bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combatting with Challenges in Medical Education During COVID-19 Pandemic: A Mixed-Methods Study Identifying the Effectiveness of Using E-Learning in Pediatric Clinical Clerkship of A University Hospital, Pakistan
Authors: Raza Mahanoor , Kaleem Sidra , Qureshi Sonia , Aslam Nadeem , Madhwani Akber , Saeed Sana 
Published: December 2020

Abstract
Background The emergence of COVID-19 raises the opportunity to reimagine medical education. One way of attempting this is online classes, also known as e-learning, through recordings and or live streaming. The purpose of this research is to ascertain the effectiveness of using the e-learning instructional methodology for a Pediatric module with the fourth year MBBS students at the Aga Khan University Hospital, Karachi. Methods It was a sequential (Quantitative-Qualitative) mixed-method study. The quantitative component of the study consisted of pre and post-tests, as well as feedback on each session. The qualitative component was composed of focused-group discussions to explore students' experiences. Statistical analysis was performed using SPSS 20.0. Mean ±SD was reported for quantitative variables, and frequency and percentages were calculated for nominal variables. The pre and post-test scores were compared using a paired t-test. Pre and post mean test scores were analyzed in comparison to the level of student groups (Experts, Semi-experts, and Novice) by one-way ANOVA. For qualitative content analysis, categories were clumped together to yield sub-themes that were further merged into themes.Results All students (n= 102) participated and enrolled in this study. Fifty-nine participants (68.8%) were female. Participants were stratified into three groups, Novice 41(40.2%), Semi-expert 21 (19.6%), and Expert 40 (39.2%). The majority of the students appreciated the session structure and facilitation. There was a significant effect (p<0.005) on knowledge enhancement during each session, depicted by the improvement in post-test scores. It was also supported by the positive association (r=0.242 to 0.595) between the gain in knowledge and each session held. The ANOVA yielded no statistical significance between the knowledge gained among the three group levels, denoting that our online module had been proven successful in achieving the same learning goals as an in-person rotation.Conclusion E-learning is an effective way of continuing the process of delivering medical education, especially in unprecedented times. Technological enhancements will help carry the impact forward as a blended-learning pedagogical approach in undergraduate medical education.
The Relationship of Supportive Roles With Mental Health and Satisfaction With Life in Female Household Heads: A Structural Equations Model
Authors: Shadabi Nooshin , Saeieh Sara Esmaelzadeh – , Qorbani Mostafa , Babaheidari Touran Bahrami , Mahmoodi Zohreh 
Published: December 2020

Abstract
Background: Female household heads are faced with many more problems than men due to their multiple concurrent roles. The present study was conducted to determine the relationship of supportive roles with mental health and satisfaction with life in female household heads using a structural equations model.Methods: The present descriptive-analytical study was conducted on 286 eligible female household heads in Karaj, Iran, in 2020, who were selected by convenience sampling. Data were collected using VAX social support, the perceived social support scale, the general health questionnaire (GHQ), and the satisfaction with life questionnaire plus a socio-demographic checklist, and were analyzed in SPSS-16 and Lisrel-8.8.Results: The participants’ mean age was 43.1±1.7 years. According to the path analysis results, satisfaction with life had the highest direct positive relationship with perceived social support (B=0.33) and the highest indirect positive relationship with age (B=0.13) and the highest direct and indirect positive relationship with education and social support (B=0.13). Also, mental health had a direct negative relationship with satisfaction with life (B=-0.29), an indirect negative relationship with social support, and both a direct and indirect negative relationship with perceived support (B=-0.26).Conclusion: Based on the results, supportive roles had a negative relationship with mental health and a positive relationship with satisfaction with life in female household heads. Accordingly, given the status and role of women in the health of family members and the community and the greater vulnerability of this group, further attention and support should be directed toward these women by the government and relevant organizations.
Subgrouping of Iranian Women Based on Breast Cancer Risk Factors in A Population-Based Screening Program.
Authors: Sepandi Mojtaba , Rezaianzadeh Abbas , Afrashteh Sima , Alimohamadi Yousef , Abbasi-Ghahramnaloo Abbas 
Published: December 2020

Abstract
Background: Breast cancer is the most common type of cancer in women worldwide. The aim of this study was to find the subgroups of women on the basis of clustering of breast cancer risk factors. Methods: This cross sectional study was performed within the framework of Shiraz breast cancer screening program between 2004 and 2013. Clinical breast examination, mammography or sonography, fine needle aspiration or biopsy, and surgery in case of indications were performed for all participants. Also, face-to-face interviews were performed by trained staff using a structured questionnaire to collect demographic information. Latent class analysis was used to achieve study’s objectives. Results: four latent classes were indemnified; 1) general population risk (83.4% in healthy and 65.7% in diseased women), 2) moderate risk (7.8% in healthy and 20.5% in diseased women), 3) semi moderate risk [for healthy women (7.6%)] / low risk [for diseased women (8.9%)], and 4) low risk [for healthy women(0.9%)] /high risk [for diseased women(4.9%)]. This study showed that among healthy and diseased women, in the latent class 1 and 2 there was a similar pattern of breast cancer risk factors. However, in latent class 3 and 4 there were some different in the clustering of risk factors among two groups. Conclusions: Results from the present study indicated that among healthy women, 15.4% of them fell under moderate risk or semi moderate risk classes, which stresses the necessity of implementing educational and preventive intervention for this stratum of women.
A Prospective Cohort Study providing Insights for Markers of Adverse Pregnancy Outcome in Women of Advanced Maternal Age
Authors: Lean Samantha , Jones Rebecca , Roberts Stephen , Heazell Alexander 
Published: December 2020

Abstract
Background Advanced maternal age (AMA; ≥35 years) is associated with increased rates of adverse pregnancy outcome. Better understanding of underlying pathophysiological processes may improve identification of AMA mothers who are at greatest risk of adverse outcome. This study aimed to investigate changes in oxidative stress and inflammation in AMA women and identify clinical and biochemical predictors of adverse pregnancy outcome in women of AMA.Methods The Manchester Advanced Maternal Age Study (MAMAS) was a multicentre, observational, prospective cohort study of 527 mothers. Participants were divided into three age groups for comparison 20-30 years (n=158), 35-39 years (n=212) and ≥40 years (n=157). Demographic and medical data were collected along with maternal blood samples at 28 and 36 weeks’ gestation. Multivariable analysis was conducted to identify variables associated with adverse outcome, defined as one or more of: small for gestational age (<10th centile), FGR (<5th centile), stillbirth, NICU admission, preterm birth <37 weeks gestation or Apgar score <7 at 5 minutes. Biomarkers of inflammation, oxidative stress and placental dysfunction were quantified in maternal serum. Univariate and multivariable statistical analyses were used to identify associations with composite adverse fetal outcome.Results: Maternal smoking was associated with adverse outcome in older mothers (Adjusted Odds Ratio (AOR) 4.34, 95% Confidence Interval (95%CI) 1.88, 9.99), whereas multiparity reduced the odds (AOR 0.56, 95% CI 0.34, 0.99). In uncomplicated AMA pregnancies, lower circulating anti-inflammatory IL-10, IL-RA and increased antioxidant capacity (TAC) were seen. In AMA with adverse outcome, TAC and oxidative stress markers were increased and levels of maternal circulating placental hormones (hPL, PlGF and sFlt-1) were reduced (p<0.05). Of these, placental growth factor had the strongest predictive accuracy (Area Under the Receiver Operator Characteristic (AUROC) = 0.74) followed by TAC (AUROC=0.69).Conclusions: This study identified alterations in circulating inflammatory and oxidative stress markers in AMA women and in AMA women with adverse pregnancy outcome providing preliminary evidence of mechanistic links. Further, larger studies are required to determine if these markers can be developed into a predictive model of an individual AMA woman’s risk of APO, enabling a reduction in stillbirth rates whilst minimising unnecessary intervention.
Valorization of Pet-Al Composite Obtained From Packaging Waste in Basic Conditions
Authors: Souilhi Aymen , Abidi Rym 
Published: December 2020

Abstract
The recycling of Risidu Pet-Al (a laminated foil made from polyethylene and aluminum foil in food brike packaging) continues to be a challenge. Despite the fact that previous studies proposed green solutions for the recycling of the Pet-Al composite, the handicaps linked to the increase of the cost of the reagents involved in the recycling mechanism, the complexity of the steps, resulting in products with a critical aspect, really reflect a problem. The growing concern about environmental impacts such as greenhouse gas emissions from inceneration treatment is distinctly clear to the scientific community. This article involves chemical treatment by adding a strong base NaOH or KOH as the dissolving reagent, Followed by the addition of the strong acid HCl . The birth of a neutral environment promotes the recovery of aluminum salts as well as sodium (or potassium). The released H2, polyethylene and cardboard are also products regenerated by this recycling.The study contributes to the optimal conditions of time concentration temperature as well as the mode of separation. The recovered salts are identified, however their purity remains an important factor of quality before adapting their use.
Comprehensive Assessment of Changes in Left Ventricular Volume and Myocardial Function After Acute Myocardial Infarction in the Elderly: The Role of Real-Time Three-Dimensional Echocardiography and Two-Dimensional Speckle Tracking Imaging
Authors: Deng Yujiao , Huang Xin , Liu Lu , Sun Shasha , Luo Jiakun , Tian Fan , Ma Yufei , Guan Bo , Yu Yan , Cao Jian , Luo Yukun 
Published: December 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
3-Dimensional Ventricular Electrical Activation Pattern Assessed From A Novel High-Frequency Electrocardiographic Imaging Technique: Principles and Clinical Importance
Authors: Jurak Pavel , Bear Laura , Nguyên Uyên , Viscor Ivo , Andrla Petr , Plesinger Filip , Halamek Josef , Vondra Vlastimil , Abell Emma , Cluitmans Matthijs , Dubois Rémi , Curila Karol , Leinveber Pavel , Prinzen Frits 
Published: December 2020

Abstract
The study introduces and validates a novel high-frequency (100-400 Hz) electrocardiographic imaging (HFECGI) technique that measures intramural ventricular electrical activation. Ex-vivo experiments and clinical measurements were employed. Ex-vivo, two pig hearts were suspended in a human-torso shaped tank using surface tank electrodes, epicardial electrode sock, and plunge electrodes. We compared conventional epicardial electrocardiographic imaging (ECGI) with intramural activation by HFECGI and verified with sock and plunge electrodes. Clinical importance of HFECGI measurements was performed on 14 patients with variable conduction abnormalities. From 2 kHz ECG records (3x4 needle and 108 sock electrodes, 256 torso or 184 body surface electrodes), transmural activation times, sock epicardial activation times, ECGI-derived activation times, and high-frequency activation times were computed. The ex-vivo transmural measurements showed that HFECGI measures intramural electrical activation, and ECGI-HFECGI activation times differences indicate endo-to-epi or epi-to-endo conduction direction. HFECGI-derived volumetric dyssynchrony was significantly lower than epicardial ECGI dyssynchrony. HFECGI dyssynchrony was able to distinguish between intraventricular conduction disturbance and bundle branch block patients.
Effect of Different Cardioprotective Methods on Extracorporeal Circulation in Fetal Sheep: A Randomized Controlled Trial
Authors: Yan Yibo , Shi Shuo , Wu Qianbiao , Cai Jinsheng , Lei Binfeng 
Published: December 2020

Abstract
Background Congenital heart disease is one of the leading causes of death in newborns and infants. The development of fetal cardiac surgery is inextricably linked to extracorporeal circulation. We aimed to compare the effects of heart-stopping solutions and extracorporeal circulation on fetal sheep myocardium.Methods Eighteen pregnant sheep were divided into the non-stop group, St. Thomas stopping solution group, and histidine–tryptophan–ketoglutarate stopping solution group. The three groups underwent the extracorporeal circulation. The right atrial myocardial tissue was removed from the fetal sheep at specific time points, and apoptosis was detected by TUNEL staining. Creatine kinase‒muscle band (CKMB), troponin I (cTnI), and troponin T (cTnT) were measured as indicators of myocardial damage.Results There were no significant differences in the serum cTnT, cTnI, and CKMB concentrations of fetal sheep among the three groups before starting extracorporeal circulation (P = 0.430, P = 0.391, P = 0.071). Changes in the serum cTnI (ng/L) concentrations were not significantly different among the three groups before and during the extracorporeal circulation (P > 0.05). The cTnI in the St. Thomas solution group at 1 hour post extracorporeal circulation was significantly higher than prior to it (P < 0.05), and cTnI in the non-stop group and histidine–tryptophan–ketoglutarate group after 2 hours was higher than in the pre-bypass value (P < 0.05). The cTnI in the histidine–tryptophan–ketoglutarate group at 1 and 2 hours after the extracorporeal circulation was lower than in the St. Thomas solution group. The number of TUNEL-positive cells in the two solution groups was higher than in the non-stop group (P = 0.001 and P = 0.048, respectively). The number of TUNEL-positive cells in the St. Thomas solution group was higher than in the histidine–tryptophan–ketoglutarate group (P = 0.007).Conclusion Myocardial protection in fetal sheep undergoing extracorporeal circulation was significantly better with non-stop beating than when the beating was stopped. Compared to the St. Thomas arrest solution, histidine‒tryptophan‒ketoglutarate stopping solution was associated with significantly reduced markers of myocardial damage in fetal sheep. Less cardiomyocyte apoptosis was observed when the beating was not stopped.
Association Between Different Lipid Ratios and Diabetes in Chinese Adults With H-type Hypertension
Authors: tao yu , jiang yu , yu yu , bao huihui 
Published: December 2020

Abstract
Background: Previous studies have shown that lipid ratios [total cholesterol (TC)/high-densitylipoprotein cholesterol (HDL-C), atherogenic index of plasma (AIP, lg [triglyceride (TG)/HDL-C]), low-density lipoprotein cholesterol (LDL-C)/HDLC, non-HDL-C/HDL-C] were associated with the risk of diabetes in non-hypertension population. However, the relationship between different lipid ratios and diabetes is unclear in the H-type hypertension population. The purpose of this study is to investigate the relationship between lipid ratios and diabetes in Chinese adults with H- type hypertension.Methods: The current study included 13,581 H-type hypertension participants from the China hypertension registry study. Logistic regression analysis and smooth curve fitting were used to assess the association between different lipid ratios and diabetes.Results: Prevalence of diabetes was 17.8%. All lipid ratios (TC/HDL-C, AIP, LDL-C/HDL-C, and non-HDL-C/HDL-C) were positively and independently associated with diabetes. In the fully adjusted model, AIP manifested the largest ORs of diabetes (OR:2.84, 95%CI:2.37-3.41). However, the fully adjusted ORs (95%CI) of TC/HDL-C, LDL-C/HDL-C and non-HDL-C/HDL-C ratio was only 1.34 (1.27, 1.43), 1.40 (1.29, 1.51), 1.42 (1.35, 1.50), respectively. Comparing the area under receiver-operating characteristic curve (AUC), we found that AIP had the stronger ability to identify diabetes.Conclusions: all lipid ratios (TC/HDL-C, AIP, LDL-C/HDL-C, and non-HDL-C/HDL-C) were independently and positively correlated with the risk of diabetes in the Chinese population with H-type hypertension. Compared with other lipid ratios (TC/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C), AIP was superior in discriminating diabetes.
Pressure-Induced Void and Crack Closure Improves the Photoconversion Efficiency and Stability of Perovskite Solar Cells
Authors: Oyewole Deborah , Oyewole Oluwaseun , Agyei-Tuffour Benjamin , Tamayo Juan Hinostroza , Koech Richard , Oyelade Omolara , Adeniji Sharafadeen , Ichwani Reisya , Cromwell Jaya , Ahmed Ridwan , Ulloa Erika Colin , Titova Lyubov , Burnham Nancy , Soboyejo Winston 
Published: December 2020

Abstract
One route to a brighter global energy future may be through enhancing the efficiency and stability of perovskite solar cells (PSCs), which depends on the level of defects in the photoactive absorber and along the interfaces of the multilayered structure. Here, we use a combined experimental and theoretical approach to study the effects of pressure-induced compaction of microvoids and closure of cracks on the power conversion efficiency (PCEs) and stability of formamidinium-rich PSCs. A range of mechanical pressures was applied to the PSCs to reduce pre-existing grain-boundary voids and interfacial cracks within the devices. The PCEs of the PSCs increased from ~19.5% to ~ 23.5% for applied pressures between ~ (0 – 7) MPa. Unlaminated device stability increased by 33%, falling to 80% of initial PCE in 1800 hrs without compression, as compared to 2400 hrs with compression. The implications of this study are discussed in light of possible future manufacturing processes.
Renocardiac Syndrome Induced by Renal Ischemia and Reperfusion: Vibrational Markers
Authors: Nepomuceno Gabrielle , Junho Carolina , Carneiro-Ramos Marcela , Martinho Herculano 
Published: December 2020

Abstract
Renal injury caused by renal ischemia and reperfusion is capable to change heart morphology, electrophysiology, and redox unbalance. The so-called cardio-renal syndrome is an important class of dysfunction since heart and kidneys are responsible for hemodynamic stability and organ perfusion through a complex network. In the present work we investigate the Fourier-Transform Raman vibrational spectral features of cardiac hypertrophy induced by renal ischemic reperfusion. C57BL/6J mice were subjected to unilateral occlusion of the renal pedicle for 60 minutes and reperfused for 5 days, 8 days, and 15 days. It was observed that bands around 540, 1100, 1300, 1450, 1650, and 2500 cm-1 dominates the spectra. They are associated to stretching of S-S in Cysteine amino acid, stretching of C-C in lipids, twisting of CH2 in collagen and phospholipids, bending modes of CH3 in lipids and amino acids side chains, Amide I vibration of proteins. The intensities of these vibrations are modulated during renocardiac syndrome. We find that tyrosine, tryptophan, cystine/cysteine, fibroblast growth factors, collagen III alterations from homeostasis were the metabolites associate with these changes. These findings are clinically relevant once the presented bands can be used as molecular markers of preventing cardiac diseases’ development in patients with renal injury.
GWENA: Gene Co-expression Networks Analysis and Extended Modules Characterization in a Single Bioconductor Package
Authors: Lemoine Gwenaëlle , Scott-Boyer Marie-Pier , Ambroise Bathilde , Perin Olivier , Droit Arnaud 
Published: December 2020

Abstract
Background: Network-based analysis of gene expression through co-expression networks can be used to investigate modular interactions occurring between genes toward diﬀerent biological functions. An extended description of the network modules is therefore a critical step to understand the underlying processes contributing to a disease or a phenotype. Biological integration, topology study and conditions comparison (e.g. wild vs mutant) are the main methods to do so, but to date no tool combines them all into a single pipeline.Results: Here we present GWENA, a new R package that integrates gene co-expression network construction and a whole characterization of the detected modules through gene set enrichment, phenotypic association, hub genes detection, topological metric computation, and diﬀerential co-expression. To demonstrate its performances, we applied GWENA on two skeletal muscle datasets from young and old patients of GTEx study. We successfully prioritized a gene whose involvement was unknown in the muscle development and growth. We also gave new insight about the variations in patterns of co-expression as the already known age-dependent loss of connectivity was found coupled to a genes interactions reorganization leading to the expression of other functions involved in aging. Conclusion: GWENA is an R package available through Bioconductor (https://bioconductor.org/packages/release/bioc/html/GWENA.html) developed to perform extended analysis of gene co-expression networks. Thanks to biological and topological information as well as conditions comparison, it eases the understanding of genes interactions involved in diseases or phenotypes. Going beyond actual packages to perform co-expression analysis, GWENA includes new tools to fully characterize modules, such as diﬀerential co-expression, additional enrichment databases, and network visualization.