bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oncological Outcomes of Laparoscopic Versus Open Gastrectomy After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Retrospective Multicenter Study
Authors: Khaled Islam , Soliman Hany , Faisal Mohamed , Saad Ihab 
Published: August 2020

Abstract
Background: Oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neo-adjuvant chemotherapy were investigated in few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy for patients with locally advanced GC to determine its safety and feasibility.Methods: We conducted a retrospective chart review for all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for 3 cycles, which was then repeated for 5 cycles 6 to 12 weeks after the operation.Results: The hospital stay length and intraoperative blood loss the LG group were significantly lower than in the OG group. The in-hospital mortality rate and the 3-year survival rate for patients in the OG group were comparable to that of patients in the LG group (4.6% vs 9.7%; 58.1% vs 68.3%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2–61.6) in the OG group compared with 43.3 (95% CI, 36.6–49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36–65.8) in the LG group compared with 50.9 months (95% CI, 44.6–57.2) in the OG group.Conclusion: Compared to OG, LG is a feasible and safe alternative for patients receiving neoadjuvant chemotherapy with locally advanced GC.
Clinical diagnosis in paediatric patients at urban primary health care facilities in southern Malawi: a longitudinal observational study
Authors: Gondwe Mtisunge Joshua , Henrion Marc YR , O’Byrne Thomasena , Masesa Clemens , Lufesi Norman , Dube Queen , Majamanda Maureen D , Makwero Martha , Lalloo David G , Desmond Nicola 
Published: August 2020

Abstract
Background: Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children.Objective: Adopting ETAT to improve ability to identify severe illness in children at primary health centre (PHC) level through comparison with secondary level diagnoses.Methods: We implemented ETAT mHealth algorithm at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions.Results: Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E,P,Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%) , while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.56%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility.Conclusions Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.
Diagnostic Accuracy of Physical Examination for Detecting Pelvic Fractures Among Blunt Trauma Patients: A Systematic Review and Meta-Analysis
Authors: Okada Yohei , Nishioka Norihiro , Ohtsuru Shigeru , Tsujimoto Yasushi 
Published: August 2020

Abstract
Background: Pelvic fractures are common among blunt trauma patients, and timely and accurate diagnosis can improve patient outcomes. However, it remains unclear whether physical examinations are sufficient in this context. This study aims to perform a systematic review and meta-analysis of studies on the diagnostic accuracy and clinical utility of physical examination for pelvic fracture among blunt trauma patients.Methods: Studies were identified using the MEDLINE, EMBASE, and CENTRAL databases starting from the creation of the database to January 2020. A total of 20 studies (49,043 patients with 8,300 cases [16.9%] of pelvic fracture) were included in the quality assessment and meta-analysis. Two investigators extracted the data and evaluated the risk of bias in each study. The meta-analysis involved a hierarchical summary receiver operating curve (ROC) model to calculate the diagnostic accuracy of the physical exam. Subgroup analysis assessed the extent of between-study heterogeneity. Clinical utility was assessed using decision curve analysis.Results: The median prevalence of pelvic fracture was 10.5% (interquartile range: 5.1–16.5). The pooled sensitivity (and corresponding 95% confidence interval) of the hierarchical summary ROC parameters was 0.859 (0.761–0.952) at a given specificity of 0.920, which was the median value among the included studies. Subgroup analysis revealed that the pooled sensitivity among patients with a Glasgow Coma Scale score ≥ 13 was 0.933 (0.847–0.998) at a given specificity of 0.920. The corresponding value for patients with scores ≤ 13 was 0.761 (0.560–0.932). For threshold probability < 0.01 with 10%–15% prevalence, the net benefit of imaging tests was higher than that of physical examination. Conclusion: Imaging tests should be performed in all trauma patients regardless of findings from physical examination or patients’ levels of consciousness. However, the clinical role of physical examination should be considered given the prevalence and threshold probability in each setting.
Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia
Authors: Munajat Mohd Bakhtiar , Rahim Mohd Amirul Fitri A. , Wahid Wathiqah , Rakna Mohd Ikhwan Mukmin Seri , Divis Paul C. S. , Chuangchaiya Sriwipa , Lubis Inke Nadia D. , Osman Emelia , Kasri Muhd Rafiq Mohd , Id Zulkarnain Md 
Published: August 2020

Abstract
Background
Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community’s knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia.
Methods
A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Communities aged 6 years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics.
Results
Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bednet ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% aware of bednets were use to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their house and 20.1% reported entering nearby forests within the last six months.
Conclusion
We conclude that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices with respect to managing malaria require marked improvement.
Exploring the mRNA Expression Level of RELN in Peripheral Blood of Schizophrenia Patients Before and After Antipsychotic Treatment
Authors: Yin Jiajun , Lu Yana , Yu Shui , Dai Zhanzhan , Zhang Fuquan , Yuan Jianmin 
Published: August 2020

Abstract
Background: The Reelin (RELN) gene encodes the protein reelin, which is a large extracellular matrix glycoprotein that plays a key role in brain development. Additionally, this protein may be involved in memory formation, neurotransmission, and synaptic plasticity, which have been shown to be disrupted in schizophrenia (SCZ). A decreasing trend in the expression of RELN mRNA in the brain and peripheral blood of SCZ patients has been observed. There is a need to determine whether changes in RELN mRNA expression in SCZ patients are the result of long-term antipsychotic treatment rather than the etiological characteristics of schizophrenia. The expression levels of RELN mRNA in the peripheral blood of 48 healthy controls and 30 SCZ patients before and after 12-weeks of treatment were measured using quantitative real-time PCR. Results: The expression levels of RELN mRNA in the SCZ group were significantly lower than that of healthy controls; however, after 12-weeks of antipsychotic treatment, RELN mRNA levels were significantly increased in the SCZ group.Conclusion: The up-regulation of RELN mRNA expression was concurrent with the improvement of symptoms in SCZ patients after antipsychotic treatment, suggesting that the changes in RELN mRNA expression were related to the effect of the antipsychotic treatment.
Psychometric Properties of the Contextual Body Image Questionnaire for Athletes: A Replication and Extension Study in Female Collegiate Athletes
Authors: Stewart Tiffany , Kilpela Lisa , Wesley Nicole , Baule Kate , Thompson Ronald , Sherman Roberta , Becker Carolyn 
Published: August 2020

Abstract
Background: Although the link between body dissatisfaction and eating disorder (ED) pathology is well-stablished in general female samples, less is known about correlates of contextual body image (CBI) among female athletes. CBI refers to female athletes experiencing body image concerns in two distinct contexts: sport and daily life (de Bruin et al., 2011). The Contextual Body Image Questionnaire for Athletes (CBIQA) measures four factors of body image (Appearance, Thin-Fat Self-Evaluation, Thin-Fat Others’ Evaluation, and Muscularity) in both contexts. This study sought to A) investigate the psychometric properties of the CBIQA, B) examine the prospective relation of CBI with ED pathology and negative affect among female collegiate athletes, and C) the degree to which CBI prospectively predicts ED pathology and negative affect in female collegiate athletes. Method: Using self-report data collected from a multi-site parent trial, we first examined the psychometric properties of the CBIQA by conducting a confirmatory factor analysis. We assessed construct validity via cross-sectional bivariate correlation analyses with thin-ideal internalization, negative affect, and ED pathology. Lastly, using data collected at Time 1 and 6 months later (Time 2), we investigated the degree to which CBI prospectively predicted ED pathology and negative affect.Results: Results from the CFA largely confirmed de Bruin et al.’s (2011) original factor analysis. Two CBIQA factors (Thin-Fat Self and Appearance) in both contexts correlated with ED pathology and negative affect. Thin-Fat Others also correlated with ED pathology in both domains and negative affect in the sport domain. The Muscularity domain was predominantly orthogonal with other measures. CBIQA factors were uncorrelated with thin-ideal internalization. Finally, when controlling for BMI and Time 1 scores, daily life and sport appearance concerns predicted ED pathology, whereas perceived evaluation of thin-fat by others in the sport context predicted negative affect 6 months later. Conclusions: Results support the psychometric validity of the CBIQA and suggest that this measure appears to capture variance discrete from thin-ideal internalization. The Muscularity factor largely was not related to other outcomes. Further, specific elements of perceived self- and other-evaluation in both contexts is relevant to risk for ED pathology and negative affect. Future research could examine the impact of dual body image between seasons and after transitioning out of sport.Clinical trials registration: NCT01735994
Unconventional reconciliation path for quantum mechanics and general relativity
Authors: Yuguru Samuel 
Published: August 2020

Abstract
Physics in general is successfully governed by quantum mechanics at the microscale and principles of relativity at the macroscale. Any attempts to unify them using conventional methods have somewhat remained elusive for nearly a century up to the present stage. Here in this study, a classical gedanken experiment of an electron-wave diffraction of a single slit is intuitively examined for its quantized states. A unidirectional monopole field as quanta of the electric field is pictorially conceptualized. Its application towards quantum mechanics and general relativity in consistent with existing knowledge in physics paves an alternative path towards their reconciliation process by assuming a multiverse at a hierarchy of scales. Such an outcome provides an approximate intuitive guide to pursue physics in general from alternative perspectives using conventional methods.
Learner satisfaction, engagement and performances in an online module: Implications for institutional e-learning policy
Authors: Banoor Rajabalee Yousra , Issack Santally Mohammad 
Published: August 2020

Abstract
There has been much debate on the issue of whether online learning was better than traditional education and vice-versa over the past decade. Over time, the concept of blended learning became quite the norm, especially within traditional universities who could no longer turn a blind eye to the educational revolution brought about by information and communication technologies. While the pace of technology integration in universities generally varies in pace, the world has recently experienced a massive uptake, albeit in an unplanned and mostly disorganized manner, of e-learning technologies due to the Covid-19 pandemic. Researchers have emphasized on the quality of online courses from a perspective of learner achievement in terms of student satisfaction, engagement and performances. In this paper, we analyze student feedback and report the findings of a study of the relationships between student satisfaction and their engagement in an online course with their overall performances. The module was offered online to 844 university students in the first year across different disciplines, namely Engineering, Science, Humanities, Management and Agriculture. It was assessed mainly through continuous assessments and was designed using a learning-by-doing pedagogical approach. The focus was on the acquisition of new skills and competencies, and their application in authentic mini-projects throughout the module. Student feedback was coded and analyzed both from a quantitative and qualitative perspective. The association between satisfaction and engagement was significant and positively correlated. On the other hand, there was a weak but positive and significant correlation between satisfaction or engagement with their overall performances. We further observed that students were generally very satisfied with the learning design philosophy, irrespective of their performance levels. Students, however, reported issues related to lack of tutor support and experiencing technical difficulties across groups. The findings raise important implications for institutional e-learning policy making. The factors that are important relate to the object of such policies, learning design models, personalized support, distributed virtual learning through synchronous interaction, and learning analytics.
Map the Apps: a rapid review of digital approaches to support the engagement of older adults in strength and balance exercises
Authors: McGarrigle Lisa , Boulton Elisabeth , Todd Chris 
Published: August 2020

Abstract
Background: Exercise interventions, particularly those targeting strength and balance, are effective in preventing falls in older people. Activity levels are generally below recommended levels and reduce with age. There is concern that exercise levels may be further reduced in the context of the COVID-19 pandemic. Digital approaches may offer a means for older people to engage in strength and balance exercises independently in their own homes. The objective of this review was to identify and evaluate existing apps and websites to support independent engagement in strength and balance exercises by older people.Methods: We conducted a rapid review of apps and websites, following PRISMA guidelines. We searched for available apps in the Android and iOS app stores, and performed a database search (MEDLINE and EMBASE) for apps in development. We searched for websites using the Google search engine. Apps and websites were evaluated in terms of existing evidence for effectiveness, use of behaviour change techniques (BCTs), and quality. Results: We evaluated 13 apps and 24 websites on the basis of our selection criteria. Considering the evidence-base, quality and BCT scores, four apps and six websites are recommended for use by older people who wish to engage in exercise independently in their own homes. No apps or websites have been to RCT evaluation at the time of review.Conclusions: Apps and websites have the potential to provide a convenient, cost-effective, and accessible means for many older adults to engage in strength and balance training and reduce falls risk.
Epidemiology of pediatric uveitis and associated systemic diseases
Authors: Shin Yoonkyeom , Kang Ji-Man , Lee Junwon , Lee Christopher Seungkyu , Lee Sung Chul , Ahn Jong Gyun 
Published: August 2020

Abstract
Background: The early detection of uveitis associated with systemic inflammatory disease in children is important for proper treatment and prognosis. However, the diagnosis may be delayed because of difficulties in childhood examinations and early minor systemic symptoms. The objective of our study was to identify the pattern of childhood uveitis and investigate the frequency and clinical features of rheumatic diseases in pediatric patients with uveitis. Methods: This retrospective observational study reviewed the medical records of children (age ≤18 years) with uveitis at a Korean tertiary hospital between January 2005 and December 2018. Data collected included the age at onset of uveitis, sex, anatomic location of ocular inflammation, comorbid disease (including systemic inflammatory disease), ocular complications, relevant laboratory data, and treatment. Fisher’s exact test was used to compare categorical variables and the Mann–Whitney U test was used to compare continuous variables. A p-value of <0.05 was considered statistically significant. Results: A total of 155 pediatric patients with uveitis were included in this study. The median age at diagnosis was 13.0 years (interquartile range, 9.5–16.0 years). The male-to-female ratio was 1.09. The process was unilateral in 51.6% of children. Anterior uveitis, panuveitis, intermediate uveitis, and posterior uveitis represented 51.6%, 26.5%, 6.5%, and 1.9% of the cases, respectively. Idiopathic uveitis (65.2%) was the most frequent type of uveitis. Systemic rheumatic disease associations were responsible for 28.4% of the cases, among which juvenile idiopathic arthritis (JIA) was the most frequent cause (14.8%). Human leukocyte antigen (HLA)-B27 and antinuclear antibody (ANA) positive rates were significantly higher in patients with JIA than in those with idiopathic uveitis (p=0.006 and p=0.007, respectively). Conclusions: Approximately one-third of children with uveitis in Korea have a systemic rheumatic disease, of which JIA accounts for the majority of cases. HLA-B27 and ANA can be useful screening tools in children with JIA-associated uveitis.
Mass-production and Distribution of Medical Face Shields Using Additive Manufacturing and Injection Molding Process for Healthcare System Support During COVID-19 Pandemic in Brazil
Authors: Kunkel Maria Elizete , Vasques Mayra Torres , Perfeito João Aléssio Juliano , Zambrana Nataly Rabelo Mina , Bina Tainara dos Santos , Passoni Laura Helena de Melo , Ribeiro Thamires Verri , Rodrigues Sandra Maria Sousa , Castro Renato Ortolani Marcondes de , Ota Natacha Harumi 
Published: August 2020

Abstract
Face shields have been adopted worldwide as personal protective equipment for healthcare professionals during the COVID-19 pandemic. This device provides a transparent facial physical barrier reducing the exposure to aerosol particles. The fused deposition modeling (FDM) is the most applied process of additive manufacturing due to its usability and low-cost. The injection molding (IM) is the fastest process for mass production. This study is the first to perform a qualitative comparison between the use of FDM and IM processes for mass production and rapid distribution of face shields in a pandemic. The design of the face shield and tests were conducted in prototyping cycles based on requirements of medical, Brazilian standards, manufacturing, and production. The FDM face shields manufacturing was carried out by a volunteer network, and the IM manufacturing was carried out by companies. The volunteers produced 35,000 medical face shields through the FDM process with daily delivery to several hospitals. A total of 80,000 face shields was produced by the IM process and delivered to remote Brazilian regions. The mass production of 115,000 face shields protected health professionals from public hospitals in all states of Brazil. In a pandemic, both FDM and IM processes are suitable for mass production of face shields. Once a committed network of volunteers is formed in strategic regions, the FDM process promotes a fast daily production. The IM process is the best option for large scale production of face shields and delivery to remote areas where access to 3D printing is reduced.