bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical Faculty Profile is an Important Determinant of Student Profile and Future Practice Expectations of Medical Students in Angola
Authors: Fronteira Inês , Freitas Helga , Guimarães Nkanga , Fresta Mário , Ferrinho Paulo 
Published: November 2020

Abstract
Background: Angola is among one of the most deprived countries in the world in terms of medical professionals. In the past decade, the Angolan Government has invested in the expansion of faculties of medicine in the country. We analysed the profiles of medical students in Angola according to four clusters of medical schools: older faculty in the country, private faculties, Cuban sponsored faculties and military faculty; under the assumption that the organizational culture of the different faculties might influence the expectations and decisions towards future professional life of medical students regarding where they want to work (community versus hospital) and in which sector (exclusively public versus not exclusively public).Methods: Observational cross-sectional study. Piloted, standardized questionnaire to final year medical students or higher year of training in the first four-month of 2014 (N=402). Data were entered into a SPSS v.20 database and descriptive statistics computed. Statistical significance for categorical variables was tested by Pearson chi-square, Fisher exact or likelihood ratio tests as appropriate. Comparison of means was tested with Anova. Backward elimination binary logistic regression was used to test the hypothesis that type of faculty of medicine is an important determinant of future professional practice, i.e., level (hospital vs community) or sector of practice (exclusive public sector vs private or private and public), while controlling for confounders. Results: After controlling for age, sex, marital status, place of birth and place of primary and secondary education, type of family and family influence, students were more likely to choose community over hospital practice and to prefer exclusive public practice if attending a Cuba supported faculty of medicine. Conclusions: Medical education cannot be isolated from planning of the medical workforce. Some important and impactful careers choices, like choosing rural over urban practice, public over private sector practice, have deep influences in the medical professionals’ labour market. Some of these decisions are shaped even before the end of the medical training. As such, the monitoring of future professional intentions in medical schools should be done regularly to accommodate both the health system needs and the hopes and dreams of medical trainees.
Callous-unemotional Traits in Preschool Children With Attention Deficit/hyperactivity Disorder
Authors: Zhang Jinsong , Li Wei , Zhang Huifeng , Wilson Amanda , Shuai Lan , Xia Weiping , Wang Zhouye , Qiu Meihui , Wang Yuanyuan 
Published: November 2020

Abstract
Background:Children with early onset of callous unemotional ( CU traits are at risk for long term, persistent psychosocial problems The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder ( ADHD and the diagnostic significance of CU traits in ADHD. Method: A total of 227 preschool children (89 with ADHD, 51 with Autism Spectrum Disorder [ ASD ]], and 87 Typically Developing Children [ TDC ]]) aged 4 5 years old were recruited. The participants were diagnosed using the Diagnostic Infant and Preschool Assessment (DIPA), and assessed using t he Swanson, Nolan, and Pelham Rating Scale IV , The Inventory of Callous Unemotional Traits I CU ), t he Behavior Rating Scale of Executive Function Preschool Version BRIEF P )), and t he parent rated Strengths and Difficulties Questionnaire (SDQ ). Results: The results showed that there was a significant difference between ICU subscale scores and total scores among the ADHD, ASD and TDC groups F 59.87 P < 0.001 with the ASD group s coring the higheset 37.16±10.19 ) and the TDC scoring the lowest 20.39±7.40 )). T he callousness scores in the ADHD+ODD group showed the highest level of significance , and the ADHD only group was significantly higher than the TDC F 20.42 , P < 001) The ICU subscales showed low to moderate positive correlations with the SDQ subscales γ 0.21 ~ 0.68 P < 0.01) except the unemotional subscale T he ICU subscales were also negatively associated with the prosocial behaviour subscale γ = 0.45 ~ 0.68 P < The total ICU score was moderately and positively related to the BRIEF-P subscales (γ = 0.4 7 ~0.6 7 P < 0.01). The CU traits were also used to predict oppositional defiant symptoms β = 0.32, R2 = 0.11, P < 0.001). The callousness and uncaring subscale scores and the total ICU score were significantly correlated with ADHD symptoms and explained a significant 3 proportion of the variance (15-24%).Conclusions: The current study indicated that having high CU scores was associated with increased odds of having ADHD. Screening for CU traits could be used to predict ADHD diagnosis in preschool children .
Facing Costs With Dementia: Daily Lives Perspectives From Informal Caregivers
Authors: Lindeza Patrícia , Virgolino Ana , Santos Osvaldo , Guerreiro Manuela , Rosa Mário 
Published: November 2020

Abstract
Background: Caregivers of people with dementia report stress, depression and economic burden compared to other caregivers. This study aimed to characterize the daily lives experiences of dementia patients’ informal caregivers and to uncover day-to-day sources of expenses related with dementia care. Research design and methods: Qualitative observational study, following a grounded theory approach. Data were collected with semi-structured focus groups with informal caregivers of persons with dementia. Discussed themes included changes in daily lives, formal care services utilization, quality of life and costs. Content analysis was conducted with Charmaz’s line-by-line open coding procedure.Results: Overall, 14 relatives of persons with dementia were included. Most of participants were female (12) and eight of them were daughters of the patient. Ages ranged from 39 to 84 years and eight had a high degree of education. Four of the caregivers were professionally active and the range of years assuming the role of main informal caregiver varied from two to 15 years. Conclusions: Findings provide insight into the daily life experience of caring for a person with dementia, while revealing the impact on the quality of life of caregivers. The individual sociodemographic and psychosocial characteristics, together with a lack of adapted formal care services and low financial aid leaded to a high burden experience for these caregivers. A multidirectional approach addressing caregivers needs, while improving formal care services and creating social and financial support programmes for families affected by dementia is required to decrease its financial and psychosocial burden.
Effects of Early Neurological Deterioration in Acute Ischemic Stroke on Multiple Dimensions of Functional Outcomes Using Propensity Score Matching Analysis
Authors: Qu Jian-Feng , Zhong Huo-Hua , Liang Wen-Cong , Chen Yang-Kun , Liu Yong-lin , Wang Shi-fang 
Published: November 2020

Abstract
Background: Early neurological deterioration (END) is common in acute ischemic stroke (AIS), but its effect on functional outcomes is not well understood. The aim of the present study was to explore the effects of END on multiple dimensions of functional outcomes.Methods: In the present study, 256 patients with AIS were analyzed. All patients were followed up for 1 year. We used the modified Rankin Scale (mRS) to assess body function impairment, the Lawton activities of daily living scale to assess activity limitations, and the reintegration to normal living index (RNLI) to assess participation restrictions. Brain magnetic resonance imaging was performed to identify acute infarcts and preexisting abnormalities, such as white matter lesions, medial temporal lobe atrophy, microbleeds, and silent lacunae. To reduce the effects of a lack of randomization, we conducted a propensity score analysis. Results: The study sample consisted of 185 men (72.3%) and 71 women (27.7%). Sixty-one patients (23.8%) had END. Before matching, patients with END had higher levels of small artery-type stroke, higher National Institutes of Health Stroke Scale scores on arrival, higher systolic blood pressure on admission, and larger infarct volumes. After matching, there were no significant differences between the two groups in any clinical or neuroimaging variables, except for stroke subtype and cortical region infarct. Logistic regression analysis revealed that END was a significant predictor of poor mRS (odds ratio [OR], 3.829; 95% confidence interval [CI], 1.367–10.723, p = 0.011) and poor RNLI (OR, 2.777; 95% CI, 1.133–6.806, p = 0.026) scores after adjusting for confounding factors.Conclusions: END is relatively common in AIS, with an incidence of 23.8%. END might be able to predict poor functional outcomes, including body function impairment and reduced social participation.
Acute kidney injury among preterm infants receiving non-steroidal anti-inflammatory drugs for patent ductus arteriosus
Authors: Ting Joseph , McDougal Kate , Mello Alanna De , Kwan Eddie , Mammen Cherry 
Published: November 2020

Abstract
Background: Nonsteroidal anti-inflammatory drugs (NSAID) are a frequently prescribed class of medication in the neonatal intensive care unit (NICU). Hospitalized patients receiving NSAID therapy are at an increased risk of acute kidney injury (AKI). Our primary objective was to reveal AKI epidemiology in NSAID-exposed premature infants admitted to the NICU using a standardized definition.Methods: This retrospective study included infants born at ≤34 weeks gestational age who received NSAID for intraventricular haemorrhage prophylaxis [“prophylaxis group”] or symptomatic treatment for patent ductus arteriosus (PDA) [“treatment group”] between January and December 2014 at British Columbia Women’s Hospital NICU. All available serum creatinine (SCr) and 12-hour urine output (UO) were recorded from admission till day 7 post NSAID exposure. AKI incidence was determined using the modified Kidney Disease: Improving Global Outcomes (KDIGO) classification with an increase in SCr (ΔSCr) (50% rise from prior SCr within 7 days or 26.5 mmol/L rise within 48 hours) and/or UO < 1 mL/kg/hour, excluding the first 24 h of life.Results: We identified 70 eligible subjects, 32 of whom received prophylactic NSAID (prophylaxis group), and 38 received indomethacin or ibuprofen for treatment of symptomatic PDA (treatment group), with an overall AKI incidence of 23% (16/70). The treatment group had a higher proportion of infants with SCr monitoring during the NSAID than the prophylaxis group (87% vs. 13%, p<0.001). Based upon the above defined criteria (fulfilling at least one—either the UO or SCr monitoring criteria), the prophylaxis group had a significantly lower AKI rate compared with the treatment group (9% vs. 34%; p=0.014). Conclusions: AKI incidence is higher in infants treated with NSAID for symptomatic PDA than in those treated prophylactically during the first day of life, based on the criteria applied. However, the burden of AKI may be underestimated in the prophylaxis group due to fewer available SCr values after exposure, and inability to utilize UO criteria in the 1st 24 hours of life. Standardized protocols for monitoring daily SCr and UO after exposure should be implemented for all neonates with NSAID exposure and should be considered to improve AKI recognition.
Characterising water loss in pomegranate fruit cultivars (‘Acco’, ‘Herskawitz’ &amp; ‘Wonderful’) under cold and shelf storage conditions
Authors: Lufu Robert , Tsige Alemayehu , Opara Umezuruike 
Published: November 2020

Abstract
Fruit water loss results in a huge financial loss to the industry due to loss of aesthetic appeal and direct loss of saleable fruit weight. There is currently a limited knowledge on the mechanism of water loss in pomegranate fruits, given their complex structure. Therefore, this study aimed to characterise water loss in the most common export pomegranate cultivars (‘Acco’, ‘Herskawitz’ and ‘Wonderful’) of South Africa. Fruits were stored for 42 d at 7 ºC and 90 % RH and thereafter transferred to shelf at 23 ºC and 58 % RH. Another batch of fruit was immediately stored under prolonged shelf conditions for 16 d. Water loss, respiration rate, arils-peel proportions and moisture content, peel thickness and colour attributes, puncture resistance property and chemical quality attributes of fruit juice were measured. The study revealed that despite the physiological and structural differences among pomegranate cultivars, water loss was similar during the 42 d of cold storage. However, the medium-sized fruits (‘Herskawitz’ and ‘Wonderful’) had significantly higher water loss (0.32 ± 0.01 g cm-2) than the small-sized fruits (‘Acco)’ (0.25 ± 0.01 g cm-2) during the prolonged 16 d of shelf storage. The observed maximum water loss of 24.2 % is mainly from the peel proportion. Therefore, research should primarily focus on the peel fraction in addressing the water loss problems of pomegranate fruits.
A Cross-Case Analyses of Laboratory Professionals-Patients Interaction for Patients Accessing Laboratory Services at University of Cape Coast Hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana
Authors: Adu Patrick 
Published: November 2020

Abstract
Background: There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana. Methods: This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25. Results: Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the prescriber has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations from their respective prescribers. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing. Conclusion: There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-prescribers engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing.
Beneficial Effects of Weekly Walking Activity on Vascular Hypertensive Mediated Organ Damage in Community-dwelling Elderly Chinese: Northern Shanghai Study
Authors: Lyu Yuyan , Yu Shikai , Chi Chen , Teliewubai Jiadela , Ji Hongwei , Zhang Yi , Xu Yawei 
Published: November 2020

Abstract

Background: The value of exercise is well-established for health promotion. Walking as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear.Methods: 2830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from June 2014 to June 2018. Weekly walking activity was evaluated by standard questionnaire based on the International Physical Activity Questionnaires-short form (including walking duration per time and walking days per week). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness (CIMT), arterial plaque, creatinine clearance rate (CCR), urinary albumin-creatinine ratio (UACR), carotid-femoral pulse wave velocity (cf-PWV) and ankle-brachial index (ABI), were all evaluated.Results: 1862 (65.8%) participants were enrolled in weekly walking activity, with 56.8 ± 36.8 min/day and a median of 6.71 days/week walking. Young elderly, fewer smokers, lower CIMT, lower cf-PWV, fewer abnormal ABI, lower prevalence of hypertension and coronary heart disease were observed in walking activity group. Similarly, pearson’s correlation analysis revealed that weekly walking activity was significantly correlated with elderly (age ≥ 70 years) and smoker. After adjusting for cardiovascular risk factors, weekly walking activity was only significantly associated with peripheral artery diseases in logistic regression analysis. Finally, only walking duration more than 30 min per time was related to arterial plaque in subgroup analysis of weekly walking acitivity (OR: 1.048, 95% CI: 1.002-1.095, P = 0.038).Conclusions: In the community-dwelling elderly Chinese, weekly walking activity seemed to be a way to encourage a healthy lifestyle for HMOD prevention and management, especially for vascular HMOD, irrespective of walking duration per time and walking days per week.Clinical Trial Registration: NCT02368938 (clinicaltrials.gov)
Late Acute Kidney Injury is a Poor Prognosis Sign in Severe Burns: A Retrospective Cohort Study
Authors: You Bo , Yang Zi Chen , Zhang Yu Long , Chen Yu , Shi Yun Long , Gong Ya Li , Chen Ya Jie , Chen Jing , Yuan Li Li , Luo Gao Xing , Peng Yi Zhi , Yuan Zhiqiang 
Published: November 2020

Abstract
BackgroundAcute kidney injury (AKI) is a morbid complication and the main cause of multiple organ failure and death in severely burned patients. The objective of this study was to explore the epidemiological characteristics, the risk factors, and impact of both early and late AKIs, respectively.MethodsThis retrospective study was performed with prospectively collected data of severely burned patients from the Institute of Burn Research in Southwest Hospital during 2011-2017. AKI was diagnosed according to Kidney Disease Improving Global Outcomes (KDIGO) criteria (2012), and it was divided into early and late AKIs depending on its onset time (within the first 3 days or >3 days post burn). The baseline characteristics, clinical data, and outcomes of the three groups (early AKI, late AKI and non-AKI) were compared using logistic regression analysis. Mortality predictors of patients with AKI were assessed.ResultsA total of 637 patients were included in analysis. The incidence of AKI was 36.9% (early AKI 29.4%, late AKI 10.0%). The mortality of patients with AKI was 32.3% (early AKI 25.7%, late AKI 56.3%), and that of patients without AKI was 2.5%. AKI was independently associated with obviously increased mortality of severely burned patients [early AKI, OR = 12.98 (6.08-27.72); late AKI, OR = 34.02 (15.69-73.75)]. Multiple logistic regression analysis revealed that age, gender, total burn surface area (TBSA), full-thickness burns of TBSA, chronic comorbidities (hypertension or/and diabetes), hypovolemic shock of early burn, and tracheotomy were independent risk factors for both early and late AKIs. However, sepsis was only a risk factor for late AKI. Decompression escharotomy was a protective factor for both AKIs. ConclusionsAKI remains prevalent and is associated with high mortality in severely burned patients. Compared with early AKI, late AKI has a lower occurrence rate, but greater severity and worse prognosis，is a devastating complication. Late AKI is a poor prognosis sign in severe burns.
Mechanically reconfigurable multi-functional meta-optics studied at microwave frequencies
Authors: Ballew Conner , Roberts Gregory , Camayd-Muñoz Philip , Debbas Maximilien , Faraon Andrei 
Published: November 2020

Abstract
Metasurfaces advanced the field of optics by reducing the thickness of optical components and merging multiple functionalities into a single layer device. However, this generally comes with a reduction in performance, especially for multi-functional and broadband applications. Three-dimensional metastructures can provide the necessary degrees of freedom for advanced applications, while maintaining minimal thickness. This work explores 3D mechanically reconfigurable devices that perform focusing, spectral demultiplexing, and polarization sorting based on mechanical configuration. As proof of concept, a rotatable device, auxetic device, and a shearing-based device are designed with adjoint-based topology optimization, 3D-printed, and measured at microwave frequencies (7.6-11.6 GHz) in an anechoic chamber.
Safflower Yellow a Attenuates Osteoarthritis via Regulating Inflammation and Cholesterol Metabolism
Authors: Ju Shaohua , Tan Lirong , Liu Panwang , Li Xiaohong , Tan Youli , Xia Yu , Wang Mingjian 
Published: November 2020

Abstract
BackgroundOsteoarthritis (OA) is known to be associated with inflammation and cholesterol metabolism disorder. As a chronic and complex disease, uncovering its molecular mechanism and finding effective therapy with low side effects are urgent. Hydroxysafflor yellow A (HSYA) is extracted from Carthamus tinctorius L, which has extensive pharmacological effects. MethodsIn this study, Interleukin 1β (IL-1β) was used to establish the OA model in vitro, and the impacts of HSYA on the OA cell model were analyzed. We used CCK-8 to measure the cell viability and Flow Cytometry to test the apoptosis. ELISA was performed to calculate the release of inflammatory cytokines. And WB was carried out to measure the expression of collagen and cholesterol relevant proteins. We also measured the protein levels in NF-κB and PI3K/Akt/mTOR signaling pathways. ResultsThe results showed that HSYA promoted cell viability and inhibited apoptosis. And it up-regulated the expression levels of collagen II (Col-II) and Sry related HMG box-9 (SOX9) while down-regulated the expression of matrix metalloproteinase-13 (MMP13). The IL-1β induced high levels of IL-6 and TNF-α were inhibited by HSYA. Also, HSYA regulated the expression of cholesterol relevant proteins. Compared with the model group, the levels of APT-binding cassette transporter 1 (ABCA1) and cholesterol transport gene (APOA-1) were significantly elevated. However, the levels of cholesterol-processing enzymes cholesterol 25-hydroxylase (CH25H) and 25-hydroxy-cholesterol 7-alpha- hydroxylase (CYP7B1) were inhibited. Besides, HSYA inhibited the protein expression in NF-κB and PI3K/Akt/mTOR signaling pathways. Conclusions﻿HSYA was proved to regulate inflammatory response and cholesterol metabolism in vitro.