bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding demand for, and feasibility of, centre-based child-care for poor urban households: A mixed methods study in Dhaka, Bangladesh.
Authors: Elsey Helen , Fieroze Fariza , Shawon Riffat Ara , Nasreen Shammi , Hicks Joseph Paul , Das Mahua , Huque Rumana , Hirano Izumi , Wallace Hilary Jane , Mashreky Saidur 
Published: November 2020

Abstract
Background: Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods: We used sequential mixed methods including a household survey (n=222) and qualitative interviews with care-givers (n=16), community leaders (n=5) and policy-makers (n=5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n=5), non-users (n=3), ex-users (n=3) and staff (2) were used to refine the model and identify implementation issues. Results: We found 24% (95% CI: 16%,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74%, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need. Conclusion: Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.
Survival among patients with severe high cervical spine injuries – A TraumaRegister DGU® database study
Authors: Kamp Oliver , Jansen O. , Lefering R. , Aach M. , Waydhas C. , Dudda M. , Schildhauer T. A. , Hamsen U. 
Published: November 2020

Abstract
BackgroundTrauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients with a severe high cervical spinal cord injury that could be discharged from hospital despite the prognosis of trauma scores. We estimate that the trauma scores and prediction models miscalculate these injuries. For this reason, we evaluated these findings in a larger control group.MethodsIn a retrospective, multi-centre study, we used the data recorded in the TraumaRegister DGU® (TR-DGU) to select patients with a severe cervical spinal cord injury and an AIS of 3 to 6 between 2002 to 2015. We compared the estimated mortality rate according to the Revised Injury Severity Classification II (RISC II) score against the actual mortality rate for this group.ResultsSix hundred and twelve patients (0.6%) sustained a severe cervical spinal cord injury with an AIS of 6. The mean age was 57.8 ± 21.8 years and 441 (72.3%) were male. 580 (98.6%) suffered a blunt trauma, 301 patients were injured in a car accident and 29 through attempted suicide. Out of the 612 patients, 391 (63.9%) died from their injury and 170 during the first 24 hours. The group had a predicted mortality rate of 81.4%, but we observed an actual mortality rate of 63.9%.ConclusionsAn AIS of 6 with a complete cord syndrome above C3 as documented in the TR-DGU is survivable if patients get to the hospital alive, at which point they show a survival rate of more than 35%. Compared to the mortality prognosis based on the RISC II score, they survived much more often than expected.
Adult-onset autoimmune diabetes: comparative analysis of classical and latent presentation
Authors: Fadiga Lúcia , Saraiva Joana , Catarino Diana , Frade João , Melo Miguel , Paiva Isabel 
Published: November 2020

Abstract
Introduction: Adult-onset autoimmune diabetes (AID) has two different phenotypes: classic type 1 diabetes mellitus (T1DM), with insulin requirement just after diagnosis, and latent autoimmune diabetes in adults (LADA). The purpose of this study is to characterize patients with AID followed on a tertiary centre, comparing classic T1DM and LADA.Methods: We collected data from patients with diabetes and positive islet autoantibodies, aged 30 years old and over at diagnosis. Patients who started insulin in the first 6 months were classified as T1DM and patients with no insulin requirements in the first 6 months were classified as LADA. Data regarding clinical presentation, autoantibodies, A1C and C-peptide at diagnosis, pharmacologic treatment and complications were analysed. Results: We included 92 patients, 46 with classic T1DM and 46 with LADA. The percentage of females was 50% in T1DM group and 52.1% in LADA group. The median age at diagnosis was 38 years (IQR – 15) for T1DM and 42 years (IQR – 15) for LADA (p=0.057). The median time between diagnosis of diabetes and diagnosis of autoimmune aetiology was 0 months in T1DM group and 60 months in LADA group (p<0.001). The mean BMI at diagnosis was 24.1Kg/m2 in T1DM group and 26.1Kg/m2 in LADA group (p=0.042). In T1DM group, 67.4% of the patients had more than one positive autoantibody, comparing to 41.3% of LADA patients (p=0.012). There was no statistical difference in what concerns to title of GAD autoantibodies, A1C and C-peptide at diagnosis of autoimmune aetiology. The presence of symptoms at diagnosis was associated with T1DM group (p<0.001). The median daily insulin dose was 40IU for T1DM (0.58IU/Kg) and 33.5IU for LADA (0.57IU/Kg), with no statistical difference. LADA patients were more often under non-insulin antidiabetic drugs (p=0.001). At 10 years follow up, 21.1% of T1DM patients and 63.3% of LADA patients had microvascular complications (p=0.004). Diabetic nephropathy was present in 23.5% of T1DM patients and 53.3% of LADA patients (p=0.047). At the last evaluation, 55.6% of T1DM and 82.6% of LADA patients had metabolic syndrome and this difference was independent of diabetes duration. Conclusion: Patients with classic T1DM presented more often with symptoms, lower BMI and higher number of autoantibodies, which may be related to a more aggressive autoimmune process. Patients with LADA developed more frequently microvascular complications for the same disease duration, namely diabetic nephropathy, and had more often metabolic syndrome.
Incidence and Malignancy Rate of Bethesda Category III Thyroid Lesions in A Tertiary Hospital
Authors: Celes Aneeshya , Fernandes Hilda 
Published: November 2020

Background: The introduction of The Bethesda System for Reporting Thyroid Cytopathology in 2010 provided the opportunity to establish worldwide standard reporting and terminology guidelines diagnostic category in reporting of thyroid FNAC. Indeterminate lesion included in the category III are those with insufficient degree of atypia to qualify for any of the suspicious categories. This study was conducted to determine the incidence and malignancy rate of Bethesda category III thyroid lesions.
Methods: A two- and half-year retrospective study was conducted in Father muller medical college. Thyroid lesion which were diagnosed as Bethesda category III on fine needle aspiration cytology during the study period were included. The cytology-histopathological correlation was done where ever available to calculate the incidence and malignancy rate of this category.
Result: A total of 1397 cases underwent thyroid FNA during the study period. Out of this, 57 cases were reported as Bethesda category III lesion. The incidence rate of Bethesda category III lesions in the study was 4.08%. Twenty-one cases had histopathology correlation. The malignancy rate was found to be 38.09%.
Conclusion: The Bethesda category III still remains a very challenging group with a large and varied range of diagnosis. The risk of malignancy might be higher that what is currently estimated for this category. Sub-classification of this category might help in predicting the nature of lesion better and aid patient management more accurately.
Detection of Micrometasteses In Lymph Nodes in Cases of Carcinoma Breast by Immunohistochemistry
Authors: Sharma Sunita , Mohanty C S 
Published: November 2020

Background – We evaluated archived lymph nodes of breast carcinoma for micrometastases detection by serial multiple sections (SMS) and immunohistochemistry (IHC) and found increased positive lymph nodes yield which led to change in staging in few cases, treatment and prognosis.
Method – Metastatic free, early breast cancer cases of 36 patients with lymph node status pN0 or pN1 were evaluated. These were the cases had been treated with modified radicle mastectomy and axillary lymph node dissection. All the lymph node was cut at 50µm interval to get 5µm thick serial sections. These serial sections (SMS) were stained with Hematoxyline and Eosin (H&E). Out of these 2 sections were subjected to Immunohistochemistry (IHC). Monoclonal antibodies chosen for IHC were panCK (Cytokeratin) and EMA (Epithelial membrane antigen) to detect micrometasteses.
Results – Total 463 lymph nodes from 36 cases of carcinoma breast were studied. New serial sections (SMS) cut from 435 lymph nodes of breast revealed 16(3.67%) additional positive lymph nodes from 12 cases. Out of 16 positive lymph nodes 4 were macrometasteses and 12 were micrometastases. Immunostaining with CK antibody revealed micrometasteses in 40 of 435 (9.19%) lymph nodes and by EMA antibody 33 of 435 (7.59%). Out of 40 micrometasteses 8 were positive for isolated tumor cells (ITC). We calculated the Z value and corresponding p value between the two methods as H&E versus SMS, H&E versus IHC and SMS versus IHC for carcinoma breasts. The tests revealed that SMS and IHC are definitely the superior methods in detection of a greater number of positive lymph nodes in cases of carcinoma breast.
P value for detection of micrometasteses H&E versus SMS is <0.05 (S), H&E versus IHC <0.01(S) and SMS versus IHC (<0.02). Out of 36 cases 06 cases showed change in staging and 03 out of 06 cases were upstaged from early to advanced stage carcinoma.
Conclusion – Significant number of metasteses are missed by routine processing of lymph nodes on H&E staining. SMS and IHC increase the yield of metasteses in lymph nodes. CK is superior marker than EMA.
Right Ethmoidal Sinus Schwannoma: Case Report of a Common Entity with an Unusual Presentation
Authors: Kavitha E M , Swapna L , Kumarguru B N , Kumar S Kranthi , Kumar M Udaya 
Published: November 2020

Schwannomas are benign, encapsulated nerve sheath tumors arising from Schwann cells. Approximately, 25-40% of all Schwannomas occur in the head and neck region, acoustic nerve being the most frequent site. The tumors originating from nasal cavity or paranasal sinuses are rare and constitutes only four percent.
A 40-year-old male presented with history of blurred vision of right eye and protrusion of right eye ball since 6 months. It was associated with history of watering and redness. Examination of right eye revealed mild proptosis and ptosis. Computed Tomography [CT] scan showed a large expansile cystic lesion measuring about 5.2x5.6x6.5cm involving entire right ethmoidal sinus. It showed expansion into anterior cranial fossa, roof and medial wall of right orbit. Radiological opinion suggested mucocele of right ethmoidal sinus. Intra-operatively, tissue specimen was sent for squash smear cytology. Cytology smears showed features suggestive of spindle cell tumor. Possibility of Schwannoma was considered. The specimen was subsequently subjected to histopathological examination. Microscopy showed tumor tissue composed of tumor cells arranged in alternate hypercellular and hypocellular pattern. Hypercellular areas showed occasional verocay bodies. Hypocellular areas showed loosely arranged spindle shaped tumor cells. Histopathological features were suggestive of Schwannoma. On Immunohistochemistry (IHC), neoplastic cells were positive for S-100 and negative for EMA.
Ethmoidal sinus schwannoma extending into anterior cranial fossa is an unusual presentation. Clinically, it poses a diagnostic dilemma. Squash smear cytology is challenging, but helpful in establishing the correct diagnosis. Histopathology is confirmatory and immunohistochemistry is supportive.
Clinicohistologic Characteristics of Breast Cancer in Ghanaian Patients
Authors: Derkyi-Kwarteng Leonard , F Agyemang-Yeboah , L Ahenkorah Fondjo , E Gustav Imbeah , P Kafui Akakpo 
Published: November 2020

Background
Breast cancer is the leading cause of cancer morbidity and mortality worldwide. The management and prognosis of breast cancer depend heavily on the different histologic and molecular biologic features of the tumour. The different histologic types describe the distinct growth patterns and cytological features of the tumour.

Methodology
This is a retrospective study of archival breast cancer excision and mastectomy specimen at KBTH from 2012-2016. 729 cases were retrieved over the period and examined by two pathologists independently. Demography of the cases, tumour size, grade, histologic type, stage, mitosis, site of lesion etc. were entered into SPSS and analysed with chi-square done with P-value set at P < 0.05.

Results and Conclusion
The mean age of presentation is 52.45 ± 12.75 years. The commonest histologic type of breast cancer is invasive carcinoma (NOS) forming (87%). Only 1.2% of male presented with breast cancer with the other percentage in females. Most (88%) of the tumours were greater than 5cm at the time of surgery. The tumours are of high grade (II and III) forming 88%. Seventy-eight percent of cases presented with late stage of the disease (≥ stage IIB). There was association between histologic type and vascular invasion (P < 0.000) and lymph node involvement (P = 0.010). Moreover, tumour size showed an association with tumour grade (P < 0.05).
This study has shown that breast cancer among Ghanaian patients has a worse histologic type with poor tumour characteristics giving it poor prognosis.
Immunohistochemical expression of p16INK4A in the lesions of uterine cervix
Authors: Rawat Niharika , Rajan Shivapriya 
Published: November 2020

Background: Cervical cancer is the major cause of cancer deaths among women. Globally, around 5,70,000 new cases of cervical cancer and 3,11,000 deaths occurred in the year 2018. In India, Cervical cancer is a leading cause of cancer related mortality among women and the number of deaths is 60,000 per year among 97,000 diagnosed patients, especially those from lower socioeconomic group. Human Papilloma Virus (HPV) plays a crucial role in causing cervical dysplasia. This is done by upregulating p16INK4A, a cyclin dependent kinase inhibitor through interaction with cellular regulatory proteins. Hence p16INK4A can be used as a biomarker, since it is directly related variable for the presence of HPV. This study was conducted to evaluate the expression of p16INK4A in benign, premalignant and malignant cervical lesions and to assess its utility in diagnosing and grading cervical lesions.
Methods: A total of 80 cervical specimens categorized histopathologically into nonspecific cervicitis, low grade squamous intraepithelial neoplasia (LSIL), high grade squamous intraepithelial neoplasia (HSIL) and squamous cell carcinoma cervix were included in this prospective study of one-year duration. Immunohistochemical study of p16INK4A were interpreted qualitatively and semi-quantitatively by Allred scoring system (0 to 8 points) which measures the proportion of stained cells and intensity of staining of cells. The collected data were statistically analyzed by ANOVA and chi square test.
Result: Qualitative method showed absence of p16INK4A expression in all nonspecific cervicitis. 16.7% (2/12) LSIL, 100% (12/12) HSIL and 100% (28/28) squamous cell carcinoma cases showed p16INK4A positivity. Allred scoring of p16INK4A showed 66% (8/12) HSIL and 85.7% (24/28) squamous cell carcinoma cases with score 3 positivity. Hence high-grade lesions showed higher expression of this marker.
Conclusion: IHC expression of p16INK4A showed increasing degree of expression from benign to premalignant and malignant lesions suggesting its diagnostic and prognostic value in the cervical cancer management
The suppression of lone-pair stereoactivity in [Cu+(As3+O3)4] clusters in dixenite: A tribute to Paul B. Moore
Authors: Hawthorne Frank C. , Hughes John M. 
Published: November 2020

Abstract
The crystal structure of dixenite, ideally Cu+Fe3+Mn142+(As5+O4)(As3+O3)5(SiO4)2(OH)6, from Långban, Sweden, was refined to an R1-index of 1.58%, and the structure proposed by Araki and Moore (1981) was confirmed and details elucidated. The structure, crystallizing in space group R3 with a = 8.2204(3) and c = 37.485(3) Å, consists of layers of (Mn2+,Fe3+)(O,OH)6 octahedra linked by (As5+O4) and (SiO4) tetrahedra, (As3+O3) trigonal pyramids, and (CU+As43+) tetrahedra. There are five distinct layers in the repeat unit of the cell, four of which are very similar to the layers in mcgovernite. An unusual aspect of one of the trimers of octahedra is that there is a triangular-prismatic hole through the center of the cluster. The (CU+As43+) tetrahedra are parts of larger clusters: [Cu+(As3+O3)4] in which four (As3+O3) groups link to a central Cu+ that occupies the positions normally taken by the stereoactive lone-pairs of electrons that generally characterize As3+ in triangular-pyramidal coordination by O. Thus, the stereoactive lone-pair behavior that is characteristic of (As3+O3) trigonal pyramids is suppressed by the coordination of Cu+ by four As3+ ions.
Integrasi program SPARK dalam pendidikan jasmani terhadap peningkatan health-related fitness siswa
Authors: Setiawan Heri , Rahayu Nur Indri , Juliantine Tite 
Published: November 2020

AbstrakProgram SPARK sebagai salah satu program pelatihan substansial masih jarang diintegrasikan pada pembelajaran jasmani di sekolah. Tujuan penelitian ini adalah untuk menguji pengaruh integrasi program SPARK dalam pendidikan jasmani terhadap peningkatan health-related fitness serta menguji perbandingan antara pendidikan jasmani terintegrasi program SPARK dengan pendidikan jasmani tanpa program SPARK terhadap peningkatan health-related fitness siswa. Metode penelitian ini menggunakan matching only-pretest-postest control group design. Sampel penelitian ini adalah siswa kelas VII berjumlah 48 siswa. Pengambilan sampel dengan menggunakan teknik Intact Group. Instrumen yang digunakan dalam penelitian ini adalah FITNESSGRAM. Hasil penelitian menunjukan bahwa terdapat pengaruh program SPARK dalam pendidikan jasmani terhadap peningkatan health-related fitness siswa dan terdapat perbedaan yang signifikan antara siswa yang diberikan treatment program SPARK yang terintegrasi dalam pendidikan jamani dibandingkan siswa yang diberikan pendidikan jasmani tanpa program SPARK terhadap peningkatkan health-related fitness. Program SPARK dalam pendidikan jasmani merupakan wahana ideal untuk meningkatkan health-related fitness siswa yang dikemas secara sistematis dan terstruktur. Integration of the SPARK program in physical education towards the improvement of student health-related fitnessSPARK program as one of the substantial training programs is still rarely integrated into physical learning in schools. The purpose of this study was to examine the effect of the integration of the SPARK program in physical education on improving health-related fitness and to examine the comparison between the integrated physical education of the SPARK program and conventional physical education on improving student health related fitness. This research method uses Pretest-Posttest Control Group Design. The sample of this research was 48 students in grade VII, taking samples using the Intact Group technique. The instrument used in this study was Fitnessgram. The results showed that. There is an effect of the SPARK program in physical education on improving students' health-related fitness. There is a significant difference between students who are given SPARK treatment programs that are integrated in physical education compared to students who are given conventional physical education to improve health related fitness. SPARK program in physical education is an ideal method to improve the health-related fitness of students that is systematically prepared.
Smartphone-Based Interventions and Internalizing Disorders in Youth: Systematic Review and Meta-analysis
Authors: Buttazzoni Adrian , Brar Keshbir , Minaker Leia 
Published: November 2020

Background
Mental health disorders in youth are a global issue that have important implications for the future quality of life and morbidity of affected individuals. In the context of public health initiatives, smartphone-based interventions have been suggested to hold the potential to be an effective strategy to reduce the symptoms of mental health disorders in youth; however, further evaluation is needed to confirm their effectiveness. This systematic review and meta-analysis documents and synthesizes existing research on smartphone-based interventions targeting internalizing disorders in youth populations.

Objective
This study aims to synthesize existing research on smartphone-based interventions targeting internalizing disorders in youth populations.

Methods
PubMed and SCOPUS were searched in 2019, and 4334 potentially relevant articles were found. A total of 12 studies were included in the final synthesis. We used the Hedges g meta-analysis approach and a random effects model for analysis.

Results
The results of this review note that depression and anxiety are the most commonly targeted symptoms, and unlike other similar topics, most studies reviewed were linked to a proven treatment. The overall pooled effect from the meta-analysis showed small but significant effects (κ=12; N=1370; Hedges g=0.20; 95% CI 0.02-0.38) for interventions in reducing the symptoms of internalizing disorders. In total, 4 subgroup analyses examining specific symptoms and intervention styles found varied small significant and nonsignificant effects.

Conclusions
Future research should focus on developing robust evaluative frameworks and examining interventions among more diverse populations and settings. More robust research is needed before smartphone-based interventions are scaled up and used at the population level to address youth internalizing disorders.