bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Age Threshold of the 8th Edition AJCC Classification Is Useful for Indicating Patients with Aggressive Papillary Thyroid Cancer in Clinical Practice.&nbsp;
Authors: Kaliszewski Krzysztof , Diakowska Dorota , Nowak Łukasz , Wojtczak Beata , Rudnicki Jerzy 
Published: November 2020

Abstract
Background: Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classification is to increase the age cut off for risk stratification in PTC from 45 to 55 years. However, whether this cut off is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC.Methods: We retrospectively analyzed the clinicopathological features and overall survival rate of patients with PTC admitted to and surgically treated at a single surgical center. The study protocol was divided into two series. In each series all patients (n=523) were divided in 2 groups according to age cut off. In the first series (cut off 45) patients <45 (n=193) vs. ≥45 (n=330) were compared, and in the second series (cut off 55) patients <55 (n=306) vs. ≥55 (n=217) were compared.Results: The rate of the prevalence of locally advanced disease (pT3 and pT4) was significantly higher in the patients above 55 years old than in those below 55 years old (p=0.013). No significant differences were found for this parameter in series with cut off point 45 years old. A significantly higher risk of locally advanced disease T3+T4 (OR=4.87) and presence of LNM (N1) (OR=3.78) was observed in ≥45 years old group (p=0.021 and p<0.0001, respectively). More expressive results were found for the patients ≥55 years old group, where the risk of locally advanced disease (T3+T4) was higher (OR=5.21) and LNM presence was OR=4.76 (p<0.001 and p<0.0001, respectively). None of the patients below 55 years old showed distant metastasis, but 19 patients above 55 years old showed M1 (p<0.0001). In older patients group (≥55 years old) we observed deaths related thyroid cancer in 11 individuals.Conclusions: The age cut off of 55 years old for risk stratification proposed by the 8th Edition of AJCC effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.
Gender differences in self-harm and drinking behaviors among high school students in Beijing, China
Authors: Li Chai-Quan , ZHANG Jing-Shu , MA Shang , Ruo-Ran LV , DUAN Jia-Li , LUO Dong-Mei , YAN Xiao-Jin , MA Ning , SONG Yi 
Published: November 2020

Abstract
BackgroundSelf-harm and drinking were both serious problems in adolescents and many studies presented evidence of their association. However, gender differences in this association was seldom deeply discussed. Our study was aimed to evaluate the prevalence of self-harm and explore its association with drinking behaviors by gender and investigate the extent to which the gender differences exist in the association between self-harm and drinking. MethodsA total of 32,362 students in grades 7 to 12 were anonymously surveyed and included in our study using two-stage, stratified probability proportion sampling in Beijing, China. Self-harm, drinking behaviors and other basic information were obtained from anonymous questionnaire. Demographic variables, self-harm as well as drinking behaviors were analyzed with Chi-square test and Gamma test between genders and the gender differences in this association was analyzed by log-binomial regression. ResultsThe total prevalence of self-harm was 13.7% with no significant gender difference (B=0.352, P=0.553). The prevalence of self-harm decreased with age in girls (G=-0.163, P<0.001). Self-harm was associated with drinking behaviors in both boys and girls. The Log-binomial regression demonstrated that girls in 16-19 years were at lower risk of self-harm than girls in 12-15 years while this association was weaker in boys (1.493 vs 1.128). The higher OR for self-harm was found among girls with early drinking experiences compared with boys (2.565 vs 1.863). Girls who ever drunk (2.211 vs 1.636), were currently drinking (3.400 vs 2.122) and binged drinking (6.357 vs 3.924) were of greater risk for self-harm than boys. ConclusionSelf-harm has significant positive association with drinking among high school students and girls with drinking behaviors were at higher risk of suffering self-harm. Identifying adolescents’ drinking behaviors is of vital importance to self-harm prevention and special attention should be focused on younger girls.
Epidemic and molecular characterization of fluoroquinolone-resistant Shigella dysenteriae 1 isolates from calves with diarrhea
Authors: Cao Mingze , Wang Weiwei , Zhang Liwei , Liu Guanhui , Zhou Xuzheng , Li Bing , Shi Yuxiang , Zhu Zhen , Zhang Jiyu 
Published: November 2020

Abstract
Background: The widespread distribution of antimicrobial-resistant Shigella has become a recurrent challenge in many parts of the developing world. Previous studies indicate that the host of Shigella has expanded from humans to animals. This study aimed to investigate the prevalence of fluoroquinolone resistance and associated molecular characterization of S. dysenteriae 1 isolated from calves. Results: All 38 unduplicated S. dysenteriae 1 isolates were collected from calves in Gansu Province from October 2014 to December 2016. According to MLST and PFGE analysis, these isolates were separated into 4 and 28 genotypes, respectively. The most common STs identified were ST228 (34.21%, 13/38) and ST229 (39.47%, 15/38), which were first found in the present study. All isolates harbored virulence genes, and the incidence of the seven virulence genes were ipaH (100%), ipaBCD (92.11%), stx (73.68%), ial (57.89%), sen (28.95%), set1A and set1B (0%). According to the results of antimicrobial susceptibilities, 76.32% (29/38) were resistant to fluoroquinolone and showed multidrug resistance. In a study on the polymorphism of quinolone resistance–determining region (QRDR) of gyrA/B and parC/E genes, we identified two mutations in gyrA (Ser83→Leu and Asp87→Asn) and parC (Ser80→Ile and Ser83→Leu), respectively. Among them, 55.17% (16/29) of resistant strains had the gyrA point mutations (Ser83→Leu) and parC point mutation (Ser83→Leu). Moreover, 41.38% (12/29) of isolates had all five point mutations of gyrA and parC. In addition, the prevalence of the plasmid-mediated quinolone resistance (PMQR) determinant genes was also investigated. All 29 fluoroquinolone-resistant isolates were positive for the aac(6’)-Ib-cr gene but negative for qepA, except for SD001. In addition, only 6 (20.69%, 6/29) isolates harbored the qnr gene, including two with qnrB (6.90%, 2/29) and four with qnrS (13.79%, 4/29). Conclusion: Given the increased common emergence of multidrug resistant isolates, uninterrupted surveillance will be necessary to understand the actual epidemic burden and control this infection.
Sex differences in an Italian pediatric population COVID-19 positive
Authors: Straface Elisabetta , De Jacobis Isabella Tarissi , Vona Rosa , Cittadini Camilla , Marchesi Alessandra , Cursi Laura , Gambardella Lucrezia , Villani Alberto 
Published: November 2020

Abstract
Background: Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy, taking into account gender differences. Methods: A pediatric population admitted with COVID-19 to Bambino Gesù Children's Hospital of Rome (Italy) in the period from the end of February to May 2020 has been studied taking into account sex differences. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients' electronic medical records. Results: In 41 patients (21 males and 20 females) we found that: i) fever and cough were the dominant symptoms, while gastrointestinal symptoms were rare; and ii) all ages of childhood were susceptible to COVID-19. Moreover, we found that females with COVID-19, although not significantly, were older than males and required more days of hospitalization (p = 0.01). Conversely, males had, although not significantly, higher values of C reactive protein and erythrocyte sedimentation rate than females. Conclusions: Based on the data listed above, sex differences were detected in an Italian pediatric COVID-19 positive population. Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.
Diabetes Risk Status and Physical Activity in Pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017
Authors: Rand Bethany Grace , Johnson Tammie M , Ehrlich Samantha F , Wideman Laurie , Pivarnik James M. , Richardson Michael Ryan , Stone Michelle L , Churilla James R 
Published: November 2020

Abstract
Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations. We sought to examine differences in aerobic activity (AA) and muscle strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.Methods: The sample (n=9,597) included pregnant women, age 18-44 years, who participated in the 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS include: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or pre-diabetes, and overt diabetes due to self-reported, clinically diagnosed diabetes (DM). Odds ratios (ORs) and 95% confidence intervals (CI) for meeting PA recommendations were obtained. Covariates included age, race, education, household child count, alcohol consumption, and smoking status.Results: Findings revealed that on average, DM had 46.5 fewer minutes of weekly AA compared to ND. Furthermore, a significantly lower OR (0.39; CI 0.19-0.82) for meeting both recommendations was observed in DM as compared to ND after adjustment.Conclusions: We observed that pregnant women with overt diabetes had a lower odds of engaging in PA, while those at high risk were similar in their PA engagement to ND. Future studies aimed at assessing determinants of PA behavior may help guide efforts to promote exercise in pregnant women with diabetes.
Haptoglobin gene diversity and incidence of uncomplicated malaria among children in Iganga, Uganda
Authors: Lwanira Catherine Nassozi , Kironde Fred , Swedberg Göte 
Published: November 2020

Abstract
Background Haptoglobin (Hp) is an acute phase protein that takes part in systemic regulation of haem during Plasmodium falciparum infections. Numerous genotypes of haptoglobin have been reported in malaria endemic populations. In this study, the relationship between haptoglobin genotypes and incidence of uncomplicated malaria in a cohort of children living in a malaria-endemic area of Uganda was determined. Methods This is an extension of a longitudinal study comprising of 423 children aged between six months and nine years, who were actively followed up for one year. Malaria episodes occurring in the cohort children were detected and the affected children treated with national policy drug regimen. Haptoglobin genotypes were determined by an allele-specific PCR method and their frequencies were calculated. A multivariate negative binomial regression model was used to estimate the impact of haptoglobin genotypes on incidence of uncomplicated malaria in the children’s cohort. In all statistical tests, a P – value of <0.05 was considered as significant. Results The prevalence of the Hp 1-1, Hp 2-1 and Hp 2-2 genotypes in the children’s cohort was 41%, 36.2% and 22.9%, respectively. The overall frequency for the Hp 1 allele was 59%, while Hp 2 allele occurred at a frequency of 41%. After adjustment of incidence rates for age, insecticide treated bed net (ITN) use and malaria history, the incidence of uncomplicated malaria for children carrying the Hp 2-2 genotype and those with the Hp 2-1 genotype was statistically similar (P=0.41). Also, no difference in the incidence of uncomplicated malaria was observed between children carrying the Hp 1-1 genotype and those having the Hp 2-1 genotype (P=0.84) or between Hp 2-2 Vs Hp 1-1 genotypes (P=0.50).Conclusions This study showed that the Hp 1-1 and Hp 2-1 genotypes each occur in nearly 4 in 10 children and the Hp 2-2 genotype occurs in 2 of every 10 children. No association with incidence of uncomplicated malaria was found. Additional studies of influence of haptoglobin genotypes on P. falciparum malaria severity are needed to understand the role of these genotypes in malarial protection.
Survival of silver diamine fluoride among patients treated in community dental clinics: A naturalistic study
Authors: Raskin Sarah Elaine , Tranby Eric P , Ludwig Sharity , Okunev Ilya , Frantsve-Hawley Julie , Boynes Sean 
Published: November 2020

Abstract
Background: Silver diamine fluoride (SDF) is a minimally-invasive preventive services used in the U.S. to avert and arrest caries since 2014. Survival outcomes based in real world delivery settings have not been documented. We analyzed 12-month survival outcomes of SDF applied independently or concurrently with other restorative procedures among a population receiving community dental careMethods: We analyzed data on SDF applications from de-identified dental claims on Oregon Health Plan patients served by Advantage Dental in 2016, who had been seen in 2015 (patient n=2,269; teeth n=7,787). We compared survival rates of SDF alone, SDF applied with a sedative filling, and SDF with a same-day restoration. Failure was defined as a restoration or extraction of the tooth 7 to 365 days after initial application. Survival was defined as a patient returning 180 or more days after application whose tooth did not have restoration or extraction. Differences were assessed through Wilcoxon equality of survivor function tests and log-rank equality of survivor tests to compare failure rates, Cox Proportional Hazards models to assess factors associated with survival of SDF, and Kaplan-Meier survival estimate to calculate the probability of survival over time.Results: SDF alone had an overall survival rate of 76%. SDF placed with sedative filling and with a same-day restoration had survival rates of 50% and 84% respectively, likely reflecting treatment intent. SDF alone survived exceptionally well on primary cuspids, permanent molars, and permanent bicuspids and among patients aged 10 to 20 years, with modest variation across caries risk assessment categories. A single annual application of SDF was successful in 68% of cases. Among SDF failures on permanent dentition, more than two-thirds of teeth received a minor restoration.Conclusions: SDF is a minimally invasive non-aerosolizing option that prevented and arrested early stage dental caries among patients in one community dentistry setting. Professional organizations, policy makers, providers, and payors should broaden optional SDF use by informing clinical guidelines, reimbursement policies, and treatment decisions. Future research should address clinical, social, service delivery, workforce, and economic outcomes using diverse population-based samples, and the mechanisms underlying single application success and caries prevention potential. Trial registration: N/A
Application of Random Forest and Data Integration Identifies Three Dysregulated Genes and Enrichment of Central Carbon Metabolism Pathway in Oral Cancer
Authors: Mukhopadhyay Srija , Ghosh Sahana , Das Debodipta , Arun P , Roy Bidyut , Biswas Nidhan K , Maitra Arindam , Majumder Partha 
Published: November 2020

Abstract
Background: Studies of epigenomic alterations associated with diseases primarily focus on methylation profiles of promoter regions of genes, but not of other genomic regions. In our past work (Das et al. 2019) on patients suffering from gingivo-buccal oral cancer – the most prevalent form of cancer among males in India – we have also focused on promoter methylation changes and resultant impact on transcription profiles. Here, we have investigated alterations in non-promoter (gene-body) methylation profiles and have carried out an integrative analysis of gene-body methylation and transcriptomic data of oral cancer patients. Methods: Tumor and adjacent normal tissue samples were collected from 40 patients. Data on methylation in the non-promoter (gene-body) regions of genes and transcriptome profiles were generated and analyzed. Because of high dimensionality and highly correlated nature of these data, we have used Random Forest (RF) and other data-analytical methods.Results: Integrative analysis of non-promoter methylation and transcriptome data revealed significant methylation-driven alterations in some genes that also significantly impact on their transcription levels. These changes result in enrichment of the Central Carbon Metabolism (CCM) pathway, primarily by dysregulation (overexpression) of (a) NTRK3, which plays a dual role as an oncogene and a tumor suppressor; (b) SLC7A5 (LAT1) which is a transporter dedicated to essential amino acids, and is overexpressed in cancer cells to meet the increased demand for nutrients that include glucose and essential amino acids; and, (c) EGFR which has been earlier implicated in progression, recurrence, and stemness of oral cancer, but we provide evidence of epigenetic impact on overexpression of this gene for the first time.Conclusions: In rapidly dividing cancer cells, metabolic reprogramming from normal cells takes place to enable enhanced proliferation. Here, we have identified that among oral cancer patients, genes in the CCM pathway – that plays a fundamental role in metabolic reprogramming – are significantly dysregulated because of perturbation of methylation in non-promoter regions of the genome. This result compliments our previous result that perturbation of promoter methylation results in significant changes in key genes that regulate the feedback process of DNA methylation for the maintenance of normal cell division.
The Knowledge of Danger Signs of Obstetric Complications among Women in Rural India: Evaluating an Integrated&nbsp;Microfinance and Health Literacy &nbsp;Program
Authors: Ahmad Danish , Mohanty Itismita , Hazra Avishek , Niyonsenga Theo 
Published: November 2020

Abstract
Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Methods: Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level. Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.
Development and feasibility testing of a multicomponent program to support the implementation of a guideline
Authors: Vandervelde Sara , Scheepmans Kristien , Milisen Koen , Achterberg Theo van , Vlaeyen Ellen , Flamaing Johan , de Casterlé Bernadette Dierckx 
Published: November 2020

Abstract
Background: A validated evidence-based guideline was developed to reduce physical restraint use in home care. However, the implementation of guidelines in home care is challenging. Therefore, this study aims to systematically develop and evaluate a multicomponent program for the implementation of the guideline for reducing the use of physical restraints in home care.Methods: Intervention Mapping was used to develop a multicomponent program. This method contains six steps. Each step comprises several tasks towards the design, implementation and evaluation of an intervention; which is theory and evidence informed, as well as practical. To ensure that the multicomponent program would support the implementation of the guideline in home care, a feasibility study of eight months was organized in one primary care district in Flanders, Belgium. A concurrent mixed methods design was used to evaluate the multicomponent program consisting of a knowledge test, focus groups and an online survey. Results: The Social Cognitive Theory and the Theory of Planned Behavior are the foundations of the multicomponent program. Based on modeling, active learning, guided practice, belief selection and resistance to social pressure, eight practical applications were developed to operationalize these methods. The key components of the program are: the ambassadors for restraint-free home care (n = 15), the tutorials, the physical restraint checklist and the flyer. The results of the feasibility study show the necessity to select uniform terminology and definition for physical restraints, to involve all stakeholders from the beginning of the process, to take time for the implementation process, to select competent ambassadors and to collaborate with other home care providers.Conclusions: The multicomponent program shows promising results. Prior to future use, further research needs to focus on the last two steps of Intervention Mapping (program implementation plan and developing an evaluation plan), to guide implementation on a larger scale and to formally evaluate the effectiveness of the multicomponent program.