bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Moderate‐to‐Vigorous Physical Activity and the Risk of Major Adverse Cardiovascular Events or Mortality in People With Various Metabolic Syndrome Status: A Nationwide Population‐Based Cohort Study Including 6 Million People
Authors: Park Sehoon , Han Kyungdo , Lee Soojin , Kim Yaerim , Lee Yeonhee , Kang Min Woo , Park Sanghyun , Kim Yong Chul , Han Seung Seok , Lee Hajeong , Lee Jung Pyo , Joo Kwon Wook , Lim Chun Soo , Kim Yon Su , Kim Dong Ki 
Published: November 2020

Background
A population‐scale evidence for the association between moderate‐to‐vigorous physical activity (MV‐PA) and risks of major adverse cardiovascular event (MACE) or all‐cause mortality in people with various metabolic syndrome (MetS) status is warranted.

Methods and Results
We performed a nationwide retrospective cohort study based on the claims database of South Korea. We included people who received ≥3 national health screenings from 2009 to 2013 without a previous MACE history. We determined the MetS status of 6 108 077 people: MetS‐chronic (N=864 063), MetS‐developed (N=348 163), MetS‐recovery (N=348 313), and MetS‐free (N=4 547 538). The exposure was self‐reported MV‐PA frequencies. The outcome was incident MACEs or all‐cause mortality. The incidence rate ratios (IRR) were calculated with adjustments for clinical/demographic characteristics. During the median follow‐up of 4.28 years, 78 770 and 51 840 people experienced MACEs or died, respectively. Those who engaged in MV‐PA had a significantly lower risk of MACEs or all‐cause mortality than those not engaged in MV‐PA in every spectrum of MetS. Even among those who were free from MetS (for MACEs, IRR 0.94 [0.92–0.97], for all‐cause mortality, IRR 0.85 [0.82–0.87]) or who had already recovered from MetS (for MACEs, IRR 0.89 [0.84–0.95], for all‐cause mortality, IRR 0.74 [0.68–0.81]), 1 to 2 days per week of MV‐PA were significantly associated with lower risk of the adverse outcomes when compared with not being engaged in MV‐PA. Those who were engaged in MV‐PA more frequently also had significantly lower risks of MACEs or all‐cause mortality.

Conclusions
This nationwide study suggests that MV‐PA may be recommended to the general population regardless of recent MetS status.
Eleanor Elsner’s Discordant Discourse and Split Subjectivity in The Magic of Morocco (1928)
Authors: Aammari Lahoucine 
Published: November 2020

Abstract
On board the Macoris, the British woman traveller Eleanor Elsner peregrinated into French Morocco, landing in Casablanca in 1928. Elsner’s The Magic of Morocco is about the author’s search for the atavistic at a time when the European colonial power structure and the rise of tourism had transformed the exotic referent into the familiar sign of Western hegemony. Elsner could not help but experience a sense of displacement in time and space, an experience that produced either a sense of disorientation and loss, or an obsessive urge to discover the “authentic” Other. Elsner’s account is imbued with discursive ambivalences and ideological uncertainties. Her discourse is complicitous as she vociferously lauds the French colonial enterprise in the person of General Lyautey, the engineer of the “peaceful pacification.” The present paper focuses on Elsner and her account as a staunch advocate of the French colonial enterprise in Morocco and her quest for elsewhere. This paper explores Elsner’s discordant practices and discourses as a split subject/traveller in Protectorate Morocco.
An agent-based model of sign language persistence informed by real-world data
Authors: Mudd Katie , de Vos Connie , de Boer Bart 
Published: November 2020

Abstract
As evidence from sign languages is increasingly used to investigate the process of language emergence and evolution, it is important to understand the conditions that allow for sign languages to persist. We build on a mathematical model of sign language persistence (i.e. protection from loss) which takes into account the genetic transmission of deafness, the cultural transmission of sign language and marital patterns (Aoki & Feldman, 1991). We use agent-based modeling techniques and draw inspiration from the wealth of genetic and cultural data on the sign language Kata Kolok to move towards a less abstract model of sign language persistence. In a set of experiments we explore how sign language persistence is affected by language transmission types, the distribution of deaf alleles, population size and marital patterns. We highlight the value of using agent-based modeling for this type of research, which allows for the incorporation of real-world data into model development.
Feasibility of Implementing Opioid Stewardship Recommendations for Sinonasal Surgery
Authors: Jordan Jaxon W. , Spankovich Christopher , Stringer Scott P. 
Published: November 2020

ObjectiveThe objective of our study was to review the current literature pertaining to perioperative opioids in sinus surgery and to determine the effects of implementing opioid stewardship recommendations in the setting of endoscopic sinonasal surgery.Study DesignSingle‐institution retrospective case‐control study.SettingAcademic medical center outpatient area.MethodsThis retrospective review comprised 163 patients who underwent routine functional endoscopic sinus surgery, septoplasty, and/or inferior turbinate reduction before and after implementation of a standardized pain control regimen based on published opioid stewardship recommendations. The regimen consisted of an oral dose of gabapentin (400 mg) and acetaminophen (1000 mg) at least 30 minutes prior to surgery, absorbable nasal packing soaked in 0.5% tetracaine intraoperatively, and a postoperative regimen of acetaminophen and nonsteroidal anti‐inflammatory medications. Tramadol tablets (50 mg) were prescribed postoperatively for breakthrough pain. The primary outcome measure for the study was the average number of hydrocodone equivalents (5 mg) prescribed before and after the new protocol.ResultsThe average number of opioid medications prescribed, measured as hydrocodone equivalents (5 mg), decreased from 24.59 preprotocol to 18.08 after the initiation of the new perioperative regimen (P <. 001). There was no significant difference between the periods (P >. 05) in number of postoperative phone calls regarding pain or in patient satisfaction scores.ConclusionOpioid stewardship recommendations can be instituted for sinonasal surgery, including multimodal perioperative pain management and substitution of tramadol for breakthrough pain, as a method to decrease the volume of opioids prescribed, without increasing patient phone calls or affecting the likelihood of physician recommendation Press Ganey scores.
Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis
Authors: Mathew Asha , Doorenbos Ardith Z. , Li Hongjin , Jang Min Kyeong , Park Chang Gi , Bronas Ulf G. 
Published: November 2020

Background: Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. Purpose: To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. Methods: Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. Results: Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. Conclusion: This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.
Is the Use of Intermaxillary Fixation Screws an Alternative to Erich Arch Bars for Maxillomandibular Fixation During Management of Maxillofacial Fractures? A Systematic Review and Meta-Analysis
Authors: Jain Anuj , Rai Anshul 
Published: November 2020

Study Design: Systematic review and meta-analysis. Objective: Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma. Methodology: An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF. Results: A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable. Conclusion: The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.
MicroRNA-296-5p inhibits cell metastasis and invasion in nasopharyngeal carcinoma by reversing transforming growth factor-β-induced epithelial–mesenchymal transition
Authors: Chen Meihui , Chen Chen , Luo Haiqing , Ren Jing , Dai Qiuqin , Hu Wenjia , Zhou Keyuan , Tang Xudong , Li Xiangyong 
Published: November 2020

Abstract

Aim
To explore the effect of miR-296-5p on the metastasis of nasopharyngeal carcinoma (NPC) cells and investigate the underlying mechanism.

Methods
The expressions of miR-296-5p in NPC tissues and cells were determined using GSE32920 database analysis and real-time PCR and miRNA microarray assays. An miR-296-5p mimic and inhibitor were transfected into NPC cells. Then, immunofluorescence imaging, scratch wound-healing, transwell migration and invasion assays were used to observe the effects of miR-296-5p on cell metastasis and invasion. Real-time PCR and western blotting were carried out to detect the expressions of genes and proteins related to epithelial–mesenchymal transition (EMT). A dual luciferase reporter assay was used to identify whether TGF-β is the target gene of miR-296-5p. Finally, TGF-β expression plasmids were transfected into NPC cells to verify the role of TGF-β in the miR-296-5p-mediated inhibition of nasopharyngeal carcinoma cell metastasis.

Results
Our results show that miR-296-5p inhibits the migratory and invasive capacities of NPC cells by targeting TGF-β, which suppresses EMT. Importantly, the miR-296-5p level was significantly lower in human NPC tissues than in adjacent normal tissues. It also negatively correlated with TGF-β and was significantly associated with the lymph node metastasis of patients with NPC.

Conclusions
Our findings show that miR-296-5p represses the EMT-related metastasis of NPC by targeting TGF-β. This provides new insight into the role of miR-296-5p in regulating NPC metastasis and invasiveness.
Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature
Authors: Zahedi Maryam , Hizomi Arani Reyhane , Tohidi Maryam , Haghighi Shirin , Mehrpour Masoud , Hadaegh Farzad 
Published: November 2020

Abstract

Background
Primary nasopharyngeal lymphoma (NPL) is a very rare tumor of Waldeyer ring (WR) lymphoid tissue. It is challenging to differentiate lymphoma infiltration of pituitary from a pituitary adenoma, meningioma infiltration, and other sellar lesions to plan a suitable treatment strategy. We presented for the first time a unique case of NPL with an unusual presentation of oculomotor nerve palsy associated with pan-pituitary involvement in a diabetic patient.

Case presentation
A 64-year old diabetic woman with no previous history of malignancy presented with intermittent diplopia for about the last nine months. Severe headache, left eye ptosis and hypoglycemic episodes were added to her symptoms after a while. Further complaints include generalized weakness, loss of appetite, generalized musculoskeletal pain, and 6–7 kg weight loss within six months. Her family history was unremarkable. Physical examinations of eyes indicated left eye 3rd, 4th, and 6th nerve palsy. But, she was not anisocoric, and the pupillary reflexes were normal on both eyes. No lymphadenopathy, organomegaly and other abnormalities were found. Magnetic resonance imaging (MRI) showed a heterogeneous enhancement in the seller and suprasellar regions, enlargement of the stalk, parasellar dural enhancement and thickening of the sphenoid sinus without bone erosion. Also, both cavernous sinuses were infiltrated and both internal carotid arteries were encased by the neoplastic lesion. It suggested an infiltrative neoplastic lesion which compressed the cranial nerves. Pituitary hormone levels assessment indicated a pan-hypopituitarism. Following nasopharyngeal mucosal biopsy, the immunohistochemistry (IHC) findings revealed a low-grade non-Hodgkin’s B-cell lymphoma. Systemic workup, including cerebrospinal fluid (CSF) studies, bone marrow aspiration, chest and abdominopelvic high-resolution computed tomography (HRCT) indicated no other involvement by the lymphoma. After chemotherapy courses, central adrenal insufficiency, partial central diabetes incipidious (CDI) and central hypothyroidism have been resolved. To our best knowledge, we found 17 cases of NPL with cranial nerve palsy, 1 case of NPL with pan-hypopituitarism and no NPL case with both cranial nerve palsy and pituitary dysfunction.

Conclusions
The incidence of cranial neuropathy in patients with diabetes should not merely be attributed to diabetic neuropathy without further evaluation.
Does the type of health insurance enrollment affect provider choice, utilization and health care expenditures?
Authors: Atake Esso-Hanam 
Published: November 2020

Abstract

Background
Two of the objectives of Universal Health Coverage are equity in access to health services and protection from financial risks. This paper seeks to examine whether the type of health insurance enrollment affects the utilization of health services, choice of provider and financial protection of households in Togo.

Methods
Data were obtained from a cross-sectional, representative household survey involving 1180 insured households that had reported either illness in the household in the 4 weeks preceding the survey or hospitalization in the 12 months preceding the survey. A nested logit model was used to account for the utilization of health services and provider choice, and methods of assessing catastrophic health care expenditures were used to analyze the level of household financial protection.

Results
Policyholders of private health insurance use private health care facilities more than policyholders of public health insurance. The main reasons for not using health centers among households with public insurance were out-of-pocket payments (49.19%), waiting time (36.80%), and distance to the nearest health center (36.76%). Furthermore, on average, households with public insurance spent a higher proportion of their total monthly nonfood expenditures on health care than those with private insurance. We find that the type of insurance, share of expenditures allocated to food, distance to the nearest health center, and waiting time significantly impact the choice of provider. Regardless of the type of health insurance, elderly individuals avoid using private health centers and referral hospitals due to the high cost.

Conclusion
We found that a multiple health insurance system results in a multilevel health system that is not equitable for everyone. The capacity of the health insurance system to provide equitable health care services and protect its members from catastrophic health care expenditures should be at the core of health care reform. This study recommends raising awareness of the criteria for the reimbursement of medical procedures within the framework of public insurance and promoting specific health insurance mechanisms for elderly individuals. Careful attention should be paid to ensuring universal education and literacy as a means of improving access to and the use of health care.
Forced exercise activates the NrF2 pathway in the striatum and ameliorates motor and behavioral manifestations of Parkinson's disease in rotenone-treated rats
Authors: Monir Dina M. , Mahmoud Motamed E. , Ahmed Omyma G. , Rehan Ibrahim F. , Abdelrahman Amany 
Published: November 2020

Abstract

Background
Parkinson's disease (PD) is a common neurodegenerative disorder characterized by progressive loss of nigrostriatal dopaminergic neurons leading to dopamine depletion and problems of movement, emotions, and cognition. While the pathogenesis of PD is not clear, damage of dopaminergic neurons by oxygen-derived free radicals is considered an important contributing mechanism. This study aimed to evaluate the role of treadmill exercise in male Wister rats as a single treatment and as an aid-therapy with L-dopa for rotenone-induced PD. To study the role of the Nrf2- ARE pathway as a mechanism involved in exercise-associated improvement in rotenone-induced PD in rats.

Method
Animals were divided into 5 groups, (Control, rotenone, rotenone\exercise, rotenone\L-dopa, and rotenone\exercise\L-dopa (combination)groups). After the PD induction, rats in the rotenone\exercise and combination groups were daily treadmill exercised for 4 weeks.

Results
Treadmill exercise significantly improved behavioral and motor aspects of rotenone-induced PD. When treadmill exercise was introduced as a single intervention, it amended most behavioral aspects of PD, gait fully corrected, short-term memory, and motor coordination. Where L-dopa corrected locomotor activity and motor coordination but failed to improve short-term memory and only partially corrected the gait of rotenone-treated rats. When treadmill exercise was combined with L-dopa, all features of PD were corrected. It was found that exercise upregulated some of its associative genes to Nrf2 pathways such as TFAM, Nrf2 and NQO.1 mRNA expression.

Conclusion
This study suggests that forced exercise improved parkinsonian like features by activating the Nrf2 pathway.
Effects of baby-friendly practices on breastfeeding duration in China: a case-control study
Authors: Zhang Yue , Yang Jinliuxing , Li Wenhao , Wang Nianrong , Ye Ya , Yan Shuangqin , Wang Sumei , Zeng Ting , Huang Zijuan , Zhang Fenghua , Li Yin , Yao Shiyi , Wang Haijun , Rozelle Scott , Xu Tao , Jin Xi 
Published: November 2020

Abstract

Background
The Baby-Friendly Hospital Initiative is generally considered an effective way to promote breastfeeding. Although China has the largest number of baby-friendly hospitals in the world, research on baby-friendly practices in China is limited, and the rate of exclusive breastfeeding (EBF) at 6 months, 20.7%, compared to the 2025 global goal of 50% is low. It is, therefore, important to determine the factors that remain significant barriers to EBF in China. To explore how the key baby-friendly practices affect EBF duration in China, we used a case-control study to compare the effects of baby-friendly-related practices on both EBF and non-breastfeeding (NBF) mothers at 3 months and to investigate the effects of both single and comprehensive baby-friendly practices in promoting EBF duration at 3 months, which is one step toward EBF at 6 months.

Methods
Participants were recruited from four maternal and child health hospitals in western (Chongqing), eastern (Qingdao), southern (Liuzhou), and central China (Maanshan). A total of 421 mothers (245 in the EBF group, 176 in the NBF group) of infants aged 3 months were surveyed through a self-reported questionnaire from April 2018 to March 2019. The experience of baby-friendly practices and breastfeeding during hospitalization were assessed with yes/no questions. Socio-demographic factors that influenced breastfeeding at 3 months were analyzed using bivariate and multivariate logistic regression analyses.

Results
Of mothers in the EBF group, 65.57% reported engaging in at least seven baby-friendly practices compared to 47.72% of mothers in the NBF group. Significantly more mothers in the EBF group engaged in baby-friendly practices than in the NBF group. These practices included “breastfeeding within one hour after birth” (74.29% vs. 59.09%), “breastfeeding on demand” (86.48% vs. 75.00%), and “never use a pacifier” (46.53% vs. 31.25%). After adjusting for confounding variables, we found that the mothers who engaged in fewer than seven baby-friendly practices were about 1.7 times less likely to breastfeed than were those who engaged in seven or more baby-friendly practices (odds ratio [OR] 1.720, 95% confidence interval [CI] 1.106, 2.667). Further, the mothers who did not breastfeed on demand were as likely to not breastfeed up to 3 months (OR 2.263, 95% CI 1.265, 4.049), as were mothers who did not breastfeed during hospitalization (OR 4.379, 95% CI 1.815, 10.563).

Conclusions
These data from hospitals in China suggest that higher compliance with baby-friendly practices may have a positive impact on EBF at 3 months, particularly in terms of promoting the implementation of breastfeeding on demand and breastfeeding during hospitalization in China.