bluuebunny/crossref_metadata_2025_split huggingface dataset:
The online learning experience and reported headaches associated with screen exposure time among Saudi health sciences students during the COVID-19 pandemic
Authors: Abou Hashish Ebtsam Aly , Baatiah Nada Yasser , Bashaweeh Alia Hamdi , Kattan Abdullah Mohammad 
Published: April 2022

Abstract
Background
The COVID-19 pandemic has become a global health issue and has significantly impacted university education. As a result, learning methods have been shifted to be delivered through online learning. Online learning has increased reliance on computer screens, which can cause visual discomfort and may cause or exacerbate headaches due to prolonged screen exposure. However, time spent using electronic devices has not yet been examined in relation to the online learning experience.

Purpose
This study assessed the online learning experiences and reported headaches associated with screen exposure time among health sciences university students.

Methods
A cross-sectional study was conducted among a convenience sample of 353 students at Saudi University. Online learning experiences, screen time exposure, and reported headache questionnaires were used to collect the data.

Results
Students were moderately satisfied with the online learning experience. Nevertheless, they faced many challenges with online learning that affected their communication efficacy, and they preferred that blended learning be continued. In addition, this study found a high prevalence of headache (65.72%) and a high screen exposure time among the studied students (52.69%). Increased screen time exposure is linked with increased headache and migraine reporting among students (p < 0.05).

Conclusion
Headache is a common health issue among health professional students, and it can harm their academic performance and quality of life, especially related to online learning. Greater awareness of headaches, stress reduction and prevention programs, and ergonomic practices to deal with headaches are essential. Blended learning approaches can improve student learning and performance in health science courses.
The association between assisted reproductive technology and cardiac remodeling in fetuses and early infants: a prospective cohort study
Authors: Bi Wenjing , Xiao Yangjie , Wang Xin , Cui Li , Song Guang , Yang Zeyu , Zhang Ying , Ren Weidong 
Published: April 2022

Abstract
Background
Limited data exist regarding the potential impact of assisted reproductive technology (ART) on cardiac remodeling. In particular, whether different ART techniques are related to different cardiac alterations remains unclear. We aimed to evaluate cardiac changes in fetuses and infants arising from ART and fetal cardiac alterations in fetuses conceived by specific ART procedures.

Methods
This prospective and observational cohort study recruited 111 fetuses conceived by ART and 106 spontaneously conceived controls between December 2017 and April 2019. Echocardiography was performed between 28+0 and 32+6 weeks-of-gestation and at 0–2 and 6 months after birth.

Results
A total of 88 ART fetuses and 85 controls were included in the final analysis. Compared to controls, ART fetuses demonstrated a globular enlarged left ventricle (LV) (LV sphericity index of mid-section, 2.29 ± 0.34 vs. 2.45 ± 0.39, P = 0.006; LV area, 262.33 ± 45.96 mm2 vs. 244.25 ± 47.13 mm2, P = 0.002), a larger right ventricle (RV) (RV area, 236.10 ± 38.63 mm2 vs. 221.14 ± 42.60 mm2, P = 0.003) and reduced LV systolic deformation (LV global longitudinal strain (GLS), −19.56% ± 1.90% vs. −20.65% ± 1.88%, P = 0.013; LV GLS rate S, −3.32 ± 0.36 s-1 vs. −3.58 ± 0.39 s-1, P = 0.023). There were no significant differences between the ART and control groups at postnatal follow-ups. Furthermore, we found fetal cardiac morphometry and function were comparable between different ART procedures. Compared to controls, the fetuses derived from various ART procedures all exhibited impairments in the LV GLS and the LV GLS rate S.

Conclusions
Our analysis demonstrated that subclinical cardiac remodeling and dysfunction were evident in ART fetuses, although these alterations did not persist in early infancy. In addition, various ART procedures may cause the same unfavorable changes in the fetal heart.

Trial registration
This trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (ChiCTR1900021672) on March 4, 2019, retrospectively registered.
Pathological count of IgG4-positive plasmacytes suggests extraophthalmic involvement and relapse in patients with IgG4-related ophthalmic disease: a retrospective study
Authors: Yuan Yiqun , Meng Fengxi , Ren Hui , Yue Han , Xue Kang , Zhang Rui 
Published: April 2022

Abstract
Background
IgG4-related ophthalmic disease (IgG4ROD) is a phenotype of IgG4-related disease (IgG4RD) with ophthalmic involvement. The pathological IgG4+ plasmacyte count has only been used for diagnosis. We aimed to explore its possible clinical value in the management of IgG4ROD.

Methods
Fifty-five pathologically diagnosed IgG4ROD patients were included, and their clinical, pathological, serological, and radiological findings and treatment outcomes were reviewed and analyzed. The pathological IgG4+ plasmacyte counts in lesions from different anatomic sites were compared, and their association with serum IgG4 concentrations, systemic involvement, and relapse risk was analyzed.

Results
The patients were divided into groups according to the anatomic site of their biopsied lesions, namely, the lacrimal gland, extraocular muscle, and orbital soft tissue. No significant difference was found in the pathological IgG4+ plasma cell counts among these groups (p = 0.975). The pathological IgG4+ plasmacyte count positively correlated with the IgG4 concentration in peripheral blood (R2 = 0.5469, p < 0.001). The serum IgG4 concentration and the pathological infiltrating IgG4+ plasmacyte count were significantly higher in patients with extraophthalmic involvement (p < 0.001 and p = 0.005, respectively). The areas under the receiver operating characteristic (ROC) curve (AUCs) of the serum IgG4 level and pathological IgG4+ plasmacyte count for identifying systemic involvement were 0.897 (p < 0.001) and 0.759 (p = 0.015), respectively. The patients with relapse had higher levels of serum IgG4, more germinal centers (GCs), and infiltrating IgG4+ plasmacytes in lesions. Multivariate Cox regression analysis revealed that a pathological IgG4+ plasmacyte count of > 150/high-power field (HPF) and an elevated serum IgG4 level of > 500 mg/dL were risk factors for relapse after steroid treatment.

Conclusions
Lesions from different ophthalmic sites in IgG4ROD patients have similar counts of IgG4+ and IgG+ plasmacytes. The quantity of pathological IgG4+ plasmacytes corresponded to the serum IgG4 concentration in patients with IgG4ROD and could be meaningful in identifying systemic involvement and predicting subsequent relapse.
Knowledge of cardiovascular disease risk and exercise duration among asymptomatic sedentary male individuals participating in Islamic prayer (Salaah)
Authors: Jalal Abdul Hamid , Noorbhai Habib 
Published: April 2022

Abstract
Background
This study aimed to investigate the knowledge of cardiovascular disease risk among asymptomatic sedentary males participating in Islamic prayer, alongside various exercise durations and age groups.

Methods
A cross-sectional study design was used. Sedentary male participants (n = 243) completed an online 78-point self-administered CVD risk questionnaire. Descriptive and inferential statistical methods were used to determine the research findings. For statistical rigour, participants were divided into two age groups. Participants were divided into three categories based on current exercise durations. Inter-group comparisons were completed using a one-way ANOVA, Kruskal–Wallis and Mann–Whitney test. The Pearson correlation coefficient was used to explore significant relationships. All statistical analyses were conducted using SPSS (Version 26, IBM). The level of significance was set at p < 0.05.

Results
The 21–30 age group 71.09% (7.53) and the 31–40 age group 72.74% (5.53) presented with Knowledge of CVD risk and prevention scores which indicated that older individuals were more knowledgeable about CVD risk and prevention. A significant difference [95% CI (− 6.76: 1.28), (p = 0.002)] existed among the 10–60-min and 61–140-min exercise duration categories. A significant difference (p = 0.006) was also found for inter-group comparisons. This result confirmed variability with duration categories. Significant differences were found between overall knowledge of CVD scores within the two age groups (p = 0.03). A negative correlation was demonstrated regarding knowledge of CVD risk and prevention, and duration of exercise (r = − 0.252; p = 0.000).

Conclusions
Knowledge about CVD risk and prevention is crucial for understanding the risk factors for CVD. The older individuals become, the more knowledgeable they are of CVD risk and prevention factors. Results show more inactive people are less likely to seek out knowledge of CVD risk and prevention. The study recommends that sedentary populations should engage in public health information interventions, physical activity (such as Salaah) and healthy lifestyle modifications. This will inform, increase awareness, and improve understanding of prevention strategies and risk factors for CVD.
The diversity and evolution of electric organs in Neotropical knifefishes
Authors: Bray Isabelle E. , Alshami Ilham J. J. , Kudoh Tetsuhiro 
Published: April 2022

AbstractThe Gymnotiformes, also known as the South American or Neotropical knifefishes, include the strongly electric Electrophorus electricus and many other weakly electric species. These fish possess specialised electric organs that are able to release electric discharges into the water, for electrolocation and communication, and sometimes for predation and defence. All Gymnotiform species possess a myogenic electric organ (mEO) derived from the muscle tissue, and members of the Apteronotidae family uniquely possess a neurogenic electric organ (nEOs) derived from the nervous tissue. A mEO may consist of ‘Type A’ electrocytes that develop within the tail muscle (for example, in Apteronotus leptorhynchus), or ‘Type B’ electrocytes that develop below the tail muscle (for example, in Brachyhypopomus gauderio). In this review, we discuss the diversity in the anatomy, electric discharge and development of electric organs found in different Gymnotiform species, as well as the ecological and environmental factors that have likely contributed to this diversity. We then describe various hypotheses regarding the evolution of electric organs, and discuss the potential evolutionary origin of the nEO: a pair of nerve cords that are located on either side of the aorta in B. gauderio, and which may have expanded and developed into a nEO in the Apteronotidae family during its evolution from a common ancestral species. Finally, we compare potential Gymnotiform phylogenies and their supporting evidence.
Exploring the economic impact of inappropriate antibiotic use: the case of upper respiratory tract infections in Ghana
Authors: Janssen Jip , Afari-Asiedu Samuel , Monnier Annelie , Abdulai Martha Ali , Tawiah Theresa , Wertheim Heiman , Baltussen Rob , Asante Kwaku Poku 
Published: April 2022

Abstract
Background
Antibiotic consumption is increasing worldwide, particularly in low and middle-income countries (LMICs). Access to lifesaving antibiotics in LMICs is crucial while minimising inappropriate use. Studies assessing the economic impact of inappropriate antibiotic use in LMICs are lacking. We explored the economic impact of inappropriate antibiotic use using the example of upper respiratory tract infections (URIs) in Ghana, as part of the ABACUS (AntiBiotic ACcess and USe) project.

Methods
A top-down, retrospective economic impact analysis of inappropriate antibiotic use for URIs was conducted. Two inappropriate antibiotic use situations were considered: (1) URIs treated with antibiotics, against recommendations from clinical guidelines; and (2) URIs that should have been treated with antibiotics according to clinical guidelines, but were not. The analysis included data collected in Ghana during the ABACUS project (household surveys and exit-interviews among consumers buying antibiotics), scientific literature and stakeholder consultations. Included cost types related to health care seeking behaviour for URIs. Additionally, cost saving projections were computed based on potential effects of future interventions that improve antibiotic use.

Results
Health care costs related to inappropriate antibiotic use for URIs were estimated to be around 20 million (M) USD annually, including 18 M USD for situation 1 and 2 M USD for situation 2. Travel costs and lost income due to travel, together, were estimated to be around 44 M USD for situation 1 and 18 M USD for situation 2. Possible health care cost savings range from 2 to 12 M USD for situation 1 and from 0.2 to 1 M USD for situation 2.

Conclusions
This study indicates that inappropriate antibiotic use leads to substantial economic costs in a LMIC setting that could have been prevented. We recommend investment in novel strategies to counter these unnecessary expenditures. As the projections indicate, this may result in considerable cost reductions. By tackling inappropriate use, progress can be made in combatting antibiotic resistance.
Donor T cells for CAR T cell therapy
Authors: Tang Tiffany C. Y. , Xu Ning , Nordon Robert , Haber Michelle , Micklethwaite Kenneth , Dolnikov Alla 
Published: April 2022

AbstractAdoptive cell therapy using patient-derived chimeric receptor antigen (CAR) T cells redirected against tumor cells has shown remarkable success in treating hematologic cancers. However, wider accessibility of cellular therapies for all patients is needed. Manufacture of patient-derived CAR T cells is limited by prolonged lymphopenia in heavily pre-treated patients and risk of contamination with tumor cells when isolating T cells from patient blood rich in malignant blasts. Donor T cells provide a good source of immune cells for adoptive immunotherapy and can be used to generate universal off-the-shelf CAR T cells that are readily available for administration into patients as required. Genome editing tools such as TALENs and CRISPR-Cas9 and non-gene editing methods such as short hairpin RNA and blockade of protein expression are currently used to enhance CAR T cell safety and efficacy by abrogating non-specific toxicity in the form of graft versus host disease (GVHD) and preventing CAR T cell rejection by the host.
Human sweat-based wearable glucose sensor on cotton fabric for real-time monitoring
Authors: Singh Anoop , Sharma Asha , Arya Sandeep 
Published: April 2022

AbstractIn this work, a human sweat-based wearable sensor for real-time glucose monitoring has been fabricated on a cotton substrate after treating it with a two-step polymerization of pyrrole. The pyrrole-treated fabric was coated with solution of copper sulphate pentahydrate to grow Cu layer. The cotton/pyrrole/Cu fabric was treated with the solutions of copper acetate and manganese acetate to form Cu–Mn transition-metal alloy via electrochemical deposition technique. Results indicate that the developed sensor is reliable with glucose detection limit of 125 µM and 378 µM. In addition, the sensor output ranged between 50 and 400 µM glucose with coefficient of correlation, R2 = 0.983, indicating a linear range of output current. The sensor's response is not significantly affected by interferents. The developed sensor is also validated on human sweat with satisfactory results.
Rhizosheath–root system changes exopolysaccharide content but stabilizes bacterial community across contrasting seasons in a desert environment
Authors: Marasco Ramona , Fusi Marco , Mosqueira Maria , Booth Jenny Marie , Rossi Federico , Cardinale Massimiliano , Michoud Grégoire , Rolli Eleonora , Mugnai Gianmarco , Vergani Lorenzo , Borin Sara , De Philippis Roberto , Cherif Ameur , Daffonchio Daniele 
Published: April 2022

Abstract
Background
In hot deserts daily/seasonal fluctuations pose great challenges to the resident organisms. However, these extreme ecosystems host unique microenvironments, such as the rhizosheath–root system of desert speargrasses in which biological activities and interactions are facilitated by milder conditions and reduced fluctuations. Here, we examined the bacterial microbiota associated with this structure and its surrounding sand in the desert speargrass Stipagrostis pungens under the contrasting environmental conditions of summer and winter in the Sahara Desert.

Results
The belowground rhizosheath–root system has higher nutrient and humidity contents, and cooler temperatures than the surrounding sand. The plant responds to the harsh environmental conditions of the summer by increasing the abundance and diversity of extracellular polymeric substances (EPS) compared to the winter. On the contrary, the bacterial community associated with the rhizosheath–root system and its interactome remain stable and, unlike the bulk sand, are unaffected by the seasonal environmental variations. The rhizosheath–root system bacterial communities are consistently dominated by Actinobacteria and Alphaproteobacteria and form distinct bacteria communities from those of bulk sand in the two seasons. The microbiome-stabilization mediated by the plant host acts to consistently retain beneficial bacteria with multiple plant growth promoting functions, including those capable to produce EPS, which increase the sand water holding capacity ameliorating the rhizosheath micro-environment.

Conclusions
Our results reveal the capability of plants in desert ecosystems to stabilize their below ground microbial community under seasonal contrasting environmental conditions, minimizing the heterogeneity of the surrounding bulk sand and contributing to the overall holobiont resilience under poly-extreme conditions.
Associations between the severity of nasal septal deviation and nasopharynx volume in different ages and sexes: a cone-beam computed tomography study
Authors: Shams Nasim , Razavi Mahshid , Zabihzadeh Mansour , Shokuhifar Mohammadreza , Rakhshan Vahid 
Published: April 2022

Abstract
Background
Nasal septum deviation (NSD) can cause serious anatomical and clinical complications. It can change the breathing pattern and thus alter the anatomy of the airway structures. Despite its importance, the association between NSD with the nasopharynx volume (NPV) has not been assessed before. Therefore, we aimed to investigate it for the first time.

Methods
Archival CBCTs of 202 patients older than 17 years and without any history of trauma or pathology of the nasopharynx and without any orthodontic/orthognathic treatments were evaluated (129 women, 73 men, mean age: 36.24 ± 14.61 years). All included CBCTs must have been taken with a 12 × 8 field of view and fully covered the nasopharynx areas. The extent of NSD (°) and NPV (mm3) were measured. NSDs were categorized as mild (NSD ˂ 9°), moderate (9 ≤ NSD ≤ 15°), and severe (NSD ˃ 15°). Associations between sex, age, NSD, and nasopharynx volume were assessed using independent-samples t test, chi-square, one-way ANOVA, Tamhane post hoc test, Pearson and point-biserial correlation coefficients, and multiple linear regressions (α = 0.05).

Results
Mean NSDs were 11.27 ± 4.69° (range 1–19.5), 11.58 ± 4.63°, and 10.70 ± 4.76° in the sample, females, and males, respectively (P > 0.05). Of females, 27.9%, 40.3%, and 31.8% had mild, moderate, and severe NSDs. These were 35.6%, 39.7%, and 24.7% in males (P > 0.05). Mean NPVs were 4.88 ± 1.49, 4.80 ± 1.43, and 5.04 ± 1.60 mm3 in the sample, females, and males, respectively (P > 0.05). Mean NPVs were 6.41 ± 1.21, 4.87 ± 0.73, and 3.30 ± 0.65 mm3 in mild, moderate, and severe NSD groups (all P values = 0.000). Mean ages were 27.06 ± 6.49, 29.80 ± 9.64, and 54.73 ± 8.45 years in mild, moderate, and severe NSD groups (severe group being older than the other two groups, P = 0.000). NSD was strongly, negatively correlated with NPV (R = − 0.793, P = 0.000). Sex was not correlated with NPV or NSD (P ≥ 0.189). Age was negatively and positively correlated with NPV and NSD, respectively (P = 0.000). Modeling NSD (β = −0.776, P = 0.000) as a predictor for NPV rendered age effect insignificant (P > 0.05).

Conclusions
It was found, for the first time, that the more deviated the nasal septum, the smaller the nasopharynx volume. Aging might increase NSD and through it, reduce the nasopharynx volume. Sex might not affect NSD or NPV.
Choroidal melanoma with synchronous Fuchs’ adenoma and novel ATRX mutation
Authors: Harford Elli , Palmer Jane M. , Glasson William J. , Warrier Sunil K. , Whitehead Kevin J. , Brooks Kelly M. , Johansson Peter A. , Hayward Nicholas K. , McGrath Lindsay A. 
Published: April 2022

Abstract
Background
To report a case of Fuchs’ adenoma occurring in an eye with a large choroidal melanoma. We have reviewed the literature to describe the clinical presentation, ultrasound characteristics and pathological features of these entities.

Case presentation
A 69-year-old Caucasian man presented with vision loss from a large choroidal melanoma. Enucleation showed an incidental Fuchs’ adenoma in the same eye. Whole-exome sequence analysis was also performed on the patient’s blood and melanoma, which showed a rarely-reported ATRX mutation.

Conclusions
Fuchs’ adenoma is an under-diagnosed benign age-related hyperplasia of the non-pigmented ciliary epithelium (NPCE). Given its location and characteristics, it can be mistaken for choroidal melanoma and clinicians are reminded how to differentiate between these pathologies and that they may co-exist.
A framework for rehabilitation for older adults living with dementia
Authors: Ries Julie D. 
Published: April 2022

Abstract
Introduction & Background
The aging of the population assures increased prevalence of Individuals Living with Dementia (ILwD) and there will be an increased representation of this cohort requiring physical rehabilitation. If physical therapists (PTs) manage these patients as they do their age-matched, cognitively-intact peers, they will likely be unsuccessful. ILwD have unique needs related to interpersonal and pragmatic components of rehabilitation. Therapeutic nihilism (doubting the benefit of therapy) is well-documented in PTs, either because of existing biases about dementia or previous challenges in working with ILwD. Physical rehabilitation eligibility and placement decisions are often made by PTs without special training in dementia, based upon brief exposure to patients in environments not well-designed for their best functioning. This can lead to underestimation of rehabilitation potential and denial of future PT services. PTs who work with ILwD desire more practical knowledge and targeted skills. Those with more education and training have a more positive attitude and outlook related to ILwD.

Purpose
The purpose of this paper is to introduce a framework for rehabilitation with ILwD equipped with pragmatic ideas to facilitate therapeutic success. The four primary components of the model are: (1) Establish a personal RELATIONSHIP, (2) Use intentional verbal and nonverbal COMMUNICATION, (3) Understand and optimize MOTOR LEARNING capabilities, and (4) Create a safe, purposeful ENVIRONMENT. Specific strategies to help PTs optimize each component are provided with supporting evidence. The model is intended to be dynamic, encouraging PTs to capitalize on the most accessible strategies within their control for a given patient and setting.

Implications
This framework provides a practical resource for working with ILwD with immediate implications for facilitating therapeutic success. The model is displayed in a schematic that reminds the reader of ideas at a glance within the context of each of the components. If an appreciation for this content was among core competencies required among PTs working with ILwD, perhaps there would be significantly fewer patients written off as “uncooperative” or “unable to participate” in PT.