bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfeccionismo, Burnout e as Atividades Extracurriculares nos Estudantes de Medicina da Universidade de Coimbra
Authors: Dinis Tomás , Santiago Luíz Miguel , Caetano Inês Rosendo , Marôco João Paulo
Published: June 2020

Introdução: A participação em atividades extracurriculares reduz a importância atribuída a alguns motivos para o perfeccionismo que influenciam a prevalência de burnout nos estudantes de medicina. Este estudo visou investigar de que forma esta relação se processa e de que fatores depende, de forma a pensar estratégias direcionadas a estes potenciais alvos de atuação.Material e Métodos: Elaborou-se um questionário capaz de avaliar a prática de atividades extracurriculares que incluiu um inquérito dos motivos para o perfeccionismo e parte do Copenhagen Burnout Inventory adapted for students. À sua aplicação, via online, aos estudantes do Mestrado Integrado em Medicina da Faculdade de Medicina da Universidade de Coimbra, seguiu-se a análise estatística e inferencial dos dados obtidos.Resultados: Numa amostra de 360 alunos, 40% pontuaram elevados níveis de burnout pessoal e 28,1% de burnout relacionado com os estudos, tendo 22,2% obtido elevados níveis nas duas componentes. Alunos que praticavam atividades extracurriculares estiveram menos frequentemente associados a altos valores de burnout pessoal e relacionado com os estudos, simultaneamente (p = 0,013). O tipo de atividade extracurricular escolhido não mostrou relação com a prevalência de burnout.Discussão: Apenas 53,9% dos alunos participam numa atividade extracurricular, fator associado a uma menor prevalência de burnout, especialmente nos alunos que a realizam várias vezes por semana. A escolha de um tipo de atividade em detrimento de outro não parece influenciar a prevalência desta síndrome, estando todos associados a benefícios em diferentes domínios.Conclusão: Verificou-se menor prevalência de burnout em estudantes que praticavam atividades extracurriculares. Será necessária a realização de estudos que nesta relação permitam inferir causalidade, de forma a formular soluções efetivas e específicas do contexto do curso médico.
Errata ao artigo “Parto por Cesariana em Grávida com COVID-19: O Primeiro Caso Descrito em Portugal”, publicado em Acta Med Port 2020 Jun;33(6):429-431
Authors: Lyra Joana , Valente Rita , Rosário Marta , Guimarães Mariana
Published: June 2020

Artigo publicado com erros:https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13883Na página xxx, secção “Discussão”, linha 6, onde se lê: (...) given the conflicting data about pre and postnatal transmission,6,7 a multi-disciplinary team consensus comprising obstetricians, neonatologists and infectious diseases specialists at our institution decided on mother-neonate separation immediately after birth until both were tested negative for SARS-CoV-2.4Deverá ler-se: (...) given the conflicting data about pre and postnatal transmission,6,7 after thoughtful discussion between a multidisciplinary team and the mother, and respecting her expressed will, a shared decision was made of mother infant separation immediately after birth until both were tested negative for SARS-CoV-2.4 Article published with errors:https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13883On page xxx, section “Discussion”, line 5, where it reads: (...) given the conflicting data about pre and postnatal transmission,6,7 a multi-disciplinary team consensus comprising obstetricians, neonatologists and infectious diseases specialists at our institution decided on mother-neonate separation immediately after birth until both were tested negative for SARS-CoV-2.4It should read: (...) given the conflicting data about pre and postnatal transmission,6,7 after thoughtful discussion between a multidisciplinary team and the mother, and respecting her expressed will, a shared decision was made of mother infant separation immediately after birth until both were tested negative for SARS-CoV-2.4
Uso das tecnologias digitais para a prática de exercícios físicos
Authors: Oliveira Braulio Nogueira de , Fraga Alex Branco
Published: June 2020

Objetivo: Mapear as principais áreas e assuntos das pesquisas acadêmicas que tratam das temáticas exercício físico e tecnologias digitais. Metodologia: Realizou-se uma revisão integrativa entre essas duas áreas, com estudos publicados entre 2013 e 2018, na SPORTDiscus with Full Text (EBSCO) e no Google Scholar, resultando em 21 textos selecionados. Resultados e discussão:  Os resultados apontam para quatro categorias: compartilhamento em mídias sociais, influenciadores digitais, tecnologias educacionais e exercícios mediados pela tecnologia.  Considerações Finais/Conclusão: Estas manifestações da complexa relação entre tecnologias digitais e exercício físico demandam novas competências por parte dos profissionais da área, bem como um olhar atento para outros fenômenos que venham a surgir.
Desempenho em Estatística de estudantes do Ensino Fundamental, no contexto do D-Estat
Authors: Cazorla Irene Maurício , Utsumi Miriam Cardoso , Santana Eurivalda Ribeiro dos Santos
Published: June 2020

Analisamos o desempenho em Estatística de 1.305 estudantes do 1º ao 9º ano, do ensino fundamental, de quatro escolas públicas do interior da Bahia, no âmbito de uma pesquisa colaborativa universidade-escola (D-Estat). Construímos três instrumentos, de acordo com o nível de ensino, dos quais analisamos três questões que envolvem variáveis qualitativas, discretas e contínuas; conversão de dados em língua materna para gráficos de barras simples; leitura em tabelas simples e de dupla entrada; cálculo da média, mediana e moda. Os principais resultados mostram que o desempenho cai substancialmente de um nível para outro, mas dentro de cada nível se observa uma tendência crescente, maior nos anos iniciais, sinalizando estagnação nos anos finais. Os resultados sinalizam que é preciso elaborar sequências de ensino validadas na realidade das escolas, que possibilitem o papel ativo dos estudantes, em seus processos de aprendizagem e, consequentemente, para o letramento estatístico.
The Design of English Syllabus and Material
Authors: Chandra Noor Eka , Listia Rina , Rosalina Elsa
Published: June 2020

Tujuan kegiatan ini ialah meningkatkan kemampuan guru membuat RPP berbasis keterampilan, agar RPP yang dihasilkan menjadi lebih kreatif dan inovatif dalam menunjang proses pembelajaran di kelas. Sasaran kegiatan ini adalah guru-guru MGMP Bahasa Inggris SMK di kota Banjarbaru yang berjumlah 30 orang. Metode yang digunakan dalam pengabdian ini adalah metode kualitatif berupa pemaparan teori–teori kemudian dilanjutkan dengan pengaplikasian teori tersebut. Adapun hasil dari pengabdian ini ialah adadanya wawasan baru bagi para guru dalam membuat RPP yang baik, benar, kreatif dan sesuai dengan kurikulum dan silabus SMK. Kegiatan ini juga menjadi sarana meningkatkan kemampuan guru dalam berkreasi membuat dan mendesain perangkat pembelajaran sendiri. Pelatihan ini juga mengajarkan guru–guru cara mendesain materi yang berkaitan dengan dunia nyata sehingga para siswa dapat menerapkan materi ajar yang diperoleh dalam kesehariannya. This activity aims to improve teachers' ability to make skills-based lesson plans so that the resulting lesson plans become more creative and innovative in supporting the learning process in the classroom. This activity target is MGMP English Vocational teachers in the city of Banjarbaru, totaling 30 people. The method used in this service is qualitative in the form of exposure to theories, then proceeding with the theory's application. This dedication is the existence of new insights for teachers in making lesson plans that are good, correct, creative, and following the curriculum and syllabus of SMK. This activity is also a means to improve teachers' ability to be creative in making and designing their learning tools. This training teaches teachers how to create material related to the real world so that students can apply teaching material obtained in their daily lives.
Sosialisasi Bahaya Hoax di Kalangan Ibu-Ibu Jamaah Pengajian Ar-Rahmah Kelurahan Sekumpul Martapura Kabupaten Banjar
Authors: Alfisyah Alfisyah , Apriati Yuli , Azkia Laila
Published: June 2020

Kegiatan pengabdian pada masyarakat ini  bertujuan untuk memberi pengetahuan tentang manfaat penggunaan internet serta pemahaman terhadap sisi negatif dan bahaya hoax.  Sasaran kegiatan ini adalah ibu-ibu jamaah pengajian Ar-Rahmah, Kelurahan Sekumpul, Kecamatan Martapura, yang berjumlah 53 orang. Kegiatan ini dilakukan dengan metode ceramah, diskusi, dan tanya jawab. Materi sosialisasi terdiri dari pengetahuan tentang hoax dan bahayanya; tips dan trik agar terhindar dari hoax; serta cara menghadapi dan mengenali hoax. Berdasarkan hasil sosialisasi yang dilaksanakan menunjukkan peningkatan pengetahuan dan kemampuan peserta tentang manfaat penggunaan internet serta sisi negatif dari bahaya hoax. Selain itu kegiatan berjalan lancar dan besarnya antusias peserta terhadap kegiatan ini. Melalui kegiatan sosialisasi ini peserta dapat memanfaatkan internet dengan sehat dan aman dan tidak terjebak dalam penyebaran hoax.The community service activities aim to provide knowledge about the benefits of internet use and understanding of the negative side and the dangers of hoax. The target of this activity is the mothers of the recitation of Ar-Rahmah, Sekumpul Village, Martapura District, totaling 53 people. This activity is carried out by lecturing, discussion, and question and answer methods. Socialization material consists of knowledge about hoaxes and the dangers, tips, and tricks to avoid hoax; and how to deal with and recognize hoax. Based on the results of the socialization carried out showed increased knowledge and ability of participants about the benefits of using the internet as well as the negative side of the dangers of hoax. Besides that, the activity went well and the amount of enthusiasm of the participants towards this activity. Through this outreach activity, participants can use the internet healthily and safely without getting caught up in the spread of hoax.
Pelatihan Model-Model Pembelajaran Inovatif dan Penulisan Karya Ilmiah
Authors: Salam Abdul , Zainuddin Zainuddin , Susilowati Eko , Miriam Sarah , Mastuang Mastuang , Dewantara Dewi , Haryandi Surya , Supriyadi Supriyadi , Rahmatullah Panji
Published: June 2020

Kegiatan pengabdian masyarakat ini bertujuan untuk meningkatkan pemahaman sekaligus melatih guru-guru di MTsN 3 Banjarmasin tentang model-model pembelajaran inovatif dan penulisan karya ilmiah. Metode yang digunakan dalam pelatihan ini meliputi ceramah (pemaparan materi), tanya jawab, diskusi, dan penugasan. Peserta pengabdian adalah seluruh guru mata pelajaran di MTsN 3 Banjarmasin yang berjumlah 52 orang. Kegiatan pelatihan berjalan lancar dan terjadi peningkatan pemahaman peserta tentang model-model pembelajaran inovatif dengan gain score 0.46 (kategori sedang), dan dalam hal penulisan karya ilmiah dengan gain score sebesar 0,54 (kategori sedang). Respon peserta baik (positif) terhadap pelatihan yang dilaksanakan dan berharap kegiatan ini bisa berkelanjutan.This training aims to improve understanding and train teachers at MTsN 3 Banjarmasin on innovative learning models and to write scientific papers. The methods used in this training include lectures (material exposure), question and answer, discussion, and assignments. The service participants were all 52 subject teachers in MTsN Banjarmasin. The training activities went smoothly. There was an increase in participants' understanding of innovative learning models with a gain score of 0.46 (medium category) and in the case of writing scientific papers with a gain score of 0.54 (medium category). The participants' response was good (positive) to the training carried out and hoped that this activity could be sustainable.
Improving Students' Creative Thinking Skills Using Problem-Based Learning (PBL) Models Assisted by Interactive Multimedia
Authors: Nulhakim Lukman , Setiawan Fajar Rizki , Saefullah Asep
Published: June 2020

This study determines the improvement of students' creative thinking using problem-based learning models assisted by interactive multimedia on the concept of substance pressure. Research conducted at SMP 2 Mandalawangi, using one-sample classes, class VIII the second semester of 2017/2018 academic year, was held in May 2018. The method used is quantitative research, while the type used is quasi-experimental research, using a one-group pretest-posttest design research design. The instrument used was a test instrument for creative thinking skills in the form of elaboration questions on the concept of pressure. The analyzing data using paired sample t-test or paired sample t-test analysis to see the effect of PBL on creative thinking skills, and n-gain to see an improvement in creative thinking skills. The study gives an increase in students' creative thinking skills. The average value of 41 to 81 with an n-gain of 0.68 or an improved of 68%, which included the medium criteria. Paired sample t-test results indicate that there is an influence of the use of problem-based learning models assisted by interactive multimedia on students' creative thinking skills on the concept of substance pressure.
Vertical Shear Pelvic Ring Injury Adjacent to Retained Pelvic Hardware
Authors: Yee Michael A. , Miles Daniel T. , Nowotarski Peter J.
Published: June 2020

Case:

A 47-year-old obese woman presented with a vertical shear (VS) pelvic ring injury after a motor vehicle accident around her previous posterior pelvic hardware. The patient underwent closed reduction with percutaneous posterior screw fixation using combined fluoroscopy and O-arm (Medtronic).

Conclusion:

A rare case of VS pelvic injury with indwelling posterior pelvic hardware does not automatically preclude placement of percutaneous sacroiliac and transiliac-transsacral screws. Combining fluoroscopic imaging and O-arm enables safe screw placement, saving patients from invasive surgeries.
Lack of Association between LCS6 Variant in KRAS Gene with the Occurrence of Breast Tumors in Iraqi Women
Authors: Al-Haddad et al. Roya
Published: June 2020

Breast cancer is the most commonly diagnosed cancer and remains one of the main reasons of cancer-related mortality in women worldwide. KRAS variant rs61764370 (T>G) is associated with an increased risk of occurrence of many cancers, Here The case-control study was accomplished on 135 women including 45 women with breast cancer patients, 45 women with benign breast lesions and 45 healthy women to analyze the association of KRAS variant rs (61764370 T>G) with breast cancer. LCS 6 variant in KRAS gene was amplified by using specific primers, then genotype was detected after sequencing the PCR products. The results showed that the genotype and allele frequency of TT and GT allele of  KRAS gene were statistically non-significant (p< 0.01) among breast cancer patients and breast benign lesions compared with healthy controls in Iraqi women.
Acoustic and Thermal Insulation of Nanocomposites for Building Material
Authors: Ahmad et al. Shanaz
Published: June 2020

This work aims to enhance acoustic and thermal insulation properties for polymeric composite by adding nanoclay and rock wool as reinforcement materials with different rations. A polymer blend of (epoxy+ polyester) as matrix materials was used. The Hand lay-up technique was used to manufacture the castings. Epoxy and polyester were mixed at different weight ratios involving (50:50, 60:40, 70:30, 80:20, and 90:10) wt. % of (epoxy: polyester) wt. % respectively. Impact tests for optimum sample (OMR), caustic and thermal insulation tests were performed. Nano clay (Kaolinite) with ratios ( 5 and 7.5% ) wt.% , also hybrid reinforcement materials involving (Kaolite 5 & 7.5 % wt.% + 10% volume fraction of rockwool ) were added as reinforcement materials to the optimum sample. Results of impact test prove that the optimum sample has (80:20) wt. % of mixing ratio of (epoxy: polyester) wt. % for using as matrix materials. Moreover, the adding of nanoclay (Kaolinite) with ratio (7.5 wt.%) leads to the highest sound insulation. The sound intensity started at (99.8) db at 100 Hz, and reached to (101.3) db at 10000 Hz., which is much lower than the values obtained from the un-reinforced blend, of which the sound intensity started at (107.2) db and reached to (108.7) db., at the same range of frequencies. Thermal conductivity results show that the optimum matrix with (7.5 %) wt. % has the lowest value about (0.443 k.w\m .c).

        The results show that the blend reinforced with nano clay in a weight fraction (7.5)% has the best sound insulation, so that the sound intensity started at (99.8) db at 100 Hz., and reached (101.3) db at 10000 Hz., which is much lower than the values obtained from the unreinforced blend, of which the sound intensity started at (107.2) db and reached (108.7) db., applying the same range of frequencies. The same casting (blend+7.5% nanoclay) showed the lowest value of thermal conductivity (xxxx) W.m°C in comparison with castings that were made of unreinforced blend and those  hybridized with rockwool.
New Concepts of Fuzzy Local Function
Authors: Almohammed et al. Raghad
Published: June 2020

The main idea of this paper is to define other types of a fuzzy local function and study the advantages and differences between them in addition to discussing some definitions of finding new fuzzy topologies. Also in this research, a new type of fuzzy closure has been defined, where the relation between the new type and different types of fuzzy local function has been studied
Oscillation Criteria for Solutions of Neutral Differential Equations of Impulses Effect with Positive and Negative Coefficients
Authors: Jaddoa et al. Aqeel
Published: June 2020

In this paper, some necessary and sufficient conditions are obtained to ensure the oscillatory of all solutions of the first order impulsive neutral differential equations. Also, some results in the references have been improved and generalized. New lemmas are established to demonstrate the oscillation property. Special impulsive conditions associated with neutral differential equation are submitted. Some examples are given to illustrate the obtained results.
Proposing Robust LAD-Atan Penalty of Regression Model Estimation for High Dimensional Data
Authors: Yousef Ali Hameed , Ali Omar Abdulmohsin
Published: June 2020

The issue of penalized regression model has received considerable critical attention to variable selection. It plays an essential role in dealing with high dimensional data. Arctangent denoted by the Atan penalty has been used in both estimation and variable selection as an efficient method recently. However, the Atan penalty is very sensitive to outliers in response to variables or heavy-tailed error distribution. While the least absolute deviation is a good method to get robustness in regression estimation. The specific objective of this research is to propose a robust Atan estimator from combining these two ideas at once. Simulation experiments and real data applications show that the proposed LAD-Atan estimator has superior performance compared with other estimators.
Quantitative Response of Healthy Muscle Following the Induction of Capsaicin: An Exploratory Randomized Controlled Trial
Authors: Evans Valerie , Behr Michael , Masani Kei , Kumbhare Dinesh
Published: June 2020

Background: Myofascial pain syndrome (MPS) is a prevalent chronic pain disorder primarily characterized by myofascial trigger points (MTrP). There is limited knowledge on the pathophysiology and mechanisms underlying MTrP and its development. Research has previously demonstrated the identification of MTrPs using ultrasound and vibration sonoelastography, although there is some contradictory evidence regarding if MTrPs present as hyper or hypoechoic regions. Electromyography (EMG) investigations of MTrP have demonstrated that MTrP are usually located proximal to innervation zones where the peak surface EMG signals are obtained from. Central sensitization has been proposed as the primary mechanism underlying MTrP development. Central sensitization is associated with hyperexcitability of neuronal responses to normal or noxious stimuli. There is a need for a study that measures ultrasound image textural changes and motor unit activity responses in the muscle following sensitization. The purpose of this study is to determine whether sensitizing healthy muscle using capsaicin induces a regional change in image texture variables within the specific and surrounding muscles, as well as the motor unit frequency and amplitude changes that accompany them. This is an exploratory trial that aims to provide preliminary evidence on whether central sensitization is a direct cause of taut band and MTrP development.Methods: Ethical approval was obtained from the University Health Network (UHN) Research Ethics Board. This proposed study is a single centered, factorial, randomized placebo-controlled trial with two independent variables, depth of capsaicin application and dose of capsaicin, for a total of six treatment arms and three control treatment groups.Discussion: This will be the first study that assesses the B-mode ultrasound image texture of induced sensitized muscles, and will provide more evidence on muscle motor unit activity and regional changes of central sensitization. Findings from this study may support one of few hypotheses proposed delineating the involvement of central sensitization in the development of trigger points.Trial Registration: Name: National Institutes of Health ClinicalTrials.gov. Identifier: NCT03944889 Date of Registration: May 07 2019 URL: https://clinicaltrials.gov/ct2/show/NCT03944889
Correlates Of Intimate Partner Violence Among Married Women In Uganda: A Cross-Sectional Survey
Authors: Gubi Derrick , Nansubuga Elizabeth , Wandera Stephen Ojiambo
Published: June 2020

Background: In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among married women are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical IPV and any form of IPV among married women in Uganda.Methods: The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 married women were selected from the Domestic Violence module. Frequency distributions were used to describe the characteristics of respondents. Chi-square tests were used to establish the association between IPV and the explanatory variables. Binary logistic regressions were used to establish the factors that were associated with IPV among married women in Uganda.Results: More than half (56%) of the married women experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41% and 40%) experienced physical and emotional IPV, respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner’s controlling behaviors, duration of the relationship, and frequency of intoxication of the male partner. Conclusion: IPV among Ugandan married women is far too common. This calls for collective efforts to reduce IPV in Uganda by addressing excessive alcohol consumption, controlling behaviors, and lack of awareness of the issue. Interventions aimed at preventing perpetration and tolerance of violence in the home settings should be promoted.
P-selectin (CD62P) and soluble TREM-like transcript-1 (sTLT-1) are associated with coronary artery disease: A case control study
Authors: Shen Li , Yang Tianlun , Xia Ke , Yan Zhiqiang , Tan Juanjuan , Li Lei , Qin Yingchun
Published: June 2020

Background: Platelet activation plays a crucial role in the pathogenesis of coronary artery disease (CAD).Platelet P-selectin (CD62P) is a platelet classic activation indicator on the platelet surface,and soluble TREM-like transcript-1 (sTLT-1) is a new indicator;hpwever, the relationship between these two markers and CAD(especially in acute coronary syndromes (ACS) has not been elucidated. This study aimed to investigate the expression of CD62Pon the platelet surface and sTLT-1 in serum and to assess their relationship with CAD.Methods: We measured the levels of CD62P and sTLT-1 in 83 patients with CAD compared to 49 controls. The associations with age, blood pressure, lipid profiles, body mass index and liver injury marker levels were also examined.Results: A stepwise increase in CD62P concentration was found based on the number of CAD patients (P <0.01), especially in Acute myocaedial infarction( AMI) patients (P <0.01). Serum sTLT-1 concentration in the AMI and Unstable angina pectoris(UAP) groups was higher than that in the Normal control (NC) group (P <0.01).Conclusions: The consistency of sTLT-1 and CD62P expression levels in CAD indicates that the sTLT-1 level may be a new marker of platelet activation and is positively related to CAD.
Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery - A cross-sectional study in Norway
Authors: Berg Matilde Risopatron , Sahlin Ylva Ingrid
Published: June 2020

Background: Aim of the study was to estimate the prevalence of postpartum anal incontinence among women who delivered vaginally, and to assess the extent to which obstetric injuries to the anal sphincters are missed. Methods: All women (both primiparous and multiparous) who delivered vaginally and received any kind of sutures in the perineal area at Innlandet Hospital Trust Elverum in Norway between January 1, 2015 and June 30, 2016 were invited to answer a questionnaire on St. Mark’s incontinence score and to participate in a clinical examination of the pelvic floor including endoanal sonography. Results: In total 52,3% (n=207) of the 396 invited women participated in the study. Mean St. Mark’s score was 1.8 points (95% CI 1.4 to 2.1) at examination 14 months (mean) postpartum, and none of the participants suffered from weekly fecal leakage. Fecal urgency affected 11.7% (95% CI 7.1 to 16.3) of the participants, and 8.7% (95%CI 5.1 to 12.8) had weekly involuntary leakage of flatus. Nine women (9.3%, 95% CI 4.1 to 15.5) had a previously undetected third degree obstetric anal sphincter injury. Conclusion: The prevalence of anal incontinence among women who have delivered vaginally and received sutures due to 1 st and 2 nd degree perineal lacerations is low. Some obstetric anal sphincter injuries remain unrecognized at the time of delivery, but the symptoms of anal incontinence due to these injuries are in the lower half of the St. Mark’s incontinence score. Women with persistent symptoms like fecal urgency or leakage of gas and/or feces should be referred to evaluation by a colorectal surgeon in order to achieve optimal treatment.
Country of first birth and neonatal outcomes in migrant and Norwegian-born parous women in Norway: a population-based study
Authors: Vik Eline Skirnisdottir , Nilsen Roy Miodini , Aasheim Vigdis , Small Rhonda , Moster Dag , Schytt Erica
Published: June 2020

Background: This study compares subsequent birth outcomes in migrant women who had already had a child before arriving in Norway with those in migrant women whose first birth occurred in Norway. The aim of this study was to investigate the associations between country of first birth and adverse neonatal outcomes (very preterm birth, moderately preterm birth, post-term birth, small for gestational age, large for gestational age, low Apgar score, stillbirth and neonatal death) in parous migrant and Norwegian-born women.Methods: National population-based study including second and subsequent singleton births in Norway from 1990-2016. Data were retrieved from the Medical Birth Registry of Norway and Statistics Norway. Neonatal outcomes were compared between births to: 1) migrant women with a first birth before immigration to Norway (n=30,062) versus those with a first birth after immigration (n=66,006), and 2) Norwegian-born women with a first birth outside Norway (n=6,205) versus those with a first birth in Norway (n=514,799). Associations were estimated as crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using multiple logistic regression. Results: Migrant women with a first birth before immigrating to Norway had increased odds of adverse outcomes in subsequent births relative to those with a first birth after immigration: very preterm birth (22-31 gestational weeks; aOR=1.27; CI 1.09-1.48), moderately preterm birth (32-36 gestational weeks; aOR=1.10; CI 1.02-1.18), post-term birth (≥42 gestational weeks; aOR=1.19; CI 1.11-1.27), low Apgar score (<7 at 5 minutes; aOR=1.27; CI 1.16-1.39) and stillbirth (aOR=1.29; CI 1.05-1.58). Similar results were found in the sample of births to Norwegian-born women.Conclusions: The increased odds of adverse neonatal outcomes for migrant and Norwegian-born women who had their first births outside Norway should serve as a reminder of the importance of taking a careful obstetric history in these parous women to ensure appropriate care for their subsequent pregnancies and births in Norway.
Exploration of Anti-inflammatory Mechanism of Forsythiaside A and Forsythiaside B in CuSO4-Induced Inflammation in Zebrafish by Metabolomic and Proteomic Analyses
Authors: Gong Lihong , Yu Linyuan , Gong Xiaohong , Wang Cheng , Hu Naihua , Dai Xuyang , Peng Cheng , Li Yunxia
Published: June 2020

Background: Inflammation is a general pathological phenomenon during severe disturbances to the homeostasis. Forsythiaside A (FA) and Forsythiaside B (FB), isolated from the dried fruit of Forsythia suspensa (Thunb.) Vahl, are phenylethanoid compounds that show a significant anti-inflammatory effect. However, the properties and therapeutic mechanisms of this effect have not yet been systematically elucidated.Methods: In this study, the anti-inflammatory effects of FA and FB were investigated in CuSO4-induced inflammation in zebrafish larvae. Intracellular generation of reactive oxygen species (ROS) and nitric oxide (NO) was investigated using fluorescence probes. Metabolomic and proteomic analyses using liquid chromatography-mass spectrometry were carried out to identify the expressions of metabolites and proteins associated with the anti-inflammatory mechanism of FA and FB. Quantitative polymerase chain reaction (PCR) was performed to detect the progressive changes in gene expression.Results: FA and FB inhibited neutrophils migration to the damaged neuromasts and remarkably reduced CuSO4-induced ROS and NO generation in zebrafish larvae. Metabolomic analysis pointed to the involvement of Nicotinate and nicotinamide metabolism, Energy metabolism, Pyrimidine metabolism, and Purine metabolism. Proteomic analysis identified 146 differentially-expressed proteins between the control and model groups. These included Collagen [collagen type II alpha 1b precursor (col2a1b), collagen alpha-2(IX) chain precursor (col9a2), collagen type IX alpha I precursor (col9a1b)], Nucleoside diphosphate kinase 3 isoform X1 (Nme3), WD repeat-containing protein 3 (Wdr3), and 28S ribosomal protein S7 mitochondrial precursor (Mrps7). FA and FB were shown to reverse the abnormal expressions of potential metabolite and protein biomarkers and alleviate CuSO4-induced damage to the neuromasts in the zebrafish lateral line.Conclusions: Our results indicate that FA and FB possess remarkable anti-inflammatory properties, protecting against CuSO4-induced neuromasts damage in zebrafish larvae. The results also suggest a multi-component and multi-regulatory therapeutic mechanism for FA and FB.
The growing impact of older patients in the Emergency Department: a 5-year retrospective analysis in Brazil
Authors: Gomes João Carlos Pereira , Dias Roger Daglius , Barros Jacson Venancio , Velasco Irineu Tadeu , Filho Wilson Jacob
Published: June 2020

Background: The average age of the global population is rising at an increasing rate. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance. Aim: To describe the sociodemographic characteristics and outcomes of tertiary Brazilian ED users. Methods: Design: Observational cross-sectional analytic study. Setting: Emergency Department, tertiary university hospital, São Paulo, Brazil. Participants: patients aged 18 years or older attending a tertiary ED (2009-2013). The primary outcomes were hospitalization and mortality; the secondary outcome was ICU admission. Age was categorized as ‘young adults’ (18-39y), ‘adults’ (40-59y), ‘young-older adults’ (60-79y), and ‘old-older adults’ (80-109y). Other variables included sex, reason for attendance, time of ED visit, mode of presentation, type of hospitalization, main procedure, length of hospital stay (LOS) and length of ICU stay (ICU-LOS). We calculated descriptive statistics, built generalized linear mixed models for each outcome and estimated Odds Ratios (95% CI) for the independent categorical variables. The significance level was 5% with Bonferroni correction. Results: Older age-groups represented 26.6% of 333,028 ED visits, 40.7% of admissions, 42.7% of ICU admissions and 58% of all deaths. Old-older patients accounted for 5.1% of ED visits, 9.5% of admissions and 10.1% of ICU admissions. Hospitalization, ICU admission and mortality rates increased with older age in both sexes. LOS and ICU-LOS were similar across age-groups. The proportions of visits and admissions attributed to young adults decreased annually, while those of people aged 60 or over increased. The ORs for hospitalization, ICU admission and mortality associated with the old-older group were 3.49 (95% CI = 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference. Conclusions: In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification.
In silico pathway analysis based on Chromosomal Instability in Breast Cancer Patients
Authors: KOUR AKEEN , Sambyal Vasudha , Guleria Kamlesh , Singh Neeti Rajan , Uppal Manjit Singh , Manjari Mridu , Sudan Meena
Published: June 2020

Background: Complex genomic changes that arise in tumors are a consequence of chromosomal instability. In tumor cells genomic aberrations disrupt core signaling pathways involving various genes, thus delineating of signaling pathways can help understand the pathogenesis of cancer. The bioinformatics tools can further help in identifying networks of interactions between the genes to get a greater biological context of all genes affected by chromosomal instability. Methods: Karyotypic analyses was done in 150 clinically confirmed breast cancer patients and 150 age and gender matched healthy controls after 72 hours Peripheral lymphocyte culturing and GTG-banding. Reactome database from Cytoscape software version 3.7.1 was used to perform. in-silico analysis (functional interaction and gene enrichment).Results: Frequency of chromosomal aberrations (structural and numerical) was found to be significantly higher in patients as compared to controls. The genes harbored by chromosomal regions showing increased aberration frequency in patients were further analyzed in-silico. Pathway analysis on a set of genes that were not linked together revealed that genes HDAC3, NCOA1, NLRC4, COL1A1, RARA, WWTR1, and BRCA1 were enriched in the RNA Polymerase II Transcription pathway which is involved in recruitment, initiation, elongation and dissociation during transcription. Conclusion: The current study employs the information inferred from chromosomal instability analysis in a non-target tissue for determining the genes and the pathways associated with breast cancer. These results can be further extrapolated by performing either mutation analysis in the genes/pathways deduced or expression analysis which can pinpoint the relevant functional impact of chromosomal instability.
Molecular characterization of Leishmania tropica and Leishmania major from stray dogs and patients in Saudi Arabia
Authors: Alanazi Abdullah D , Alouffi Abdulazi S Alouffi S , Alyousif Mohamed S Alyousif S , Rahi Abdulsadah A , Ali Magda A , Brayner Fabio A , Mendoza-Roldan Jairo Alfonso , Otranto Domenico
Published: June 2020

Background: Leishmania major and Leishmania tropica cause cutaneous leishmaniasis in humans and dogs in several parts of the world, with a large number of cases recorded in the Middle East. However, when occurring in sympatry, the role of each species of Leishmania in the epidemiology of cutaneous leishmaniasis (CL) is not clear. Methods: To determine the prevalence and to identify the species of Leishmania that infects humans and stray dogs in Riyadh and Al-Qassim (Saudi Arabia), 311 stray dogs and 27 human patients, suspected for Leishmania, were examined for CL by a nested PCR (nPCR).Results: Nested PCR (nPCR) detected seven patients (25.9%) positive for cutaneous leishmaniasis. Five patients from Riyadh were infected by L. major and two from Al-Qassim by L. tropica. In addition, five dogs (1.6%) were infected by L. tropica. Conclusions: This is one of the first molecular studies of leishmaniasis from Saudi Arabia. The relationship between the sand fly vectors and the reservoirs of both Leishmania spp. is still scarcely known in this region, and further epidemiological investigations of domestic and wild canids infected with L. major and L. tropica are needed towards a control and prevention of the infection in canine and human populations.
Effect of toxic trace element detoxification, body fat reduction following four-week intake of the Wellnessup diet: a three-arm, randomized clinical trial
Authors: Jung Su-Jin , Kim Woo-Lim , Park Byung-Hyun , Lee Seung-Ok , Chae Soowan
Published: June 2020

Background: Detox diet are known as a popular dieting strategies that helps toxins elimination and weight manage but there is very little clinical evidence. The Wellnessup diet (WD) used in the present study designed as a healthy meals based on organic plant based diets including various vegetables, fruits, whole grains, nuts and phytonutrients. Methods: To evaluate the effects of 4 week intake of the WD on toxic trace element detoxification, body fat reduction, and safety parameters. Forty-five women with body mass index (BMI) of 23.5-30 kg/m 2 were recruited. Thirty of them were assigned 1:1 to the test group (WD, 15 subjects) and control group 1 (calorie-restricted diet, CRD, 15 subjects) in a single blind and randomized, and the remaining 15 subjects were assigned to control group 2 (maintaining regular diet, MRD). The primary outcome were toxic trace element levels in hair (29 types of heavy metals), and the secondary outcomes were changes in anthropometric and urinary organic acids. Results: The levels of four toxic trace elements in hair decreased in the WD group after the diet compared to before the diet. Ni, Rh, Sn, and Ga were significantly lower in the WD group than in the CRD or MRD group (p<0.05). At the end of the trial, both WD and CRD groups had lower BMI, Waist Circumference(WC), Hip Circumference(HC) and WHR compared to the baseline values (p<0.05). Compared to the WD group, the CRD group had a greater mean change (p<0.05) from the baseline for weight loss (-3.22±0.48kg vs -1.88±0.95kg vs) and fat free mass (-2.08 kg vs -1.09 kg). The weight, BMI, body fat mass, fat free mass, WC, and HC of the CRD group were significantly decreased compared to the MRD (p<0.05). No significant changes in any safety parameter were observed. Conclusions: Use of WD might have several beneficial effects and safety such as body fat reduction and improving some the element detoxification through caloric restriction but did not reducing body fat mass more than calorie-restricted diet.
Impact of 3D genome organization, guided by cohesin and CTCF looping, on sex-biased chromatin interactions and gene expression in mouse liver
Authors: Matthews Bryan J , Waxman David J
Published: June 2020

Several thousand sex-differential distal enhancers have been identified in mouse liver; however, their links to sex-biased genes and the impact of any sex-differences in nuclear organization and chromatin interactions are unknown. To address these issues, we first characterized 1,847 mouse liver genomic regions showing significant sex differential occupancy by cohesin and CTCF, two key 3D nuclear organizing factors. These sex-differential binding sites were primarily distal to sex-biased genes but rarely generated sex-differential TAD (topologically associating domain) or intra-TAD loop anchors, and were sometimes found in TADs without sex-biased genes. A substantial subset of sex-biased cohesin-non-CTCF binding sites, but not sex-biased cohesin-and-CTCF binding sites, overlapped sex-biased enhancers. Cohesin depletion reduced the expression of male-biased genes with distal, but not proximal, sex-biased enhancers by >10-fold, implicating cohesin in long-range enhancer interactions regulating sex-biased genes. Using circularized chromosome conformation capture-based sequencing (4C-seq), we showed that sex differences in distal sex-biased enhancer - promoter interactions are common. Intra-TAD loops with sex-independent cohesin-and-CTCF anchors conferred sex specificity to chromatin interactions indirectly, by insulating sex-biased enhancer - promoter contacts and by bringing sex-biased genes into closer proximity to sex-biased enhancers. Furthermore, sex-differential chromatin interactions involving sex-biased gene promoters, enhancers, and lncRNAs were associated with sex-biased binding of cohesin and/or CTCF. These studies elucidate how 3D genome organization impacts sex-biased gene expression in a non-reproductive tissue through both direct and indirect effects of cohesin and CTCF looping on distal enhancer interactions with sex-differentially expressed genes.
Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence
Authors: Silva-Tinoco Rubén , Cuatecontzi-Xochitiotzi Teresa , Torre-Saldaña Viridiana De la , León-García Enrique , Serna-Alvarado Javier , Orea-Tejeda Arturo , Castillo-Martínez Lilia , Gay Juan G. , de-León David Cantú , Prada Diddier
Published: June 2020

Background Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.
Changes in Oral Health Indicators due to Implementation of the National Health Insurance Services Coverage for First Molar Dental Sealant for Children and Adolescents in South Korea
Authors: CHOI JINSUN , Ma Deuk-Sang
Published: June 2020

Background: In South Korea, dental sealant was included in the National Health Insurance Services (NHIS) coverage for the first molar for ages 6–14 in December 2009. The second molar was included in 2012, and the age of insurance coverage was extended to under 18 in 2013. This study aimed to verify the effectiveness of an NHIS dental sealant coverage policy for children and adolescents by comparing the changes in first molar oral health indicators before and after policy implementation. Methods: Korea National Health and Nutrition Examination Survey data were analyzed; the fourth period (2007–2009) provided data for before and the sixth period (2013–2015) provided data for after policy implementation. The proportion of individuals with first-molar sealant, decay-missing-filled first molar permanent teeth, and single crowns in the group aged 11-20 years were calculated. Data were analyzed using chi-square for complex samples and the complex samples general linear model. In addition, complex-sample logistic regression analysis was performed to confirm the association between factors. Results: Compared with non-beneficiaries, among policy beneficiaries, sealant ownership increased by 7.7% (from 27.8 to 35.5, P<0.001), and the number of permanent teeth with sealant per capita increased by approximately 0.4 to 0.8(P<0.001). the proportion of individuals with decay-missing-filled permanent teeth decreased by 9.1% (from 68.4 to 59.3, P <0.001), and the average decay-missing-filled permanent teeth index per person decreased by approximately 2.0 to 1.5( P <0.001). the rate of single-crown holders decreased by 2.7% (from 8.7 to 6.0, P >0.05), and the average single-crown index decreased by approximately 0.11 to 0.08 per person( P >0.05). The number of sealants increased with age and household income ( P <0.001). The mother’s education level affected sealant experience ( P <0.05). The caries rate was higher in females and older respondents ( P <0.001). Conclusions: The sealant covered by NHIS contributed to decreasing dental caries in Korea. However, policies that can reduce oral health inequality should also be considered, and a follow-up study is required for long-term sealant maintenance in Korea.