bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of heavy episodic drinking and associated factors among adults residing in Arba Minch health and demographic surveillance site: a cross sectional study
Authors: Gutema Befikadu Tariku , Chuka Adefris , Ayele Gistane , Tariku Eshetu Zerhun , Aschalew Zeleke , Baharu Alazar , Degefa Nega , Gurara Mekdes Kondale 
Published: December 2020

Abstract
Background
Alcohol consumption is associated with different types of illnesses; particularly heavy episodic drinking is one of the risk factors for the disease burden of alcohol intake. The aim of the study was to assess the prevalence of heavy episodic drinking and associated factors in Arba Minch Health and Demographic Surveillance Site (HDSS).

Methods
A community-based cross-sectional study was conducted in 2017 among adult residents of Arba Minch HDSS. Using Arba Minch HDSS database, 3368 individuals were selected by simple random sampling techniques. From WHO STEPS instruments, step one was applied for this study. Variables with a p-value of less than 0.10 for bivariate analysis entered into a multivariable logistic regression model to outline the independent predictors of the heavy episodic drinking. To assess the presence of an association between dependent and independent variables, a p-value of less than 0.05 was considered.

Results
The prevalence of heavy episodic drinking was 13.7% (95% CI: 12.6–14.9). The study has shown that heavy episodic drinking was significantly associated with occupation (daily laborer [AOR = 0.49; 95% C.I: 0.29–0.85] and housewives [AOR = 0.63; 95% C.I: 0.45–0.88] compared with farmers), wealth index (2nd quintiles [AOR =0.55; 95% C.I: 0.41–0.74) and 3rd quintiles [AOR = 0.66; 95% C.I: 0.46–0.93] compared with 1st quintiles), and climatic zone (midland [AOR = 1.80;95% CI: 1.11–2.93), highland [AOR = 1.95;95% CI: 1.19–3.18] compared with lowland). In addition, tobacco use [AOR = 4.28;95% CI: 3.38–5.43], and khat use [AOR = 4.75; 95% CI: 2.66–8.50) were also associated with heavy episodic drinking among the study participants.

Conclusions
More than one in ten adults reported heavy episodic drinking in the study area. Intervention programs that aim to prevent heavy episodic drinking should be designed appropriately for individuals from lower wealth status, and for highlander.
Prognostic value of the creatinine-albumin ratio in acute pancreatitis debridement
Authors: Zhao Zhifeng , Yu Yeping , Xie Rongli , Yang Kaige , Xu Dan , Li Li , Lin Jiayun , Zheng Lei , Zhang Chihao , Xu Xin , Chen Ying , Xu Zhiwei , Chen Erchen , Luo Meng , Fei Jian 
Published: December 2020

Abstract
Background
Increases in the levels of serum C-reactive protein (CRP) and creatinine (Cr) and decreases in those of albumin (Alb) are commonly observed in acute pancreatitis (AP). We aimed to evaluate the efficacy of the Cr/Alb and CRP/Alb ratios in the prediction of surgical treatment effect in AP patients.

Methods
This study retrospectively analyzed clinical data obtained from 140 AP patients who underwent debridement from January 2008 to November 2018 in Shanghai Ruijin Hospital. The Cr/Alb and CRP/Alb ratios at admission and before surgery were assessed in the analysis of clinical statistics, prediction of prognoses, and logistic regression analysis.

Results
The admission Cr/Alb had the best predictive value of the four ratios. This value was significantly higher in patients with re-operation and those who died (P < 0.05) and was correlated with the Acute Physiology and Chronic Health Evaluation (APACHE II) score, admission CRP/Alb, preoperative Cr/Alb, and post-operative complications. The admission Cr/Alb could predict the risk of AP-related re-operation and mortality with sensitivities, specificities and areas under the curve of 86.3%, 61.7% and 0.824, and 73.4%, 81.3% and 0.794, respectively. At a cut-off value of 3.43, admission Cr/Alb values were indicative of a worse clinical state, including impaired laboratory test values, APACHE II scores, rates of post-operative complications and re-operation, and mortality (P < 0.05). In the logistic regression analysis, admission Cr/Alb values were independently related to the APACHE II score, post-operative renal failure, and mortality.

Conclusion
Cr/Alb is a novel but promising, easy-to-measure, reproducible, non-invasive prognostic score for the prediction of the effect of debridement in AP patients.
Blunt abdominal injury resulting in a belly full of candy after a motocross accident, a case report
Authors: Poelmann Floris B. , IJpma Frank F. A. 
Published: December 2020

Abstract
Background
Blunt traumatic gastric perforations in children are rare. Delayed diagnosis will lead to abdominal contamination and may result in morbidity and even mortality. We present a case of an adolescent who sustained blunt abdominal injury in a motocross accident and presented with remarkable hyperdense spherical shaped structures on the computed tomography (CT).

Case presentation
A 15-year-old boy arrived at the emergency room with an acute abdomen after a motocross accident. A CT scan of the abdomen demonstrated free air and hyperdense round structures in the stomach, pelvic cavity and right paracolic gutter. During emergency laparotomy a traumatic gastric perforation was sutured, a splenic rupture was treated with a vicryl mesh and multiple spherical food scraps were removed from the abdomen. After surgery, the boy clarified that he had eaten a whole bag of colorful and spherical shaped candy just before the accident.

Conclusions
Traumatic gastric rupture in children is rare but physicians should be aware of this diagnosis in case of blunt abdominal trauma with free air on the CT scan. Gastric contents, in this case candy, can present as hyperdense shaped structures in the abdominal cavity on the CT scan.
Prevalence of oral mucosal normal variations and lesions in a middle-aged population: a Northern Finland Birth Cohort 1966 study
Authors: Oivio Ulla-Maija , Pesonen Paula , Ylipalosaari Merja , Kullaa Arja , Salo Tuula 
Published: December 2020

Abstract
Background
In this cross-sectional study we investigated the oral mucosal changes in a middle-aged Finnish population. We analyzed the prevalence of potentially malignant disorders and the influence of smoking, snuff and alcohol use on the mucosal changes.

Methods
Of the 12,068 members of the NFBC 1966, a total of 1961 participants (16.2%) constituted the study population. Mucosal changes were diagnosed and photographed by seven general dentists, and two specialists re-analyzed all the diagnoses based on the documentation Cross-tabulation with Chi-square tests and logistic regression analysis were used to analyze the data.

Results
Of the participants, 10.5% had some mucosal changes, of which 81.8% were diagnosed as oral mucosal lesions (OML) and 18.2% as normal variations. Of the normal variations, the most common were Fordyce granules (1.2%), fissured tongue (1.1%) and geographic tongue (0.9%). The most common OMLs were white lesions (6.5%), of which oral lichen planus (OLP) and lichenoid reactions (OLR), grouped as oral lichenoid diseases, were present in 3.5%, males more often (3.8% vs. 3.1%). OLP was found in 1.5% of all participants, females more often (1.8% vs. 1.2%), while OLR was more common in males (2.7% vs. 1.3%). Leukoplakia was identified in 0.5% of the population; twice more often in males (0.6% vs. 0.3%). Erythroplakia was not found. Current smokers had higher risk for oral mucosal changes than former or non-smokers (OR 3.0, 95% CI 2.11–4.28), and snuff, used occasionally or regularly, also raised the risk (OR 2.6, 95% CI 1.48–4.70).

Conclusions
In the middle-aged northern Finland population, 4% of OMLs were potentially malignant disorders, including OLR (2%), OLP (1.5%) and leukoplakia (0.5%). In particular, smoking and snuff use increased the risk for having any oral mucosa changes.
Acorus tatarinowii Schott extract reduces cerebral edema caused by ischemia–reperfusion injury in rats: involvement in regulation of astrocytic NKCC1/AQP4 and JNK/iNOS-mediated signaling
Authors: Lee Yu-Chen , Kao Shung-Te , Cheng Chin-Yi 
Published: December 2020

Abstract
Background
This study aimed to evaluate the effects of the Acorus tatarinowii Schott [Shi Chang Pu (SCP)] extract administered at the start of 2 h of middle cerebral artery occlusion (MCAo), followed by 3 d of reperfusion, and to determine mechanisms involved in anti-edema effects in the penumbra of the cerebral cortex.

Method
Rats were intraperitoneally administered the SCP extract at a dose of 0.25 g/kg (SCP-0.25 g), 0.5 g/kg (SCP-0.5 g), or 1 g/kg (SCP-1 g) at the start of MCAo.

Result
SCP-0.5 g and SCP-1 g treatments effectively reduced the cerebral infarct size, ameliorated cerebral edema, reduced blood–brain barrier permeability, and restored neurological function. SCP-0.5 g and SCP-1 g treatments markedly downregulated the levels of glial fibrillary acidic protein, Na+-K+-2Cl− cotransporter type 1 (NKCC1), aquaporin 4 (AQP4), phospho-c-Jun N-terminal kinase (p-JNK)/JNK, inducible nitric oxide synthase (iNOS), 3-nitrotyrosine, intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor-A (VEGF-A), and zonula occluden-1 (ZO-1) and upregulated ZO-3 expression in the penumbra of the cerebral cortex 3 d after reperfusion.

Conclusions
SCP-0.5 g and SCP-1 g treatments exert neuroprotective effects against cerebral infarction and cerebral edema partially by mitigating astrocytic swelling and blood–brain barrier disruption. Moreover, the anti-cerebral edema effects of SCP extract treatments are possibly associated with the downregulation of astrocytic NKCC1/AQP4 and JNK/iNOS-mediated ICAM-1/MMP-9 signaling in the penumbra of the cerebral cortex 3 d after reperfusion.
Simulation training for emergency skills: effects on ICU fellows’ performance and supervision levels
Authors: Zante Bjoern , Schefold Joerg C. 
Published: December 2020

Abstract
Background
The application of manual emergency skills is essential in intensive care medicine. Simulation training on cadavers may be beneficial. The aim of this study was to analyze a skill-training aiming to enhance ICU-fellows´ performance.

Methods
A skill-training was prepared for chest tube insertion, pericardiocentesis, and cricothyroidotomy. Supervision levels (SL) for entrustable professional activities (EPA) were applied to evaluate skill performance. Pre- and post-training, SL and fellows´ self- versus consultants´ external assessment was compared. Time on skill training was compared to conventional training in the ICU-setting.

Results
Comparison of pre/post external assessment showed reduced required SL for chest tube insertion, pericardiocentesis, and cricothyroidotomy. Self- and external assessed SL did not significantly correlate for pre-training/post-training pericardiocentesis and post-training cricothyroidotomy. Correlations were observed for self- and external assessment SL for chest tube insertion and pre-assessment for cricothyroidotomy. Compared to conventional training in the ICU-setting, chest tube insertion training may further be time-saving.

Conclusions
Emergency skill training separated from a daily clinical ICU-setting appeared feasible and useful to enhance skill performance in ICU fellows and may reduce respective SL. We observed that in dedicated skill-training sessions, required time resources would be somewhat reduced compared to conventional training methods.
Qualitative study of comprehension of heritability in genomics studies among the Yoruba in Nigeria
Authors:   the Indigene Study as part of the H3Africa Consortium, Taiwo Rasheed O. , Ipadeola John , Yusuf Temilola , Fagbohunlu Faith , Jenfa Gbemisola , Adebamowo Sally N. , Adebamowo Clement A. 
Published: December 2020

Abstract
Background
With growth of genomics research in Africa, concern has arisen about comprehension and adequacy of informed consent given the highly technical terms used in this field. We therefore decided to study whether there are linguistic and cultural concepts used to communicate heritability of characters, traits and diseases in an indigenous African population.

Methods
We conducted Focus Group Discussions among 115 participants stratified by sex, age and socio-economic status and Key Informant Interviews among 25 stakeholders and Key Opinion Leaders among Yoruba living in Ibadan, Nigeria. We used Atlas-ti v.8.3.17 software to analyze the data, using thematic approach.

Results
The study participants identified several linguistic and cultural concepts including words, proverbs, and aphorisms that are used to describe heritable characters, traits and diseases in their local dialect. These included words that can be appropriated to describe dominant and recessive traits, variations in penetrance and dilution of strength of heritable characteristics by time and inter-marriage. They also suggested that these traits are transmitted by “blood”, and specific partner’s blood may be stronger than the other regardless of sex.

Conclusions
Indigenous Yoruba populations have words and linguistic concepts that describe the heritability of characters, traits and diseases which can be appropriated to improve comprehension and adequacy of informed consent in genomics research. Our methods are openly available and can be used by genomic researchers in other African communities.
A plea to merge clinical and public health practices: reasons and consequences
Authors: Unger Jean-Pierre , Morales Ingrid , De Paepe Pierre , Roland Michel 
Published: December 2020

AbstractBackgroundRevisiting professionalism, both as a medical ideal and educational topic, this paper asks whether, in the rise of artificial intelligence, healthcare commoditisation and environmental challenges, a rationale exists for merging clinical and public health practices. To optimize doctors’ impact on community health, clinicians should introduce public health thinking and action into clinical practice, above and beyond controlling nosocomial infections and iatrogenesis. However, in the interest of effectiveness they should do everything possible to personalise care delivery. To solve this paradox, we explore why it is necessary for the boundaries between medicine and public health to be blurred.Main bodyProceeding sequentially, we derive standards for medical professionalism from care quality criteria, neo-Hippocratic ethics, public health concepts, and policy outcomes. Thereby, we formulate benchmarks for health care management and apply them to policy evaluation. During this process we justify the social, professional - and by implication, non-commercial, non-industrial - mission of healthcare financing and policies.The complexity of ethical, person-centred, biopsychosocial practice requires a human interface between suffering, health risks and their therapeutic solution – and thus legitimises the medical profession’s existence. Consequently, the universal human right to healthcare is a right to access professionally delivered care. Its enforcement requires significant updating of the existing medical culture, and not just in respect of the man/machine interface. This will allow physicians to focus on what artificial intelligence cannot do, or not do well. These duties should become the touchstone of their practice, knowledge and ethics. Artificial intelligence must support medical professionalism, not determine it. Because physicians need sufficient autonomy to exercise professional judgement, medical ethics will conflict with attempts to introduce clinical standardisation as a managerial paradigm, which is what happens when industrial-style management is applied to healthcare.ConclusionPublic healthcare financing and policy ought to support medical professionalism, alongside integrated clinical and public health practice, and its management. Publicly-financed health management should actively promote ethics in publicly- oriented services. Commercialised healthcare is antithetical to ethical medical, and to clinical / public health practice integration. To lobby governments effectively, physicians need to appreciate the political economy of care.
Integrating clinical and public health knowledge in support of joint medical practice
Authors: Unger Jean-Pierre , Morales Ingrid , De Paepe Pierre , Roland Michel 
Published: December 2020

AbstractBackgroundStrong relations between medicine and public health have long been advocated. Today, professional medical practice assumes joint clinical/public health objectives:GPs are expected to practice community medicine;Hospital specialists can be involved in disease control and health service organisation;Doctors can teach, coach, evaluate, and coordinate care;Clinicians should interpret protocols with reference to clinical epidemiology.Public health physicians should tailor preventive medicine to individual health risks.This paper is targeted at those practitioners and academics responsible for their teams’ professionalism and the accessibility of care, where the authors argue in favour of the epistemological integration of clinical medicine and public health.Main textBased on empirical evidence the authors revisit the epistemological border of clinical and public health knowledge to support joint practice. From action-research and cognitive psychology, we derive clinical/public health knowledge categories that require different transmission and discovery techniques.The knowledge needed to support the universal human right to access professional care bridges both clinical and public health concepts, and summons professional ethics to validate medical decisions. To provide a rational framework for teaching and research, we propose the following categories:‘Know-how/practice techniques’, corresponding a.o. to behavioural, communication, and manual skills;‘Procedural knowledge’ to choose and apply procedures that meet explicit quality criteria;‘Practical knowledge’ to design new procedures and inform the design of established procedures in new contexts; andTheoretical knowledge teaches the reasoning and theory of knowledge and the laws of existence and functioning of reality to validate clinical and public health procedures.Even though medical interventions benefit from science, they are, in essence, professional: science cannot standardise eco-biopsychosocial decisions; doctor-patient negotiations; emotional intelligence; manual and behavioural skills; and resolution of ethical conflicts.ConclusionBecause the quality of care utilises the professionals’ skill-base but is also affected by their intangible motivations, health systems should individually tailor continuing medical education and treat collective knowledge management as a priority. Teamwork and coaching by those with more experience provide such opportunities. In the future, physicians and health professionals could jointly develop clinical/public health integrated knowledge. To this end, governments should make provision to finance non-clinical activities.
Improving the transition process to independent living for adolescents with profound intellectual disabilities. Experiences of parents and employees
Authors: Roos Eirik , Søndenaa Erik 
Published: December 2020

AbstractBackgroundThe transition process from the family home to independent living for young adults with profound intellectual disability (PID) becomes delayed. Those families face challenges that exceed those of typical families such as higher objective and subjective burden, more frequent psychological distress and lower social support. The aim of this study was to explore the collaboration process between parents and employees and identify factors that improve the transition with less burden.MethodsA descriptive qualitative study was undertaken with 18 persons (9 parents and 9 employees) interviewed individually and in groups. In accordance with the municipality’s guidelines, families with a child with PID should apply for housing, when the child turns 16. The purpose is to ensure interdisciplinary collaboration, information flow and coordinated services according to family’s needs. The main question in the interviews was ‘What was your experience with cooperation in the transition process, and what would you do to improve this process?’ The interviews were analysed with a thematic approach using systematic text condensation.ResultsThe parents experienced a lack of general information about the ‘housing waiting list’, level of services, and the plan for time of moving from the family home, and how to choose where and whom to live with. Parents described an unsustainable burden of care during the waiting period, and a family crisis caused the allocation of an apartment in a group house. Employees shared challenges to meet families’ wishes, as there were too few group homes. They experienced good collaboration with families and said they offered respite care, due to reduce parents’ burden of care. Employees experienced that PID adolescents developed skills, mastery and degrees of independence after completing a residency at the Folk High School.ConclusionsTo improve the transition process from family home to independent living for young adults with PID, the informants highlighted some factors to reduce the burden of care on families: 1) Systematic follow-up program for families to observe their needs at an early stage; 2) More available group houses; 3) Information about the housing priorities of the services and; 4) Educational preparation programs for families.
Psychomotor development and attention problems caused by a splicing variant of CNKSR2
Authors: Zhang Yi , Yu Tingting , Li Niu , Wang Jiwen , Wang Jian , Ge Yihua , Yao Ruen 
Published: December 2020

Abstract
Background
Mutations in CNKSR2 have been described in patients with neurodevelopmental disorders characterized by childhood epilepsy, language deficits, and attention problems. The encoded protein plays an important role in synaptic function.

Case presentation
Whole-exome sequencing was applied to detect pathogenic variants in a patient with clinical symptoms of psychomotor development, attention deficit, poor logical thinking ability, and an introverted personality, but without epilepsy or any significant electroencephalogram changes. Genetic study revealed a splicing mutation (c.1904 + 1G > A) and RT-PCR revealed aberrant splicing of exon 16, leading to a reading-frame shift and a truncated protein in the PH domain.

Conclusions
This is the first report of a splicing variant of CNKSR2, and the unique clinical features of this pedigree will help extend our understanding of the genetic and phenotypic spectra of CNKSR2-related disorders.
ETS1-activated SNHG10 exerts oncogenic functions in glioma via targeting miR-532-3p/FBXL19 axis
Authors: Jin Lide , Huang Shengquan , Guan Congjin , Chang Shun 
Published: December 2020

AbstractBackgroundIn past few years, long non-coding RNAs (lncRNAs) have been reported to play regulatory roles during cancer progression. LncRNA SNHG10 has been explored in several sorts of cancers. However, its detailed role and mechanism are still not well understood in glioma.MethodsExpression levels of genes were evaluated by RT-qPCR. EdU, TUNEL, sphere formation, wound healing and transwell assays appraised the effect of SNHG10 on glioma cellular processes. The interaction between molecules was examined by ChIP, RIP, RNA pull down and luciferase reporter assays.ResultsHigh level of SNHG10 was detected in glioma cells. Functional assay confirmed that SNHG10 promoted the proliferation, migration, invasion and stemness of glioma cells. Moreover, miR-532-3p was validated to bind with SNHG10 and expressed at a low level in glioma cells. Importantly, miR-532-3p exerted inhibitory functions in glioma. Furthermore, it was found that FBXL19 targeted by miR-532-3p facilitated cell growth and stemness in glioma, and that SNHG10 worked in glioma by increasing FBXL19 expression through sequestering miR-532-3p. More importantly, ETS1 promoted the transcription of SNHG10 and it mediated contribution to the malignant behaviors of glioma cells by SNHG10/miR-532-3p/FBXL19 signaling.ConclusionSNHG10 was transcriptionally activated by ETS1 and played an oncogenic role in glioma by sponging miR-532-3p and up-regulating FBXL19.