bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foreign allometric exponents adequately normalize isokinetic knee extension strength to identify muscle weakness and mobility limitation in Portuguese older adults: a cross-sectional study
Authors: Machado Dalmo Roberto Lopes , Abdalla Pedro Pugliesi , Bohn Lucimere , Stratton Gareth , Mota Jorge 
Published: September 2022

Abstract
Background
Identifying muscle weakness is challenging, because the reduction of strength with aging does not depend only on sarcopenia, but also on sensorimotor deficits. Nevertheless, this identification is improved by adjusting muscle strength allometrically, by removing the influence of body size. However, the effectiveness of foreign models to normalize these (dys)functionalities is not yet tested. This study aimed to compare and apply foreign allometric exponents for normalizing isokinetic knee extension strength in Portuguese older adults to identify muscle weakness/mobility limitation. Additionally, to attest any populational difference, data of these people and Brazilian older adults were compared

Methods
This is a cross-sectional study encompassing 226 Portuguese (n = 132) and Brazilian (n = 94) older adults. Mobility limitation (six-minute walk test, at lowest quartile), lower limb strength (knee extension isokinetic strength at 60º/s), and body dimensions measures were taken. Foreign allometric exponents (b) were used to normalize Portuguese strength (strength/body-size variablesb). Non-normalized and normalized strength were compared (ROC) to generate the most accurate cut-point for identifying muscle weakness/mobility limitation.

Results
Older Portuguese men and women had better mobility than their Brazilian counterparts. Older Portuguese women had superior muscle strength to Brazilian women. Normalization from 11 foreign models removed the influence of body size on muscle strength, with a negligible correlation (r ≤ 0.30). In contrast to the non-normalized strength, the normalized strength cut-off points were sufficiently accurate (AUC ≥ 0.70) to avoid identifying false-negative cases of weakness/mobility limitation.

Conclusions
Portuguese older women were stronger and had superior functional capacity compared to Brazilian ones. Normalized foreign models improved the accuracy in identifying muscle weakness/mobility limitation in Portuguese older adults. The isokinetic knee extension muscle strength normalized, even using foreign allometric exponents, should be better than no adjustment.
Association between previous spontaneous abortion and preeclampsia: a case–control study
Authors: Mohamedain Ahmed , Rayis Duria A. , AlHabardi Nadiah , Adam Ishag 
Published: September 2022

Abstract
Background
The association between previous spontaneous abortion and preeclampsia is not yet fully understood. The current study was conducted to assess the association between previous spontaneous abortion and preeclampsia among pregnant women in Sudan.

Methods
A case–control study (involving 180 women in each study group) was conducted at Saad Abuelela Hospital, Khartoum, Sudan. The cases were pregnant women with preeclampsia, while the control group included healthy pregnant women. The participants’ sociodemographic, obstetric, and clinical characteristics were assessed via a questionnaire.

Results
There was no significant difference in the age, parity, education level, employment status, blood group, body mass index, and hemoglobin level between the patient and control groups. Forty (22.2%) women with preeclampsia and 68 (37.8%) women in the control group had a history of spontaneous abortion (p = 0.001).
Multivariate logistic regression analysis (adjusted) revealed that women with a history of spontaneous abortion had a lower risk of preeclampsia than those without a history of spontaneous abortion [adjusted odds ratio (AOR) = 0.44, 95% confidence interval (CI) = 0.26‒0.73]. However, women with a history of preeclampsia had a higher risk of recurrence of preeclampsia (AOR = 1.92, 95% CI = 1.11‒3.32).

Conclusion
The present study revealed that previous spontaneous abortion reduced the risk of preeclampsia by 59.0%.
The effect of educational intervention based on theory of planned behavior on mothers’ skills in sexual care of children
Authors: Jeihooni Ali Khani , Moradi Arman , Yari Asiyeh , Kiyani Amin , Hasirini Pooyan Afzali 
Published: September 2022

Abstract
Background
The parent’s and especially the mothers’ skills play a major role in the the education of healthy sexual behaviors in children. This study investigates the effect of educational intervention based on the Theory of Planned Behavior (TPB) on mothers’ skills in the sexual care of children in Fasa city, Fars province, Iran in 2019.

Methods
This study was a quasi-experimental intervention with a control group. 200 mothers of children aged 5 to 6 years in Fasa preschool were selected using a multi-stage random sampling method and were divided into two groups of intervention (100) and control (100). After providing a pre-test to both groups, only the experimental group received training on sexual care of children's abilities based on the Theory of Planned Behavior constructs. The educational intervention consisted of seven 55–60-minute sessions in which the presenter gave a presentation, asked and answered questions, and used posters, brochures, films, animations, and PowerPoints. Both groups completed the questionnaire three months following the intervention. A questionnaire and Theory of planned behavior constructs were used to collect information. The data was analyzed with SPSS22 software using paired t-tests, Chi-square tests, and independent t-tests, with a significance level of 0.05.

Results
Before the intervention, there was no significant difference in the constructs of theTheory of planned behavior between the two groups (p>0.05), but after the intervention, knowledge scores from 8.33±2.97 to 20.67±2.84, attitude scores from 29.80±4.27 to 62.22±4.34, subjective norms from 20.12±4.55 to 42.28±4.20, perceived behavioral control from 20.24±4.36 to 42.88±4.52, behavioral intention from 3.24±1.60 to 7.44±1.59 and behavior from 2.98±1.13 to 8.14±1.08 in the intervention group (p< 0.001).

Conclusion
This study showed TPB constructs’ Effectiveness in adopting the level of mothers’ skills in the sexual care of children. Hence, this model can act as a framework for designing and implementing educational interventions for the sexual care of children.
Comparison of ROX index (SpO2/FIO2 ratio/respiratory rate) with a modified dynamic index incorporating PaO2/FIO2 ratio and heart rate to predict high flow nasal cannula outcomes among patients with acute respiratory failure: a single centre retrospective study
Authors: Kansal Amit , Ong Wei Jun Dan , Dhanvijay Shekhar , Siosana Arbe Tisha Pepito , Padillo Loraine Mae , Tan Chee Keat , Gulati Kansal Monika , Khan Faheem Ahmed 
Published: September 2022

Abstract
Background
High flow nasal cannula (HFNC) is increasingly being used to support patients with acute respiratory failure (ARF) and to avoid need for intubation. However, almost one third of the patients do not respond and require escalation of respiratory support. Previously, ROX index (SpO2/FIO2 [SF] ratio/respiratory rate) has been validated among pneumonia patients to facilitate early recognition of patients likely to fail HFNC and therefore, benefit from timely interventions. However, it has been postulated that incorporation of PaO2/FIO2 (PF) ratio from arterial blood gas (ABG) analysis may better predict the outcome of HFNC compared to indices that utilizes SF ratio. Similarly, heart rate increase after HFNC therapy initiation has been found to be associated with HFNC failure. Therefore, we aimed to compare ROX index with a new modified index to predict HFNC outcomes among ARF patients.

Materials and methods
This single centre 2-year retrospective study included ARF patients of varying etiologies treated with HFNC. The modified index incorporated heart rate and substituted PF ratio for SF ratio in addition to respiratory rate. We named the index POX-HR and calculated Delta POX-HR index as the difference pre- and post-HFNC initiation POX-HR. We also recorded ROX index at the time when post-HFNC initiation ABG was done (‘post-HFNC initiation ROX’) and calculated Delta ROX. HFNC success was defined as no need of escalation of respiratory support or discharged to ward within 48 h of HFNC initiation, or successful wean off HFNC for at least 12 h. Evaluation was performed using area under the receiver operating characteristic curve (AUROC) and cut-offs assessed for prediction of HFNC outcomes.

Results
One hundred eleven patients were initiated on HFNC for ARF, of whom 72 patients (64.9%) had HFNC success. Patients with HFNC failure had significantly lower values for all the indices. At median of 3.33 h (IQR 1.48–7.24 h), Delta POX-HR demonstrated the best prediction accuracy (AUROC 0.813, 95% CI 0.726–0.900). A Delta POX-HR > 0.1 was significantly associated with a lower risk of HFNC failure.

Conclusions
Our proposed modified dynamic index (Delta POX-HR) may facilitate early and accurate prediction of HFNC outcomes compared to ROX index among ARF patients of varied etiologies.
Effect of surface treatments on biaxial flexural strength, fatigue resistance, and fracture toughness of high versus low translucency zirconia
Authors: Elraggal Alaaeldin , Aboushelib Moustafa , Abdel Raheem Islam M. , Afifi Rania R. 
Published: September 2022

Abstract
Background
Mechanical surface treatments can deteriorate the mechanical properties of zirconia. This study evaluated and compared the biaxial flexural strength, fracture toughness, and fatigue resistance of high translucency (HT) to low translucency (LT) zirconia after various mechanical surface treatments.

Methods
Four hundred eighty zirconia discs were prepared by milling and sintering two HT (Katana and BruxZir) and LT (Cercon and Lava) zirconia blocks at targeted dimensions of 12 mm diameter × 1.2 mm thickness. Sintered zirconia discs received one of the following surface treatments: low-pressure airborne particle abrasion (APA) using 50 µm alumina particles, grinding using 400 grit silicon carbide paper, while as-sintered specimens served as control. Internal structure and surface roughness were evaluated by scanning electron microscope (SEM) and a non-contact laser profilometer, respectively. Half of the discs were tested for initial biaxial flexural strength, while the rest was subjected to 106 cyclic fatigue loadings, followed by measuring the residual biaxial flexural strength. Fractured surfaces were examined for critical size defects (c) using SEM to calculate the fracture toughness (KIC). The effect of surface treatments, zirconia type, and cyclic fatigue on the biaxial flexural strength was statistically analyzed using three-way analysis of variance (ANOVA) and Tukey HSD post hoc tests (α = 0.05). Weibull analysis was done to evaluate the reliability of the flexural strength for different materials.

Results
The initial biaxial flexural strength of LT zirconia was significantly higher (p < 0.001) than that of HT zirconia in all groups. While low APA significantly increased the biaxial flexural strength of LT zirconia, no significant change was observed for HT zirconia except for Katana. Surface grinding and cyclic fatigue significantly reduced the flexural strength of all groups. High translucency zirconia reported higher fracture toughness, yet with lower Weibull moduli, compared to LT zirconia.

Conclusion
LT zirconia has higher biaxial flexural strength, yet with lower fracture toughness and fatigue resistance, compared to HT zirconia. Low-pressure APA has significantly increased the biaxial flexural strength in all zirconia groups except BruxZir. Grinding was deteriorating to biaxial flexural strength and fracture toughness in all zirconia types. Cyclic fatigue has significantly decreased the biaxial flexural strength and reliability of HT and LT zirconia.
Evaluation of salivary parameters and Streptococcus’ Mutans count in children with cerebral palsy in Egypt: a case control study
Authors: Quritum Sara M. , Ali Amel M. , Raouf May M. , Omar Tarek E. I. , Dowidar Karin M. L. 
Published: September 2022

Abstract
Background
Children with cerebral palsy (CP) are at high risk for dental caries. Alteration of some salivary properties encountered among them compared to healthy children, could play a role in this elevated risk.

Objectives
The aim of the present study was to assess salivary physicochemical properties; including total antioxidant (TAC), flow rate, viscosity, pH and buffering capacity, as well as Streptococcus mutans level among children with CP, also to correlate these variables to their caries experience.

Materials and methods
This case control study included 80 children with CP, study group (SG) and matched number of healthy children for control group (CG). Interview-based questionnaire, clinical examination, salivary biochemical and microbiological investigations using MALDI-TOF were done.

Results
In SG, the caries experience in primary teeth dmft and S. mutans log value were significantly higher than CG (P = 0.039, P = 0.002) while unstimulated salivary flow rate, buffering capacity and salivary TAC were significantly lower (P < 0.0001). Multivariate linear regression showed that the presence of CP was significantly associated with the greatest variation in caries experience in the primary teeth and permanent teeth. Higher unstimulated salivary flow rate, or an increase in buffering capacity by 1 ml of acid/ml of saliva were associated with lower number of the affected primary and permanent teeth. On the other hand, One-unit increase in S. mutans log count and higher salivary TAC were associated with higher caries experience.

Conclusion
Children with CP have higher caries experience (dmf) due to lower salivary protective factors and higher S. mutans counts.
Physicians’ legal knowledge of informed consent and confidentiality. A cross-sectional study
Authors: Plaiasu Maria Cristina , Alexandru Dragos Ovidiu , Nanu Codrut Andrei 
Published: September 2022

Abstract
Background
Only a few studies have been conducted to assess physicians’ knowledge of legal standards. Nevertheless, prior research has demonstrated a dearth of medical law knowledge. Our study explored physicians’ awareness of legal provisions concerning informed consent and confidentiality, which are essential components of the physician-patient relationship of trust.

Methods
A cross-sectional study assessed attending physicians’ legal knowledge of informed consent and confidentiality regulations. The study was conducted in nine hospitals in Dolj County, Romania. Physicians were given a questionnaire with ten scenarios and instructed to select the response that best reflected their practice. We assessed the responses of physicians who claimed their practice to be entirely legal. Their legal knowledge was evaluated by comparing their answers to applicable laws. We also calculated a score for the physicians who admitted to committing a legal breach.

Results
Of the 305 respondents, 275 declared they never committed any law violation. However, their median correct answer score was 5.35 ± 1.66 out of 10. The specialty was the strongest predictor of legal knowledge, with emergency physicians rating the lowest and non-surgical physicians scoring the highest. Physicians who worked in both private and public sectors were better knowledgeable about legal issues than those who worked exclusively in the public sector. Results indicate that physicians are aware of the patient’s right to informed consent but lack comprehensive understanding. While most physicians correctly answered simple questions, only a tiny minority identified the correct solution when confronted with ethical dilemmas. The physicians who acknowledged breaching the law, on the other hand, had a slightly higher knowledge score at 5.45 ± 2.18.

Conclusion
Legal compliance remains relatively low due to insufficient legal awareness. Physicians display limited awareness of legal requirements governing patient autonomy, confidentiality, and access to health data. Law should be taught in all medical schools, including undergraduate programs, to increase physicians’ legal knowledge and compliance.
Investigation of foot and mouth disease virus and other animal pathogens in cattle, buffaloes and goats at the interface with Akagera National Park 2017 – 2020
Authors: Udahemuka Jean Claude , Aboge Gabriel , Obiero George , Ingabire Angélique , Beeton Natasha , Uwibambe Evodie , Lebea Phiyani 
Published: September 2022

Abstract
Background
Foot-and-Mouth Disease Virus (FMDV) is a positive-sense RNA virus of the family of the picornaviridæ that is responsible for one of the livestock diseases with the highest economic impact, the Foot-and-Mouth Disease (FMD). FMD is endemic in Rwanda but there are gaps in knowing its seroprevalence and molecular epidemiology. This study reports the FMD seroprevalence and molecular characterization of FMDV in Eastern Rwanda.

Results
The overall seroprevalence of FMD in the study area is at 9.36% in cattle and 2.65% in goats. We detected FMDV using molecular diagnostic tools such as RT-PCR and RT-LAMP and the phylogenetic analysis of the obtained sequences revealed the presence of FMDV serotype SAT 2, lineage II. Sequencing of the oropharyngeal fluid samples collected from African buffaloes revealed the presence of Prevotela ruminicola, Spathidium amphoriforme, Moraxella bovoculi Onchocerca flexuosa, Eudiplodinium moggii, Metadinium medium and Verrucomicrobia bacterium among other pathogens but no FMDV was detected in African buffaloes.

Conclusions
We recommend further studies to focus on sampling more African buffaloes since the number sampled was statistically insignificant to conclusively exclude the presence or absence of FMDV in Eastern Rwanda buffaloes. The use of RT-PCR alongside RT-LAMP demonstrates that the latter can be adopted in endemic areas such as Rwanda to fill in the gaps in terms of molecular diagnostics. The identification of lineage II of SAT 2 in Rwanda for the first time shows that the categorised FMDV pools as previously established are not static over time.
Case report: genetic analysis of a child with 18q deletion syndrome and developmental dysplasia of the hip
Authors: Yu Shufeng , Wang Caixia , Lei Ke , Leng Xuefei , Zhang Lijuan , Tian Fei , Chen Zhihong 
Published: September 2022

Abstract
Objective
To analyze the genotypes and phenotypes of a child with developmental dysplasia of the hip (DDH), developmental delays, recurrent fever, hypothyroidism and cleft palate.

Methods
G-banding karyotyping analysis and next-generation sequencing (NGS) were performed for the patient. The genotypes of the parents of the patient were verified by copy number variation analysis and Sanger sequencing to determine the source of variations.

Results
The karyotype of the patient was 46, XX. A 10.44 Mb deletion (chr18:67562936-78005270del) at 18q22.2q23 was found by NGS. We identified 2 HSPG2 mutations (chr1: 22206699, c.2244C > A, exon 17, p.H748Q; chr1: 22157321–22157321, c.11671 + 154insA, intron). One mutation was inherited from the father, and the other was inherited from the mother.

Conclusion
This is the first 18q deletion syndrome case accompanied by DDH. Most phenotypes of this patient, such as developmental delays and cleft palate, may be related to the 18q22.2q23 deletion, but no variants in genes related to DDH were found in this deletion region. DDH may be related to mutations of HSPG2.
Quality control recommendations for RNASeq using FFPE samples based on pre-sequencing lab metrics and post-sequencing bioinformatics metrics
Authors: Liu Yuanhang , Bhagwate Aditya , Winham Stacey J. , Stephens Melissa T. , Harker Brent W. , McDonough Samantha J. , Stallings-Mann Melody L. , Heinzen Ethan P. , Vierkant Robert A. , Hoskin Tanya L. , Frost Marlene H. , Carter Jodi M. , Pfrender Michael E. , Littlepage Laurie , Radisky Derek C. , Cunningham Julie M. , Degnim Amy C. , Wang Chen 
Published: September 2022

Abstract
Background
Formalin-fixed, paraffin-embedded (FFPE) tissues have many advantages for identification of risk biomarkers, including wide availability and potential for extended follow-up endpoints. However, RNA derived from archival FFPE samples has limited quality. Here we identified parameters that determine which FFPE samples have the potential for successful RNA extraction, library preparation, and generation of usable RNAseq data.

Methods
We optimized library preparation protocols designed for use with FFPE samples using seven FFPE and Fresh Frozen replicate pairs, and tested optimized protocols using a study set of 130 FFPE biopsies from women with benign breast disease. Metrics from RNA extraction and preparation procedures were collected and compared with bioinformatics sequencing summary statistics. Finally, a decision tree model was built to learn the relationship between pre-sequencing lab metrics and qc pass/fail status as determined by bioinformatics metrics.

Results
Samples that failed bioinformatics qc tended to have low median sample-wise correlation within the cohort (Spearman correlation < 0.75), low number of reads mapped to gene regions (< 25 million), or low number of detectable genes (11,400 # of detected genes with TPM > 4). The median RNA concentration and pre-capture library Qubit values for qc failed samples were 18.9 ng/ul and 2.08 ng/ul respectively, which were significantly lower than those of qc pass samples (40.8 ng/ul and 5.82 ng/ul). We built a decision tree model based on input RNA concentration, input library qubit values, and achieved an F score of 0.848 in predicting QC status (pass/fail) of FFPE samples.

Conclusions
We provide a bioinformatics quality control recommendation for FFPE samples from breast tissue by evaluating bioinformatic and sample metrics. Our results suggest a minimum concentration of 25 ng/ul FFPE-extracted RNA for library preparation and 1.7 ng/ul pre-capture library output to achieve adequate RNA-seq data for downstream bioinformatics analysis.