bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of an Immune-related Gene Pair Index as a Prognostic Marker of Early-Stage Lung Squamous Cell Carcinoma
Authors: Wang Zihao , Xiang Xuan , Wei Xiaoshan , Ye Linlin , Niu Yiran , Peng Wenbei , Li Yu , Wang Xu , Zhang Siyu , Zhou Qiong 
Published: June 2020

Abstract
Background. Lung squamous cell carcinoma (LUSC) is one of the subtypes of non-small-cell lung cancer (NSCLC) and accounts for approximately 20 to 30% of all lung cancers.Methods. In this study, we developed an immune-related gene pair index (IRGPI) for early-stage LUSC from 3 public LUSC data sets, including The Cancer Genome Atlas LUSC cohort and Gene Expression Omnibus data sets, and explored whether IRGPI could act as a prognostic marker to identify patients with early-stage LUSC at high risk.Results. IRGPI was constructed by 68 gene pairs consisting of 123 unique immune-related genes from TCGA LUSC cohort. In the derivation cohort, the hazard of death among high-risk group was 10.51 times that of the low-risk group (HR, 10.51; 95%CI, 6.96-15.86; p<0.001). The hazard of death among the high-risk group was 2.26 times that of the low-risk group (HR, 2.26; 95%CI, 1.2-4.25; p=0.009) in the GSE37745 validation cohort and was 3.2 times that of low-risk group (HR, 3.2; 95%CI, 0.98-10.4; p=0.042) in the GSE41271 validation cohort. The infiltrations of CD8+ T cells and T follicular helper cells were lower in the high-risk group, as compared with the low-risk group in the TCGA cohort (6.94% vs 9.63%, p=0.004; 2.15% vs 3%, p=0.002, respectively). The infiltrations of neutrophils, activated mast cells and monocytes were higher in the high-risk group, as compared with the low-risk group in the TCGA cohort (1.63% vs 0.72%, p=0.001; 1.64% vs 1.02%, p=0.007; 0.57% vs 0.35%, p=0.041, respectively).Conclusions. IRGPI is a significant prognostic biomarker for predicting overall survival in early-stage LUSC patients.
Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?
Authors: Mattevi Catherine , Garnier Jonathan , Marchese Ugo , Ewald Jacques , Gilabert Marine , Poizat Flora , Piana Gilles , Delpero Jean-Robert , Turrini Olivier 
Published: June 2020

Abstract
Purpose: To determine if improvement in imaging reduces the non-resection rate (NRR) among patients with pancreatic ductal adenocarcinoma (PDAC).Methods: From 2000 to 2019, 751 consecutive patients with PDAC were considered eligible for a intention-to-treat pancreatectomy and entered the operating room. In April 2011, our institution acquired a dual energy spectral computed tomography (CT) scanner and liver diffusion weighted magnetic resonance imaging (DW-MRI) was included in the imaging workup. We consequently considered 2 periods of inclusion: period #1 (February 2000–March 2011) and period #2 (April 2011–August 2019). Results: All patients underwent a preoperative CT scan with a median delay to surgery of 18 days. Liver DW-MRI was performed among 407 patients (54%). Median delay between CT and surgery decreased (21 days to 16 days, P<.01), and liver DW-MRI was significantly most prescribed during period #2 (14% vs 75%, P<.01). According to the intraoperative findings, the overall NRR was 24.5%, and remained stable over the two periods (24% vs 25%, respectively). While vascular invasion, liver metastasis, and carcinomatosis rates remained stable, PALNs invasion rate (0.4% vs 4.6%; P<0.001) significantly increased over the 2 periods. The mean size of the bigger extra pancreatic tumor significantly decrease (7.9mm vs 6.4mm (P<.01), respectively) when the resection was not done. In multivariate analysis, CA 19-9<500U/mL (P<.01), and liver DW-MRI prescription (P<.01) favoured the resection. Conclusions: Due to changes in our therapeutic strategies, the NRR did not decrease during two decades despite imaging improvement.
Psycho-social wellbeing among in-school adolescents of Sri Lanka; prevalence of selected attributes and associated factors
Authors: Wellappuli Nalinda , Gunawardena Nalika Sepali , Mahesh PK Buddhika , Gunawardena Shanthi , Wickramasinghe Champika , Lokubalasooriya Ayesha , Peiris Renuka , Liyanage Chinthika , Hathurusinghe Lalindi , Mahagamage Kanchana , Senanayake Sameera 
Published: June 2020

Abstract
Background

Adolescence period is associated with psycho-social issues which affect their day to day activities and go beyond their adolescent age group. It has been recorded that prevalence of psycho-social issues are rising globally. The aim of this study was to estimate the prevalence and factors associated with the selected attributes of psycho-social well-being among 13 to 17-year in-school adolescents of Sri Lanka using the Global School Health Survey (GSHS), conducted in Sri Lanka.
Methods

GSHS, was a cross-sectional study conducted among 3,650 adolescents of aged 13–17, attending government schools. Data was collected using a self-administered questionnaire. Psychosocial well-being included questions of four selected outcomes (i.e. bullying, felling alone, sleep disturbances due to a worry, suicidal ideation and practices) and 10 potential associated factors of these. The sample was selected through a two-staged cluster sampling technique. In determining the independent associated factors, multivariable analysis was done with multiple logistic regression.
Results

Most of the students who responded belonged to the 13–15 age group (66.5%) and with 51.1% were females. More than one third of the participants (37.7%, 95%CI 36.1–39.5) had experienced bullying 30 days prior to the study. ‘Feeling loneliness’ and ‘experiencing anxiety’ had been experienced by 9.0% (95%CI 8.0–10.0) and 4.7% (95%CI 3.9–5.4), respectively. The prevalence of planning an attempt of suicide was 6.3%, while 6.6% had at least once attempted suicide. Multivariable analysis revealed that lacked parental support and being engaged in a fight were independently associated with being bullied, feeling lonely and considering attempting suicide. Mutual association of the four outcomes with each other indicate that being bullied was significantly associated with experiencing loneliness and feeling anxiety. In addition, experiencing loneliness was independently associated “considering an attempt of suicide” (OR = 2.9, 95%CI = 2.0 to 4.3). Feeling anxiety was also associated with considering attempting suicide (OR = 3.4, 95%CI = 2.1 to 5.4).
Conclusion

This study demonstrated that the prevalence of psycho-social wellbeing is among school going adolescents is a major public health problem in Sri Lanka. School-based interventions to address these issues should be designed with the goal of increasing adolescents’ awareness of possible preventive measures of unintentional injuries.
Small Bowel Volvulus (SBV) in Northcentral Ethiopia
Authors: Awedew Atalel Fentahun , Belay Woldemariam Beka , Amsalu Bedemariam Tadesse , Yalewu Dawit Zerihun 
Published: June 2020

Abstract
Background: Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia Method: The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV.Result: There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within four years. The annual occurrence rate of SBV was 35cases per year. Small bowel volvulus represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority of SBV were males (N=125, 84.5%) and females were (N=23, 15.5%). The age ranged from 15-78years.The mean age was 41.14±(SD=15.4) .The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR=2).The mean duration of illness before hospital admission was 2days (± SD=1.4) and median was 1 day (± IQR=2). The morbidity rate was 5.4% (N=8) and the mortality rate was 3.4 %( N=5) Conclusion: Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.
Bridge to Surgery Using a Self-Expandable Metallic Stent for Stages II–III Obstructive Colorectal Cancer
Authors: Ohta Katsuya , Ikenaga Masakazu , Ueda Masami , Iede Kiyotsugu , Tsuda Yujiro , Nakashima Shinsuke , Nojiri Takashi , Matsuyama Jin , Murata Jun , Kobayashi Ichizo , Tsujii Masahiko , Yamada Terumasa 
Published: June 2020

Abstract
Background: Bridge to surgery (BTS) using a self-expandable metallic stent (SEMS) for the treatment of obstructive colorectal cancer improves the patient’s quality of life. This study aimed to examine prognostic factors of obstructive colorectal cancer. Methods: We analyzed stage II-III resectable colon cancer cases (Cur A) retrospectively registered between January 2005 and 2017. We encountered Cur A cases after BTS with SEMS placement (BTS group). We compared surgical results and prognoses between the two groups. Results: A total of 50 patients underwent endoscopic SEMS placement, which technical success of 96% and morbidity rate of 18%. Overall, 117 patients were evaluated: 67 of them underwent emergency surgery (ES) and 50 underwent BTS. Primary anastomosis rates were 77.6% in ES and 95.7% in BTS (p < 0.001); postoperative complication, 46.3% in ES and 10.5% in BTS (p < 0.001); pathological findings of lymphatic invasion, 66.7% in ES and 100% in BTS (p < 0.001); venous invasion were 66.8% in ES and 92% in BTS (p = 0.04); and recurrence of 25.4% in ES and 39.1% in BTS. The 3-year overall survival was significantly different between two groups (ES, 86.8%:BTS, 58.8%), BTS is worse than ES (log-rank test; p < 0.001). Venous invasion independently predicted worsened recurrence-free and overall survival. Conclusions: The vascular invasiveness was correlated with tumor progression after SEMS placement, and the survival rate was lower in BTS. SEMS potentially worsens prognostic outcomes in stage II–III obstructive colorectal cancer.
3,4-diaminopyridine Treatment for Lambert-Eaton Myasthenic Syndrome in Adults: A Meta-analysis of Randomized Controlled Trials
Authors: Zhang Na , Hong Daojun , Ouyang Taohui , Meng Wei , Huang Jingwei , Li Meihua , Hong Tao 
Published: June 2020

Abstract
Background: Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of neuromuscular transmission. The objective was to examine the efficacy and safetyof 3,4-diaminopyridine (3,4-DAP) in LEMS. Methods: We searched several databases to identify relevant studies, including PubMed, EMBASE, Cochrane Neuromuscular Disease Group Specialized Register and the Cochrane Controlled Trials Register.The primary outcome Quantitative Myasthenia Gravis (QMG) muscle score and secondary outcome compound muscle action potentials (CMAP) amplitude were pooled by meta-analysis. Results: Six randomised controlled trials (RCT) involving 115 patients with LEMS were included. A meta-analysis of the primary outcome showed a significant improvement of 2.33 (95% CI, -2.81 to -1.85, p<0.001) in QMG muscle score after treatment with 3,4-DAP. Moreover, a meta-analysis of the secondary outcome showed that the overall mean CMAP amplitude improved significantly in LEMS patients with 3, 4-DAP treatment, compared with placebo treatment(mean difference 1.63 mV, 95% CI, 0.85 to 2.41, p<0.001). The overall assessment of all included trials showed low risk of bias and low heterogeneity. Conclusioins: The pooled results demonsrated that 3,4-DAP had a significant effect on LEMS treatment, with improvements in muscle strength score and CMAP amplitude, which are moderate to high evidence from randomized controlled trials.
Multiple Sclerosis incidence rate in southern Iran: A Bayesian epidemiological study
Authors: Asmarian Naeimehossadat , Sharafi Zahra , Mousavi Amin , Jacques Reis , Tamayo Ibon , Bind Marie-Abèle , abutorabi-zarchi Marzie , Moradian Mohammad Javad 
Published: June 2020

Abstract
Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanism and clinical impact on young people. The prevalence of this disease in Iran is reported to be 5.3 to 74.28 per 100000 cases. Due to high prevalence of this disease in Fars province, this study aimed to assess the distribution of MS in this region in southern Iran by evaluating its covariates.Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria, which was reported by the MS Society of Fars from 1991 until 2016. Bayesian spatio-temporal models was also used to describe MS incidence in Fars province. We also investigated the association between overall MS incidence rate and the overall percentage of vitamin D intake, smokers in the population as well as the overall percentage of people with normal BMI as well as alcohol consumption in a population from 1991 until 2016 by Besag, York and Mollie's (BYM) model.Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000 population. The highest relative risk was estimated at 1.8 in the city of Shiraz, the capital of Fars province while the lowest relative risk was estimated at 0.11 in Zarindasht County in southern Fars. The percentages of vitamin D3 intake was significantly associated with the incidence of MS. Although 1% increase in Vitamin D3 intake is associated with 2% decrease in the risk of MS, 1% increase in smoking is associated with 16% increase in the risk of MS, respectively.Conclusion: Spatial analysis of MS showed low incidence rate of this disease in the south and south east of Fars province, which is due to the effect of different covariates. As suggested by previous studies, vitamin D and smoking among all covaiates might be associated with high incidence of MS.
Network pharmacology based investigation into the bioactive ingredients and molecular mechanisms of QingFeiPaiDu Decoction treating COVID-19
Authors: Liu Yan , Xiong Lewen , Wang YanYu , Luo Mengxiong , Zhang Longfei , Zhang Yongqing 
Published: June 2020

Abstract
Objective: To study the QingFeiPaiDu Decoction (QFPDD) in the treatment of Corona Virus Disease 2019 (COVID-19) bioactive ingredient and its potential mechanism. Methods: Combined with the clinical symptoms of COVID-19 patients, a "component-target-disease" network model was constructed based on the network pharmacology method, and potential active components, targets and molecular mechanisms of QFPDD for COVID-19 were screened out through topology parameter analysis.Results: We collected 376 active ingredients of QFPDD from the database, and 18833 potential anti-novel coronaviruses (SARS-CoV-2) targets were analyzed and screened. The principal targets involved PIK3CA, PIK3R1, APP, SRC, MAPK1, MAPK3, AKT1, HSP90AA1, EP300, CDK1, etc. We obtained 574 GO entries by Gene Ontology enrichment analysis and obtained 214 signal pathways with P<0.05 by KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis. Among them, the antiviral biological processes of QFPDD included a cellular response to nitrogen compound, protein kinase activity, membrane raft, etc. Pathways involved in the regulation include Pathways in cancer, Endocrine resistance, PI3K-Akt signaling pathway, Proteoglycans in cancer, etc. Molecular docking results showed that the core ingredients of QFPDD have a better affinity to the 2019-nCoV 3CL hydrolytic enzyme (Mpro) and angiotensin-converting enzyme 2 (ACE2). Conclusion: Through network pharmacology research and molecular docking verification, this paper preliminarily explored the potential molecular mechanism and relevant active ingredients of QFPDD playing an anti-SARS-CoV-2 role, providing a reference for the further development and utilization of QFPDD and the development of new specific antiviral drugs.
Modern contraceptive use among sexually active female adolescent: Trends and determinants insight from National Demographic and health survey
Authors: Kebede Alemi , Belina Sena , Biratu Yonas , Kebede Ayantu 
Published: June 2020

Abstract
Background

The sexual and reproductive health of young people is a global priority. Access to sexual and reproductive health information and services will determine, the burden of adolescent pregnancies and unwanted pregnancies. Teenage pregnancy that has profound effects on the health and wellbeing of young women across their life course is a burning public health and a demographic challenge in Ethiopia. Contraceptive use allows girls to postpone motherhood and space births. However, little is known about the trends in contraceptive use and its determinant among girls aged 15 to 19 in Ethiopia. Therefore, this study was designed to identify factors associated with modern contraceptive methods use among sexually active adolescent girls in Ethiopia.
Methods

Four Ethiopian demographic and health survey data were used to examine trends of contraceptive methods use among sexually active adolescent girls. To identify factors associated with contraceptive use, the 2016 Ethiopian demographic and health survey data was used. The data was accessed from the demographic and health survey program data base and data for sexually active adolescent girls were extracted. Data analysis was done using SPSS version 21. Data were weighted for analysis. Descriptive analysis was used to describe independent variables of the study participants. And design effect was considered during analysis. Multivariable logistic regression model was used to identify factors associated with contraceptive use.
Results

Modern contraceptive use increased significantly from 5.9% in 2000 to 39.3% in 2016. The odds of contraceptive use were lower among female adolescent who had no education (AOR: .038; 95%CI: (.007 to 0.216), primary education (AOR: 0.112; 95%CI: 0.026 to 0.483). But the odds of contraceptive methods use were higher among adolescent living in rich wealth status AOR: 5.131; 95%CI: (1.795 to 14.669) and those told about family planning during their health facility visit (A0R: 3.700; 95%CI: 1.517 to 9.020)
Conclusion

Modern contraceptive use increased significantly among sexually active adolescent girls in Ethiopia. Wealth index, education, told about family planning during their health facility visit and partner occupation were factors associated with contraceptive use. Improving economic and educational status of young women may help improve contraceptive use in Ethiopia.
Systematic Development and Refinement of a Contextually Relevant Strategy for Undergraduate Medical Ethics Education: a qualitative study
Authors: Shamim Muhammad Shahid , Torda Adrienne , Baig Lubna , Zubairi Nadeem , Balasooriya Chinthaka 
Published: June 2020

Abstract
Background
Delivery of medical ethics education is complex due to various reasons, compounded by the context-dependent nature of the content. The scarcity of relevant resources in the contexts of some developing countries adds a further layer of difficulty to ethics education in these contexts. We used a consultative approach with students, teachers and external experts to develop a contextually relevant and practical approach to medical ethics education. The aim of this study was to develop and refine a contextually relevant approach to ethics education in the region of Saudi Arabia.
Methods
The study utilized explorative qualitative methodology to seek views of students and faculty of Rabigh Faculty of Medicine, Kaing Abdulaziz University, Jeddah, Saudi Arabia, and international experts in the field of ethics and education to review and enhance a preliminary version of workbook-based ethics learning strategy. Three focus groups with 12 students and in-depth interviews with four faculty members enabled the study participants to objectively critique the WBEL and provide feedback to enhance its quality. In addition, eleven external experts critically analyzed the workbook. Thematic content analysis of the data was done to draw inferences which were used to refine the educational strategy.
Results
The analysis generated twenty-one sub-themes within four main themes: design features, content, teaching methods and assessment. These findings helped to modify the educational strategy for improve its effectiveness in the given context.
Conclusion
The study drew on the views of students, faculty and external experts to systematically develop a novel approach to ethics education for countries like Saudi Arabia. It also demonstrated the use of consultative approach for informing a culturally relevant educational strategy in Middle East context.