bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends of alcohol use, dietary behaviour, interpersonal violence, mental health, oral and hand hygiene behaviour among adolescents in Lebanon: cross-sectional national school surveys from 2005, 2011 and 2017
Authors: Pengpid Supa , Peltzer Karl 
Published: June 2020

Abstract

Background: Health risk behaviours during adolescence can have long-term negative consequences. Little is known, however, about the recent health risk behaviour trends in adolescents in Lebanon, This investigation aimed to report the trends in the prevalence of various health risk behaviours, such as alcohol use, dietary behaviour, interpersonal violence, mental health, oral and hand hygiene, among adolescents in Lebanon.Methods: Cross-sectional nationally representative data were analysed from 13,109 adolescents (14 years median age) that participated in three waves (2005, 2011 and 2017) of the “Lebanon Global School-Based Student Health Survey (GSHS)”.Results: Significant improvements were found among both boys and girls in the decline of interpersonal violence (bulling victimization, being physically attack and involvement in physical fighting), poor washing of hands after using the toilet, and suicide plan, and among girls only loneliness, worry-induced sleep disturbance and suicidal ideation. Significant increases were found among both boys and girls in the prevalence of inadequate fruit consumption, and among boys only unintentional injury and not always washing hands before eating.Conclusion: Several decreases but also increases of health risk behaviours were found over three assessment points during a period of 12 years calling for continued health enhancing activities in this adolescent population.
Cost-Effectiveness Analysis of A Program to Delay Progression to Dialysis and Death Among CKD Patients in Lima, Peru
Authors: Saldarriaga Enrique M , Bravo-Zúñiga Jessica , Hurtado-Roca Yamilee , Suarez Víctor 
Published: June 2020

Abstract
Background. The Renal Health Program (RHP) was implemented in 2013 as a secondary prevention strategy to reduce the incidence of patients starting dialysis and overall mortality. A previous study found that adhered patients have 58% protection against progression to dialysis compared to non-adhered. Objective. We aim to estimate the lifetime economic and health consequences of the RHP intervention to determine its cost-effectiveness in comparison with usual care. Methods. We use a Markov model of three health stages to simulate for 30 years the cost associated with RHP and usual care, as well as years lived free of dialysis (YL) and Quality Adjusted Life Years (QALY). Costs were estimated from the payer perspective. We conduct a Probabilistic Sensitivity Analysis (PSA) to assess the robustness of our estimates. Results. We found that the RHP is a cost-saving alternative compared to usual care, with a per person difference of $-782.73in costs and 0.04 in QALYs. The Incremental Cost-Effectiveness Ratio (ICER) per QALY is $-21,660. From a PSA, RHP holds cost-saving under 999 out of 1,000 evaluated scenarios. Discussion. Our results show the lifetime economic value of a case-management intervention for CKD patients to delay its progression to dialysis. The RHP is cost-saving compared to usual care, with a negative ICER per QALY robust to different scenarios. We aim these results to help in the decision-making process of scaling-up and investment of similar strategies in Peru. Our results help to increase the evidence in Latin America where there is a lack of information in the long-term consequences of prevention and early referral strategies in CKD patients.
Carfilzomib Induced Cardiotoxicity in a Multiple Myeloma Patient
Authors: Toro Arnold Mendez , Diaz-Brochero Candida , Acosta-Gutierrez Estivalis 
Published: June 2020

Abstract
Proteasome inhibitors such as carfilzomib are indicated in multiple myeloma patients showing relapse and/or refractoriness of clonal activity after initial treatment. However, this therapy has been associated with a significative incidence of cardiotoxicity, especially in patients with known cardiovascular risk factors. Here we report a case of a 60-year-old woman with multiple myeloma, who developed congestive severe heart failure with positive myocardial lesion biomarkers and LVEF and strain reduction, after treatment with carfilzomib. Therefore chemotherapeutic drug was discontinued and neurohormonal blocking and diuretic therapy was started resulting in amelioration of symptoms, without changes in LVEF but with significant GLS improvement. This case illustrates the behavior of carfilzomib induced cardiotoxicity and the expected response to the appropriate pharmacological management. Although high-grade cardiotoxicity is relatively rare in patients with non previous cardiac risk factors, it was a predictable side effect of carfilzomib use. Recognition of this syndrome is critical to instauration of appropriate therapy and prevention of morbimortality.
A Report About a 23-year-old Young Mother Suffering From Rare Insular Thyroid Carcinoma
Authors: chen haibin , liu zhongmin , liang xiaoyan , wu rui 
Published: June 2020

Abstract
Background Insular carcinoma of thyroid (ICT) is a rare malignant tumor with poor differentiation of the thyroid , most patients are middle-aged and elderly women. Here is a report of a case involving a young woman suffering from insular thyroid carcinoma.Case report This report is about a 23-year-old young mother who already has three children of hers. she accidentally discovered a left neck mass with slight pain from local compression about half a year ago and did not seek medical treatment. She came to the hospital this time because the neck mass recently increased rapidly and she felt pressure on the trachea, affecting swallowing. Ultrasonography showed that the maximum diameter of the hypoechoic nodules was 61*46mm in the left and no lymph nodes enlargement were seen on both sides.The patient had a partial left thyroidectomy and histopathological results revealed ICT. Therefore, she completed total thyroidectomy and cervical lymph node dissection. The postoperative process was relatively smooth and the patient was successfully discharged.Conclusion：Not all patients with insular thyroid carcinoma have similar imaging findings, so Fine Needle Aspiration Cytology(FNAC)pathological diagnosis is necessary before surgery.
An Educational Intervention for Improving Knowledge of Syrian School children About Avulsion
Authors: zaher nancy Al , Dashash Mayssoon 
Published: June 2020

Abstract
Objective:The prognosis of replantation of an avulsed tooth is affected by the first aid management in the first 15 minutes after traumatic incident. Knowledge of the optimal management is crucial to successful replantation. The aim of this study was to investigate the effectiveness of educational intervention using the Arabic poster prize in improving the knowledge of primary schoolchildren about firstaid management of avulsion.Methods: An interventional educational study was undertaken. A total of 550 schoolchildren aged 9-12 years participated in this study. Thirteen public primary schools in Damascus city were chosen. A questionnaire was developed to measure the knowledge of schoolchildren about avulsion management. The translated IADT education poster about avulsion management was adopted .The content of this poster was explained to the children. Two months later, the subjects were re-evaluated using the same questionnaire. Paired sample t-test was used to compare the improvement of knowledge before and after.Result:A total of 537 schoolchildren completed the questionnaires in which (N=305(57% were females and (N=232) 43% were males. The findings demonstrated significant improvement in the participants’ responses after 8 weeks(P<0.05). The mean score of knowledge increased significantly from 3.71 in baseline to 4.03 after 8 weeks(P<0.003). Conclusion: The educational intervention showed significant improvement intheirknowledge of children about avulsion after education.This interventional method can be suggested as a practical valuable tool that can be generalized to cover all children in Syrian society in the hope to prevent negative consequences of avulsion.
Complex Lumbosacral Fracture-Dislocation with Sacral Fracture: Report of a Case and Review of the Literature
Authors: Qu Liyan , Song Jiashi , Li Fangcai , Liu Bing 
Published: June 2020

Abstract
Purpose: Traumatic lumbosacral fracture-dislocation is a very rare pattern of injury. We report a patient who has been suffered from a traffic accident and resulted in concomitant severe injuries: complex lumbosacral fracture-dislocation with pelvic ring disruption and vertical shear sacral fracture; Pneumothorax. Methods: She was transferred to the emergency department at the local provincial hospital and treated with the pelvic external fixation and closed drainage of thoracic cavity. For the further therapy, she was transferred to our hospital. The neurological examination revealed incomplete S1 paraplegia in the right lower extremity, the left lower extremity was normal, and rectal tone was existed. Standard x-rays and computed tomography revealed L5-S1 fracture-dislocation and fractures of the L5 transverse processes. Results: She was treated with S1 laminectomy and L5-S1 interbody fusion using lumbo-iliac internal fixation. Conclusions: Available literatures on lumbosacral fracture-dislocation were also reviewed which illustrate the pathogenic, clinical, radiological and therapeutic aspects of lumbosacral fracture dislocation.
Synthesis and Characterization of Human Skin-Compatible Conductive Flexible Cellulose Carbon Nanohorn Sheets
Authors: Selvam Karthik Paneer , Nagahata Taichi , Kato Kosuke , Koreishi Mayuko , Nakamura Toshiyuki , Nakamura Yoshimasa , Nishikawa Takeshi , Satoh Ayano , HAYASHI Yasuhiko 
Published: June 2020

Abstract
Background: Conductive sheets of cellulose and carbon nanomaterials and its human skin applications are an interesting research aspect as they have potential for applications for skin compatibility. Hence it is needed to explore the effects and shed light on these applications.Method: To fabricate wearable, portable, flexible, lightweight, inexpensive, and biocompatible composite materials, carbon nanohorns (CNHs) and hydroxyethylcellulose (HEC) were used as precursors to prepare CNH-HEC (Cnh-cel) composite sheets. Cnh-cel sheets were prepared with different loading concentrations of CNHs (10, 20 50,100 mg) in 200 mg cellulose. To fabricate the bio-compatible sheets, a pristine composite of CNHs and HEC was prepared without any pretreatment of the materials. Results: The obtained sheets are conductive (1.83×10-5­ S) and bio-compatible with human skin. Analysis for skin-compatibility was performed for Cnh-cel sheets by h-CLAT in vitro skin sensitization tests to evaluate the activation of THP-1 cells. It was found that THP-1 cells were not activated by Cnh-cel; hence Cnh-cel is a safe biomaterial for human skin. It was also found that the composite allowed only a maximum loading of 100 mg to retain the consistent geometry of free-standing sheets of < 100 µm thickness. Since CNHs have a unique arrangement of aggregates (dahlia structure), the composite is homogeneous, as verified by transmission electron microscopy (TEM) and, scanning electron microscopy (SEM), and other functional properties investigated by Raman spectroscopy, Fourier transform infrared spectroscopy (FT-IR), conductance measurement, tensile strength measurement, and skin sensitization.Conclusion: It can be concluded that cellulose and CNHs sheets are conductive and compatible to human skin applications.
Identification of novel genes associated with diagnosis and prognosis in glioblastoma
Authors: Li Gaowei , Cai Linjun , Tang Xin , Huang Jianhan , Zhou Liangxue 
Published: June 2020

Abstract
Background: Glioblastoma (GBM) is the most lethal primary brain cancer and its survival rate is very low. Comprehensive genomic characteristics and high degree of heterogeneity of GBM are main causes that contribute to the absence of effective therapeutic targets and prognostic markers and eventual treatment failures. Here, Gene set enrichment analysis (GSEA) was used to explore comprehensive genomic characteristics and high degree of heterogeneity of GBM. Our study will help explain potential tumorigenesis mechanism and contribute to development of targeted therapeutics and prediction of patient prognosis.Methods: Gene expression profile of GSE50161 was downloaded from Gene Expression Omnibus (GEO) database and GSEA was performed to evaluate the microarray data at level of gene sets of GO, KEGG and hallmark of Molecular Signatures Database (MSigDB). Core enrichments of selected hallmark gene sets were applied for clinical prognosis verification in Gene Expression Profiling Interactive Analysis (GEPIA). Genes associated with significant overall survival (OS) and unreported before were recognized as novel; the expression levels of novel genes in GBM samples and every novel gene between normal brain and GBM samples were compared. Receiver operating characteristic (ROC) and Pearson correlation analysis were also performed to evaluate the diagnostic biomarkers of GBM and correlations among novel genes respectively.Results: We obtained 511 and 494 GO gene sets, 12 and 10 KEGG gene sets, and 2 and 8 hallmark gene sets in normal and GBM samples respectively. Five novel genes SERPINA5, TENM2, ARAP3, THBD, TCF19 associated with GBM prognosis were selected and four novel genes SERPINA5, TENM2, ARAP3, TCF19 performed well for GBM diagnosis prediction were obtained. In addition, we also found that four novel genes SERPINA5, ARAP3, THBD, TCF19 that high expressed in GBM samples were all positively correlated with each other and correlation between ARAP3 and TCF19 was the strongest.Conclusions: Our study will help deeper understand the molecular heterogeneity and develop of targeted therapeutics of GBM; five novel related to prognosis genes (of which four are also related to diagnosis) may be applied to more accurate clinical decision-making process.
First, Do No Harm: Unintended Consequences of Skill-Based Training in Global Health
Authors: Fant Colleen , Morgan Jennifer , Galvin Shannon , Peralta Feyce M. , Swaroop Mamta , Milad Magdy P. , Doobay-Persaud Ashti 
Published: June 2020

Abstract
Background: Many medical trainees participate in international clinical rotations in resource-limited settings and they frequently describe pressure to perform outside their scope of clinical practice. Educators must provide trainees with tools to manage dilemmas prior to departure and should also review relevant procedural skills that may be useful. The Northwestern University McGaw Global Health Clinical Scholars program (GHCS), created to provide global health skills across medical disciplines and promote clinical self-awareness, incorporates a skills and ethics simulation curriculum for participating trainees and this study aims to evaluate the impact on trainee self-perceptions.Methods: Training sessions were held between 2015 and 2017 for trainees participating in the GHCS program. The sessions were: ethics, obstetrics/gynecology/pediatrics, and surgery/anesthesia. Pre- and post- surveys assessed comfort and resources to navigate ethical dilemmas including participant beliefs about benefits versus harms of performing skills potentially outside of their scope and their willingness to perform these skills, if they were the only provider present.Results: There were 56 responses from 68 trainee session experiences. After the ethics session, participants reported more confidence dealing with issues around scope of practice, professionalism, and harm (p<0.05). After the skills sessions, the majority of participants stated the benefits outweighed harms of performing skills and were more likely to perform all skills if they were the sole provider.Discussion/Conclusions: Despite having a dedicated ethical simulation reviewing basic ethical frameworks, including scope of practice, skill-based trainings resulted in increased stated willingness of trainees to perform skills outside of their scope of training.
Relationships of Coping Styles and Psychological Distress Among Patients with Insomnia Disorder
Authors: Li Yinghui , Cong Xiaoyin , Chen Suzhen , Li Yong 
Published: June 2020

Abstract
Background: Insomnia appears to be one of the most frequent sleep complaints in the general population. It has significant negative impact on daily functioning. however, there has been little research that described the effect of coping style in insomnia disorder.Methods: The Simplified Coping Style Questionnaire (SCSQ) was used to evaluate 79 adult patients with insomnia disorder alongside 80 healthy controls. Additionally, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist-90-Revised (SCL-90R) was utilized to determine the status of depression, anxiety and other psychological symptoms.Results: Positive coping style score was significantly lower, whereas negative coping style score and nine symptomatic dimensions of SCL-90R were significantly higher in insomnia patients than in controls. Positive coping style score was adversely related to PSQI score, obsessive-compulsive, depression, anxiety and phobic anxiety, whereas negative coping style score was positively related to PSQI score, somatization and interpersonal sensitivity. Further multiple stepwise regression analysis showed that PSQI total score was independently and positively correlated with negative coping style score.Conclusions: Insomniacs use more negative coping styles and less positive ones. Positive coping is adversely associated with insomnia symptoms and psychological distress, whereas negative coping is positively related to those symptoms.
Quantifying the impact of severe bushfires on biodiversity to inform conservation
Authors: Baranowski Kelsee , Faust Christina , Eby Peggy , Bharti Nita 
Published: June 2020

Abstract
The unusually severe 2019-2020 Australian bushfire season destroyed large areas of habitat along the southeastern coast. We assess the differences between this fire season and previous ones to understand their impacts and potential recovery. We used thermal satellite data to quantify the extent of eastern Australian bushfires from 2012-2020. During the 2019-2020 anomalous fire season, 134 mega-fires, each over 10,000 ha, burned 62.5% of the total affected area, including critical forested landscapes. Previous fire seasons were characterized by smaller, scattered fires in mostly non-forested areas. The anomalous fire season had direct negative impacts on wildlife including grey-headed flying foxes, which experienced substantial declines in immediately available foraging forest habitat, particularly key winter resources. We identified important areas for managing wildlife resources and supporting ecosystem health in the coming decades. Our research also identifies key monitoring areas to improve our understanding of ecosystem recovery and resilience in changing fire regimes.
Mining Novel Specific Rumen Bacteria to Enhance the Bioactive Function of Mulberry Leaf in Promoting Host Antioxidant Activity and Immunomodulatory
Authors: Wang Bing , Luo Hailing 
Published: June 2020

Abstract
Background: Rumen is a natural fermentation system and the microorganisms inside can effectively utilize plant bioresource and interact with host metabolism. Here, analysis of rumen microbiome, together with animal performance and serum metabolism in a lamb model were performed to identify the potential use of mulberry leaf silage (MS) to replace alfalfa silage (AS) as a new functional feed resource and to mining the novel specific mulberry leaf associated rumen bacteria interact with host metabolism. Results: The lambs fed with MS diet showed improved antioxidant capacity and immune function compared to those fed AS diet. The MS diet significantly altered rumen microbiota α- and β-diversity and taxonomic composition. Microbial analysis revealed that Bifidobacterium, Lactobacillus and Schwartzia were enhanced, and Ruminococcaceae UCG-010 and Lachnospiraceae_XPB1014_group were down-regulated in the rumen of MS group. A strong association was also found between these rumen microbial taxa and host antioxidant capacity and immunomodulatory. Conclusion: These findings indicated that mulberry leaf silage can be a high-quality feed source or bioactive pharmaceutical that is responsible for ruminants health benefits by modifying the rumen microbial community with potentially enhanced probiotics and inhibited biohydrogenation and methane emission.
MHC class I evolution; from Northern pike to salmonids
Authors: Grimholt Unni , Lukacs Morten 
Published: June 2020

Abstract
Background
Salmonids are of major importance both as farmed and wild animals. The financial importance to aquacultural industry as well as to rural communities that profit from wild salmon fishing is substantial. With the changing environment comes changes in pathogenic pressures so understanding the immune system of all salmonid species is of essence. Major histocompatibility complex (MHC) genes are key players in the adaptive immune system signalling infection to responding T-cells populations. Their key role in inducing immunity and their link to disease resistance instigate studies on structure, function and evolution. Northern Pike, a basal sister clade to salmonids, represent a species which has not experienced the fourth salmonid specific whole genome duplication.
Results
Comparing the gene organization and evolution of MHC class I gene sequences in Northern pike versus salmonids displays a complex picture of how many of these genes evolved. Salmonid Ia and Ib Z lineage genes are not orthologs to the Northern pike Z lineage sequences. Instead, the salmonid genes have experienced unique gene duplications in the two duplicated regions as well as in the Salmo and Oncorhynchus branch. Potentially, transposase elements enabling these duplications were already present in the Northern pike Z lineage gene.
Conclusions
Although both Northern pike as well as salmonids have expanded their U and Z lineage genes, these gene duplications have occurred separately in pike and in a salmonid ancestor. However, the similarity between these duplications suggest the transposable machinery was present in a common ancestor. The salmonid MHCIa and MHCIb regions were mostly formed during the 80MYA since the split from pike and before the Oncorhynchus and Salmon branch separated. As seen in tetrapods, the non-classical U lineage genes are diversified duplicates of their classical counterpart. One MHCI lineage, the L lineage, experienced massive species-specific gene duplications after Oncorhynchus and Salmo split approximately 25 MYA. Based on what we currently know about L lineage genes, this diversity will most likely affect immune responses in individual species.