bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study
Authors: Chen Kitty Jieyi , Liu Juan , Xu Biao , Li Yuexiao , Li Yanhong , Zhang Shinan , Chu Chun Hung 
Published: December 2020

Abstract
Background: Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan.Method: This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis.Results: This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p<0.05). The gingival-bleeding prevalence was associated with the mother’s education level, the child’s monthly-pocket money and daily toothbrushing frequency (p<0.05).Conclusion: Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.
Sudden death in the young adult: A Tunisian autopsy-based series
Authors: Saadi Said , Jomaa Sami Ben , Hadj Mariem Bel , Oualha Dorra , Salem Nidhal Haj 
Published: December 2020

Abstract
Background: We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention. Methods: We performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir (Tunisia). A review of all autopsies performed for 28 years was done (August 1990 to December 2018). In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden death in persons aged between 18 years and 35 years.Results: We collected 137 cases of sudden death during the studied period. The mean age of the studied population was 26.47 years. Almost 72% deaths were classified as cardiac death, and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6%, and from a neurological origin in 4.5%. The cause of sudden death in this group was not established by 9.5%.Conclusion: In this series, sudden death in young adults occurs mainly in a smoking male, aged between 18 and 24 years old, occurring at rest, in the morning, and early in the week. It is more common, especially in summer. Sudden death is most often the first manifestation of pathologies, especially unsuspected heart diseases. The predominance of cardiovascular causes is the common denominator of almost all studies reported in the literature. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.
The association between life satisfaction, emotional support and perceived health among Intimate Partner Violence (IPV) survivors
Authors: Hui Vivian , Constantino Rose 
Published: December 2020

Abstract
Background: Intimate partner violence (IPV) is a pressing phenomenon whose consequences are associated with severe physical and mental health outcomes. Every minute, around 24 people in the United States are raped, physically harmed, or emotionally abused by their intimate partner. Although having experienced IPV is not modifiable, emotional support is believed to be a protective factor to prevent victims from committing suicide. The psychological state of IPV victims is critical in post-traumatic events and this is evidenced in numerous qualitative interviews. Therefore, the objective of this study is to explore the association between IPV with emotional support, life satisfaction, and perceived health status in the United States. Methods: This study analyzed the data from the 2007 Behavioral Risk Factor Surveillance System. Univariate analyses, multivariable logistic regression analyses, and ordinal logistic regression analyses were used to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) for factors associated with IPV. Analyses were conducted using SPSS version 25. Results: The analyses show that there is a strong association between IPV experience and emotional support (AOR:1.810; 95% CI = 1.626 -2.015). Participants who had unwanted sex with an intimate partner in the past 12 months have 2.28 higher odds to receive less emotional support and 2.05 higher odds to perceive poor life satisfaction. Also, participants who reported experiencing IPV were associated with (AOR: 3.12; 95% CI =2.68 – 3.62) times the odds of having ≥ 6 days more mentally unhealthy days in a month. For perceived health outcomes, people who had been threatened with violence by a sex partner have 1.74 (95% CI =1.54 – 1.96) times the odds of having poor perceived general health status. IPV survivors have 3.12 (95% CI =2.68 – 3.62) times the odds of having ≥ 6 days more mentally unhealthy days in a month. Conclusions: People reported with any IPV experience are more likely to receive less emotional support, perceive dissatisfaction in life, and poor health outcomes. This study shows the need for policies centered on the development of interventions that focus on mental health for those who have experienced IPV.
Factors influencing early initiation of breastfeeding among mothers in Rajshahi district, Bangladesh
Authors: Ayesha Ummay , M Abu Sayed Md. Al , Islam Md. Nurul , Hossain Md. Ripter , Tasmia Samme Amena , Hossain Md. Golam 
Published: December 2020

Abstract
Background: Early initiation of breastfeeding (EIBF) act as the first immunization for the newborns, fortify their immune defense system and eventually reduce the mortality rate. This study aimed to identify the influential factors of EIBF among mothers in Rajshahi district, Bangladesh.Methods: A total number of 421 mothers living in Rajshahi district who had at least one child aged 6-24 months were considered as sample. Mothers were selected using multistage random sampling. This study was conducted from January to March, 2019. The EIBF was measured by a principal question, “Did you provide your breast milk to your newborns within one hour after delivery?” Frequency distribution and Chi-square test and multivariable binary logistic regression model were utilized in this study for getting prevalence and influential factors of EIBF respectively. Results: This study revealed that the prevalence of EIBF among mothers in Rajshahi district was 88.4%. Multivariable logistic model provided eight influential factors of EIBF: (i) husbands’ education level, (ii) husbands’ occupation, (iii) family monthly income, (iv) mothers’ age, (v) mothers’ BMI, (vi) place of delivery, (vii) getting pregnancy with planning, and (viii) mothers taking advice regarding the benefit of breastfeeding during their pregnancy. Conclusions: This study identified several modifiable influential factors of EIBF. The customs, culture and other characteristics are almost the same across the country. These factors could be considered to increase the rate of EIBF among mothers in Bangladesh.
“The kind of support that matters to exclusive breastfeeding” a qualitative study
Authors: Dasheka Zukiswa Theodorah , Rala Ntombana Mc'Deline 
Published: December 2020

Abstract
Background Worldwide, only 41% of infants are exclusively breastfed for the first six months while South Africa has an alarming figure of only 12%. First-time mothers are inexperienced in the initiation and maintenance of exclusive breastfeeding, hence a need for support. Data on forms and quality of exclusive breastfeeding support as experienced by first-time mothers is minimal. The study explored the exclusive breastfeeding support available to first-time mothers in the Buffalo City Metro, South Africa.Methods A qualitative explorative, descriptive and contextual study, and a non-probability, purposive sampling was used with 10 first-time mothers within the first six months postpartum. The in-depth face-to-face semi-structured individual interviews for data collection and Creswell's steps of thematic analysis were used.Results Two themes emerged; challenges, empowerment, support and resilience during initiation of exclusive breastfeeding, and diverse support and resilience during maintenance of exclusive breastfeeding. First- time mothers received practical support majorly from nurses and other mothers during the initiation; social support was from family members, friends, and community members for the maintenance of exclusive breastfeeding. Sometimes there was a disjuncture between practical support from nurses and that from family members and community. There were instances where the support was needed but not given or not supportive of exclusive breastfeeding.Conclusion These findings illustrate that professional, practical and social support for first-time mothers is crucial in the initiation and maintenance of exclusive breastfeeding for the first six months. Timing and the kind of support given to these mothers is crucial for successful exclusive breastfeeding.
Use of masks in public places in Poland during SARS-Cov-2 epidemic: a covert observational study
Authors: Ganczak Maria , Pasek Oskar , Duda-Duma lukasz , Świstara Dawid , Korzeń Marcin 
Published: December 2020

Abstract
Background: Face masks protect against SARS-Cov-2, however, if used incorrectly masks may increase transmission risk. Many countries, including Poland, recommend masks in pandemic control plans. In Poland, obligatory wearing of masks in public spaces was introduced on April 10th, 2020 [18]; a relaxation of previous universal measures was announced on May 29th, 2020, limiting use to indoor public spaces.Objective: to assess use of masks or other protective devices in public spaces in Poland during the SARS-Cov-2 epidemic and to evaluate influencing determinants.Methods: A non-participatory covert observational study was conducted on three dates, (10.05/18.05/ 25.05.2020) at public spaces in 13 regions with different risks. Ten consecutive individuals were observed by each of 82 medical students (n=2460 observations), using a structured checklist.Results: Among 2353 observed persons, the female/male ratios were 1.0, 1.1, and 1.0 on the three dates. As for age, 21-60-year-olds predominated at 70.8%, 71.9%, and 70.2%; 73.6% (n=552/750) were using masks on date 1, 66.5% (544/818) on date 2; and 65.7% (516/785) on date 3. Cloth masks predominated on all dates (64.7%-62.3%-62.6%), followed by medical (23.4%-28.5%-26.9%). Being female (OR=1.75-1.47-1.53 respectively), aged >40 years (OR=1.46-1.48 respectively), and location in a closed space (OR=2.56-2.63-2.36) were each associated with higher usage. Participants in sports were about two times less likely to use masks (OR=0.64-0.54-0.5) as compared to other activities. The proportion using masks correctly decreased gradually over time (364/552; 65.9%; 339/544; 62.3% and 304/516; 58.9%). More females wore masks correctly (date 1: 205/294; 69.7% vs 159/258; 61.6%, and date 3: 186/284; 65.5% vs 118/232; 50.9%; p=0.045; p=0.0008 respectively). Uncovered noses (47.3%-52.7%) and masks around the neck (39.2%-42.6%) were the most frequent incorrect practices. Conclusions: Practices were not in line with official recommendations, especially among young males, and deteriorated over time. Cloth masks were predominantly used in public spaces. Health promotion, through utilizing all available communication channels, would be helpful to increase compliance.
Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe COVID-19: A multicenter retrospective study
Authors: Wen Xue-song , Jiang Dan , Gao Lei , Zhou Jian zhong , Xiao Jun , Cheng Xiao-cheng , He Bin , Chen Yue , Lei Peng , Tan Xiao-wei , Qin Shu , zhang dongying 
Published: December 2020

Abstract
Background In December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. And, it has become a global pandemic. This is of great value for describing the patient's clinical symptoms in detail and looking for markers which are significant to predict the prognosis of patients with COVID-19.MethodsIn this multicenter, retrospective study, 476 patients with COVID-19 were recruited from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death was the primary endpoint. All patients were followed up from admission till discharge or death.ResultsThe dominant symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most common comorbidities were hypertension and diabetes. Compared with patients with higher CD4+T cell level, patients with lower CD4+T cell level were older and mostly males. The reduction of CD8+T cell level is an indicator of the severity of COVID-19. Both decreased CD4+T [HR:13.659; 95%CI: 3.235-57.671] and CD8+T [HR: 10.883; 95%CI: 3.277-36.145] cell levels were associated with in-hospital death in COVID-19 patients, but only the decrease of CD4+T cell level was an independent predictor of in-hospital death in COVID-19 patients. ConclusionsReductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe COVID-19 cases. It was the CD8+T cell level, not the CD4+T cell level, that reflected the severity of the patient’s disease. Only the reduction in CD4+T cell level was independently associated with increased in-hospital death in COVID-19 patients.
Quality of life of children with spinal muscular atrophy and their caregivers from the perspective of caregivers : a Chinese cross-sectional study
Authors: Yao Mei , Ma Ying , Qian Ruiying , Xia Yu , Yuan Changzheng , Bai Guannan , Mao Shanshan 
Published: December 2020

Abstract
Background: Spinal muscular atrophy (SMA) is an autosomal-recessive motor neuron disease leading to dysfunction of multiple organs. SMA can impair the quality of life (QoL) of patients and family. We aimed to evaluate the QoL of children with SMA and their caregivers and to identify the factors associated with QoL in a cross-sectional study conducted in China.Methods: We recruited 101 children aged 0-17 years with SMA and their caregivers from a children’s hospital in China. Twenty-six children had type I SMA, 56 type II and 19 type III. Each child’s QoL was measured by the Pediatric Quality of Life Inventory 3.0 Neuromuscular Module (PedsQL NMM), which was completed by the child’s caregivers. The caregiver’s QoL was measured by the Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM). Information on sociodemographic characteristics, disease-specific characteristics, and treatments were collected using the proxy-reported questionnaire. Two-sample t-tests and one-way ANOVA were used to compare differences in average scores of QoL across subgroups.Results: Children with type III SMA had a higher average Total score of PedsQL NMM and higher average scores in domains Neuromuscular disease and Family resources than children with type I or type II SMA (p < 0.001). Caregivers of children with type III SMA reported higher average scores in the domains of Physical, Emotional, Social, and Cognitive functioning of the PedsQL FIM than those of children with types I or II SMA (p < 0.05). In addition, disease-related characteristics (e.g. limited mobility, stable course of disease, skeleton deformity, and digestive system dysfunction) and respiratory support were associated with lower average scores of PedsQL NMM and PedsQL FIM (p < 0.05). Exercise training, multidisciplinary team management and use of the medication Nusinersen were each associated with higher average scores in both PedsQL NMM and FIM (p < 0.05). Conclusion: Our study has demonstrated factors that may impair or improve QoL of children patients with SMA and their parents. Particularly, QoL was relatively poor in children with type I and type II SMA as well as in their caregivers compared to those with type III SMA. We strongly recommend that standard of care in a multidisciplinary team (MDT) be strengthened to improve the QoL of SMA patients. Our study called for increased attention from clinical physicians on measuring QoL in their clinical practices in order to enhance the understanding of impacts of SMA and to make better decisions regarding treatment.
Comparisons of Simulation Results between Passive and Active Fluid Structure Interaction Models for Left Ventricle in Hypertrophic Obstructive Cardiomyopathy
Authors: Huang Xueying , Deng Long , Zuo Heng , Yang Chun , Song Yunhu , Lesperance Mary , Tang Dalin 
Published: December 2020

Abstract
Background. Patient-specific active Fluid-Structure Interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications of active computational models. Methods. The simulation results of 12 passive FSI models based on 6 patients’ pre-operative and post-operative CT images were compared with corresponding active models to investigate the differences in hemodynamics and cardiac mechanics between these models. Results. In comparing the passive and active models, it was found that there was no significant difference in pressure difference and shear stress on mitral valve leaflet (MVL) at the pre-SAM time point, but a significant difference was found in wall stress on the inner boundary of left ventricle (Endocardium). It was also found that pressure difference on the coapted MVL and the shear stress on MVL were significantly decreased after successful surgery in both active and passive models. Conclusion. Our results suggested that the passive models may provide good approximated hemodynamic results at 5% RR interval, which is crucial for analyzing the initiation of systolic anterior motion (SAM). Comparing to active models, the passive models decrease the complexity of the modeling construction and the difficulty of convergence significantly. These findings suggest that, with proper boundary conditions and sufficient clinical data, the passive computational model may be a good substitution model for the active model to perform hemodynamic analysis of the initiation of SAM.
Treatment Preference among Patients with Spinal Muscular Atrophy (SMA): A Discrete Choice Experiment
Authors: Monnette Alisha , Chen Er , Hong Dongzhe , Bazzano Alessandra , Dixon Stacy , Arnold W. David , Shi Lizheng 
Published: December 2020

Abstract
OBJECTIVE: To examine patient/caregiver preference for key attributes of treatments for spinal muscular atrophy (SMA). BACKGROUND: In the rapidly evolving SMA treatment landscape, it is critically important to understand how attributes of potential treatments may impact patient/caregiver choices.DESIGN/METHODS: A discrete choice experiment survey was developed based on qualitative interviews. Patients with SMA (³18 years) and caregivers of patients were recruited through a U.S. patient organization. Respondents made choices in each of 12 sets of hypothetical treatments. The relative importance of five treatment characteristics was compared (measured by regression coefficients [RC] of conditional logit models): (1) improvement or stabilization of motor function, (2) improvement or stabilization of breathing function, (3) indication for all ages or pediatric patients only, (4) route of administration (repeated intrathecal [IT] injections, one-time intravenous [IV] infusion, daily oral delivery) and (5) potential harm (mild, moderate, serious/life threatening).RESULTS: Patient ages ranged from less than 1 to 67 years (n=101, 65 self-reported and 36 caregiver-reported) and 64 were female. Total SMA subtypes included: type 1 (n=21), type 2 (n=48), type 3 (n=29), other (n=3). Prior spinal surgery was reported in 47 patients. Nusinersen and onasemnogene abeparvovec-xioi use were reported in 59 and 10 patients, respectively. Improvement in motor and breathing function was highly valued (RC: 0.65, 95% confidence interval [CI]: 0.47–0.83 and RC: 0.79, 95% CI: 0.60–0.98, respectively). Oral medication and one-time infusion were strongly preferred over repeated IT injections (RC: 0.80, 95% CI: 0.60–0.98 and RC: 0.51, 95% CI: 0.30–0.73, respectively). Patients least preferred an age-restricted label/approved use (£ 2 years of age) (RC: -1.28, 95% CI: -1.47 to -1.09). Cross-attributes trade-off decision suggested a lower willingness for a high-risk therapy despite additional efficacy gain. For some patients, there may be willingness to trade off additional gains in efficacy for a change in route of administration from repeated intrathecal administration to oral medication.CONCLUSIONS: Improvements in motor/breathing function, broad indication, oral or one-time infusion, and minimal risk were preferred treatment attributes. Treatment decisions should be made in clinical context and be tailored to patient needs.
TMEFF2 Promoter Hypermethylation Is an Unfavorable Prognostic Marker in Gliomas
Authors: Xie Sidi , Zhang Yunxiao , Peng Tao , Guo Jinglin , Cao Yongfu , Guo Jing , Shi Xiaofeng , Li Yaqin , Liu Yawei , Qi Songtao , Wang Hai 
Published: December 2020

Abstract
Background Transmembrane protein with EGF-like and two follistatin-like domains 2 (TMEFF2) is a transmembrane protein in the tomoregulin family. Little research has been performed to determine whether TMEFF2 methylation is a prognostic marker in adult diffuse gliomas. Methods In this study, we investigated TMEFF2 expression in surgical glioma tissue samples. In addition, we conducted bisulfite amplicon sequencing (BSAS) and methylation-specific PCR (MSP) to evaluate TMEFF2 methylation in glioblastoma (GBM) cells. Subsequently, we investigated the biological function of TMEFF2 in GBM cells. Moreover, we explored the prognostic significance of TMEFF2 in gliomas by analysing a cohort dataset from TCGA. Results Immunohistochemistry analysis of 75 paired glioma tumour and peritumoural tissues demonstrated that glioma tumour tissues expressed lower TMEFF2 levels than peritumoural tissues (P<0.001). TMEFF2 promoter methylation levels were increased in glioblastoma cells compared with SVG p12 cells (P<0.001). Inhibition of methylation reduced TMEFF2 methylation and increased its expression in LN229 and T98G cells (P<0.05). Knockdown of TMEFF2 expression significantly promoted the proliferation of U87MG cells and primary GBM cells (P<0.05). TMEFF2 methylation is negatively associated with IDH1, ATRX and TP53 mutations, and the subtype of glioma harbouring combined IDH1/ATRX/TP53 mutations was associated with low TMEFF2 methylation levels. Survival analysis confirmed that low TMEFF2 methylation levels are associated with good prognosis in glioma patients. Conclusions Our results suggest that TMEFF2 DNA methylation might be associated with glioma tumour progression and could serve as a valuable prognostic marker for adult diffuse gliomas.