bluuebunny/crossref_metadata_2025_split huggingface dataset:
The importance of cardiorespiratory fitness and sleep duration in early CVD prevention: BMI, resting heart rate and questions about sleep patterns are suggested in risk assessment of young adults, 18–25 years
Authors: Fernström Maria , Fernberg Ulrika , Hurtig-Wennlöf Anita 
Published: November 2020

AbstractBackgroundCardiorespiratory fitness (CRF) and sleep habits are lifestyle factors with potential to prevent cardiovascular disease (CVD). CVD is the leading cause of death worldwide. It is therefore important to establish a healthy lifestyle at a young age. In the Lifestyle, Biomarkers and Atherosclerosis (LBA) study we have examined 834 healthy non-smoking adults, aged 18–25 years. The general purpose of the LBA study was to study the effect of lifestyle on traditional biomarkers known to influence CVD risk. The aims of the present study were to evaluate sleep habits of young adult women and men participating in the LBA study, and to compare the importance of sleep and other lifestyle habits on clinically relevant biomarkers for CVD. An additional aim was to find easy and reliable non-invasive biomarkers to detect young adults with increased risk of developing CVD later in life.MethodsThe participants had previously been examined for lifestyle factors, biomarkers and CVD risk score. They filled in a validated computerized questionnaire about their general physical and mental health. The questionnaire included questions on sleep duration and experienced quality of sleep.ResultsIn total 27% of the young adult participants reported difficulties falling asleep or experienced troubled sleep with frequent awakenings per night. The experienced troubled sleep was not related to a higher CVD risk score, but sleep quality and duration were correlated. Shorter sleep duration was significantly associated to higher body mass index (BMI), body fat (%), homeostasis model assessment of insulin resistance (HOMA-IR) and CVD risk. The modifiable lifestyle factor with the highest odds ratio (OR) for CVD risk was CRF. Sleep duration was the second most influential lifestyle factor, more important than moderate- and vigorous physical activity (MVPA) and food habits. Correlations between CRF and heart rate (HR), (P < 0.01) and HOMA-IR and BMI (P < 0.01) were observed, indicating that BMI and resting HR in combination with questions about sleep patterns are easy and reliable non-invasive biomarkers to detect young adults who need counselling on a healthy lifestyle.ConclusionDecreased sleep duration in combination with decreased CRF, in young adults, is a serious health issue.
Oral rehydration solution coverage in under 5 children with diarrhea: a tri-country, subnational, cross-sectional comparative analysis of two demographic health surveys cycles
Authors: Gona Philimon N. , Gona Clara M. , Chikwasha Vasco , Haruzivishe Clara , Rao Sowmya R. , Mapoma Chabila C. 
Published: November 2020

Abstract
Background
More than 3 million children under 5 years in developing countries die from dehydration due to diarrhea, a preventable and treatable disease. We conducted a comparative analysis of two Demographic Health Survey (DHS) cycles to examine changes in ORS coverage in Zimbabwe, Zambia and Malawi. These surveys are cross-sectional conducted on a representative sample of the non-institutionalized individuals.

Methods
The sample is drawn using a stratified two-stage cluster sampling design with census enumeration areas, typically, selected first as primary sampling units (PSUs) and then a fixed number of households from each PSU. We examined national and sub-regional prevalence of ORS use during a recent episode of diarrhea (within 2 weeks of survey) using DHSs for 2007–2010 (1st Period), and 2013–2016 (2nd Period). Weighted proportions of ORS were obtained and multivariable- design-adjusted logistic regression analysis was used to obtain Odds Ratios (aORs) and 95% confidence intervals (CIs) and weighted proportions of ORS coverage.

Results
Crude ORS coverage increased from 21.0% (95% CI: 17.4–24.9) in 1st Period to 40.5% (36.5–44.6) in 2nd Period in Zimbabwe; increased from 60.8% (56.1–65.3) to 64.7% (61.8–67.5) in Zambia; and decreased from 72.3% (68.4–75.9) to 64.6% (60.9–68.1) in Malawi. The rates of change in coverage among provinces in Zimbabwe ranged from 10.3% over the three cycles (approximately 10 years) in Midlands to 44.2% in Matabeleland South; in Zambia from − 9.5% in Eastern Province to 24.4% in Luapula; and in Malawi from − 16.5% in the Northern Province to − 3.2% in Southern Province. The aORs for ORS use was 3.95(2.66–5.86) for Zimbabwe, 2.83 (2.35–3.40) for Zambia, and, 0.71(0.59–0.87) for Malawi.

Conclusion
ORS coverage increased in Zimbabwe, stagnated in Zambia, but declined in Malawi. Monitoring national and province-level trends of ORS use illuminates geographic inequalities and helps identify priority areas for targeting resource allocation.. Provision of safe drinking-water, adequate sanitation and hygiene will help reduce the causes and the incidence of diarrhea. Health policies to strengthen access to appropriate treatments such as vaccines for rotavirus and cholera and promoting use of ORS to reduce the burden of diarrhea should be developed and implemented.
A framework for indirect elicitation of the public health impact of gambling problems
Authors: Browne Matthew , Rawat Vijay , Newall Philip , Begg Stephen , Rockloff Matthew , Hing Nerilee 
Published: November 2020

AbstractGambling problems are increasingly understood as a health-related condition, with harms from excessive time and money expenditure contributing to significant population morbidity. In many countries, the prevalence of gambling problems is known with some precision. However, the true severity of gambling problems in terms of their impact on health and wellbeing is the subject of ongoing debate. We firstly review recent research that has attempted to estimate harm from gambling, including studies that estimate disability weights using direct elicitation. Limitations of prior approaches are discussed, most notably potential inflation due to non-independent comorbidity with other substance use and mental health conditions, and potential biases in the subjective attribution of morbidity to gambling. An alternative indirect elicitation approach is outlined, and a conceptual framework for its application to gambling is provided. Significant risk factors for propensity to develop gambling problems are enumerated, and relative risks for comorbidities are calculated from recent meta-analyses and reviews. Indirect elicitation provides a promising alternative framework for assessing the causal link between gambling problems and morbidity. This approach requires implementation of propensity score matching to estimate the counterfactual, and demands high quality information of risk factors and comorbid conditions, in order to estimate the unique contribution of gambling problems. Gambling harm is best understood as a decrement to health utility. However, achieving consensus on the severity of gambling problems requires triangulation of results from multiple methodologies. Indirect elicitation with propensity score matching and accounting for comorbidities would provide an important step towards full integration of gambling within a public health paradigm.
Associated factors of willingness to undergo routine chlamydia trachomatis screening among hospital-based patients in Shenzhen, China: a cross-sectional study
Authors: Weng Rongxing , Hong Fuchang , Zhang Chunlai , Wen Lizhang , Chen Xiangsheng , Cai Yumao 
Published: November 2020

AbstractBackgroundChlamydia trachomatis (CT) is a common sexually transmitted infection (STI) with significant morbidity. The study aimed to explore the willingness to undergo routine CT screening and its associated factors among hospital-based patients in Shenzhen.MethodsWe used data from the Shenzhen Gonorrhea and Chlamydia Intervention Programme. Participants were recruited with a stratified purposeful sampling design from 1 April 2018 to 16 May 2018. A structured questionnaire was used to obtain data on baseline characteristics and CT-related participant information.ResultsOf the 16,546 participants, 64.79% were women, with a mean age of 31.85 ± 7.31 of all participants. Of the participants, 88.78% were willing to undergo routine CT screening. According to multivariate logistic regression analyses, willingness to undergo routine CT screening was associated with the following (P < 0.05): being a woman (AOR = 1.53, 95% CI = 1.34–1.75), one year or more residency in Shenzhen (AOR = 1.64, 95% CI = 1.37–1.95), any secondary education (AOR = 2.46, 95% CI = 1.92–3.15), monthly income ≥ RMB 10,000 (AOR = 1.24, 95% CI = 1.01–1.51), having forgotten CT diagnosis history (AOR = 1.42, 95% CI = 1.12–1.79), without current STI-related symptoms (AOR = 1.24, 95% CI = 1.10–1.41), and having correct understanding of the sequelae of CT infection (AOR = 1.68, 95% CI = 1.39–2.03).ConclusionThis study reported high willingness to undergo routine CT screening among hospital-based patients in Shenzhen, and provided evidence for the promotion and the implementation of strategies and recommendations on routine CT screening in China.
The impact of internet use frequency on non-suicidal self injurious behavior and suicidal ideation among Chinese adolescents: an empirical study based on gender perspective
Authors: Yang Xueyan , Xin Moye , Liu Kun , Böke Bilun Naz 
Published: November 2020

Abstract
Background
We attempted to find if there were gender differences in Non-suicidal self injurious (NSSI) behaviors and Suicidal ideation among Chinese adolescents, then analyze the impact of Internet use frequency on these variables among adolescents of different genders.

Methods
Based on the data from 6 high-schools and 4 universities in 4 cities in China, the gender difference in NSSI behaviors and Suicidal ideation and their related factors were analyzed in the study.

Results
Gender differences were found during different purposes of Internet use; There was no significant gender difference in NSSI behaviors among Chinese adolescents, yet females reported significantly higher intensity of suicidal ideation compared to males; Internet use frequency could explain the prevalence of NSSI behaviors and Suicidal ideation by gender, to some categories.

Conclusions
There were gender differences in Internet use frequency among adolescents; Gender difference of NSSI engagement among Chinese adolescents was not statistically significant; Females had higher suicidal ideation than males; the overuse of social softwares was found to be a risk factor to both NSSI engagements and suicidal ideations for both genders; males would engage less NSSI behaviors when they spent more time on knowledge sharing softwares while might have more suicidal ideation when they spent too much time on gaming.
Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome
Authors: Pandolfi Laura , Fossali Tommaso , Frangipane Vanessa , Bozzini Sara , Morosini Monica , D’Amato Maura , Lettieri Sara , Urtis Mario , Di Toro Alessandro , Saracino Laura , Percivalle Elena , Tomaselli Stefano , Cavagna Lorenzo , Cova Emanuela , Mojoli Francesco , Bergomi Paola , Ottolina Davide , Lilleri Daniele , Corsico Angelo Guido , Arbustini Eloisa , Colombo Riccardo , Meloni Federica 
Published: November 2020

Abstract
Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. Given that the main target of SARS-CoV-2 are lungs leading to severe pneumonia with hyperactivation of the inflammatory cascade, we conducted a prospective study to assess alveolar inflammatory status in patients with moderate to severe COVID-19.

Methods
Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin (IL)6, 8 and 10 levels.

Results
ICU patients showed a marked increase in neutrophils (1.24 × 105 ml− 1, 0.85–2.07), lower lymphocyte (0.97 × 105 ml− 1, 0.024–0.34) and macrophages fractions (0.43 × 105 ml− 1, 0.34–1.62) compared to IMW patients (0.095 × 105 ml− 1, 0.05–0.73; 0.47 × 105 ml− 1, 0.28–1.01 and 2.14 × 105 ml− 1, 1.17–3.01, respectively) (p < 0.01). Study of ICU patients BAL by electron transmission microscopy showed viral particles inside mononuclear cells confirmed by immunostaining with anti-viral capsid and spike antibodies. IL6 and IL8 were significantly higher in ICU patients than in IMW (IL6 p < 0.01, IL8 p < 0.0001), and also in patients who did not survive (IL6 p < 0.05, IL8 p = 0.05 vs. survivors). IL10 did not show a significant variation between groups. Dividing patients by treatment received, lower BAL concentrations of IL6 were found in patients treated with steroids as compared to those treated with tocilizumab (p < 0.1) or antivirals (p < 0.05).

Conclusions
Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.
The role of the oral microbiota in chronic non-communicable disease and its relevance to the Indigenous health gap in Australia
Authors: Handsley-Davis Matilda , Jamieson Lisa , Kapellas Kostas , Hedges Joanne , Weyrich Laura S. 
Published: November 2020

AbstractBackgroundAboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience disproportionately poor health and low life expectancy compared to non-Indigenous Australians. Poor oral health is a critical, but understudied, contributor to this health gap. A considerable body of evidence links poor oral health to increased risks of other chronic non-communicable conditions, such as diabetes, cardiovascular disease, chronic kidney disease, and poor emotional wellbeing. MainThe oral microbiota is indisputably associated with several oral diseases that disproportionately affect Indigenous Australians. Furthermore, a growing literature suggests direct and indirect links between the oral microbiota and systemic chronic non-communicable diseases that underpin much of the Indigenous health gap in Australia. Recent research indicates that oral microbial communities are shaped by a combination of cultural and lifestyle factors and are inherited from caregivers to children. Systematic differences in oral microbiota diversity and composition have been identified between Indigenous and non-Indigenous individuals in Australia and elsewhere, suggesting that microbiota-related diseases may be distinct in Indigenous Australians. ConclusionOral microbiota research involving Indigenous Australians is a promising new area that could benefit Indigenous communities in numerous ways. These potential benefits include: (1) ensuring equity and access for Indigenous Australians in microbiota-related therapies; (2) opportunities for knowledge-sharing and collaborative research between scientists and Indigenous communities; and (3) using knowledge about the oral microbiota and chronic disease to help close the gaps in Indigenous oral and systemic health.
Crafting study tasks among medical students: the role of authentic medical teachers
Authors: Luu Tuan Trong , Vo Thao Thanh 
Published: November 2020

Abstract
Background
Though leadership has been highlighted as a salient skill for medical teachers in the medical education literature, the role of authentic leadership style among medical teachers in activating medical students’ learning behaviors has not been explored. Our study seeks to examine the effects of medical teachers’ authentic leadership on study task crafting behaviors among medical students.

Methods
Our study adopted a mixed-methods research design comprising observations of 100 surgical operations and 100 ward conferences led by medical teachers, and surveys on authentic leadership, study task crafting, and promotion focus. Structural equation modelling was utilized in the data analysis.

Results
Medical teachers’ authentic leadership demonstrated positive effects on the two study task crafting behaviors (seeking resources (B = 0.36, p < 0.001) and seeking challenges (B = 0.21, p < 0.05)) but not on reducing study task demands (B = 0.11, p > 0.10). Promotion focus was found to strengthen such positive effects of authentic leadership on seeking resources (B = 0.23, p < 0.05) and seeking challenges (B = 0.18, p < 0.05). Illustrative excerpts of intraoperative and conference conversations are presented.

Conclusions
Our study provided empirical evidence that medical students guided by authentic teachers expressed increased levels of study task crafting, which were further increased if medical students were promotion-focused.
Future medical student practice intentions: the South Africa experience
Authors: Clithero-Eridon Amy , Crandall Cameron , Ross Andrew 
Published: November 2020

AbstractBackgroundPrimary care is a broad spectrum specialty that can serve both urban and rural populations. It is important to examine the specialties students are selecting to enter, future community size they intend to practice in as well as whether they intend to remain in the communities in which they trained.AimThe goals of this study were to characterize the background and career aspirations of medical students. Objectives were to (1) explore whether there are points in time during training that may affect career goals and (2) assess how students’ background and stated motivations for choosing medicine as a career related to intended professional practice.SettingThe setting for this study was the Nelson R. Mandela School of Medicine, located in Durban, South Africa.MethodsWe conducted a cross-sectional survey of 597 NRMSM medical students in their first, fourth, or sixth-year studies during the 2017 academic year.ResultsOur findings show a noticeable lack of interest in primary care, and in particular, family medicine amongst graduating students. Altruism is not as motivating a factor for practicing medicine as it was among students beginning their education.ConclusionSelection of students into medical school should consider personal characteristics such as background and career motivation. Once students are selected, local context matters for training to sustain motivation. Selection of students most likely to practice primary care, then emphasizing family medicine and community immersion with underserved populations, can assist in building health workforce capacity. There are institutional, legislative, and market pressures influencing career choice either toward or away from primary care. In this paper, we will discuss only the institutional aspects.
Development of a pediatric ophthalmology academic partnership between Canada and Ethiopia: a situational analysis
Authors: Kletke Stephanie N. , Soboka Jibat G. , Dimaras Helen , Sherief Sadik T. , Ali Asim 
Published: November 2020

Abstract
Background
Educational capacity building in pediatric ophthalmology is necessary to address the burden of childhood blindness in Ethiopia. Residency and fellowship training at Addis Ababa University (AAU) have been enhanced with support from the University of Toronto (UofT), following the established Toronto Addis Ababa Academic Collaboration (TAAAC). Our aim was to assess the feasibility of implementing a pediatric ophthalmology fellowship at AAU with support from UofT, modeled by successful postgraduate medical education within TAAAC.

Methods
A situational analysis, including a needs assessment, was conducted at Menelik II Hospital, Addis Ababa. Staff expertise, equipment and infrastructure were compared to International Council of Ophthalmology fellowship guidelines. Patient volumes were assessed through medical chart review. Local training needs were evaluated. A strategic working meeting facilitated program specification.

Results
The faculty consisted of 11 ophthalmologists, including 2 pediatric specialists. Fourteen thousand six hundred twenty-seven medical and three thousand six hundred forty-one surgical pediatric cases were seen in the previous year. A 2-year fellowship incorporating anterior segment, retinoblastoma, strabismus, and retinopathy of prematurity modules was developed. Research collaborations, didactic teaching, and surgical supervision were identified as priorities requiring support. Quality standard indicators included faculty feedback, case log review and formal examination. Telemedicine, development of a larger eye hospital and partnerships to support equipment maintenance were identified as strategies to manage implementation barriers.

Conclusions
The situational analysis provided a way forward for the development of a pediatric ophthalmology fellowship, the first of its kind in Eastern Africa. Learning outcomes are feasible given high patient volumes, qualified staff supervision and sufficient equipment. Strategic partnerships may ensure resource sustainability.
Advances in fatty acids nutrition in dairy cows: from gut to cells and effects on performance
Authors: Bionaz Massimo , Vargas-Bello-Pérez Einar , Busato Sebastiano 
Published: November 2020

AbstractHigh producing dairy cows generally receive in the diet up to 5–6% of fat. This is a relatively low amount of fat in the diet compared to diets in monogastrics; however, dietary fat is important for dairy cows as demonstrated by the benefits of supplementing cows with various fatty acids (FA). Several FA are highly bioactive, especially by affecting the transcriptome; thus, they have nutrigenomic effects. In the present review, we provide an up-to-date understanding of the utilization of FA by dairy cows including the main processes affecting FA in the rumen, molecular aspects of the absorption of FA by the gut, synthesis, secretion, and utilization of chylomicrons; uptake and metabolism of FA by peripheral tissues, with a main emphasis on the liver, and main transcription factors regulated by FA. Most of the advances in FA utilization by rumen microorganisms and intestinal absorption of FA in dairy cows were made before the end of the last century with little information generated afterwards. However, large advances on the molecular aspects of intestinal absorption and cellular uptake of FA were made on monogastric species in the last 20 years. We provide a model of FA utilization in dairy cows by using information generated in monogastrics and enriching it with data produced in dairy cows. We also reviewed the latest studies on the effects of dietary FA on milk yield, milk fatty acid composition, reproduction, and health in dairy cows. The reviewed data revealed a complex picture with the FA being active in each step of the way, starting from influencing rumen microbiota, regulating intestinal absorption, and affecting cellular uptake and utilization by peripheral tissues, making prediction onin vivonutrigenomic effects of FA challenging.