bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phosphorus dynamics in a subtropical coastal lake in Southern Brazil
Authors: Lemes da Silva Aurea L. , Hennemann Mariana C. , Petrucio Mauricio M. 
Published: November 2019

Temporal and spatial variations of organic and inorganic forms of phosphorus in the sediments of a subtropical oligo-mesotrophic shallow lake were investigated in relation to water column parameters, sediment characteristics and benthic fauna. The main results found were: 1) Phosphorus (P) concentration varied seasonally, with organic P and total P increasing in the sediments in warmer periods; 2) Sediment spatial variation, in terms of grain size composition and organic matter content, influenced P concentrations; 3) quantities and qualities of P in the sediments were positively correlated with water parameters, especially DO and NO3, Chl-a, water temperature, pH, and total P. Negative correlations were observed between %OP and DO in sites 1, 3 and 4, and with NO3 in sites 2, 3 and 4; 4) benthic functional feeding groups showed significant relationships with temporal variation in sediment P concentration, including gathering-collectors, shredders, filterers and filtering-collectors. The results suggest a high importance of temperature mediated control of sediment-P release, both directly, through its direct effects on primary production and decomposition rates, and indirectly through its effects on other water and sediment parameters, especially dissolved oxygen concentration.
The Role of Val66Met Single Nucleotide Polymorphism in Brain-Derived Neurotropic Factor Gene in Prediction of Adverse Outcomes After ST-segment Elevation Myocardial Infarction
Authors: Petyunina Olga V. , Kopytsya Mykola P. , Berezin Alexander E. , Skrynnyk Olga V. 
Published: November 2019

Background:
The single nucleotide polymorphism of Val66Metgen of the brain-derived neurotrophic factor (BDNF) gene is a possible candidate that is associated with the development of psychopathology and combines it with cardiovascular events. The purpose of this study was to research the possible associations of single-nucleotide polymorphism of Val66Met BDNF gene with the occurrence of endpoints after 6 months of follow-up after ST-segment elevation myocardial infarction (STEMI).

Materials and Methods:
256 acute STEMI patients after successful primary percutaneous coronary intervention (PCI) were enrolled in the study. Thrombolysis in myocardial infarction III blood flow restoring through culprit artery was determined. The study of single-nucleotide polymorphism of Val66Met gene BDNF (rs6265) was performed by real-time polymerase chain reaction. The emotional state of the patients and its relationship with stress were assessed with the questionnaire “Depression, Anxiety, and Stress-21”.

Results:
The frequency of genotypes Val66Met gene for BDNF in STEMI patients (n = 256) was the following: 66ValVal = 74.2% (n = 190), 66ValMet + 66MetMet - 25.8% (n = 66). The 66ValMet + 66MetMet polymorphism in the BDNF gene, stress, and anxiety on 10–14 days before the event, as well as reduced left ventricular ejection fraction, were independently associated with combined 6 months' clinical endpoint after STEMI.

Conclusion:
The Val66Met polymorphism in BDNF gene was found as an independent predictor for combined 6-month clinical endpoints after acute STEMI-treated primary PCI.
High Alert For Cannabinoid Hyperemesis Syndrome: A Case Report
Authors: Rathi Madhur 
Published: November 2019

Background: A 32-year-old Caucasian man presented with intractable nausea, psychogenic vomiting, abdominal pain and compulsive hot-water bathing behaviors following the habitual use of cannabis for years, consistent with the uncommon and frequently overlooked diagnosis of Cannabinoid Hyperemesis Syndrome. This was his third admission to the emergency department with the same complaints and symptoms which had persisted for over two years without a recognizable etiology. All imaging studies done on each visit were unremarkable.n Results: The patient was clinically symptomatic with the aforementioned presenting complaints, but disappeared upon discontinuation of the cannabis. Within two days of supportive treatment in addition to temporary relief of symptoms with bathing. To date, noeffective cure has been sought for this unique diagnosis other than abstaining from cannabis use. Conclusion: A complete recovery was made three days following admission. The presenting symptoms were attributed to the smoking behaviors. The patient was followed up by his primary care physician once released from the hospital. A very rare diagnosis surfaced a number of times with the same patient in the same setting over the span of a couple years, but was overlooked due to its rarity. Hence, physicians should list it higher on their
differentials when dealing with a patient with a history of drug abuse.
Correlation of Fine Needle Aspiration Cytology and Histopathology Diagnosis in the Evaluation of Breast Lumps
Authors: Khan Adnan , Jamali Raza , Jan Muneeb , Tasneem Maria 
Published: November 2019

Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods: This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar, Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four cases with breast lumps were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3 lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology. In this study, FNAC and histopathology diagnoses were strongly correlated [r 0.92, p <0.001]. Conclusion: Diagnosis of breast lump based on FNAC should be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.
Penile Cancer in Cali, Colombia: 10 Years of Casuistry in a Tertiary Referral Center of a Middle-Income Country
Authors: M. Rengifo Lina , Herrera Maria del M. , Rincon-Jimenez Angie L. , Bermudez-Pupo Alberto J. , Bonilla-Escobar Francisco J. 
Published: November 2019

Background: Penile cancer is a rare disease in Colombia; in Cali, it represents 0.7% of all cancers. Penile cancer has been associated with old age, bad hygiene, smoking and lack of circumcision. This study aimed to describe the sociodemographic and clinica characteristics of patients with penile cancer who consulted to a tertiary referral hospital. Methods: A case series of all penile cance cases at a reference institution in Cali during 2001-2010. Socioeconomic, demographic and clinical features of patients were described, and bivariate analyses were carried out. Results: There were 46 penile cancer cases. The average age was 60 ± 16.9 years. The main reason for consultation was an exophytic mass on the penis (75.0%). The most common location was the glans (69.6%), and the more frequent histology type was the squamous cell carcinoma (95.7%). With regard to risk factors, 65.5% of the patients had history of smoking and90.9% did not have circumcision. Patients who underwent radical amputation had higher rates of positive nodes (55% vs. 13.5%, p=0.015) and ulcerative lesions (77.8% vs. 29.7%, p=0.018) than those who did not have the procedure done. Recurrence was associated with the presence of lymphadenopathy (p=0.02) and history of circumcision (p=0.015). Conclusion: Most of the patients with penile cancer found in this study had old age, history of tobacco use and lack of circumcision. Patients who presented with lymph node metastasis had to undergo more radical procedures and suffered a greater rate of recurrence compared with those without lymph node involvement. Robust studies to determine the risk factors among low-income populations are required.
Dynamics of Antibiotic Prescription in Royal Hampshire County Hospital in November 2016: A Prospective Study
Authors: Lee-A-Ping Kathrine , Saeed Kordo , Dryden Matthew , Sim Gavin 
Published: November 2019

Background: Antimicrobial Stewardship and The Start Smart – Then Focus strategy provide guidelines aimed at improving the increasing trend of antibiotic resistance. The aim of this study was to assess whether antibiotics were being prescribed at Royal Hampshire County Hospital (a district general hospital), in accordance with the hospital’s and the NICE guidelines and whether this followed the Start Smart – Then Focus approach.

Methods: During November 2016, medical notes of 12 randomly selected in-patients of Royal Hampshire County Hospital on 45 antibiotics, were used to measure the dynamics of their prescriptions.

Results: 91% of the 45 prescriptions were in accordance with hospital guidelines, 82% of cases had appropriate samples sent before commencing antibiotics, 5% out of 27% had a planned switch from intravenous administration to oral (the remaining 73% were initially started on oral regimes) and 80% had planned stop dates.

Conclusion: Appropriate samples, stop dates, planning and documentation in patient notes must be improved with regards to antibiotic use.
Student Heart Failure Intervention Pilot (SHIP): A Study of Risk Factor Analytics and Population Outreach
Authors: Reichert William Byron , Hoatam Gerard , Schmidt Emily , Leher Michael , Gorur Arathi , Jones Anna , Kalya Anantharam , Radhakrishnan Priya 
Published: November 2019

Background: Heart failure (HF), the leading cause of hospitalization in adults over the age of 65, is a difficult-to-treat syndrome associated with high morbidity and mortality. Home-monitoring programs may help reduce HF-associated morbidity, but can be difficult to establish in smaller clinical settings. In this quality improvement project, we identified local patients at high risk of HF-related morbidity and hospitalizations, then implemented a medical student-based constant-contact program to encourage their follow-through on self-care.

Methods: Between June 2012 and September 2014, our clinic treated 197 patients for systolic or diastolic HF. These patients’ baseline characteristics were evaluated for trends that increased their risk for hospitalization. Of the high-risk patients identified (n=80), 12 (15%) were enrolled in the project. An 8-week constant-contact intervention was initiated through weekly calls. Patients’ health statuses were recorded and the importance of self-care was reiterated.

Results: High-risk HF patients were identified based on >10 clinic visits during the study period; 3 were lost to follow-up. Each patient completed two questionnaires at the study’s beginning and conclusion, with response rates of 67% (6/9) and 56% (5/9). Most participants reported symptom improvement and increased knowledge about their conditions.

Conclusion: Our preliminary population-guided, medical-student initiated intervention in a small clinical setting was designed to increase patient understanding and compliance and to improve HF symptoms. Although the study was limited by its low participation rate, drastic improvements in self-reported outcomes were noted among participants. A larger study with similar positive outcomes could ultimately influence follow-up methods.
Assessment of Medical Students’ Attitudes Towards Research and Perceived Barriers
Authors: Althubaiti Alaa , Al Muqbil Bashayer , Al Buraikan Doaa 
Published: November 2019

Background: Health research has been integrated as part of the curriculum of many health sciences teaching universities. The aim of this study is to measure the attitude of medical students towards research.
Methods: A cross-sectional survey study was conducted from March to May 2016 using the Student Attitude Towards Research (SAR) scale. The survey was distributed amongst undergraduate medical students at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia. Main outcome measure was score on attitude scale with 15 Likert-type statements.
Results: A total of 237 responses were collected from the students (55.6% males and 44.3% females). In general, students agreed that ‘research is important for identifying and investing problems in a subject matter’ (N=206, 86.9%). Female students showed significantly more positive attitude towards research (P<0.05). In regards to the degree of involvement of the faculty in the research program, 35% of students agreed that it was acceptable, and 48.1% agreed that the faculty members have adequate skills to handle research methodology.
Conclusion: Most of the surveyed students were aware of the importance of undertaking medical research, but their attitude to the field was not always positive. There is an urgent need to introduce research programs as a part of the curriculum of all medical colleges, and ensure that these programs meet their goals and continue to be improved by providing good infrastructural facilities in order to provide skillful physicians to support research related activities.
Awareness among Parents of Beta Thalassemia Major and Intermedia Patients in Three Centers in Baghdad and Al-Nasiriyah, Iraq in 2017
Authors: Mutar Mohammed Tareq , Majid Mustafa , Jaleel Ammar , Saad Ali , Abdulmortafea Ali , Talib Hashim 
Published: November 2019

Background: Thalassemia is an autosomal recessive disease common in Iraq with a prevalence of 35.7 per 100000. Beta thalassemia major is a life-threatening condition with many complications which if not managed could cause death at an early age. This cross-sectional study aimed to assess the awareness of parents/caregivers of children with beta-thalassemia major and intermedia, as enhancing awareness is the first and the most important step in all prevention programs
Methods: We conducted this study in three thalassemia centers (two in Baghdad and one in Al-Nasiriyah) from July 20th, 2017 to September 20th, 2017. This study involved 193 parents of thalassemic children under the age of 15 who come to the centers frequently for blood transfusion. The study assessed the awareness questionnaire through interviews. Data analysis was performed using the Statistical Package for the Social Sciences program (SPSS) version 24.
Results: We found that awareness was low in many aspects. The highest knowledge was for foods that thalassemic patients shouldn't eat and for the early manifestation signs in thalassemic patients which is 94.8% and 86%, respectively. The lowest knowledge was for the consideration of human immune deficiency virus as a transfusion-transmitted disease and for the chance of having an affected child when both parents are carriers which were 37.3% and 11.9%, respectively.
Conclusion: Parents have low awareness of thalassemia in many aspects. Thalassemia care centers may need to provide more education for the parents of patients with thalassemia.
Aneurysmal Subarachnoid Hemorrhage in a 68-Year-old Hyperglycemic Female Patient: Case Report and Literature Review
Authors: Morgan Paul Marcel 
Published: November 2019

Background: While hyperglycemia is intimately associated with uncontrolled diabetes mellitus (DM), recent clinical studies have demonstrated that hyperglycemia is also present in the early acute phase of stroke and is associated with poor prognosis and increased long-term mortality. About half of patients with acute hemorrhagic stroke also present with hyperglycemia upon admission. But more than 50% of patients with acute hemorrhagic stroke develop hyperglycemia even without a previous history of DM. This sheds new light on the relationship between DM, hyperglycemia, and hemorrhagic stroke, with a pathophysiology that is perhaps more profound than is conventionally understood.
The Case: We report a case of a 68-year-old female, with a history of DM Type 2 and stage 3 hypertension who presents to the emergency room (ER) at the Western Regional Hospital in Belmopan City, Belize, with hemorrhagic stroke and hyperglycemia. Diffuse subarachnoid hemorrhage was found in the frontal, temporal, and parietal regions. Mild intraventricular hemorrhage was also observed in the frontal horns and basal cisterns. And small areas of intraparenchymal hemorrhage were present in the frontal lobes. The patient was stabilized and treated conservatively with calcium channel blockers, and diuretics.
Conclusion: Despite a unifying consensus that is still pending, maintaining glucose levels between 110-120 mg/dl by using continuous insulin infusions after traumatic brain injury or aneurysmal subarachnoid hemorrhage may carry some clinical benefit with slightly improved outcome.
The Missing Generation: The Completion of Matthew’s Genealogy
Authors: Bryan Steven M. 
Published: November 2019

Abstract
At the beginning of Matthew’s Gospel, the precisely conceived genealogical scheme of 3 tables of 14 generations falls short by one generation in the third table. This shortfall was intended by Matthew as a puzzle that the conclusion of the narrative resolves with the appearance of Jesus as the resurrected Christ with the 11 disciples, newly designated as his “brothers.” If “Judah and his brothers” in the first table of the genealogy represent Israel in its original constitution and “Jeconiah and his brothers” represent Israel in its experience of national judgment and dissolution, the depiction of the Twelve as the resurrected Christ and his brothers at the end of the narrative represents Israel in its reconstitution. Part of Matthew’s literary genius is evident in the fact that he uses a genealogy to launch an argument that the identity of this people has never simply been a matter of ancestry. The missing generation at the end of the genealogy poses a question explored throughout the narrative but not fully resolved until the end of the Gospel.
Structure and Theology in Proverbs: Its Function as an Educational Program for Novice Leaders in Ancient Israel
Authors: Dunham Kyle C. 
Published: November 2019

Abstract
Proverbs has languished from neglect in biblical scholarship as an allegedly deficient fund for theological formulation. Recent studies have plied to fill this lacuna by focusing on the book’s literary structure as the key to its theological contribution. While some skepticism concerning its purposeful arrangement remains, several studies have adduced evidence from the final form of Proverbs to suggest it served in ancient Israel as an educational curriculum aimed at moving the implied reader from simple ethical decisions to complex social applications. This article argues that this reading strategy finds support in the preamble, which outlines a training regimen designed to advance the inexperienced youth toward the virtues of righteousness, justice, and integrity for the goal of exercising sociopolitical leadership. The literary structure of Proverbs discloses the collocation of key terms from the preamble that the final author/editor has embedded as mnemonic signposts in the opening and closing seams of its seven wisdom collections. A structural-canonical reading highlights this intentional and dynamic movement: by progressing through the seven courses of leadership, the callow initiate matures and matriculates to navigate the intricate demands and dangers of societal leadership in the royal court.
Variabilité interannuelle des précipitations dans la plaine de la Mitidja en Algérie du Nord
Authors: Drouiche Abdelmadjid , Nezzal Fatiha , Djema Manal 
Published: November 2019

Le bassin versant de la Mitidja (1 300 km2), situé au Nord de l'Algérie, a enregistré une sécheresse vers la fin du XXe siècle. Le but du présent travail est de caractériser cet épisode et de déterminer son extension spatiale dans le bassin versant au moyen de l’analyse des données pluviométriques mesurées dans huit stations. L’analyse de la longue série pluviométrique de la station de référence d’Hamiz barrage (1905-2010) au moyen de plusieurs tests statistiques (Mann-Kendall, Pettitt, U de Buishand et la procédure bayésienne de Lee et Heghinian) a révélé que cet épisode de sécheresse a sévi de 1973 à 2001 et a provoqué une baisse des précipitations annuelles variant entre 16 % et 24 % dans le bassin versant. Après cette période de sécheresse, une période humide s’est installée dans la Mitidja et est à l’origine d’une hausse des précipitations annuelles de 31,4 %, notamment à la station de Réghaïa.
The acute effect of match-play on hip range of motion and isometric strength in elite tennis players
Authors: Moreno-Pérez Victor , Nakamura Fabio Yuzo , Sánchez-Migallón Violeta , Domínguez Raul , Fernández-Elías Valentín Emilio , Fernández-Fernández Jaime , Pérez-López Alberto , López-Samanes Alvaro 
Published: November 2019

Background
Groin injuries are some of the most common injuries tennis players suffer. Several factors (e.g., post-match decrease in hip adductor (ADD) strength) have been proposed as possible mechanisms for increasing the incidence of this type of injury. However, the risk factors of developing groin injuries after a tennis match have not yet been delineated.

Objective
The aim of this study was to determine the effect of tennis match-play on isometric ADD and abductor (ABD) strength and passive hip range of motion (ROM).

Methods
Twenty-six male tennis players (20.30 ± 4.98 years) took part in this study. Participants completed an evaluation of strength and flexibility hip measurements before and after a simulated tennis match. Dominant and non-dominant passive hip ROM, ADD and ABD isometric strength, and the ADD/ABD strength ratio were measured before and immediately post-match. A global positioning system (GPS) and a session rating of perceived exertion (RPE) were used to assess the locomotive demands and internal match load.

Results
Isometric dominant ADD strength (17.8%, p ≤ 0.01) and ADD/ABD strength ratio (11.6%, p = 0.04) were lower post-match compared to the pre-match values. No between-limbs differences were observed for isometric ADD strength, ABD strength, and passive hip ROM tests. RPE showed an expected increase between pre- vs. post-match (pre- vs. post-warming-up, 3.42 ± 2.08 vs. 5.62 ± 2.29, p < 0.01). In addition, a significant relationship between ADD strength and the volume of tennis practice per week was found, stablishing that tennis players with lower volume of training per week suffered a reduction in ADD strength in their dominant limb after match-play (r = 0.420, p = 0.04).

Conclusion
The assessment of ADD strength and the ADD/ABD strength ratio in the dominant limb may be considered a post-match tool that can be used to identify players who require rest and additional recovery strategies before competing again.