bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation and comparison of quadriceps endurance and knee joint position sense in individuals with and without unilateral knee osteoarthritis
Authors: Saeed Alshahrani Mastour , Reddy Ravi Shankar , Asiri Faisal , Tedla Jaya Shanker , Alshahrani Adel , Kandakurti Praveen Kumar , Kakaraparthi Venkata Nagaraj 
Published: May 2022

Abstract
Background
Knee osteoarthritis (KOA) is a painful degenerative joint disease that may limit activities of daily living. This study aimed to determine the relationship between quadriceps endurance and knee joint position sense (JPS) in KOA individuals and compare the quadriceps endurance and knee JPS with and without KOA.

Methods
This comparative cross-sectional study was conducted in medical rehabilitation clinics, King Khalid University, Saudi Arabia. This study recruited 50 individuals diagnosed with unilateral KOA (mean age = 67.10 ± 4.36 years) and 50 asymptomatic individuals (mean age = 66.50 ± 3.63 years). Quadriceps isometric endurance capacity (sec) was measured using a fatigue resistance test, and knee JPS (degrees) were assessed using a digital inclinometer and evaluated in sitting and standing positions.

Results
Quadriceps isometric endurance showed a significant moderate negative correlation with knee JPS in 20° of flexion (r = -0.48, p < 0.001); 40° of flexion: r = -0.62, p < 0.001; 60° of flexion: r = -0.58, p < 0.001) in sitting and 20° of flexion (r = -0.25, p = 0.084) in standing position in KOA individuals. When compared to the asymptomatic, the quadriceps endurance was lower (p < 0.001), and knee joint position errors were larger (p < 0.001) in KOA individuals.

Conclusion
Results of this study showed that quadriceps endurance capacity is negatively associated with knee JPS. KOA individuals demonstrated lower quadriceps endurance and larger JPS compared to asymptomatic.
Role of protective stoma after primary anastomosis for generalized peritonitis due to perforated diverticulitis—DIVERTI 2 (a prospective multicenter randomized trial): rationale and design (nct04604730)
Authors: Pinson Jean , Tuech Jean-Jacques , Ouaissi Mehdi , Mathonnet Murielle , Mauvais François , Houivet Estelle , Lacroix Elie , Rondeaux Julie , Sabbagh Charles , Bridoux Valérie 
Published: May 2022

Abstract
Background
Traditionally, patients with peritonitis Hinchey III and IV due to perforated diverticulitis were treated with Hartmann’s procedure. In the past decade, resection and primary anastomosis have gained popularity over Hartmann’s procedure and recent guidelines recommend Hartmann’s procedure in two situations only: critically ill patients and in selected patients with multiple comorbidity (at high risk of complications).
The protective stoma (PS) is recommended after resection with primary anastomosis, however its interest has never been studied. The aim of this trial is to define the role of systematic PS after resection and primary anastomosis for peritonitis Hinchey III and IV due to perforated diverticulitis.

Methods/design
This DIVERTI 2 trial is a multicenter, randomized, controlled, superiority trial comparing resection and primary anastomosis with (control group) or without (experimental group) PS in patients with peritonitis Hinchey III and IV due to perforated diverticulitis.
Primary endpoint is the overall 1 year morbidity according to the Clavien–Dindo classification of surgical complications. All complications occurring during hospitalization will be collected. Late complications occurring after hospitalization will be collected during follow-up.
In order to obtain 80% power for a difference given by respective main probabilities of 67% and 47% in the protective stoma and no protective stoma groups respectively, with a two-sided type I error of 5%, 96 patients will have to be included in each group, hence 192 patients overall. Expecting a 5% rate of patients not assessable for the primary end point (lost to follow-up), 204 patients will be enrolled.
Secondary endpoints are postoperative mortality, unplanned reinterventions, incisional surgical site infection (SSI), organ/space SSI, wound disruption, anastomotic leak, operating time, length of hospital stay, stoma at 1 year after initial surgery, quality of life, costs and quality-adjusted life years (QALYs).

Discussion
The DIVERTI 2 trial is a prospective, multicenter, randomized, study to define the best strategy between PS and no PS in resection and primary anastomosis for patients presenting with peritonitis due to perforated diverticulitis.

Trial registration
ClinicalTrial.gov: NCT04604730 date of registration October 27, 2020. https://clinicaltrials.gov/ct2/show/NCT04604730?recrs=a&cond=Diverticulitis&draw=2&rank=12.
Germany-wide evaluation of residency in neurological intensive care medicine
Authors: Ernst Ann-Kathrin , Zupanic Michaela , Ellrichmann Gisa , Biesalski Anne-Sophie 
Published: May 2022

Abstract
Background
Neurointensive medicine is an important subspecialization of neurology. Its growing importance can be attributed to factors such as demographic change and the establishment of new therapeutic options. Part of the neurological residency in Germany is a six-month rotation on an intensive care unit (ICU), which has not yet been evaluated nationwide. The aim of this study was to evaluate kind and feasibility of neurointensive care training in Germany and to discover particularly successful training concepts.

Methods
In a preliminary study, ten residents and ten instructors were interviewed. Using content analysis, two questionnaires were created, which contained questions about specific teaching methods as well as individual satisfaction. The questionnaires were sent to 187 neurological clinics in Germany, and residents and instructors were asked to participate in the study. The data analysis was performed using SPSS and content analysis for the free-text data.

Results
Seventy of the 187 clinics contacted did not offer ICU-rotation. At 59,8% (n = 70) of the remaining hospitals, a total of 154 participants (84 residents, 70 educators) could be recruited. General satisfaction with the neurointensive medical training is high in both groups (residents: 3.34 ± 0.54; instructors: 3.79 ± 0.41, evaluated on the basis of a Likert scale from 1 = “not satisfied” to 5 = "fully satisfied"). Specific teaching methods (e.g. simulation trainings, feedback sessions) are perceived as very useful by residents, but rarely take place. Instructors are interested in educational opportunities such as didactic courses.

Conclusion
This study provides an overview of the ICU-rotation as part of the five-year neurological residency. Neurointensive care rotations usually take place at maximum care hospitals and last at least seven months. Despite frequent time and personnel restrictions, motivation of trainers and residents is high. Nevertheless, teaching methods as simulation training and educational opportunities for instructors must be expanded.
Development of a machine learning model to predict mild cognitive impairment using natural language processing in the absence of screening
Authors: Penfold Robert B. , Carrell David S. , Cronkite David J. , Pabiniak Chester , Dodd Tammy , Glass Ashley MH , Johnson Eric , Thompson Ella , Arrighi H. Michael , Stang Paul E. 
Published: May 2022

AbstractBackgroundPatients and their loved ones often report symptoms or complaints of cognitive decline that clinicians note in free clinical text, but no structured screening or diagnostic data are recorded. These symptoms/complaints may be signals that predict who will go on to be diagnosed with mild cognitive impairment (MCI) and ultimately develop Alzheimer’s Disease or related dementias. Our objective was to develop a natural language processing system and prediction model for identification of MCI from clinical text in the absence of screening or other structured diagnostic information.MethodsThere were two populations of patients: 1794 participants in the Adult Changes in Thought (ACT) study and 2391 patients in the general population of Kaiser Permanente Washington. All individuals had standardized cognitive assessment scores. We excluded patients with a diagnosis of Alzheimer’s Disease, Dementia or use of donepezil. We manually annotated 10,391 clinic notes to train the NLP model. Standard Python code was used to extract phrases from notes and map each phrase to a cognitive functioning concept. Concepts derived from the NLP system were used to predict future MCI. The prediction model was trained on the ACT cohort and 60% of the general population cohort with 40% withheld for validation. We used a least absolute shrinkage and selection operator logistic regression approach (LASSO) to fit a prediction model with MCI as the prediction target. Using the predicted case status from the LASSO model and known MCI from standardized scores, we constructed receiver operating curves to measure model performance.ResultsChart abstraction identified 42 MCI concepts. Prediction model performance in the validation data set was modest with an area under the curve of 0.67. Setting the cutoff for correct classification at 0.60, the classifier yielded sensitivity of 1.7%, specificity of 99.7%, PPV of 70% and NPV of 70.5% in the validation cohort.Discussion and conclusionAlthough the sensitivity of the machine learning model was poor, negative predictive value was high, an important characteristic of models used for population-based screening. While an AUC of 0.67 is generally considered moderate performance, it is also comparable to several tests that are widely used in clinical practice.
Acceptance of COVID-19 vaccine and determinant factors in the Iranian population: a web-based study
Authors: Omidvar Shabnam , Firouzbakht Mojgan 
Published: May 2022

Abstract
Background
Iran had a high rate of death in several COVID 19 waves. Vaccination is a method for prevention and control of the COVID-19 pandemic. Success in controlling the pandemic is not solely dependent on the effectiveness of the vaccines. It is also dependent on the global acceptance and vaccine coverage rate. This study aimed to determine the acceptance rate of COVID-19 vaccination in the Iranian population and the factors affecting it.

Methods and materials
This study was a cross-sectional research on 1564 Iranian people above 18. Study data were collected using a web-based questionnaire and analyzed using linear regression analysis and logistics at a significance level of 0.05 using SPSS.

Results
Approximately 70% of the participants reported acceptance of the vaccines. Ten percent of the people were against and 20% were hesitant to get vaccinated. The results showed that risk perception (P = .003), Knowledge of the disease (P < .001), trust in the health system (P < .001), attitude towards vaccination (P < .001), and vaccination literacy (P < .001) were predictors of vaccine acceptance. People with higher levels of education and mistrust towards the health system had a reduced vaccine acceptance rate.

Conclusions
The acceptance rate of the COVID-19 vaccine in Iran was higher than in the other countries in the Middle East. Extensive interventions are important to increase the trust in the health system and improve the knowledge of vaccine efficacy and literacy.
Documenting response to COVID-individual and systems successes and challenges: a longitudinal qualitative study
Authors: Shaukat Natasha , Ali Daniyal Mansoor , Barolia Rubina , Hisam Butool , Hassan Sheza , Afzal Badar , Khan Abdus Salam , Angez Meher , Razzak Junaid 
Published: May 2022

Abstract
Background
This study aimed to document the evolution of perceptions of frontline healthcare workers (FHCW) regarding their well-being and the quality of health systems' response to the COVID-19 pandemic over four months in Pakistan.

Methods
We conducted this prospective longitudinal qualitative study during the four months (June–September 2020) coinciding with the peak and trough of the first wave of Pakistan's COVID-19 pandemic. We approached frontline healthcare workers (physicians and nurses) working in emergency departments (ED) in two hospitals using the WhatsApp group of the Pakistan Society of Emergency Physicians (PSEM). Participants were asked to self-record their perception of their wellness and their level of satisfaction with the quality of their hospitals' response to the pandemic. We transcribed, translated, and analysed manually using MAXQDA 2020 software and conducted the thematic analysis to identify themes and sub-themes.

Results
We invited approximately 200 FHCWs associated with PSEM to participate in the study. Of the 61 who agreed to participate, 27 completed the study. A total of 149 audio recordings were received and transcribed. Three themes and eight sub-themes have emerged from the data. The themes were individual-level challenges, health system-level challenges, and hope for the future. Sub-themes for individual-level challenges were: fear of getting or transmitting infection, feeling demotivated and unappreciated, disappointment due to people’s lack of compliance with COVID-19 protocols, physical exhaustion, and fatigue. For the healthcare system, sub-themes were: Infrastructure, logistics, management, and communications response of the hospital/healthcare system and financial stressors. For sub-themes under hope for the future were the improved disease knowledge and vaccine development. The overall perceptions and experiences of FHCWs evolved from fear, grief, and negativity to hope and positivity as the curve of COVID-19 went down.

Conclusion
This study shows that the individuals and systems were not prepared to deal with the challenges of the COVID-19 pandemic. The findings highlight the challenges faced by individuals and health systems during the wake of the Covid-19 pandemic. The healthcare workers were emotionally and physically taxed, while the health systems were overwhelmed by COVID-19. The overall perceptions of FHCWs evolved with time and became negative to positive as the curve of COVID-19 went down during the first wave of COVID-19 in Pakistan.
Serotonin modulates insect gut bacterial community homeostasis
Authors: Zeng Tian , Su Hong-ai , Liu Ya-lan , Li Jian-fang , Jiang Ding-xin , Lu Yong-yue , Qi Yi-xiang 
Published: May 2022

Abstract
Background
Metazoan guts are in permanent contact with microbial communities. However, the host mechanisms that have developed to manage the dynamic changes of these microorganisms and maintain homeostasis remain largely unknown.

Results
Serotonin (5-hydroxytryptamine [5-HT]) was found to modulate gut microbiome homeostasis via regulation of a dual oxidase (Duox) gene expression in both Bactrocera dorsalis and Aedes aegypti. The knockdown of the peripheral 5-HT biosynthetic gene phenylalanine hydroxylase (TPH) increased the expression of Duox and the activity of reactive oxygen species, leading to a decrease in the gut microbiome load. Moreover, the TPH knockdown reduced the relative abundance of the bacterial genera Serratia and Providencia, including the opportunistic pathogens, S. marcescens and P. alcalifaciens in B. dorsalis. Treatment with 5-hydroxytryptophan, a precursor of 5-HT synthesis, fully rescued the TPH knockdown-induced phenotype.

Conclusions
The findings reveal the important contribution of 5-HT in regulating gut homeostasis, providing new insights into gut–microbe interactions in metazoans.
LINC00662 enhances cell progression and stemness in breast cancer by MiR-144-3p/SOX2 axis
Authors: An Congjing , Hu Zhigang , Li Yuehong , Zhao Pengxin , Liu Runtian , Zhang Qing , Zhu Peiling , Li Yanting , Wang Ying 
Published: May 2022

Abstract
Background
Breast cancer (BC) is one of the most prevalent malignancies among women globally. Emerging evidence indicates that long non-coding RNAs (lncRNAs) are associated with BC carcinogenesis. In the current study, we explored the mechanism by which LINC00662 regulates BC.

Methods
Quantitative real-time PCR (qRT-PCR) assessed RNA expressions while western blot for protein levels. Kaplan Meier analysis evaluated overall survival (OS). Cytoplasmic/nuclear fractionation, RNA binding protein immunoprecipitation (RIP) and luciferase reporter assays probed into the underlying molecular mechanism of LINC00662 in BC. Xenograft model was established to explore the influence of LINC00662 on BC progression in vivo. R square graphs were utilized to represent RNA relationships.

Results
LINC00662 is overtly overexpressed in BC tissues and cell lines. LINC00662 knockdown hampers cell proliferation, migration, invasion and stemness. LINC00662 expression is negatively correlated with OS of BC patients. LINC00662 up-regulates SOX2 expression by competitively binding to miR-144-3p, thereby modulating BC cell progression. Xenograft experiments verified that LINC00662 promotes BC tumor growth and cell stemness in vivo.

Conclusion
LINC00662 enhances cell proliferation, migration, invasion and stemness in BC by targeting miR-144-3p/SOX2 axis. The findings in the present study suggested that LINC00662 could be a potential therapeutic target for BC treatment.

Graphical Abstract
Boosting nutrient starvation-dominated cancer therapy through curcumin-augmented mitochondrial Ca2+ overload and obatoclax-mediated autophagy inhibition as supported by a novel nano-modulator GO-Alg@CaP/CO
Authors: Wang Xuan , Li Yunhao , Jia Fan , Cui Xinyue , Pan Zian , Wu Yan 
Published: May 2022

Abstract
Background
By hindering energy supply pathway for cancer cells, an alternative therapeutic strategy modality is put forward: tumor starvation therapy. And yet only in this blockade of glucose supply which is far from enough to result in sheer apoptosis of cancer cells.

Results
In an effort to boost nutrient starvation-dominated cancer therapy, here a novel mitochondrial Ca2+ modulator Alg@CaP were tailor-made for the immobilization of Glucose oxidase for depriving the intra-tumoral glucose, followed by the loading of Curcumin to augment mitochondrial Ca2+ overload to maximize the therapeutic efficiency of cancer starvation therapy via mitochondrial dysfunctions. Also, autophagy inhibitors Obatoclax were synchronously incorporated in this nano-modulator to highlight autophagy inhibition.

Conclusion
Here, a promising complementary modality for the trebling additive efficacy of starvation therapy was described for cutting off the existing energy sources in starvation therapy through Curcumin-augmented mitochondrial Ca2+ overload and Obatoclax-mediated autophagy inhibition.

Graphical Abstract
The cost-effectiveness of standalone HEPA filtration units for the prevention of airborne SARS CoV-2 transmission
Authors: Zafari Zafar , de Oliveira Pedro M. , Gkantonas Savvas , Ezeh Chinenye , Muennig Peter Alexander 
Published: May 2022

Abstract
Objective
Airborne infection from aerosolized SARS-CoV-2 poses an economic challenge for businesses without existing heating, ventilation, and air conditioning (HVAC) systems. The Environmental Protection Agency notes that standalone units may be used in areas without existing HVAC systems, but the cost and effectiveness of standalone units has not been evaluated.

Study design
Cost-effectiveness analysis with Monte Carlo simulation and aerosol transmission modeling.

Methods
We built a probabilistic decision-analytic model in a Monte Carlo simulation that examines aerosol transmission of SARS-CoV-2 in an indoor space. As a base case study, we built a model that simulated a poorly ventilated indoor 1000 square foot restaurant and the range of Covid-19 prevalence of actively infectious cases (best-case: 0.1%, base-case: 2%, and worst-case: 3%) and vaccination rates (best-case: 90%, base-case: 70%, and worst-case: 0%) in New York City. We evaluated the cost-effectiveness of improving ventilation rate to 12 air changes per hour (ACH), the equivalent of hospital-grade filtration systems used in emergency departments. We also provide a customizable online tool that allows the user to change model parameters.

Results
All 3 scenarios resulted in a net cost-savings and infections averted. For the base-case scenario, improving ventilation to 12 ACH was associated with 54 [95% Credible Interval (CrI): 29–86] aerosol infections averted over 1 year, producing an estimated cost savings of $152,701 (95% CrI: $80,663, $249,501) and 1.35 (95% CrI: 0.72, 2.24) quality-adjusted life years (QALYs) gained.

Conclusions
It is cost-effective to improve indoor ventilation in small businesses in older buildings that lack HVAC systems during the pandemic.
Strategies to reduce the energy content of foods pre-ordered for lunch in the workplace: a randomised controlled trial in an experimental online canteen
Authors: Breathnach Sarah , Lally Phillippa , Llewellyn Clare H. , Sutherland Alex , Koutoukidis Dimitrios A. 
Published: May 2022

Abstract
Background
Prompting employees to swap their usual lunches for lower-energy alternatives may help align energy intake with public health recommendations. We tested the effect of offering lower-energy swaps with and without physical activity calorie equivalent (PACE) information on the energy of lunches pre-ordered in an online hypothetical workplace canteen.

Methods
UK employed adults (n = 2,150) were invited to hypothetically pre-order their lunch from the canteen through a custom-made online platform. They were randomised 1:1:1 to: (i) control: no swaps offered; (ii) lower-energy swaps offered; or (iii) lower-energy swaps offered with PACE information. The primary outcome was the total energy ordered using analysis of covariance and controlling for the energy content of the initial items ordered. Secondary outcomes were swap acceptance rate and intervention acceptability.

Results
Participants were 54% female, had a mean age of 36.8 (SD = 11.6) and a BMI of 26.3 (SD = 5.6). Compared with an average 819 kcal energy ordered in the control, both the swaps and swaps + PACE interventions significantly reduced average energy ordered by 47 kcal (95% CI: -82 to -13, p = 0.003) and 66 kcal (95% CI: -100 to -31, p < 0.001), respectively. Compared with offering swaps only, the swaps + PACE intervention led to significantly higher swap acceptance (OR: 1.63, 95% CI: 1.27 to 2.09, p < 0.001) but did not significantly reduce energy ordered (-19 kcal, 95% CI: -53 to 16, p = 0.591). About 65% and 16% of intervention participants found the swap interventions acceptable and unacceptable, respectively, with the swaps + PACE intervention being considered more acceptable than swaps only (OR: 1.32, 95%CI: 1.09 to 1.60, p < 0.004).

Conclusion
Offering lower-energy swaps with or without PACE information reduced the energy of pre-ordered lunches experimentally. Both interventions hold promise for reducing the energy of purchased foods and drinks.
Trial Registration
As Predicted reference number: 56358, 22/01/21, https://aspredicted.org/pw2qr.pdf