bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive mental health and burnout in first to fourth year medical students
Authors: Morgan Tamara L , McFadden Taylor , Fortier Michelle S , Tomasone Jennifer R , Sweet Shane N 
Published: July 2020

Background: Medical students are at risk of poor mental health and burnout compared to general population age- and education-matched peers, which has future implications for patient care. Research has suggested that demographic factors can predict mental illness and burnout among medical students. However, less is known about predictors of mental health and how they compare to predictors of burnout, and few studies have examined multiple demographics simultaneously. Objectives: This study examined and compared demographic predictors (gender, ethnicity, age, level of education, year of study and proposed specialty) of mental health and burnout in first to fourth year Canadian medical students. Method: Medical students ( n = 129) completed online surveys comprised of validated questionnaires. Results: Multiple regression indicated that third year (β = −.243, p = .013) negatively predicted mental health ( R2 = 15.0%). Female gender (β = .242, p = .005), ‘other’ ethnicities (β = .189, p = .028), third year (β = .391, p < .001) and fourth year (β = .212, p = .023) positively predicted burnout ( R2 = 32.7%). Female gender and fourth year predicted mental health and burnout differently. ‘Other’ ethnicity, second year and third year predicted mental health and burnout similarly. Conclusion: Findings fill gaps in the literature and may inform medical stakeholders in developing targeted programmes for improving medical students’ mental health and burnout. Medical students with greater well-being can progress into physicians who will be more likely to promote well-being in their patients.
Hearing Vital Signs: Mobile Audiometry in the Emergency Department for Evaluation of Sudden Hearing Loss
Authors: Lubner Rory J. , Barbarite Eric , Kondamuri Neil , Knoll Renata M. , Ota H. Gregory , Lewis Rebecca M. , Franck Kevin , Remenschneider Aaron K. , Kozin Elliott D. 
Published: July 2020

Emergency departments (EDs) are a common location for patients to present with sudden hearing loss (SHL). Unfortunately, high‐quality, rapid quantitative measurement of hearing loss is challenging. Herein, we aim to evaluate the accuracy of tablet‐based audiometry in patients complaining of SHL. Prospective tablet‐based testing was completed in the ED in patients complaining of SHL. Air conduction thresholds (ACTs) obtained via tablet‐based audiometry were compared to same‐day measurements with a clinical‐grade audiometer. Hearing loss (HL) was defined as >20 dB ACT for any frequency. In participant‐level analysis, 30+ dB HL in 3 consecutive frequencies was used to define SHL. In the ED, mobile audiogram ACTs were within 5 dB (77%) and 10 dB (89.6%) of those determined by conventional audiometry. The sensitivity and specificity for mobile audiometry to detect 3 or more consecutive thresholds with 30+ dB HL were 100% and 62.5%, respectively. Findings have implications for increasing access to high‐quality audiometry.
Diverse MRI findings and clinical outcomes of acute Marchiafava-Bignami disease
Authors: Li Wei , Ran Chao , Ma Jun 
Published: July 2020

Background The acute onset of Marchiafava-Bignami disease (MBD) is difficult to capture, and its clinical manifestations are overlapped. Magnetic resonance imaging (MRI) is very useful in the diagnosis of acute MBD. Purpose To investigate the MRI features and clinical outcomes of acute MBD. Materials and Methods Sagittal T2-weighted (T2W) or T1-weighted (T1W) imaging, axial T1W and T2W imaging, and axial FLAIR and diffusion-weighted imaging (DWI) sequences were performed in 17 patients with acute MBD on 1.5-T MR. According to the different ranges of callosal restricted diffusion, MBD was divided into Type I (n = 7, the completely involved), Type II (n = 5, the mostly involved), and Type III (n = 5, the partly involved). The MRI findings and outcomes of each type were retrospectively analyzed. Results With the reduced range of the callosal restricted diffusion, the callosal atrophy or cavitation was more common: no case of Type I; 1 (20%) case of Type II; and 3 (60%) cases of Type III. With the increased range of callosal restricted diffusion, the extracallosal involvement was more common: 6 (86%) cases of Type I; 3 (60%) cases of Type II; and 1 (20%) case of Type III. During the follow-up, five cases had neuropsychiatric sequelae: 1 (14%) case of type I; 1 (20%) case of Type II; 3 (60%) cases of Type III. Conclusion The MRI findings and clinical outcomes of acute MBD are regular. The extensive restricted diffusion of acute MBD may present the curable condition. Callosal heterogeneity may affect the outcome of acute MBD.
MiR-28-5p mediates the anti-proliferative and pro-apoptotic effects of curcumin on human diffuse large B-cell lymphoma cells
Authors: Kang Tian , Sun Wei-Li , Lu Xiao-Fei , Wang Xin-Liang , Jiang Lian 
Published: July 2020

Objective To investigate the anti-proliferative and pro-apoptotic effects of curcumin on diffuse large B-cell lymphoma (DLBCL) cells and explore the mechanism. Methods OCI-LY7 cells were treated with curcumin (2.5, 5, 10, 20, and 40 μM) for 24, 48, or 72 hours. Cell viability and apoptosis were determined using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5 diphenyl tetrazolium bromide assay and TdT-mediated dUTP nick-end labeling staining, respectively. MiR-28-5p expression was detected via qRT-PCR. The binding site of miR-28-5p was predicted using online databases and verified using the dual-luciferase reporter assay. MiR-28-5p overexpression and inhibition were achieved via transfection with an miR-28-5p mimic and inhibitor, respectively. Results Curcumin decreased the viability of OCI-LY7 cells in a concentration- and time-dependent manner, and these effects were attenuated by miR-28-5p inhibition. MiR-28-5p expression was upregulated by curcumin. Curcumin increased the numbers of apoptotic cells and upregulated cleaved caspase-3 expression, and these effects were attenuated by miR-28-5p inhibition. The dual-luciferase reporter assay confirmed that miR-28-5p directly targets the 3′-untranslated region of BECN1. Curcumin downregulated BECN1 and microtubule-associated protein 1 light chain 3 beta-II/I expression and upregulated p62 expression. Conclusions Our results described the curcumin exerted anti-proliferative and pro-apoptotic effects on OCI-LY7 cells through a mechanism potentially involving miR-28-5p.
Huge peripapillary staphyloma with craniofacial clefts: A case report
Authors: Yu Fei , Fu Yao 
Published: July 2020

Purpose: We reported the occurrence of a congenital unilateral huge peripapillary staphyloma in association with craniofacial clefts for the first time. Case report: A 1-year-old boy presented with a large defect on his left eyelid, a wide oblique columella nasi and an atypical wedge-shaped extension of the unilateral anterior hairline. Magnetic resonance imaging (MRI) examinations revealed there were cracks on his nasal septum, palate, and superior alveolar midline. Moreover, we surprisingly uncovered a gourd-shaped eyeball with the compressed optic nerve on the right side, while the right eye seemed normal from appearance. Under anaesthesia, fundus examination of the right eye showed a 15 mm-deep excavation surrounding the optic disc with defective choroid and dysplastic optic papilla. We reconstructed the left eyelid of the patient to protect his cornea and would make other solutions according to the results of follow-up. Conclusion: Peripapillary staphyloma and craniofacial clefts are two dissimilar rare congenital anomalies. In this patient, we firstly observed the co-existence of the two defects, which may provide the experience to the diagnosis and treatment of peripapillary staphyloma and craniofacial clefts. This case also gives us the pathogenic inspiration for further studies of peripapillary staphyloma and craniofacial clefts.
SNHG7 Facilitates Glioblastoma Progression by Functioning as a Molecular Sponge for MicroRNA-449b-5p and Thereby Increasing MYCN Expression
Authors: Chen Yaogang , Yuan Shaoyong , Ning Tieying , Xu Huiqing , Guan Bo 
Published: July 2020

Background and Aims: Long noncoding RNA (small nucleolar RNA host gene 7) has been reported to be involved in multiple malignancies and acts as an oncogene. However, the potential mechanism of small nucleolar RNA host gene 7 in glioblastoma is rarely known. In this study, we attempted to elucidate the biological effects of small nucleolar RNA host gene 7 and the possible molecular mechanism in glioblastoma. Methods: The expression level of small nucleolar RNA host gene 7 in glioblastoma tissues and corresponding tumor cell lines was evaluated by using quantitative real-time polymerase chain reaction. Bioinformatics analyses and dual-luciferase reporter gene assay were conducted to verify the correlation among small nucleolar RNA host gene 7, miR-449b-5p, and MYCN. The role of small nucleolar RNA host gene 7 on cell viability, migration, and invasion was measured. Results: Small nucleolar RNA host gene 7 expression was markedly increased in glioblastoma tumor tissue. Small nucleolar RNA host gene 7 can sponge miR-449b-5p and negatively regulate miR-449b-5p expression. MiR-449b-5p was remarkably repressed in glioblastoma tissues. Reduction of miR-449b-5p reversed the repressive effects of small nucleolar RNA host gene 7 knockdown on cellular behaviors in glioblastoma. In addition, miR-449b-5p can directly bind with MYCN. Compared with normal samples, MYCN expression was increased. The MYCN expression was negatively related to miR-449b-5p expression while positively related to small nucleolar RNA host gene 7 expression. Rescue experiments revealed that MYCN overexpression reversed the repressive role of small nucleolar RNA host gene 7 knockdown on viability, migration, and invasion of U251 cells. Conclusion: In summary, our results demonstrated that small nucleolar RNA host gene 7 regulates glioblastoma proliferation, migration, and invasion via regulating miR-449b-5p and its target gene MYCN, thereby providing a potential therapeutic target for glioblastoma.
Five-Year Experience with VATS Versus Thoracotomy Segmentectomy for Lung Tumor Resection
Authors: Sabra Michel J. , Alwatari Yahya , Bierema Christine , Wolfe Luke G. , Cassano Anthony D. , Shah Rachit D. 
Published: July 2020

Objective Segmentectomy for lung tumors has been performed with either video-assisted thoracoscopic surgery (VATS) or thoracotomy; however, there is a lack of contemporary, multicenter study that compares both approaches. The aim of this study was to compare the 30-day surgical outcomes of VATS versus thoracotomy for segmentectomy using a large national database. Methods We performed a retrospective analysis of prospectively maintained American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent segmentectomy for benign or malignant tumors between 2013 and 2017 were included and divided into 2 groups based on whether they received a thoracotomy or VATS approach. All VATS patients were then into 2 subgroups: early (2013 to 2015) and late (2016 to 2017). Propensity-matched analysis was conducted, and the perioperative variables and outcomes were compared. Results A total of 1,785 patients met the inclusion criteria. VATS segmentectomy was associated with shorter hospital stays (3.9 vs 5.8 days, P < 0.001) and higher rates of home discharge (94% vs 89%, P = 0.002) compared to thoracotomy segmentectomy. VATS was also associated with less postoperative pneumonia (2.8% vs 5.8%, P = 0.007), unplanned intubation (1.5% vs 3.5%, P = 0.016), prolonged intubation (0.6% vs 2.7%, P = 0.001), transfusion requirement (1.7% vs 5.8%, P < 0.001), and deep venous thrombosis (0.1% vs 1.1%, P = 0.03). Compared to the earlier VATS group, the late group was associated with less cardiac arrests (0% vs 0.8%, P = 0.025) and shorter hospital stays (3.3 vs 4.2 days, P < 0.001). Conclusions When compared with thoracotomy, VATS segmentectomy is associated with less postoperative complications and shorter hospital length of stay. VATS segmentectomy has been used more frequently and with improved outcomes.
Physical exercise training in patients with a Fontan circulation: A systematic review
Authors: Scheffers Linda E , Berg Linda E M vd , Ismailova Gamida , Dulfer Karolijn , Takkenberg Johanna J M , Helbing Wim A 
Published: July 2020

Abstract

Background
Patients with a Fontan circulation have a reduced exercise capacity, which is an important prognostic predictor of morbidity and mortality. A way to increase exercise capacity in Fontan patients might be exercise training. This systematic review assesses the effects of exercise training investigated in Fontan patients in order to provide an overview of current insights.

Design and methods
Studies evaluating an exercise training intervention in Fontan patients published up to February 2020 were included in this systematic review.

Results
From 3000 potential studies, 16 studies reported in 22 publications met the inclusion criteria. In total, 264 Fontan patients with mean age range 8.7–31 years, were included. Different training types including inspiratory muscle training, resistance training and aerobic training were investigated. Main outcome measures reported were peak oxygen uptake, cardiac function, lung function, physical activity levels and quality of life. Peak oxygen uptake increased significantly in 56% of the studies after training with an overall mean increase of +1.72 ml/kg/min (+6.3%). None of the studies reported negative outcome measures related to the exercise programme. In four studies an adverse event was reported, most likely unrelated to the training intervention.

Conclusions
Exercise training in Fontan patients is most likely safe and has positive effects on exercise capacity, cardiac function and quality of life. Therefore exercise training in Fontan patients should be encouraged. Further studies are required to assess the optimal training type, intensity, duration and long-term effects.
Use of colour Doppler to eliminate rectal bleeding from trans-rectal ultrasound-guided biopsy of the prostate
Authors: Aminu Sani R , Ansari Asif H , Rana Muhammad Q 
Published: July 2020

Bleeding is one of the complications of trans-rectal ultrasound (TRUS)-guided biopsy of the prostate. Urethral bleeding could be prevented by avoiding the trajectory on the urethra. However, rectal bleeding is difficult to predict because the peri-prostatic, intra-prostatic and rectal vessels cannot be seen on an ordinary ultrasound scan. Use of colour Doppler to map out the vessels cognitively before injection of local anaesthesia prevents puncture of the vessels, which is a key cause of rectal bleeding. Level of evidence: Not applicable.
Henoch–Schönlein purpura and epididymitis in an adult: A case report and literature review
Authors: McAdam Andrew , Thompson Trevor 
Published: July 2020

Henoch–Schönlein purpura (HSP) is a small-vessel immunoglobulin A1-mediated vasculitis which often presents as a purpuric rash affecting the cutaneous tissue, gastrointestinal tract and joints. Commonly reported in childhood is scrotal involvement with pain and swelling, but this is exceptionally rare in the adult population. We report a case of a 33-year-old male with bilateral testicular pain and swelling on the background of concurrent HSP. The history, examination, subsequent investigations and ultrasound scan confirmed a non-bacterial and non-viral epididymo-orchitis. This was managed effectively with systemic steroids and topical emollients for symptomatic relief. This is a rare but important manifestation of HSP for clinicians assessing HSP patients with acute testicular pain. Level of evidence Level 5.
Stacked genetically modified soybean harboring herbicide resistance and insecticide rCry1Ac shows strong defense and redox homeostasis disturbance after glyphosate-based herbicide application
Authors: Zanatta Caroline Bedin , Benevenuto Rafael Fonseca , Nodari Rubens Onofre , Agapito-Tenfen Sarah Zanon 
Published: July 2020

Abstract
Background
World agricultural production of genetically modified (GM) products, in particular, the combination of different traits/genes in the same plant has been a trend over the last decade. There have been concerns raised over stacking multiple herbicide and insect-resistant transgenes that could result in fitness costs depending on the type and strength of selection pressures exerted by the environment. Here, we report the results of transcriptomic analysis comparing the effect of glyphosate-based herbicide (GBH) in the single-transgene versus stacked, herbicide-resistant soybean varieties on various biological processes, metabolic pathways, and key shikimic enzymes.

Results
Gene expression data showed that defense metabolism and redox homeostasis were equally modulated in single-transgene and stacked-variety samples. Carbon accumulation and energy metabolisms were distinct between the varieties and photosynthesis metabolism was found negatively affected in the single-transgene variety only. In the stacked variety, the shikimate pathway was modulated by the accumulation of transcripts from phenylalanine gene and other cascade genes. As expected, the expression of native EPSPS was upregulated in both varieties when herbicide was applied. On the other hand, transgenic EPSPS expression was down-regulated in both GM varieties upon herbicide application which cannot be explained.

Conclusion
Glyphosate-based herbicides toxicity suggests its effects on carbon central metabolism and flux, redox metabolism, photosynthesis, and to hormone and defense response in plants. The observed unintended effects in GM herbicide-tolerant varieties unravel the deleterious effects previously observed on GM-tolerant varieties growth and production. The impact of GBH on shikimate and cascade pathways was observed in terms of both native and transgenic insensitive EPSPS modulation, alteration of jasmonic acid and lignin metabolism in both single-transgene and stacked variety. The energy metabolism and carbon flux were differently affected in these varieties. Oxidative stress, more specifically glutathione metabolism, induced by GBH, was also observed in this study. The stacked variety showed a more pronounced stress response (activation of specific stress defense proteins, Rboh, WRKY) and secondary compounds (β-glucosidase, isoflavone 7-O-methyltransferase). Omics profiling techniques, such as transcriptomics, can be considered tools to support risk assessment in detecting unintended effects due to the GBH application.
Cost-effectiveness of inhaled oxytocin for prevention of postpartum haemorrhage: a modelling study applied to two high burden settings
Authors: Carvalho Natalie , Hoque Mohammad Enamul , Oliver Victoria L. , Byrne Abbey , Kermode Michelle , Lambert Pete , McIntosh Michelle P. , Morgan Alison 
Published: July 2020

Abstract
Background
Access to oxytocin for prevention of postpartum haemorrhage (PPH) in resource-poor settings is limited by the requirement for a consistent cold chain and for a skilled attendant to administer the injection. To overcome these barriers, heat-stable, non-injectable formulations of oxytocin are under development, including oxytocin for inhalation. This study modelled the cost-effectiveness of an inhaled oxytocin product (IHO) in Bangladesh and Ethiopia.

Methods
A decision analytic model was developed to assess the cost-effectiveness of IHO for the prevention of PPH compared to the standard of care in Bangladesh and Ethiopia. In Bangladesh, introduction of IHO was modelled in all public facilities and home deliveries with or without a skilled attendant. In Ethiopia, IHO was modelled in all public facilities and home deliveries with health extension workers. Costs (costs of introduction, PPH prevention and PPH treatment) and effects (PPH cases averted, deaths averted) were modelled over a 12-month program. Life years gained were modelled over a lifetime horizon (discounted at 3%). Cost of maintaining the cold chain or effects of compromised oxytocin quality (in the absence of a cold chain) were not modelled.

Results
In Bangladesh, IHO was estimated to avert 18,644 cases of PPH, 76 maternal deaths and 1954 maternal life years lost. This also yielded a cost-saving, with the majority of gains occurring among home deliveries where IHO would replace misoprostol. In Ethiopia, IHO averted 3111 PPH cases, 30 maternal deaths and 767 maternal life years lost. The full IHO introduction program bears an incremental cost-effectiveness ratio (ICER) of between 2 and 3 times the per-capita Gross Domestic Product (GDP) ($1880 USD per maternal life year lost) and thus is unlikely to be considered cost-effective in Ethiopia. However, the ICER of routine IHO administration considering recurring cost alone falls under 25% of per-capita GDP ($175 USD per maternal life-year saved).

Conclusions
IHO has the potential to expand access to uterotonics and reduce PPH-associated morbidity and mortality in high burden settings. This can facilitate reduced spending on PPH management, making the product highly cost-effective in settings where coverage of institutional delivery is lagging.
Bacillus subtilis spore vaccines displaying protective antigen induce functional antibodies and protective potency
Authors: Oh Yeonsu , Kim Jung Ae , Kim Chang-Hwan , Choi Soo-Keun , Pan Jae-Gu 
Published: July 2020

AbstractBackgroundBacillus anthracisis the causative agent of anthrax, a disease of both humans and various animal species, and can be used as a bioterror agent. Effective vaccines are available, but those could benefit from improvements, including increasing the immunity duration, reducing the shot frequency and adverse reactions. In addition, more sophisticated antigen delivery and potentiation systems are urgently required.The protective antigen (PA), one of three major virulence factors associated with anthrax was displayed on the surface ofBacillus subtilisspores, which is a vaccine production host and delivery vector with several advantages such as a low production cost, straightforward administration as it is safe for human consumption and the particulate adjuvanticity. Mice were immunized orally (PO), intranasally (IN), sublingually (SL) or intraperitoneally (IP) with the PA displaying probiotic spore vaccine. Clinical observation, serological analysis and challenge experiment were conducted to investigate the safety and efficacy of the vaccine.ResultsA/J mice immunized with the PA spore vaccine via PO, IN, SL, and IP were observed to have increased levels of active antibody titer, isotype profiles and toxin neutralizing antibody in sera, and IgA in saliva. The immunized mice were demonstrated to raise protective immunity against the challenge with lethalB. anthracisspores.ConclusionsIn this study, we developed aB. subtilisspore vaccine that displays the PA on its surface and showed that the PA-displaying spore vaccine was able to confer active immunity to a murine model based on the results of antibody isotype titration, mucosal antibody identification, and a lethal challenge experiment.