bluuebunny/crossref_metadata_2025_split huggingface dataset:
What should medical students be taught about abortion? An evaluation of student attitudes towards their abortion teaching and their future involvement in abortion care
Authors: Cohen Pollyanna , Mayhew Jonathan , Gishen Faye , Potts Henry W. W. , Lohr Patricia A. , Kavanagh Jayne 
Published: September 2020

Abstract
Background
One in three women in the United Kingdom (UK) will have an abortion before age 45, making abortion provision an essential aspect of reproductive healthcare. Despite this, abortion remains ethically contested and stigmatised, with variable teaching in UK medical schools and concerns about falling numbers of doctors willing to participate in abortion care. University College London Medical School (UCLMS) has designed practical, inclusive, teaching that aims to give students an understanding of the importance of abortion care and prepare them to be competent practitioners in this area. This study aimed to determine students’ opinions of this teaching and their wider attitudes towards abortion.
Methods
We invited all 357 final-year UCL medical students to complete an online survey consisting of closed-ended questions, exploring their opinions on their abortion teaching, their personal beliefs about abortion and their future willingness to be involved in abortion care. We analysed responses using non-parametric tests.
Results
146 questionnaires (41% response rate) showed 83% of students identified as pro-choice (agree with the right to choose an abortion). 57% felt they received the right amount of abortion teaching, 39% would have liked more and 4% stated they received too much. There was no correlation between students’ attitudes to abortion and the rating of teaching; both pro-choice and pro-life (opposed to the right to choose an abortion) students generally rated the teaching as important and valued the range of methods used. Students requested more simulated practice speaking to patients requesting an abortion. Students with pro-life beliefs expressed lower willingness to discuss, refer, certify and provide future abortions. Students interested in careers in specialties where they may encounter abortion were more likely to be pro-choice than pro-life.
Conclusions
The majority of participating UCL medical students were pro-choice and willing to be involved in future abortion care. Efforts to make teaching on abortion practical, engaging, sensitive and inclusive were appreciated. As well as preparing students to be competent and caring practitioners, the teaching appears to contribute towards them viewing abortion as an essential aspect of women’s healthcare, and may contribute to destigmatising abortion.
Targeting Spindle-Associated Protein HAUS6 Prevents Cell Growth of Colorectal Cancer Cells by Activating the p53/p21 Pathway
Authors: Shen Aling , Liu Liya , Huang Yue , Shen Zhiqing , Wu Meizhu , Chen Xiaoping , Wu Xiangyan , Lin Xiaoying , Chen Youqin , Li Li , Cheng Ying , Chu Jianfeng , Sferra Thomas , Wei Lihui , Zhuang Qunchuan , Peng Jun 
Published: September 2020

Abstract
Background: HAUS6 participates in microtubule-dependent microtubule amplification, but its role in malignancies including colorectal cancer (CRC) has not been explored. We therefore assessed the potential oncogenic activities of HAUS6 in CRC.Methods: We investigated HAUS6 expression and its prognostic value in CRC by microarray, analysis of public datasets, quantitative reverse transcription - polymerase chain reaction (qRT-PCR) and immunohistochemistry. Biological functions of HAUS6 were investigated using loss-of-function and gain-of-function assays in vivo and/or in vitro. Effectors downstream of HAUS6 were identified using cDNA microarray, bioinformatics analysis, qRT-PCR and western-blotting in CRC cells. The putative mechanism by which HAUS6 knockdown elevated p53 and p21 expression were assessed by rescue experiment. The combination effects of HAUS6 knockdown and 5-fluorouracil (5-FU) treatment in cultured CRC cells were further evaluated. Results: HAUS6 mRNA and protein expression is higher in CRC tissues, and high HAUS6 expression is correlated with shorter overall survival in CRC patients. HAUS6 knockdown in CRC cell lines suppressed cell growth in vitro and in vivo by inhibiting cell viability, survival and arresting cell cycle progression at G0/G1, while HAUS6 over-expression increased cell viability. We showed that these effects are dependent on activation of the p53/p21 signalling pathway by reducing p53 and p21 degradation. Moreover, HAUS6 knockdown enhanced the effects of 5-FU treatment in CRC cells by increasing activation of the p53/p21 pathway.Conclusions: Our study highlights a potential oncogenic role for HAUS6 in CRC. Targeting HAUS6 may be a promising novel prognostic marker and chemotherapeutic target for treating CRC patients.
Developing and Validating an Integrated Gross Tumor Volume (GTV)-TNM&nbsp;Stratification System for Supplementing Unresectable Locally Advanced Non-small Cell Lung Cancer Treated With Concurrent Chemoradiotherapy
Authors: Chen NaiBin , Li QiWen , Zhu ZhengFei , Wang YiMing , Cheng ZhangKai , Hui ZhouGuang , Guo SuPing , He HaoQiang , Wang Bin , Huang XiaoYan , Li JiBin , Guo JinYu , Hu Nan , Ai XinLei , Zhou Yin , Wang DaQuan , Liu FangJie , Xie ChuanMiao , Qiu Bo , Liu Hui 
Published: September 2020

Abstract
PurposeThe gross tumor volume (GTV) could be an independent prognostic factor for unresectable locally advanced non-small cell lung cancer (LANSCLC). We aimed to develop and validate a novel integrated GTV-TNM stratification system to supplement LANSCLC sub-staging in patients treated with concurrent chemoradiotherapy (CCRT).MethodsWe performed a retrospective review of 340 patients with unresectable LANSCLC receiving definitive CCRT. All included patients were divided into two randomized cohorts. Then the Kaplan-Meier method and Cox regression were calculated to access the prognostic value of the integrated GTV-TNM stratification system, which was further validated by the area under the receiver operating characteristic curve (AUC) score and F1-score.ResultsThe optimal outcome-based GTV cut-off values (70 and 180 mL) of the modeling cohort were used to determine each patient’s integrated GTV-TNM stratum in the whole cohort. Our results indicated that a lower integrated GTV-TNM stratum could had better overall survival and progression-free survival (all P<0.001), which was recognized as an independent prognostic factor. Also, its prognostic value was robust in both the modeling and validation cohorts. Furthermore, the prognostic validity of the integrated GTV-TNM stratification system was validated by significantly improved AUC score (0.636 vs. 0.570, P=0.027) and F1-score (0.655 vs. 0.615, P<0.001), compared with TNM stage. The discordance rates between the GTV-TNM stratum and TNM stage were 49.3% and 49.6% in the modeling and validation cohort, respectively.ConclusionsWe proposed a novel integrated GTV-TNM stratification system to supplement unresectable LANSCLC sub-staging due to its prognostic value independent of TNM stage and other clinical characteristics, suggesting that it could be considered in pretreatment assessment and individual treatment decision-making process.
Cessation of Resuscitation in Pulseless Electrical Activity Out of Hospital Cardiac Arrest: A Mixed Methods Study of Senior Paramedic Decision Making
Authors: Coppola Alison , Black Sarah , Endacott Ruth 
Published: September 2020

Abstract
BackgroundPulseless electrical activity, a non-shockable cardiac arrest, is treated using advanced life support resuscitation. Typically, survival rates are poor and there is a paucity of evidenced-based guidelines for paramedics on when to cease resuscitation. This led to one UK Ambulance Service developing a local guideline to support senior paramedics when making cessation decisions. This study aimed to describe the patient characteristics, clinical features and system factors of pulseless electrical activity and explore the experiences of senior paramedics making autonomous cessation decisions. Design and MethodsAn explanatory sequential mixed method design conducted in a single UK Ambulance Service. Data was retrieved for all adult Out of Hospital Cardiac Arrest patients from 1st December 2015 to 31st December 2018. Cases subject to a coronial or police investigation were excluded. Senior paramedics ceased resuscitation for 50 PEA patients, a consecutive sample, which was reviewed in detail using descriptive statistics. Independent t-test and Chi Square examined associations between variables known to prognosticate survival. Interviews were conducted with six senior paramedics who remotely supported on-scene paramedics and findings were analysed using content framework analysis. ResultsPatient characteristics: Mean age 78 years, male (n=30, 60%), co-morbidities (n=40, 80%), witnessed collapse (n=37, 74%), bystander BLS (n=30, 60%). Clinical features: defibrillation (n=22, 44%), ROSC (n=8, 16%), heart rate< 50 (n=46, 92%), mean ETCO2 2.3kPa. System factors: Advanced life support duration 59mins. A significant association between witnessed cardiac arrest and bystander basic life support was found (95% p=.00). Themes arising from interviews were defining resuscitation futility, the impact of ceasing resuscitation, conflicting views and clinical decision tools. ConclusionSenior paramedics interpreted and applied a multifactorial approach to ceasing resuscitation for patients with PEA. Patient characteristics, clinical features and system factors were balanced using clinical judgement, found to be vital to the decision-making process. This finding questions the appropriateness of paramedics making cessation decisions based on clinical features alone. As prognostic factors for survival were present, further investigation to identify the difference between an unsuccessful or futile resuscitation is required.
Key metabolism pathways and regulatory mechanisms of high polysaccharide yielding in Hericium erinaceus
Authors: Gong Ming , Zhang Henan , Wu Di , Zhang Zhong , Bao Dapeng , Zhang Jinsong , Yang Yan 
Published: September 2020

Abstract
Background
Hericium erinaceus, a rare edible and medicine fungus, is widely used in the food and medical field. H. erinaceus polysaccharide is the main bioactive compound that exerts high bioactive value in the medical and healthcare industries.
Results
Here, we obtained two mutated strains (HEB and HEC) with high polysaccharide yield using ARTP mutagenesis from the original H. erinaceus strain HEA which genome was also reported 38.16 Mb, encoding 9,780 predicted genes by single-molecule, real-time sequencing technology. The polysaccharide content in the fermented mycelia of HEB and HEC was improved 23.25% and 47.45%, and a new β-glucan fraction with molecular weight 1.056 × 106 Da was produced in HEC. The phylogenomic analysis showed that H. erinaceus had the closest evolutionary affinity with Dentipellis sp. Integrative analysis of transcriptome and proteomics showed the upregulation of the carbohydrate metabolism pathway modules in HEB and HEC, which might lead to the increased production of glucose-6P and, in turn promoted the repeating units synthesis of polysaccharide. qPCR and PRM analysis confirmed that most of the co-enriched and differentially co-expressed genes involved in carbohydrates metabolism shared a similar expression trend with the transcriptome and proteome data in HEB and HEC. Heatmap analysis showed a noticeably decreased protein expression profile of the RAS-cAMP-PKA pathway in HEC with a highly increased 47.45% of polysaccharide content. The S phase progression blocking experiment further verified that the RAS-cAMP-PKA pathway's dysfunction might promote high polysaccharide and β-glucan production in the mutant strain.
Conclusions
The study revealed the main mechanism of the increased polysaccharide synthesis induced by ARTP mutagenesis and explored the key genes and pathways of polysaccharide synthesis.
Prevalence and Possible Risk Factor of Premarital Sexual Behaviour among Nepalese Adolescents
Authors: Dahal Maginsh , Subedi Raj Kumar , Khanal Sudip , Adhikari Anup , Sigdel Manoj , Baral Kushalata , Sangroula Raj Kumar , Xu Cheng , Gu Aihua 
Published: September 2020

Abstract
Background: To determine the prevalence of premarital sex and its risk factors in Nepal.Methods: A cross-sectional study was carried out among adolescents in Nepal. A self-administered questionnaire was used to collect information from 6,147 unmarried adolescents. Random sampling by using a lottery method was applied to select 20 colleges from all three districts. All the students who were studying at those colleges were enrolled in the study. Simple and multivariate logistic regression analyses were carried out to analyse the associations of risk factors and premarital sex.Results: The prevalence of premarital sex was 38.1%. Male students were more likely to engage in premarital sex (adjusted odds ratio [AOR]=2.04, confidence interval [CI]=1.76-2.36) than female students. Alcohol consumption (AOR=1.26, CI=1.08-1.47), smoking (AOR=1.69, CI=1.41-2.02), drug use (AOR=1.85, CI=1.23-2.83), going to night clubs (AOR=1.46, CI=1.24-1.70), clothing style of girls AOR=1.35, CI=1.15-1.58), clothing style of boys (AOR=3.51, CI=2.74-4.53), and unmarried friends having sex (AOR= 1.51, CI=1.31-1.73) were found to be major influencing factors for premarital sex. Moreover, students who had never received sex education were 2.92 times more likely to engage in premarital sex (CI=2.22-3.85) than those who had previously received sex education.Conclusions: We found several risk factors associated with premarital sex in Nepal. Preventing premarital sex may require the promotion of sex education.
Electrical Switching of High-Performance Bioinspired Nanocellulose Nanocomposites
Authors: Jiao Dejin , Lossada Francisco , Guo Jiaqi , Skarsetz Oliver , Hoenders Daniel , Liu Jin , Walther Andreas 
Published: September 2020

Abstract
Nature fascinates with living organisms showing mechanically adaptive behavior. In contrast to gels or elastomers, it is profoundly challenging to switch mechanical properties in stiff bioinspired nanocomposites as they contain high fractions of immobile reinforcements. Here, we introduce facile electrical switching to the field of bioinspired nanocomposites, and show how the mechanical properties adapt to low direct current (DC). This is realized for renewable cellulose nanofibrils/polymer nanopapers with tailor-made interactions by deposition of thin single-walled carbon nanotube electrode layers for Joule heating. Application of DC at specific voltages translates into significant electro-thermal softening via dynamization and breakage of the thermo-reversible supramolecular bonds. The altered mechanical properties are reversibly switchable in power on/power off cycles. Furthermore, we showcase electricity-adaptive patterns and reconfiguration of deformation patterns using electrode patterning techniques. The simple and generic approach opens avenues for bioinspired nanocomposites for facile application in adaptive damping and structural materials, and soft robotics.
Inverse Association Between Triglyceride Glucose Index and Muscle Mass in Korean Adults: 2008–2011 KNHANES
Authors: Ahn Sung Ho , Lee Jun hyuk , LEE JI WON 
Published: September 2020

Abstract
Aim: The early detection and prevention of sarcopenia is increasingly emphasized considering that sarcopenia is an important risk factor for falls or cardiovascular disease. Recently, there have been emerging evidences that support the relationship between sarcopenia, insulin resistance, and inflammation. The TyG index, a novel surrogate marker of insulin resistance and systemic inflammation, has not yet been verified for an association with sarcopenia. This study aimed to examine the relationship between the TyG index and muscle mass in Korean adults.Methods: This study included 15,741 non-diabetic adults over 19 years old using data from the 2008–2011 Korea National Health and Nutrition Examination Survey. Participants were divided into three groups according to tertiles of the TyG index. Low skeletal muscle mass index (LMSI) was defined by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project criteria. Weighted multivariate logistic regression model was used to analyze the relationship between TyG index tertiles and LSMI.Results: The ORs (95% CIs) for LSMI of the second and third tertiles, compared to first tertile, were 1.300 (1.001–1.689) and 1.448 (1.104–1.900), respectively, after adjusting for confounding factors. Higher TyG index was also associated with increased odds of LSMI in subgroups such as adults under 65-year old who did not exercise regularly, who consumed less than 30g alcohol per day, who did not currently smoke, and who ate less than 1.5g protein/kg/day.Conclusion: The TyG index was significantly and positively associated with LSMI in Korean adults.
Developing and Validating Regression Models for Predicting Household Consumption to Introduce an Equitable and Sustainable Health Insurance System in Cambodia
Authors: Nakamura Haruyo , Amimo Floriano , Yi Siyan , Tuot Sovannary , Yoshida Tomoya , Tobe Makoto , Rahman Mizanur , Yoneoka Daisuke , Ishizuka Aya , Nomura Shuhei 
Published: September 2020

Abstract
BackgroundFinancial protection is a key health system objective and an essential dimension of universal health coverage. However, it is a challenge for low- and middle-income countries, where the general tax revenue is limited, and a majority of the population is engaged in the informal economy. This study developed and validated regression models for Cambodia to predict household consumption, which allows the country to collect insurance contributions according to one’s ability to pay. This strategy would maximize the contribution revenue, optimize the government subsidy, and simultaneously ensure equity in healthcare access.MethodsThis study used nationally representative survey data collected annually between 2010 and 2017, involving 38472 households. We developed four alternative prediction models for annual household consumption: ordinary least squares (OLS) method with manually selected predictors, OLS method with stepwise backward variable selection, mixed-effects linear regression, and elastic net regression, which resulted in an adaptive least absolute shrinkage and selection operator (LASSO) regression. Household-level socioeconomic characteristics were also included as the predictors. Subsequently, we performed out-of-sample cross-validation for each model. Finally, we evaluated the prediction performance of the models using mean absolute error, root mean squared error, and mean absolute percentage error (MAPE). ResultsOverall, we found a linearly positive relationship between observed and predicted household consumptions in all four models. While the prediction performance of the four alternative models did not substantially differ, Stepwise Linear Model showed the best performance with the lowest values in all three statistical measurements, including MAPE of 1.376%. The use of regularization and the mixed effects in the regression was not particularly effective in this environment. The household consumption was better predicted for those with lower consumption, and the predictive performance declined as the consumption level increased. Although the richer household consumptions were likely to be overestimated, the trend was less noticeable in Adaptive LASSO Model.ConclusionsThis study suggests the possibility of predicting household consumption at a reasonable level with the existing survey data. Such a prediction would enable the country to raise the secured health insurance revenue equitably. The prediction model should be tested in real settings and continuously improved.
Serological Determinants of COVID-19
Authors: Noce Annalisa , Santoro Maria Luisa , Marrone Giulia , D’Agostini Cartesio , Amelio Ivano , Duggento Andrea , Tesauro Manfredi , Daniele Nicola Di 
Published: September 2020

Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection spreaded rapidly worldwide, as far as it has become a global pandemic. Therefore, the introduction of serological tests useful for the determination of IgM and IgG antibodies, it has become the main diagnostic tool, useful for tracking the spread of the virus and consequently its containment. In our study we compared point of care test (POCT) lateral flow immunoassay (FIA) vs automated chemiluminescent immunoassay (CLIA), in order to assess their specificity and sensibility against COVID-19 antibodies detection. Results: We find that different specificities and sensitivities for IgG and IgM tests. Notably IgM POCT FIA method vs CLIA method (gold standard) has a low sensitivity (0.526), while POCT FIA method vs CLIA method (gold standard) test has a much higher sensitivity (0.937); further, with respect of IgG, FIA and CLIA could arguably provide the same information. Conclusions: FIA method could be helpful in assessing in short time, the possible contagiousness of subjects that for work reasons cannot guarantee “social distancing”.
Multi-Color and Multi-Material 3D Printing of Knee Joint Models
Authors: Ruiz Oliver Grimaldo , Dhaher Yasin 
Published: September 2020

Abstract
BackgroundEvery year, 3DP provides more alternatives and solutions in the medical field. Applications such as custom-made prosthetics and implants, platforms for pharmaceutical research, and PSAMs are the immediate emerging trends. Certainly, 3DP advancement is the convergence of multiple factors including improvements in medical software, 3D printer evolution, availability of new printing materials, improved industry support, and increasing commitment from medical societies and regulators. The overarching theme of this study is centered on exploring possible PSAMs and 3DP applications for improving surgical outcomes in orthopedics, particularly in ACL-R as well as providing functional models for TKA.Methods3-Matic, Rhinoceros, and SolidWorks were used to create three 3D computer-generated PSAMs: (1) Knee Joint model, wherein collagen fibers matrix structure is mimicked, (2) ACL-R model using a BPTB graft, incorporating key surgical outcomes such as orientations-architecture and positions-dimensions of the tunnels, as well as a custom-made SG based on patella anatomy (3) TKA model considering custom-made CS implants with symmetric tibial bearing design. Before printing, mechanical uni-axial tensile tests of materials were conducted using an Instron S3300, following the ASTM designation D412-C. The printing materials selection process and matching with anatomical structures were based on the analysis of the mechanical pattern of the strain-stress curves from different combinations of Agilus30™. The Stratasys J750™ printer was used to manufacture the ACL-R model (previous study), the ACL-R model with SG, and the TKA model. ResultsThe combinations No. 1-4 were chosen for 3DP with elastic modules of 1.8-0.7 MPa and Pearson coefficients of 0.980-0.991 respectively. The PSAMs were tested manually simulating 50 flexo-extension cycles without presenting ruptures, custom-made SG matches perfectly with PT anatomy. ConclusionFunctional PSAMs were printed with high fidelity, considerable cost, and short duration from planning to manufacturing. These coincided completely with 3D computer-generated PSAMs replicating fibers and features of the Knee Joint anatomy. The proposed PSAMs can be considered as an alternative to replacing cadaver specimens for medical training, pre-operative planning, education purposes, and validation of predictive models. We highlight the potential of PolyJet manufacturing combined with specialized medical software as a path to change the way specialists and researchers plan, execute, and validate complex procedures.