of Enzalutamide after chemotherapy (HR: 0.47, P = 0.02; HR: 0.36, P < 0.01; HR: 0.31, P < 0.01). In multivariate analysis only the application of Enzalutamide after chemotherapy remained an independent prognostic factor for worse OS (HR: 0.36, P = 0.01).

Conclusions
Dynamic changes of ALP (non-rise) and LDH (normalization) under therapy with Enzalutamide may be associated with clinical benefit, better PFS, and OS in patients with bmCRPC who do not show a PSA decline.
Are habitually barefoot children compelled to wear ill-fitting school shoes? A cross-sectional study
Authors: Breet Marise Carina , Venter Ranel 
Published: April 2022

Abstract
Background
Research shows that ill-fitting shoes can negatively impact the development of the pediatric foot, in a very direct manner. The primary aim of the study was to determine if the dimensions of available prescribed school shoes fit the foot dimensions of habitually barefoot South African children and adolescents.

Methods
A cross-sectional observational study was conducted where static standing foot measurements of children and adolescents from urban and rural schools were obtained with a mobile caliper. The maximum heel-toe-length and foot width with an added 10 mm toe- and width fit allowance to each participant, were compared to the corresponding school shoe length and shoe width available in retail. A mixed model ANOVA was used to compare foot dimensions between gender, age and side.

Results
Six hundred and ninety-eight school children (N = 698) (431 girls; 267 boys; average age 10.86 years, SD = 2.55) were participants. A total of seventy-seven (N = 77) black coloured prescribed school shoes currently available in retail ranging from different styles and brands were measured. Results show that, comparing the shoe length and maximum heel-toe-length of participants, as well as taking 10 mm toe allowance into account, fifty-nine percent (59%) of children wore shoes that were not the correct length. With regards to the shoe width and the added 10 mm of width fit allowance, ninety-eight percent (98%) of the shoes worn by participants were too narrow for their feet.

Conclusions
Results confirmed that school shoes currently available in retail, are not suited for the habitually barefoot population studied. It is recommended that the shoe manufacturing industry should consider the shoe width of school shoes for children and adolescents in habitually barefoot populations to avoid the long-term negative effect of ill-fitting shoes on the pediatric foot.
Does an active play standard change childcare physical activity and healthy eating policies? A natural policy experiment
Authors: Tugault-Lafleur Claire N. , Naylor Patti-Jean , Carson Valerie , Faulkner Guy , Lau Erica Y. , Wolfenden Luke , Mâsse Louise C. 
Published: April 2022

Abstract
Background
In 2017, the provincial government of British Columbia (BC) implemented a mandatory policy outlining Active Play Standards (AP Standards) to increase physical activity (PA) levels, sedentary and motor skills among children attending licensed childcare centers. Concurrently, a capacity-building initiative was launched to help implement policies and practices supporting both PA and healthy eating (HE) in the early years. This study evaluated differences in center-level PA and HE policies and practices before and after the enforcement of the new provincial AP Standards.

Methods
Using a repeat cross-sectional design, surveys were distributed to managers and staff of licensed childcare facilities serving children aged 2–5 years before (2016–2017 or ‘time 1’) and after (2018–2019 or ‘time 2’) implementation of the AP Standards across BC. The total sample included 1,459 respondents (910 and 549 respondents at time 1 and time 2, respectively). Hierarchical mixed effects models were used to examine differences in 9 and 7 PA/sedentary policies and practices, respectively, as well as 11 HE policies between time 1 and time 2. Models controlled for childcare size and area-level population size, education, and income.

Results
Compared to centers surveyed at time 1, centers at time 2 were more likely to report written policies related to: fundamental movement skills, total amount of Active Play (AP) time, staff-led AP, unfacilitated play/free play, total amount of outdoor AP time, limiting screen time, breaking up prolonged sitting, staff role modeling of PA, and training staff about PA (P < 0.01 for all 9 policies examined). Compared to time 1, centers at time 2 reported more frequent practices related to ensuring children engaged in at least 120 min of AP, 60 min of outdoor AP daily, and limiting screen time (P < 0.01 for 3 out of 7 practices examined). Despite no additional policy intervention related to HE, centers were more likely to report having written policies related to: HE education for children, encouraging new foods, having family-style meals, offering only milk or water, limiting the amount of juice served, staff role modeling of HE, limiting the types of foods at parties/celebrations and foods brought from home (P < 0.05 for 9 out of 11 HE policies).

Conclusion
Approximately a year after the implementation of a governmental policy targeting PA supported by a capacity-building initiative, childcare centers reported positive changes in all 9 PA/sedentary policies examined, all 3 out of 7 PA/sedentary practices and 9 out of 11 HE policies evaluated at the center-level.
Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study
Authors: Elshami Mohamedraed , Abukmail Hanan , Aqel Wafa , Alser Mohammed , Al-Slaibi Ibrahim , Shurrab Hanan , Qassem Shahd , Usrof Faten Darwish , Alruzayqat Malik , Nairoukh Roba , Mansour Ahmad , Kittaneh Rahaf , Sawafta Nawras , Habes Yousef M. N. , Ghanim Obaida , Aabed Wesam Almajd , Omar Ola , Daraghmeh Motaz , Aljbour Jomana , Elian Razan , Zuhour Areen , Habes Haneen , Al-Dadah Mohammed , Abu-El-Noor Nasser , Bottcher Bettina 
Published: April 2022

Abstract
Background
The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness.

Methods
Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0–4), fair (5–9), and good (10–14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection.

Results
Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was ‘worsening in an existing cough’(n = 3884, 81.6%) while the least recognized was ‘a cough that does not go away for two or three weeks’(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was ‘persistent tiredness or lack of energy’(n = 3205, 67.3%) while the least recognized was ‘persistent shoulder pain’(n = 1170, 24.6%).
A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers.

Conclusion
About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.
Retrospective clinical outcomes in the definitive treatment of high-energy tibial diaphyseal fractures using hexapod external fixator versus monolateral external fixator
Authors: Liu Yanshi , Liu Kai , Cai Feiyu , Zhang Xingpeng , Li Hong , Zhang Tao , Ma Chuang , Yusufu Aihemaitijiang 
Published: April 2022

AbstractBackgroundExternal fixation, which can preserve the biomechanical microenvironment of fracture healing, plays an important role in managing the high-energy fractures with poor surrounding soft tissues. The purpose of this study was to determine the differences of clinical outcomes, if any, between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures.MethodsA total of 53 patients with high-energy tibial diaphyseal fractures and definitively treated by the hexapod external fixator (HEF) or monolateral external fixator (MEF) were retrospectively collected and analyzed, from March 2015 to June 2019. There were 31 patients in the HEF treatment, and the other 22 patients were managed by the MEF. The demographic data, surgical duration, external fixation time, final radiological results, complications, and clinical outcomes were documented and analyzed. Difficulties that occurred during the treatment were classified according to Paley. The clinical outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit.ResultsThe mean surgical duration in the HEF group (62.4 ± 8.3 min) was shorter than that in the MEF group (91.4 ± 6.9 min) (P < 0.05). All patients acquired complete bone union finally. Patients in the HEF group (24.2 ± 3.1 weeks) underwent a shorter average external fixation time than that in the MEF group (26.3 ± 3.8 weeks) (P < 0.05). Satisfactory alignment was achieved in all patients without the need for remanipulation. The residual sagittal plane deformities in the HEF group were all less than that in the MEF group (P < 0.05). The complication rate was 35.5% in the HEF group, while 45.5% in the MEF group. There was no statistically significant difference between the two groups in ASAMI scores (P > 0.05).ConclusionThere is no statistically significant difference in finally clinical outcomes between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures. The hexapod external fixation treatment is a superior effective method, including advantages of stable fixation, less surgical duration, postoperatively satisfactory fracture reduction, and fewer complications.
Characteristics of the patellofemoral joint of patients with DDH and the effects of Bernese periacetabular osteotomy on the patellofemoral joint
Authors: Peng Jianping , Xiao Fei , Zhu Junfeng , Shen Chao , Li Yang , Han Xiuguo , Cui Yimin , Chen Xiaodong 
Published: April 2022

Abstract
Background
Some patients with developmental dysplasia of the hip (DDH) complained of anterior knee pain (AKP) before and after Bernese periacetabular osteotomy (PAO) surgery. The purpose of this study was to (1) identify the characteristics of patellofemoral joint (PFJ) deformities in patients with DDH and (2) to determine the effects of PAO on the PFJ.

Methods
Seventy patients (86 hips) were included in the DDH group. Thirty-three patients (33 knees) without AKP and hip pain were included in the control group. All patients underwent simultaneous CT scans of the hip and knee joints before PAO and after hardware removal surgery. The distance from the anterior inferior iliac spine to the ilioischial line (DAI), was measured in DDH patients. Imaging parameters of knees, including the sulcus angle (SA), femoral trochlear depth (FTD), patellar width (PW), tibial tuberosity-trochlear groove (TT-TG), patellar tilt angle (PTA) and lateral shift of the patella (LSP) were measured in patients in both the DDH and control group. TT-TG, PTA, and LSP of DDH patients were measured before PAO and after hardware removal. The DAI, PTA, LSP and TT-TG of all DDH patients before and after Bernese PAO were compared using paired t-tests. The FTD, PW, and SA of the DDH patients and the control group were analyzed using independent t-tests. PTA, TT-TG, and LSP between the control group and preoperative DDH patients, between the control group and post PAO patients were compared using independent t-tests.

Results
The DAI changed from 4.04 ± 0.61 mm before PAO surgery to 5.44 ± 0.63 mm after PAO surgery. The SA of the DDH group (140.69 ± 11.30 degree) was greater than that of the control group (130.82 ± 6.43 degree). The FTD and the PW of the DDH group (5.45 ± 1.59 mm, 4.16 ± 0.36 mm) were smaller than that of the control group (7.39 ± 1.20 mm, 4.24 ± 0.38 mm). The changes in LSP, PTA, and TT-TG before and after surgery were not statistically significant. Both before and after PAO, there was no statistically significant difference in the parameters of LSP, PTA, and TT-TG compared with the control group.

Conclusion
The knee joints of DDH patients presented a certain degree of femur trochlear groove dysplasia and patellofemoral instability. PAO surgery did not change PFJ stability, although the origination point of the rectus femoris muscle moved laterally during PAO surgery.
Evaluation and comparison of errors on nursing notes created by online and offline speech recognition technology and handwritten: an interventional study
Authors: Peivandi Sahar , Ahmadian Leila , Farokhzadian Jamileh , Jahani Yunes 
Published: April 2022

Abstract
Background
Despite the rapid expansion of electronic health records, the use of computer mouse and keyboard, challenges the data entry into these systems. Speech recognition software is one of the substitutes for the mouse and keyboard. The objective of this study was to evaluate the use of online and offline speech recognition software on spelling errors in nursing reports and to compare them with errors in handwritten reports.

Methods
For this study, online and offline speech recognition software were selected and customized based on unrecognized terms by these softwares. Two groups of 35 nurses provided the admission notes of hospitalized patients upon their arrival using three data entry methods (using the handwritten method or two types of speech recognition software). After at least a month, they created the same reports using the other methods. The number of spelling errors in each method was determined. These errors were compared between the paper method and the two electronic methods before and after the correction of errors.

Results
The lowest accuracy was related to online software with 96.4% and accuracy. On the average per report, the online method 6.76, and the offline method 4.56 generated more errors than the paper method. After correcting the errors by the participants, the number of errors in the online reports decreased by 94.75% and the number of errors in the offline reports decreased by 97.20%. The highest number of reports with errors was related to reports created by online software.

Conclusion
Although two software had relatively high accuracy, they created more errors than the paper method that can be lowered by optimizing and upgrading these softwares. The results showed that error correction by users significantly reduced the documentation errors caused by the software.
Using social network analysis methods to identify networks of physicians responsible for the care of specific patient populations
Authors: Flemming Ronja , Schüttig Wiebke , Ng Frank , Leve Verena , Sundmacher Leonie 
Published: April 2022

Abstract
Background
Coordinating health care within and among sectors is crucial to improving quality of care and avoiding undesirable negative health outcomes, such as avoidable hospitalizations. Quality circles are one approach to strengthening collaboration among health care providers and improving the continuity of care. However, identifying and including the right health professionals in such meetings is challenging, especially in settings with no predefined patient pathways. Based on the Accountable Care in Germany (ACD) project, our study presents a framework for and investigates the feasibility of applying social network analysis (SNA) to routine data in order to identify networks of ambulatory physicians who can be considered responsible for the care of specific patients.

Methods
The ACD study objectives predefined the characteristics of the networks. SNA provides a methodology to identify physicians who have patients in common and ensure that they are involved in health care provision. An expert panel consisting of physicians, health services researchers, and data specialists examined the concept of network construction through informed decisions. The procedure was structured by five steps and was applied to routine data from three German states.

Results
In total, 510 networks of ambulatory physicians met our predefined inclusion criteria. The networks had between 20 and 120 physicians, and 72% included at least ten different medical specialties. Overall, general practitioners accounted for the largest proportion of physicians in the networks (45%), followed by gynecologists (10%), orthopedists, and ophthalmologists (5%). The specialties were distributed similarly across the majority of networks. The number of patients this study allocated to the networks varied between 95 and 45,268 depending on the number and specialization of physicians per network.

Conclusions
The networks were constructed according to the predefined characteristics following the ACD study objectives, e.g., size of and specialization composition in the networks. This study shows that it is feasible to apply SNA to routine data in order to identify groups of ambulatory physicians who are involved in the treatment of a specific patient population. Whether these doctors are also mainly responsible for care and if their active collaboration can improve the quality of care still needs to be examined.