bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience, Attitude, and Perceived Barriers Toward Research Among Ophthalmology Residents in Saudi Arabia: A National Cross-Sectional Study
Authors: Saeed Ali Al , Aljindan Mohanna , AlEnezi Saad , Alwadani Fahad , Owaifeer Adi Al 
Published: December 2020

Abstract
Background Research sets the foundation for evidence-based practice in medicine. Globally resident doctors in various specialties are facing major obstacles to accomplish high quality research projects. Understanding these obstacles may help residents achieve their maximum research potential. This current study was undertaken to document the experience, attitude, and perceived barriers toward research among Saudi ophthalmology residents.Methods A specific questionnaire was developed and validated for the purpose of this study. The questionnaire was distributed online via email to actively enrolled residents in all five ophthalmology training programs in Saudi Arabia. Result Out of a total number of 193 ophthalmology residents in all five training programs, 147 responded to the questionnaire yielding a 76.1% response rate the mean age of participants was 27.6 ±1.8 and the number of males and females was almost equal. The vast majority [96.4%] have worked on at least one research project before starting residency training. Involvement was mainly in the phases of concept and design [72.5%], proposal preparation [85.9%], the three most frequent obstacles to conducting research projects for trainees were burden of other activities [4.27], lack of protected time for research [4.11] and too many regulations in obtaining ethical approval [3.67].Conclusion Our current study shows that ophthalmology residents understand the importance of clinical research, but they are facing a considerable number of barriers toward accomplishing high-quality research projects. Findings of our study may help program directors to address these barriers and improve the incorporation of research along with clinical training in residency curricula.
Standard Blood Laboratory Values As A Clinical Support Tool to Distinguish Between SARS-CoV-2 Positive and Negative Patients
Authors: Thell Rainer , Zimmermann Jascha , Szell Marton , Tomez Sabine , Eisenburger Philip , Haugk Moritz , Kreil Anna , Spiel Alexander , Blaschke Amelie , Klicpera Anna , Janata Oskar , Krugluger Walter , Sebesta Christian , Herkner Harald , Laky Brenda 
Published: December 2020

Abstract
Standard blood laboratory parameters may have diagnostic potential, if polymerase-chain-reaction (PCR) tests are not available on time. We evaluated standard blood laboratory parameters of 655 COVID-19 patients suspected to be infected with SARS-CoV-2, who underwent PCR testing in one of five hospitals in Vienna, Austria. We compared laboratory parameters, clinical characteristics, and outcomes between positive and negative PCR-tested patients and evaluated the ability of those parameters to distinguish between groups. Of the 590 patients (20-100years, 276 females and 314 males), 208 were PCR-positive. Positive compared to negative PCR-tested patients had significantly lower levels of leukocytes, neutrophils, basophils, eosinophils, lymphocytes, neutrophil-to-lymphocyte ratio, monocytes, and thrombocytes; while significantly higher levels were detected with erythrocytes, hemoglobin, hematocrit, C-reactive-protein, ferritin, activated-partial-thromboplastin-time, alanine-aminotransferase, aspartate-aminotransferase, lipase, creatine-kinase, and lactate-dehydrogenase. From all blood parameters, eosinophils, ferritin, leukocytes, and erythrocytes showed the highest ability to distinguish between COVID-19 positive and negative patients (area-under-curve: 72.3-79.4%). Leukopenia, eosinopenia, elevated erythrocytes, and hemoglobin were among the strongest markers regarding accuracy, sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and post-test probabilities. Our findings suggest that especially leukopenia, eosinopenia, as well as elevated erythrocytes, hemoglobin, and ferritin are helpful to distinguish between COVID-19 positive and negative tested patients.
Evaluation of Ferula Assa-Foetida Accessions for Germination Parameters Under Cold Stratification to Overcome Seed Dormancy and Effect of Media Mixtures on Seedling Growth
Authors: Kumar Ashok , Kumar Ravi , Singh Satbeer , Sharma Sahil , Singh Sanatsujat , Kumar Sanjay 
Published: December 2020

Abstract
Ferula assa-foetida L. is a perennial of Apiaceae family having seed dormancy which inhibits the germination. Oleo-gum resin obtained from the rhizomes of Ferula assa-foetida plant has several medicinal properties and used for the treatment of various diseases, pharmaceutical industries and in cooking of food in some countries. In present study, three different temperature treatments (5°, 15° and 25°C) were used to break seed dormancy in six Ferula assa-foetida accessions repeatedly for two years. Also the seedling survival rate with other morphological parameters like plant height, no. of leaves, leaf width, leaf length, root length and root diameter were observed on 3 month old seedlings in six different media mixtures during year 2019-20. The germination ranges from 3.63 (EC968466 at 25°C) to 81.88 percent (EC966538 at 5°C) with an average of 31.14 percent over all temperatures and genotypes. The mean germination time was ranged from 19.69 to 42.71 days with an average of 30.14 days. The highest germination (66.9%) and least mean germination time was observed at 5ºC (20.85) which showed that this crop required a 5ºC chilling treatment of about 20 days for breaking seed dormancy. The results pertaining to seedling survival experiment showed that media mixture of sand, soil, FYM and cocopeat (1:2:2:1 and 1:1:1:1 ratio) gave higher seedling survival rate (87.66%) and other morphological traits. It was also observed that the genotype EC966538 and EC968470 were the best performer for overall germination as well as seedling survival parameters and could be used as base population in future selection and improvement breeding programs.
Turning A Crisis into Opportunity, E-Learning During COVID-19 Pandemic: A Cross-Sectional Study
Authors: Hani Amjad Bani , Hijazein Yazan , Hadadin Hiba , Jarkas Alma , Al-Tamimi Zahraa , Amarin Marzouq , Shatarat Amjad , Abeeleh Mahmoud Abu , Al-Taher Raed 
Published: December 2020

Abstract
Background: The COVID-19 pandemic highlighted the necessity of e-learning, which has been integrated in education worldwide at varying degrees. The University of Jordan has started introducing e-learning in its curriculum. However, the COVID-19 pandemic accelerated the process. This study aims to assess the satisfaction and knowledge attainment of the medical students through distant learning during the COVID-19 pandemic.Methods: This is a cross-sectional, self-reported, questionnaire-based study that was conducted at the School of Medicine at the University of Jordan in April 2020. The targeted population was the students at the school of medicine throughout the basic and clinical years of study. Results: 506 of the 1000 student participants are basic science students (BSS) and 494 are clinical science students (CS), 65.5% of all students were either satisfied, or neutral with e-learning. The most popular devices used to connect to the internet are the mobile phone, and the laptop. Streaming (Zoom and Skype) video conference platforms are used by 60% of students. Conclusion: Transition from traditional in-class teaching to distant learning, whether full or blended, is an inevitable step. It is not a lockdown redemption plan instead a step that needs commitment from the teaching institutions, the teachers, and the students.
Formation Characteristics of Endosperm Structures in Different Rice Genotypes
Authors: Yuan Limin , Li Runqin , Fu Lidong , Wang Zhiqin , Yang Jianchang 
Published: December 2020

Abstract
To explore the formation characteristics of endosperm structures in different rice genotypes, indica, japonica and glutinous rice cultivars were used and grown in the paddy field. The endosperm structures in the grain during the filling period were investigated. The results showed that the compactness of amyloplast arrangement was positively correlated with grain filling percentage. The endosperm structure varied with the position within a grain. At maturity, the structure was the best in the back, the intermediate in the center, and the worst in the belly of a kernel. However, the filling was better in the center than in the back and in the belly from 5 to 10 days after flowering (DAF). The endosperm structure was different among genotypes. From 5 to 25 DAF, starch accumulation was the earliest in glutinous rice, followed by indica rice and japonica rice. Gaps and pores in endosperm were closely associated with rice transparency. The starch crystallinity in endosperm was negatively correlated with amylose content. Among the three genotypes, glutinous showed the highest crystallinity, followed by japonica and indica rice. The starch crystallinity in a grain was lower on a primary branch than that on a secondary branch. Among all grains, the second grain on a primary branch showed the lowest starch crystallinity. The results indicated that the starch structure of endosperm not only differ between rice genotypes, but also varies with the location of a grain on the panicle, and that it affects the grain-filling, transparency and amylose content of rice.
SIRT2 Promotes Murine Melanoma Progression Through Natural Killer Cell Inhibition
Authors: Zhang Manchao , Acklin Scarlett , Gillenwater John , Du Wuying , Patra Mousumi , Yu Hao , Yu Jianhua , Xia Fen 
Published: December 2020

Abstract
SIRT2, an NAD+-dependent histone deacetylase, has been shown to play a pivotal role in various physiological processes, however, its role in cancer is currently controversial. In recent years, SIRT2 has been described as both a tumor suppressor and oncogene with divergent expression and function in various malignancies. Using murine xenograft melanoma models, our results suggest increased systemic expression of SIRT2 promotes tumor progression. In this study, SIRT2-overexpressing mice exhibited enhanced tumor growth and larger tumor volumes compared to their wild-type littermates. Mechanistically, systemic overexpression of SIRT2 reduces the number of tumor-infiltrating natural killer (NK) cells and suppresses NK cell activation and proliferation within the tumor microenvironment (TME). Furthermore, despite the effect of increased tumor growth rate and tumor volume in wild-type littermate mice, NK cell depletion does not affect that in SIRT2-overexpressing mice. Lastly, pharmacological inhibition of SIRT2 increases NK cell tumor infiltration and suppresses melanoma tumor growth in mice. The findings of this study identify a dynamic functional interaction between systemic SIRT2 and NK cell activity, which promotes melanoma tumor progression. Given the recent renewed interest in NK-cell-mediated immunotherapy response, SIRT2 could present a new opportunity to mediate immunotherapy response and resistance.
Students’ ”D”ILEMMA: An Assessment of Knowledge, Attitudes and Practice Toward Vitamin D Among University Students
Authors: Mohamed Negia , Al-Qerem Walid , Gassar Ezeddin , Hailat Mohammad , Elhamdy Faiza , Ling Jonathan 
Published: December 2020

Abstract
Background: The message delivered to the public regarding vitamin D is unclear, and contradictory; particularly regarding sun exposure; previous studies in Jordan have revealed high prevalence of low vitamin D among university students. The aim of this study was to investigate university students’ knowledge, attitudes and practice regarding vitamin D.Method: A web-based cross-sectional survey completed by students at a Jordanian university in 2019. Binary logistic regression analysis was used to predict supplement use.Results: 496 students completed the questionnaire. The mean knowledge score was 31.3 (± 11.3) out of 100. Women had significantly higher beliefs that vitamin D deficiency is an escalating health issue (p<0.01). Negative practices regarding sun exposure was significantly higher in women than men (p<0.01). The majority of participants recognized that insufficient sun exposure was a cause of vitamin D deficiency, but 50.7 % avoid sun exposure, and 67.6% expose only their face and hands. The consumption of fortified foods (OR 3.59-;p<0.001) was the only studied variable associated with vitamin D consumption.Conclusion: There is a gap between knowledge, attitude, and practice regarding vitamin D which can be bridged by promoting Vitamin D related awareness.
Assessment of Neonatal Thermal Cares: Practices and Beliefs Among Rural Women in West Guji Zone, South Ethiopia: A Cross-Sectional Study
Authors: Wako Wako Golicha , Beyene Belda Negesa 
Published: December 2020

Abstract
Introduction: A newborn has limited capacity to maintain temperature when exposed to cold environments. Therefore it is important to maintain newborn in optimal thermal environment. Neonatal hypothermia carries higher case fatality rate when concurrently occurs with other neonatal problems. Neonatal hypothermia is common neonatal problem.Objectives: This study assessed neonatal thermal care practices and beliefs among rural women in west Guji Zone, south Ethiopia. Methods and Materials: A community based cross sectional study combined with qualitative study was undertaken in rural areas of west Guji Zone. Randomly selected 388 rural mothers of infants less than 6 months old were participated in quantitative study. Three focus group discussions and three in-depth interviews were conducted among mothers of infants less than 6 months old; and grandmothers and traditional birth attendants respectively. Quantitative data was collected by using structured and pretested Afaan Oromo version questionnaire adapted from relevant literatures. Qualitative data was collected by in-depth interviews and focus group discussions. The qualitative data was cleaned, coded and analyzed by SPSS version 20. Qualitative data was analyzed by thematic approach. Results: Out of 423 women planned for the study, 388 women were successfully interviewed and included into the analysis. In general rural women believe in importance of newborn thermal protection. The findings show that approximately 75% and 85% of women dried and wrapped their newborns respectively after delivery. However in study area drying and wrapping newborn are usually done after first newborn bath. Just over 84% of women bathed their newborns in less than 6 hours of delivery and majority of them used warm water for the bathing. About 69.1% and 57.7% of women put head cover to their newborns immediately after birth and initiated breast feeding within one hour of delivery respectively. Skin to skin care of newborn is non-existent in study area and perceived as odd, frightening and potential dangerous practice. Conclusion: Studied women practice some of recommended neonatal thermal care and believe in their importance in keeping newborn warm. However practice and believes about delayed first bath is against standard recommendation, whereas skin to skin care is non-existent and perceivably odd practice.
Optimal Timing of Sequencing From Platinum-based Chemotherapy to Pembrolizumab for Advanced Urothelial Carcinoma Based on Real-World Data: A Multi-Institutional Retrospective Study
Authors: Furubayashi Nobuki , Morokuma Futoshi , Tomoda Toshihisa , Hori Yoshifumi , Negishi Takahito , Miura Akihiro , Nakamura Nobutaka , Sato Yoshiaki , Tokuda Noriaki , Kuroiwa Kentaro , Nakamura Motonobu 
Published: December 2020

Abstract
BackgroundTo evaluate the optimal timing of sequencing from platinum-based chemotherapy to pembrolizumab with advanced urothelial carcinoma (UC) in real-world clinical practice.MethodsA total of 34 patients who received pembrolizumab as second-line treatment after first-line platinum-based chemotherapy for advanced UC at 4 institutions between January 2018 and August 2020 were retrospectively evaluated.ResultsThe gemcitabine and cisplatin regimen was administered to 27 patients (79.4%), and the gemcitabine and carboplatin regimen was administered to 6 patients (20.6%). Regarding the number of chemotherapy cycles administered before pembrolizumab, ≤4 cycles were administered to 22 patients (64.7%), 5-6 cycles to 4 patients (11.8%) and ≥7 cycles to 8 patients (23.5%). When the number of cycles was divided into 4 courses, the median overall survival (OS) for ≤4 and >4 prior chemotherapy cycles was 7.0 months and 25.5 months, respectively (P=0.034). When the number of cycles was divided into 6 courses, the median OS for ≤6 and >6 prior chemotherapy cycles was 11.3 months and 6.6 months, respectively (P=0.658). Multivariate analyses for the OS of pembrolizumab revealed that the Eastern Cooperative Oncology Group Performance Status (≥2: hazard ratio [HR] 9.994, 95% CI=1.854-53.879, P=0.007), liver metastases (positive: HR 3.751, 95% CI=0.958-13.603, P=0.047) and time from previous chemotherapy (≥3 months: HR 0.094, 95% CI=0.023-0.357, P<0.001) were independent prognostic factors, but the number of chemotherapy cycles before pembrolizumab was not an independent prognostic factor. When the number of cycles was divided into 4 courses, the median OS from the first-line treatment with ≤4 and >4 prior chemotherapy cycles was 17.3 months and 37.1 months, respectively (P<0.001). When the number of cycles was divided into 6 courses, the median OS from the first-line treatment for ≤6 and >6 prior chemotherapy cycles was 18.6 months and 27.3 months, respectively (P=0.276).ConclusionsThese real-world findings suggest that the optimal timing of sequencing from platinum-base chemotherapy to pembrolizumab in advanced UC is around six cycles, even if no exacerbations are observed with first-line chemotherapy.
Causes for Late Diagnosis of Cervical Cancer in Three Colombian Border Regions and Strategies to Implement a Program for Its Control
Authors: Garcés-Palacio Isabel C. , Jaraba Sara Milena Ramos , Berrio Diana Patricia Molina , Buelvas Anderson Rocha , Baena Armando , Chamorro María Clara Yépez , Porras Elia Johana Gómez , Dorado María Alicia del Castillo 
Published: December 2020

Abstract
Background: Although cervical cancer is preventable through early detection and appropriate treatment, it is still one of the most common cancers in the developing word. In Colombia approximately half of the women diagnosed with cervical cancer die. The purpose of our study was to determine factors associated with delay in the diagnosis of cervical cancer (CC) and to establish strategies for its control in three border regions of Colombia with high number of indigenous and impoverished population.Methods: We conducted a mixed study with convergent triangulation. The study was developed in two stages, first the quantitative component comprising a case-control study, followed by the qualitative component that included interviews and focus groups to healthcare personnel, members of women’s associations, indigenous communities, and quantitative phase´participants. We used the three-delay model as our theoretical framework; this has helped understanding the delay in decision-making by women regarding seeking care (delay 1: individual), arriving at the healthcare institution (delay 2: access), and receiving the appropriate treatment at the institution (delay 3: care and quality).Results: Fifty-five women participated in the quantitative phase, and we conducted 64 interviews and 9 focus groups. Time between the first appointment or Pap smear and final diagnosis was more than two months in 76% of the participants. Delay one was most common among women in La Guajira (higher concentration of indigenous population), and delay two and three in Nariño. Pap smear after 25 years of age (p= 0.002), and more than 3 years apart, once in a lifetime, or never (p< 0.001) were associated with invasive CC. Barriers to undergo a Pap smear were negative experiences with the healthcare system, lack of symptoms, lack of an active sexual life, having only one partner or their partner not having other sexual partners, and fear of the test being painful. The main strategies proposed to prevent and control CC were education, improve actions to promote Pap smear, and human talent strengthening.Conclusion: Even though individual factors played an important role in a delay diagnosis, they are closely influenced by actions of health care services, insurers, and public health actions.
Determination of Significant Prognostic Factors for Maxillary Gingival Squamous Cell Carcinoma in 90 Cases
Authors: Ohyama Yoshio , Yamashiro Masashi , Michi Yasuyuki , Uzawa Narikazu , Myo Kunihiro , Sonoda Itaru , Sumino Jun , Miura Chika , Mizutani Miho , Yamamoto Daisuke , Kayamori Kou , Yoda Tetsuya 
Published: December 2020

Abstract
BackgroundMaxillary gingival squamous cell carcinoma (MGSCC) occurs rather infrequently, compared to tongue and mandibular gingival carcinomas, among the cancers of the oral cavity. Therefore, significant numbers of MGSCC cases have not been statistically analysed. The aim of this study is to clarify the prognostic factors for MGSCC. MethodsWe performed the statistical analysis of 90 MGSCC cases primarily treated in our department from 1999 to 2014. ConclusionsThe patients (male: 36, female: 54) were aged between 38 and 93 years, and the mean age was 68.7 years. The number of patients in each tumour stage according to the TNM classification was as follows: T1: 15 cases, T2: 32 cases, T3: 13 cases, and T4: 30 cases. Forty-two patients were treated only by surgery, 5 only by radiotherapy, 3 by preoperative radiotherapy and surgery, and 40 patients were treated by combination therapy with preoperative chemoradiotherapy and surgery. Neck dissections were performed in 40 cases including 29 cases (11 primary and 18 secondary cases) of histopathologically diagnosed lymph node metastases. Extranodal extension was found in 74.3% cases with metastatic lymph nodes. The 5-year overall survival rate was 81.9%. In univariate analysis, the site of occurrence, stage of tumour, lymph node metastasis, and treatment contributed to the 5-year survival rate. Multivariate analysis demonstrated that the site of occurrence (posterior region) was an independent prognostic factor. Seventeen deaths occurred due to the primary disease, while three deaths were caused by other diseases. ConclusionThe posterior region cancers, according to the classification based on site of occurrence, were independent predictors of poor 5-year overall survival rate.
Quantitative Assessment of HER2 Gene Amplification of Breast Cancer Using Droplet Digital PCR
Authors: Otsuji Kazutaka , Sasaki Takeshi , Tanabe Masahiko , Seto Yasuyuki 
Published: December 2020

Abstract
We previously reported the usefulness of droplet digital polymerase chain reaction (ddPCR) for the assessment of Human epithelial growth factor receptor 2 (HER2) gene amplification in breast cancer using formalin-fixed and paraffin-embedded sections. In our previous study, we combined HER2/CEP17 ratio (HER2 gene signals to chromosome 17 signals) with ddPCR and tumor content ratio (TCR) of each sample and determined the HER2 status by adopting a two-dimensional chart. This “ddPCR-TCR method” showed a high concordance with conventional HER2 status. In this study, we updated our method to assess the HER2 status of breast cancer in a more quantitative manner. We combined obtained data of the ddPCR ratio [Rx] and TCR [x]; we calculated “(Rx − 1) / x + 1” for 41 samples with primary breast cancer and named the value led by this formula as “eHER2 (estimated HER2/CEP17 ratio of a tumor cell)”. eHER2 was equivalent to conventional ISH HER2/CEP17 ratio in most cases. eHER2 and ISH ratio showed a very strong correlation (Spearman rank correlation; ρ = 0.70, P < 0.0001). The obtained results indicated that eHER2 is a potential tool for HER2 status diagnosis in breast cancer.