bluuebunny/crossref_metadata_2025_split huggingface dataset:
The rate of use of Veterans Affairs chiropractic care: a 5-year analysis
Authors: Burdick Ryan , Corcoran Kelsey L. , Zhao Xiwen , Lisi Anthony 
Published: January 2022

Abstract
Background
The US Department of Veterans Affairs (VA) has initiated various approaches to provide chiropractic care to Veterans. Prior work has shown substantial increase in use of VA chiropractic care between fiscal years (FY) 2005–2016. However, the extent of the availability of these services to the Veteran population remains unclear. The purpose of this study was to analyze the rate of Veteran use of VA chiropractic services, both from on-site care at VA facilities and VA purchased care from community care providers. This study analyzed facility characteristics associated with chiropractic use by both care delivery mechanisms (on-site and in the community).

Methods
Cross-sectional analyses of administrative data were conducted for FY 2014–2019. Data were obtained from VA’s Corporate Data Warehouse. The variables extracted included number of unique Veterans receiving VA chiropractic care on-site and in the community, total Veteran population of the VA facilities, size of the VA chiropractic workforce (measured as Full-Time Equivalent, FTE), and facility characteristics (geographic region and the facility complexity). Descriptive statistics, mixed model, and multivariant models were used to analyze data.

Results
Use of VA chiropractic care increased over the six-year period for both on-site and community care. National average for on-site use of the population was 1.27% in FY14 and 1.48% in FY19. Community care use was 0.29% and 1.76% for the same years. Use at individual facilities varied widely in each FY. Factors such as chiropractor FTE, geographic locations, and the complexity of the VA facility are associated with use of chiropractic services.

Conclusion
The VA has expanded the non-pharmacologic treatments available to Veterans by providing chiropractic services, yet chiropractic use remains low compared to other US populations. As Veterans have a high prevalence of pain and musculoskeletal conditions, continued work to assess and achieve the optimal levels of chiropractic use in this population is warranted.
Irradiation-induced nasopharyngeal necrosis (INN) in newly diagnosed nasopharyngeal carcinoma treated by intensity-modulated radiation therapy: clinical characteristics and the influence of treatment strategies
Authors: Xu Yi , Liu Yang , Wang Zekun , Wang Jingbo , Zhang Jianghu , Chen Xuesong , Wu Runye , Liu Qingfeng , Qu Yuan , Wang Kai , Huang Xiaodong , Luo Jingwei , Gao Li , Xu Guozhen , Zhang Ye , Yi Junlin 
Published: January 2022

Abstract
Purpose
To define the clinical characteristics of irradiation-induced nasopharyngeal necrosis (INN) after intensity-modulated radiotherapy (IMRT) and identify the influence of treatment strategies on INN in primary nasopharyngeal carcinoma (NPC) patients.

Patients and methods
From 2008 to 2019, NPC patients pathologically diagnosed with INN after primary IMRT were reviewed. Those patients were matched with propensity scores for patients without INN in our center. The impact of treatment strategies on INN occurrence was assessed using univariate and multivariate logistic regression analysis.

Results
The incidence rate of INN was 1.9% among the primary NPC population, and 53 patients with INN were enrolled. Headache and foul odor were the main symptoms, and 71.7% of cases had pseudomembrane during or at the end of radiotherapy. All patients were in early or middle stage INN, and no one presented with skull-based osteoradionecrosis. Then 212 non-INN patients were included based on propensity scores match. Overall survival (p = 0.248) and progression-free survival (p = 0.266) curves were similar between the INN and non-INN groups. Treatment strategies including combining chemotherapy or molecular targeted therapy with radiotherapy were not associated with INN occurrence, while boost dose (OR 7.360; 95% CI 2.301–23.547; p = 0.001) was a predictor factor for it. However, the optimal threshold for an accumulated dose to predict INN's occurrence was failed to determine.

Conclusion
In the IMRT era, the severity of INN in primary NPC patients is lessened. This study showed that treatment strategies contributed little to develop INN, while the accumulated dose of radiation may relate to its occurrence.
Maximum isometric torque at individually-adjusted joint angles exceeds eccentric and concentric torque in lower extremity joint actions
Authors: Stotz Andreas , Maghames Ebrahem , Mason Joel , Groll Andreas , Zech Astrid 
Published: January 2022

Abstract
Background
Previous research indicates the high relevance of optimal joint angles for individual isometric strength assessment. The objective was to compare lower limb peak isometric muscle strength abilities at the strongest joint angles with those of dynamic contractions in healthy young adults.

Methods
Eighteen young male adults performed maximum concentric, isometric, and eccentric contractions of the ankle, knee, and hip flexors and extensors, and hip adductors and abductors in a randomized sequence on an isokinetic dynamometer (ISOMED 2000). Angular velocity was set at 60°/s. The peak of concentric contraction torque curves was used to define optimal joint angles best suited to generate maximum torque during isometric contractions. Maximum voluntary contraction torque of all contraction conditions was adjusted for limb weight and analyzed via a generalized linear mixed gamma regression model (GLMM).

Results
The gamma GLMM revealed strongly significant effects for all three categorical covariates (contraction types, muscle group, and test order) ($$p < 2 \times 10^{ - 16}$$

p
<
2
×

10

-
16

). Eccentric contraction increases the muscle torque ($$\hat{\beta }_{k} = 0.147$$

β
^

k

=
0.147

) compared to concentric contraction, and isometric contraction even more ($$\hat{\beta }_{k} = 0.258$$

β
^

k

=
0.258

). A moderate individual-specific variation was found (random effects standard deviation $$\sigma_{b} = 0.093$$

σ
b

=
0.093

).

Conclusion
The results support the importance of optimal joint angles for isometric maximum strength assessment. When such conditions are given, isometric contractions can produce higher muscle torques than eccentric contractions in the lower body.
Differences in the muscle activities of the quadriceps femoris and hamstrings while performing various squat exercises
Authors: Lee Joo-Hyun , Kim Soojin , Heo Jihye , Park Dong-Ho , Chang Eunwook 
Published: January 2022

Abstract
Background
Knee injuries in the lower limbs frequently occur, and lower limb muscles need to be strengthened to reduce injuries. Activating muscles can help strengthen muscles.. This study aimed to determine the squat exercises [general squat (GS), wall squat (WS), and Spanish squat (SS)] that effectively increased muscle activity using electromyography (EMG).

Methods
In this cross-sectional study, 22 participants performed three different squat exercises with EMG attached to the rectus femoris (RF), vastus lateralis (VL), vastus medialis, biceps femoris, semitendinosus, and semimembranosus. The Kruskal–Wallis H test was used to compare thigh muscle activities among the various squat exercises.

Results
During SS, RF showed greater muscle activation compared to WS and GS (RF: χ2 = 21.523, p = 0.000, η2 = 0.333). VL also showed greater muscle activation during SS compared to WS (VL: χ2 = 7.101, p = 0.029, η2 = 0.109).

Conclusions
The results from this study indicate that SS shows more activation in the RF and VL muscles compared to GS and WS. These findings suggest that SS can provide more muscle activation for the RF and VL muscles and will greatly help those who lack muscle activation in these muscles.
Complex effects of different types of acid rain on root growth of Quercus acutissima and Cunninghamia lanceolata saplings
Authors: Liu Xin , Ma Shilin , Jia Zhaohui , Ramzan Muhammad , Meng Miaojing , Wang Jinping , Li Chong , Zhang Yinlong , Zhang Jinchi 
Published: January 2022

Abstract
Background
Soil acidification caused by acid rain (AR) can damage plant roots, which in turn negatively impacts plant health. In response to changing AR types, research efforts to elucidate their specific impacts on plants have become intense.

Methods
For this study, we investigated the effects of simulated sulfuric, nitric, and mixed AR on the root systems of Quercus acutissima Carr. and Cunninghamia lanceolata (Lamb.) Hook. under different acidity levels.

Results
As the AR S/N ratio and pH decreased, the height growth rate (HGR), basal diameter growth rate (DGR), total root length (TRL) and total root surface area (TRS) of C. lanceolata decreased, whereas the TRL and TRS of Q. acutissima remained the same. When the NO3− concentration in AR was increased, the root activity, superoxide dismutase (SOD) and catalase (CAT) activities of C. lanceolata roots revealed a downward trend; however, the root activity of Q. acutissima and the peroxidase (POD) activity of C. lanceolata roots revealed an upward trend. Further, redundant analysis and structural equation models indicated that AR pH had a greater impact on the HGR of Q. acutissima than that of C. lanceolata, while the impact of the AR S/N ratio on C. lanceolata growth rates was greater than that of Q. acutissima.

Conclusions
Our results suggested that the root systems of different tree species had variable responses to AR, and the AR S/N ratio was an important factor affecting plant root growth. This might facilitate new strategies for the cultivation and protection of plantations in the future.
Abiotic drivers shape seed inputs and outputs in a tropical wetland on Croton trinitatis population
Authors: Bao Francielli , Pott Arnildo , Villa Pedro Manuel 
Published: January 2022

Abstract
Background
Predicting how natural and anthropogenic drivers shape different ecological indicators, such as plant populations along environmental gradients, can be a relevant tool for establishing management and conservation criteria of tropical wetlands. We aimed to assess the effects of seasonal flood disturbance, type of grasslands and topographical conditions on Croton trinitatis population distribution in a tropical wetland.

Methods
The study was carried out in a seasonally flooded grassland (Central-West Brazil). We conducted samplings of soil on the dry and flood hydrophases of the Pantanal. We took the samples in eight seasonal ponds, with 1 km interval between them. Transects were marked during the flood period, observing the water level, one in the lowest zone, in the middle of the pond = low (ca. 60 cm deep), one at the pond edge = mid (ca. 30 cm deep) and one in the higher zone, on the external part = high (ca. 1 cm deep).

Results
The results showed that the topography, seasonality, and types of grassland determine differences in the abundance patterns of adult plants and seedlings, and seed bank and seed predation. The abiotic factors can shape plant population-related ecological processes and patterns, with outputs (germination and predation) and inputs (local dispersion and from neighbouring areas) of proportional seeds for the population maintenance in this environment.

Conclusion
We emphasize the importance of these findings, to show that abiotic factors are not the only ones to be considered in ecological studies of distribution and structuring of populations in habitats with extreme seasonal events.
Phenotype-genotype correlations among carbapenem-resistant Enterobacterales recovered from four Egyptian hospitals with the report of SPM carbapenemase
Authors: Abdelaziz Neveen A. 
Published: January 2022

Abstract
Background
Carbapenem-resistant Enterobacterales (CRE), currently listed by the World Health Organization (WHO) as top priority critical pathogens, are a major global menace to human health. In low- and middle-income countries (LMICs) the threat is mounting fueled by selective pressures caused by antibiotic abuse and inadequate diagnostic resources.

Methods
This study phenotypically and genotypically characterized carbapenem resistance among 115 Enterobacterales isolates including 76 Klebsiella (K.) pneumoniae, 19 Escherichia (E.) coli, 14 Shigella (S.) sonnei, 5 Enterobacter (E.) cloacae, and 1 Proteus (P.) mirabilis.

Results
Ninety-three isolates (80.9%) were carbapenem-resistant with an alarming 57.5% carbapenem non-susceptibility in isolates collected from the outpatient department. Molecular characterization of the carbapenemases (CPases) encoding genes showed that blaNDM (80.5%) was the most prevalent; it was detected in 62 isolates (54 K. pneumoniae, 6 E. coli and 2 S. sonnei), followed by blaVIM (36.4%) which was observed in 28 isolates (24 K. pneumoniae, 3 E. coli and 1 E. cloacae). Other CPases included blaKPC (28.6%; in 20 K. pneumoniae, 1 E. coli and 1 S. sonnei), blaOXA-48 (26%; in 17 K. pneumoniae, 1 E. coli,1 E. cloacae and 1 P. mirabilis), blaIMP (6.5%; in 5 K. pneumoniae) and blaSPM (1.3%; in K. pneumoniae). Notably more than half of the Enterobacterales isolates (54.5%) co-harboured more than one CPase-encoding gene. Co-existence of blaNDM and blaVIM genes was the most dominant (31.2%), followed by association of blaNDM and blaKPC (24.7%), then blaVIM and blaKPC (13%). Moreover, the effects of different genotypes on meropenem MIC values were assessed, and a statistically significant difference between the genotype (Ambler classes A and B) and the genotype (Ambler classes B and D) was recorded.

Conclusion
The current findings may serve for a better understanding of the context of CRE in Egypt, associated drivers and CPases.
Interrelation between grid systems and star polygons of muqarnas ground projection plans
Authors: Agirbas Asli , Yildiz Gulnur , Sahin Murat 
Published: January 2022

Abstract
Many muqarnas ground projection plans contain stars with unequal edge lengths in their compositions. In this study, the geometric reasons behind the unequality of star edge lengths in muqarnas ground projection plans have been searched. The main gates with complex-looking muqarnas belonging to the period of Suleiman the Magnificent (Kanuni Sultan Suleyman), designed by Architect Sinan in Istanbul, have been selected to examine. From the data obtained by 3D laser scanning and from the verification made, it has been confirmed that there are stars with unequal edge lengths in these muqarnas plans. From the geometrical examinations made according to the shape grammar theory, it was concluded that the muqarnas plans were created using spider-web grid and square grid layouts. It was also concluded that these grid types cause some of the star edge lengths to be unequal.
Plastic film mulching with ridge planting alters soil chemical and biological properties to increase potato yields in semiarid Northwest China
Authors: Shi Mingfu , Kang Yichen , Zhang Weina , Yang Xinyu , Fan Yanling , Yu Huifang , Zhang Ruyan , Guo Aixia , Qin Shuhao 
Published: January 2022

Abstract
Background
The growth of potato (Solanum tuberosum L.) is severely affected by the complex and variable soil environment, and film mulching has been widely used for potato growth in semiarid areas of western China. However, there are few studies on the effects of film mulching on soil quality and tuber yield in potato fields.

Methods
The effects of four mulching patterns (flat plot without film mulching, FP; flat plot with film mulching, FPM; ridge planting with half mulch, RPHM; ridge planting with full mulch, RPFM) on soil chemical and biological properties and potato tuber yield were investigated during two growing seasons (2018 and 2019) in the field.

Results
The results showed that compared with FP, the mulching treatments significantly increased the tuber yield of potato, with an increase of 3.7–20.77% and 7.89–26.35% in 2018 and 2019, respectively, and the yield of RPFM was higher than that of other treatments. In both growing seasons, RPFM significantly increased the contents of alkali-hydrolyzed N and available P, and the activities of soil urease, catalase, alkaline phosphatase, and sucrase. Bacterial and actinomycete counts were significantly higher in RPFM than those in the other treatments. Furthermore, RPFM significantly increased large potatoes and decreased small potatoes. Pearson’s correlation analysis revealed that soil alkaline dissolved nitrogen and actinomycete populations were the main factors affecting potato yield formation.

Conclusions
These results indicate that RPFM can improve the soil environment and further increase potato tuber yield, which is a viable option for potato production in semiarid areas.

Graphical Abstract
Nevertheless, the importance of coagulation abnormalities should be emphasized in international sepsis guidelines
Authors: Iba Toshiaki , Nishida Osamu , Levy Jerrold H. , Levi Marcel 
Published: January 2022

AbstractIt is generally accepted that a coagulation/fibrinolysis disorder is involved in the pathogenesis of sepsis, and the association of disseminated intravascular coagulation (DIC) and poor outcomes have been reported. Based on these findings, recently released “Japanese Surviving Sepsis Campaign guidelines 2020” recommend the diagnosis of DIC and the application of anticoagulants for sepsis-associated DIC. Meanwhile, the updated “International Guidelines for the Management of Sepsis and Septic Shock 2021” did not mention coagulation abnormalities or DIC. Because management strategies continue to evolve to provide improved outcomes in sepsis, the role of adjunctive anticoagulant treatment should be included in subsequent international guidelines.
Salvage surgery following immuno-chemo-radiotherapy for advanced non-small cell lung cancer
Authors: Nawashiro Ayako , Tanaka Fumihiro , Taira Akihiro , Shinohara Shinji , Takenaka Masaru , Kuroda Koji , Shimajiri Shohei 
Published: January 2022

Abstract
Background
Salvage surgery following definitive radiotherapy or systemic treatment has become a feasible treatment option in selected patients with advanced initially unresectable non-small cell lung cancer. Recent clinical trials of neoadjuvant treatment have showed that surgery following immuno-chemotherapy is safely performed. Here, we present the first case of salvage surgery following immuno-chemotherapy with concurrent definitive radiotherapy for advanced lung large cell carcinoma.

Case presentation
A 44-year male was admitted to our hospital for salvage surgery. Ten months prior to this administration, he had been diagnosed with unresectable large cell carcinoma with malignant pericardial effusion (clinical stage IVA/T3N2M1A; no driver-gene alteration) originating from the right upper lobe (RUL). Due to rapid intrabronchial tumor growth causing severe dyspnea, emergency bronchial stenting in the right main bronchus using an expandable metallic stent had been performed. Thereafter, he had received immuno-chemotherapy with concurrent definitive radiotherapy. Despite dramatic radiographic response, he had suffered from persistent and refractory Pseudomonas aeruginosa lung infection associated with bronchial stent placement. As pericardial effusion had disappeared and no distant metastasis had developed, he was diagnosed with a potentially curable disease and was referred to our hospital. An extended sleeve resection was successfully performed, and pathological sections revealed that pathologic complete response was achieved with immuno-chemo-radiotherapy. The patient received no subsequent treatment, and is alive without tumor recurrence at 8 months after surgery.

Conclusions
Salvage surgery following immuno-chemotherapy with concurrent definitive radiotherapy for advanced non-small cell lung cancer may be feasible in selected patients, and may be considered as a treatment option to control local disease.
Development and Validation of a Predictive Model of Severe Fatigue After Breast Cancer Diagnosis: Toward a Personalized Framework in Survivorship Care
Authors: Di Meglio Antonio , Havas Julie , Soldato Davide , Presti Daniele , Martin Elise , Pistilli Barbara , Menvielle Gwenn , Dumas Agnes , Charles Cecile , Everhard Sibille , Martin Anne-Laure , Coutant Charles , Tarpin Carole , Vanlemmens Laurence , Levy Christelle , Rigal Olivier , Delaloge Suzette , Lin Nancy U. , Ganz Patricia A. , Partridge Ann H. , André Fabrice , Michiels Stefan , Vaz-Luis Ines 
Published: January 2022

PURPOSE Fatigue is common and troublesome among breast cancer survivors; however, limited tools exist to predict its risk. PATIENTS AND METHODS Participants with stage I-III breast cancer were prospectively included from CANTO (ClinicalTrials.gov identifier: NCT01993498 ), collecting longitudinal data at diagnosis (before the initiation of any cancer treatment) and 1 (T1), 2 (T2), and 4 (T3) years after diagnosis. The main outcome was severe global fatigue at T2 (score ≥ 40/100, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30). Analyses at T3 were exploratory. Secondary outcomes included physical, emotional, and cognitive fatigue (EORTC Quality of Life Questionnaire-FA12). Multivariable logistic regression models retained associations with severe fatigue by bootstrapped Augmented Backward Elimination. Validation methods included 10-fold internal cross-validation, overoptimism-corrected area under the receiver operating characteristic curves, and external validation. RESULTS Among 5,640, 5,000, and 3,400 patients at T1, T2, and T3, respectively, the prevalence of post-treatment severe global fatigue was 35.6%, 34.0%, and 31.5% in the development cohort. Retained risk factors for severe global fatigue at T2 were severe pretreatment fatigue (adjusted odds ratio v no 3.191 [95% CI, 2.704 to 3.767]); younger age (for 1-year decrement 1.015 [1.009 to 1.022]), higher body mass index (for unit increment 1.025 [1.012 to 1.038]), current smoking behavior ( v never 1.552 [1.291 to 1.866]), worse anxiety ( v noncase 1.265 [1.073 to 1.492]), insomnia (for unit increment 1.005 [1.003 to 1.007]), and pain at diagnosis (for unit increment 1.014 [1.010 to 1.017]), with an area under the receiver operating characteristic curve of 0.73 (95% CI, 0.72 to 0.75). Receipt of hormonal therapy was a risk factor for severe fatigue at T3 ( v no 1.448 [1.165 to 1.799]). Dimension-specific risk factors included body mass index for physical fatigue and emotional distress for emotional and cognitive fatigue. CONCLUSION We propose a predictive model to assess fatigue among breast cancer survivors, within a personalized survivorship care framework. This may help clinicians to provide early management interventions or to correct modifiable risk factors and offer more tailored monitoring and education to patients at risk of severe post-treatment fatigue.