bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthy lifestyle, endoscopic screening, and colorectal cancer incidence and mortality in the United States: A nationwide cohort study
Authors: Wang Kai , Ma Wenjie , Wu Kana , Ogino Shuji , Chan Andrew T. , Giovannucci Edward L. , Song Mingyang 
Published: February 2021

Background
Healthy lifestyle and screening represent 2 major approaches to colorectal cancer (CRC) prevention. It remains unknown whether the CRC-preventive benefit of healthy lifestyle differs by endoscopic screening status, and how the combination of healthy lifestyle with endoscopic screening can improve CRC prevention.

Methods and findings
We assessed lifestyle and endoscopic screening biennially among 75,873 women (Nurses’ Health Study, 1988 to 2014) and 42,875 men (Health Professionals Follow-up Study, 1988 to 2014). We defined a healthy lifestyle score based on body mass index, smoking, physical activity, alcohol consumption, and diet. We calculated hazard ratios (HRs) and population-attributable risks (PARs) for CRC incidence and mortality in relation to healthy lifestyle score according to endoscopic screening. Participants’ mean age (standard deviation) at baseline was 54 (8) years. During a median of 26 years (2,827,088 person-years) follow-up, we documented 2,836 incident CRC cases and 1,013 CRC deaths. We found a similar association between healthy lifestyle score and lower CRC incidence among individuals with and without endoscopic screening, with the multivariable HR per one-unit increment of 0.85 (95% CI, 0.80 to 0.90) and 0.85 (95% CI, 0.81 to 0.88), respectively (P-interaction = 0.99). The fraction of CRC cases that might be prevented (PAR) by endoscopic screening alone was 32% (95% CI, 31% to 33%) and increased to 61% (95% CI, 42% to 75%) when combined with healthy lifestyle (score = 5). The corresponding PAR (95% CI) increased from 15% (13% to 16%) to 51% (17% to 74%) for proximal colon cancer and from 47% (45% to 50%) to 75% (61% to 84%) for distal CRC. Results were similar for CRC mortality. A limitation of our study is that our study participants are all health professionals and predominantly whites, which may not be representative of the general population.

Conclusions
Our study suggests that healthy lifestyle is associated with lower CRC incidence and mortality independent of endoscopic screening. An integration of healthy lifestyle with endoscopic screening may substantially enhance prevention for CRC, particularly for proximal colon cancer, compared to endoscopic screening alone.
Regional anesthesia educational material utilization varies by World Bank income category: A mobile health application data study
Authors: Moll Vanessa , Mariano Edward R. , Kitzman Jamie M. , O'Reilly-Shah Vikas N. , Jabaley Craig S. 
Published: February 2021

Introduction
Regional anesthesia offers an alternative to general anesthesia and may be advantageous in low resource environments. There is a paucity of data regarding the practice of regional anesthesia in low- and middle-income countries. Using access data from a free Android app with curated regional anesthesia learning modules, we aimed to estimate global interest in regional anesthesia and potential applications to clinical practice stratified by World Bank income level.

Methods
We retrospectively analyzed data collected from the free Android app “Anesthesiologist” from December 2015 to April 2020. The app performs basic anesthetic calculations and provides links to videos on performing 12 different nerve blocks. Users of the app were classified on the basis of whether or not they had accessed the links. Nerve blocks were also classified according to major use (surgical block, postoperative pain adjunct, rescue block).

Results
Practitioners in low- and middle-income countries accessed the app more frequently than in high-income countries as measured by clicks. Users from low- and middle-income countries focused mainly on surgical blocks: ankle, axillary, infraclavicular, interscalene, and supraclavicular blocks. In high-income countries, more users viewed postoperative pain blocks: adductor canal, popliteal, femoral, and transverse abdominis plane blocks. Utilization of the app was constant over time with a general decline with the start of the COVID-19 pandemic.

Conclusion
The use of an in app survey and analytics can help identify gaps and opportunities for regional anesthesia techniques and practices. This is especially impactful in limited-resource areas, such as lower-income environments and can lead to targeted educational initiatives.
Sustained functional benefits after a single set of injections with abobotulinumtoxinA using a 2-mL injection volume in adults with cervical dystonia: 12-week results from a randomized, double-blind, placebo-controlled phase 3b study
Authors: Patel Atul T. , Lew Mark F. , Dashtipour Khashayar , Isaacson Stuart , Hauser Robert A. , Ondo William , Maisonobe Pascal , Wietek Stefan , Rubin Bruce , Brashear Allison 
Published: February 2021

Cervical dystonia (CD) is primarily treated with botulinum toxin, at intervals of ≥ 12 weeks. We present efficacy, patient-reported outcomes (PROs), and safety in adults with CD at the last available visit after a single set of abobotulinumtoxinA (aboBoNT-A) injections versus placebo using 500 U in a 2-mL injection volume. In this 12-week, randomized, double-blind trial, patients were ≥ 18 years of age with primary idiopathic CD, had a Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total score ≥ 20, and TWSTRS-Severity subscale score > 10 at baseline. Patients (N = 134) were randomized (2:1) to aboBoNT-A (n = 89) or placebo (n = 45), with aboBoNT-A patients treated with 500 units (U) if toxin-naïve, and 250 to 500 U based on previous onabotulinumtoxinA dose if non-naïve. Endpoints included total TWSTRS, Pain Numeric Rating Scale (NRS-Pain; 24-hour), Treatment Satisfaction Questionnaire for Medication, and other PROs for pain, depression, and global health. Results are for the intent-to-treat population, with “Week 12” (Wk12) comprising the last available post-baseline assessment (end-of-study or early withdrawal). Mean TWSTRS total scores improved from 42.5 at baseline to 35.4 at Wk12 with aboBoNT-A and 42.4 to 40.4 with placebo (treatment difference: –4.8; 95% confidence interval [CI]: –8.5, –1.1; p = 0.011). At Wk12, mean (95% CI) change from baseline in NRS-Pain was –1.0 (–1.59, –0.45) for aboBoNT-A and –0.2 (–0.96, 0.65) for placebo. AboBoNT-A demonstrated numeric improvements in other PROs. More aboBoNT-A–treated patients than patients receiving placebo reported being at least “somewhat satisfied” with treatment (60.4% vs 42.2%, respectively), symptom relief (57.0% vs 40.0%), and time for treatment to work (55.8% vs 33.3%). No new adverse events were reported. Results indicate that in patients with CD, treatment with aboBoNT-A using a 2-mL injection provided sustained improvement in the TWSTRS total score and patient-perceived benefits up to 12 weeks.
Trial registration: Clinicaltrials.gov Identified: NCT01753310.
Association between metabolically healthy obesity/overweight and cardiovascular disease risk: A representative cohort study in Taiwan
Authors: Yeh Tzu-Lin , Hsu Hsin-Yin , Tsai Ming-Chieh , Hsu Le-Yin , Hwang Lee-Ching , Chien Kuo-Liong 
Published: February 2021

Objectives
To investigate the relationship between metabolically healthy obesity and cardiovascular disease risk in Taiwanese individuals.

Methods
Taiwanese individuals were recruited from a nationwide, representative community-based prospective cohort study and classified according to body mass index as follows: normal weight (18.5–23.9 kilogram (kg)/meter(m)2) and obesity/overweight (≥24 kg/m2). Participants without diabetes, hypertension, and hyperlipidemia and who did not meet the metabolic syndrome without waist circumference criteria were considered metabolically healthy. The study end points were cardiovascular disease morbidity and mortality. Multivariable adjusted hazard ratios and 95% confidence intervals were obtained from a Cox regression analysis.

Results
Among 5 358 subjects (mean [standard deviation] age, 44.5 [15.3] years; women, 48.2%), 1 479 were metabolically healthy with normal weight and 491 were metabolically healthy with obesity. The prevalence of metabolically healthy obesity/overweight was 8.6% in the Taiwanese general population, which included individuals who were >20 years old, not pregnant, and did not have CVD (n = 5,719). In the median follow-up period of 13.7 years, 439 cardiovascular disease events occurred overall and 24 in the metabolically healthy obesity group. Compared with the reference group, the metabolically healthy obesity group had a significantly higher cardiovascular disease risk (adjusted hazard ratio: 1.74, 95% confidence interval: 1.02, 2.99).

Conclusions
Individuals with metabolically healthy obesity have a higher risk of cardiovascular disease and require aggressive body weight control for cardiovascular disease control.
Non-Oil Sector and Economic Growth in Nigeria: The National Accounts Perspective
Authors: Ideh Abel Oghenevwoke , Okolo Ndu Marvis , Emengini Emeka Steve 
Published: February 2021

This study examines the impact of expansion in non-oil sector on sustainable economic growth of Nigeria economy. The study sourced data from the Central bank of Nigeria (CBN) statistical bulletin covering the periods of 2000 – 2019. An economic growth model was formulated using the study variables and the model was estimated using vector auto-regression (VAR) techniques, other diagnostic tests such as Roots of Characteristic Polynomial for VAR model stability, Augmented Dickey-Fuller test for time series stationarity, and granger causality tests were conducted to ensure the reliability of the model estimates. The analysis revealed that the estimated model is stable while the VAR and variance decomposition results shows that real gross domestic product is strongly endogenous in the short run but weakly endogenous in the long run. Further findings suggest that in the long run non-oil sector is strongly endogenous to real gross domestic product (92% contribution). The study, therefore, recommends diversification of the Nigerian economy by focusing more attention on agriculture, solid minerals, and service sectors as they tend to influence economic growth in the long run. More so, improved frameworks of accounting in areas of non-oil revenues are desirable for the accountancy profession.
Corporate Social Responsibility as Core Competence for the Business Model of Social Start-Ups in the Netherlands
Authors: Wevers Herman T. , Voinea Cosmina L. 
Published: February 2021

Little is known about how social enterprises and social start-ups compete with the bigger players on the market. It could be reasoned that social start-ups gain an advantage by the deployment of Corporate Social Responsibility (CSR) elements from the early beginning as a part of their core competences. The aim of this paper is to investigate if CSR elements can be a core competence and how they can contribute to the robustness of the business models of social start-ups. Data was gathered by conducting a case study and interviewing four social entrepreneurs in the first half of 2017. The data was analyzed with the help of a framework built upon the CSR pyramid, the business case for CSR and the Canvas business model. The main findings show that the CSR elements economic, ethical and discretionary responsibilities can be a core competence for social start-ups. Moreover, CSR elements can play an important role in the design of social business models. Especially the deployment of interrelationships between the CSR elements seems to be effective in designing a robust business model of a social start-up.
Evaluation of Financial Sustainability of the Federal Health Institutions in Nigeria
Authors: Odewole Philip Olawale , Salawu Mary Kehinde , Salawu Rafiu Oyesola 
Published: February 2021

The study investigated the financial sustainability of the federal health institutions in Nigeria. The population of the study comprised twenty-five (25) federal health institutions from four (4) geo-political zones and Abuja. Secondary data were sourced from Annual General Warrant from the Office of the Accountant General of the Federation and Audited Financial Statements of the Public Sector Entities. Data obtained were analyzed using Balanced Score Card techniques. The results showed that none of the sampled federal health institutions in Nigeria attained a basic standard of sustainability test, whereby the ratios of their Internally Generated Revenue to recurrent expenditure is between (40 – 60)% or 0.04 and 0.6.This indicates the inability of the institutions to generate sufficient revenue independently to cover even the operational expenses in the short-run. Also, the results equally showed the highest positive operating surplus ratios of 1%-5% of operational sustainability indicating that the health institutions heavily depended on central authority’s funding for their survival. The results further revealed that none of the federal health institutions attained both intermediate and advance standards of sustainability tests. In conclusion, federal health institutions in Nigeria are heavily dependent on central authority for sustenance. Therefore, the central authorities should roll out blueprints that will make the institutions widen their internally generated revenue capacity and reduce the reliance on central authority’s funding for survival.
EDUCAÇÃO SEXUAL NA EDUCAÇÃO INCLUSIVA: ATITUDES DE PROFESSORES DIANTE DE SITUAÇÕES PROJETIVAS ENVOLVENDO COMPORTAMENTOS SEXUAIS DE ALUNOS
Authors: Bortolozzi Ana Claudia , Vilaça Teresa 
Published: February 2021

A Educação Sexual é uma dificuldade para muitos professores nas escolas inclusivas. Este estudo investigou as possíveis atitudes de 55 professores portugueses diante de seis situações projetivas envolvendo o público alvo da educação especial, apresentadas em um questionário, envolvendo diferentes comportamentos sexuais de alunos: autoerotismo (deficiência intelectual- DI), toques indevidos (cego/deficiência visual-DV), beijo/namoro (surdez- S), abuso sexual (deficiência física- DF), pergunta sobre sexo na aula (deficiência múltipla- DM) e exibicionismo (autismo-TEA). Diante das situações, as atitudes mais frequentes relatadas pelos professores foram: o “diálogo acolhedor” (TEA e DM), “pedir ajuda” (DF e TEA) e “corrigir comportamentos” (DI e DV); eles não se omitem diante dos comportamentos, mas não refletem porque eles ocorreram, nem como poderiam preveni-los. Conclui-se que, apesar de uma postura favorável à Educação Sexual na escola, é importante investir na formação continuada e as situações projetivas foram procedimentos úteis no levantamento dessa necessidade.
Studi Morfologi Dasar Laut dengan Survey Batimetri di Daerah Pantai Pasar Palik, Bengkulu Utara
Authors: Lubis Ashar Muda , Sari Nanda , Sinaga Juhendi , Hasanudin M. , Kusmanto Edi 
Published: February 2021

Daerah Pantai Pasir Palik, Bengkulu Utara merupakan salah satu daerah dengan tingkat abrasi yang tinggi. Salah satu faktor pemicu cepatnya laju abrasi adalah morfologi dasar laut yang mempengaruhi tinggi gelombang yang sampai ke pantai. Tujuan penelitian ini untuk mengetahui bentuk morfologi dasar laut di daerah Pantai Pasar Palik dengan survey batimetri dan membandingkannya dengan data batimetri dari Badan Informasi Geospasial (BIG) resolusi 25 m, Earth Topography 1-Arc Minute Gird (ETOPO1) dengan resolusi 1850 m dan General Bathymetric Chart of the Ocean (GEBCO) resolusi 450 m dan 900 m. Pengambilan data dilakukan dengan pemeruman menggunakan Single Beam Echosounder danGlobal Positioning System (GPS). Koreksi pasang surut dilakukan dengan bantuan perangkat lunakwxtide4.7. Hasil penelitiaan menunjukkan pada pengukuran Echosounderkedalaman maksimum mencapai10 m, sedangkan data BIG maksimum 8 m, GEBCO 450 m mencapai 55 m, GEBCO 900 m mencapai 32 m sedangkan ETOPO1 hanya 2,67 m. Kemiringan morfologi dasar laut dikategorikan landai dengan nilai kemiringan 0,32˚. Morfologi bawah laut di daerah pantai dapat dipengaruhi oleh faktor hidrografi dan oseanografi, maka penelitian lanjutan sangat diperlukan untuk melihat dinamika perubahan morfologi dasar laut. The Palik Coast area, North Bengkulu, is one of the area with high level of abrasion. One of the factors triggering the rapid rate of abrasion is the seabed morphology which affects the height wave energy near the coast. The purpose of this study was to determine the seabed morphology based on slope of seabed in Pasar Palik coast area with bathymetry survey, and also to compare the result with other bathymetry data; the BIG with resolution of 25 m, ETOPO1 with resolution of 1850 m and GEBCO resolution of 450 m and 900 m. The research was carried out by measuring bathymetry using Single Beam Echosounder and GPS. Tidal correction was conducted by using wxtide4.7 software. The result shows that the maximum depth reaches 10 m while the BIG data has the maximum depth of 8 m.Maximum depth from GEBCO, GEBCO 900 m, ETOPO1 data is 55 m, 32 m and 2.67 m respectively. The slope of the seabed morphology is categorized as as declivous with a slope value of 0.32˚. Morphology in coastal areas can be influenced hydrography dan oceanography factors, further research is needed to better understand the dynamics of morphology changes.
Natural increase, net replacement rate, output and population dynamic of Aceh cattle in Livestock Breeding and Forage Center of Indrapuri
Authors: Widyaningrum R. , Budisatria I. G. S. , Maharani D. 
Published: February 2021

This study aimed to estimate natural increase (NI), net replacement rate (NRR), output, and population dynamics of Aceh cattle at Livestock Breeding and Forage Center in Indrapuri, Aceh province. Data of population structure, mortality, birth rate, the number of animals entering the herd, and the number of animals released from the herd during 2019were used for determining NIandNRR, and it isusedfor estimation of output. Population structure data (2015-2019) were used to estimate the population dynamics. The results showed that NI was 19.08% (medium category). The availability of replacement stock exceeded the need for replacement (140.08% for male and 73.33% for female); the NRR was 240.08% (male) and 173.33% (female). The output of Aceh cattle was 3.92% (culled male), 5.58% (culled female); the remaining replacement stocks were 5.49% (male) and 4.09% (female) of the total population. The population of Aceh cattle from 2020 to 2024 was expected to increase by 6.02% (65 heads) on average. In conclusion, that BPTU-HPT Indrapuri can be categorized as a beef cattle producing region, but still need efforts to increase natural increase by increasing birth rate minimum 32.77% and reducing mortality maximum 3.0%, in combination with better management systems.
The effects of shearing and ascorbyl palmitate administration on physiological and blood metabolite profile of Padjadjaran sheep under heat exposure treatment
Authors: Taofik A. , Bandiati S. , Maskoen A. M. , Yusuf M. 
Published: February 2021

Ascorbyl-6-palmitate (AP) was a lipid-soluble synthetic ester of ascorbic acid that has been used as a preservation agent for foods and as an antioxidant in cosmetics and related products. This study aims to investigate the effect of shearing management and ascorbyl palmitate administration on physiological and hematological profiles in under heat load Padjadjaran sheep. The physiological profile involves respiration rate (RR), Pulse rate (PR), and rectal temperature (RT). Twenty rams Padjadjaran 1 – 1,5 year-old, weighing between 25 to 47.5 kg used from sheep breeding station Purwakarta, West Java - Indonesia. There are two treatments level in this research, (1). Shearing divide into two groups, unshearing (c0) and shearing (c1); (2). AP administration also divides two groups, not given (a0) and given 400 mg each head daily (a1). The whole treatments were a0c0, a0c1, a1c0 and a1c1. Heat exposure application was exposed to sunlight when the sheep exposed, the animal tethered by rope at the neck region. The sheep exposed to the sun when the ambient temperature at least 34oC, 180 minutes each day, three days a week. The result showed that AP administration and shearing have interaction effects on RR, PR and RT. The level of glucose and total protein is affected by interaction effect of AP administration and shearing, while cholesterol affected to shearing. The conclusion, supplementing AP and shearing application could reduce the negative impact of heat stress on physiological and blood metabolite profiles of Padjadjaran sheep. Although the wool of local breed has not economic value, the shearing is regularly needed.
Thinking ethics differently (challenges and opportunities for engineers education)
Authors: Pasca Carmen Mariana , Riman Chadi Fouad 
Published: February 2021

Ethics has many definitions, each depending on its domain. In the ancient times, ethics was based on the principles of good action and the search for the common good. Generally, Ethics is understood as a system of moral principles which affect our ways of living. Ethics are related with what is good for society and individuals and is described as moral philosophy. Ethics only makes sense if we put them in the context of human action understood as responsible, creative and communicative. Applied Ethics and Codes of conducts have appeared in the contemporary period. One of the key issues in the engineering education ethics program is the problem of margins/limits of autonomy that will enable future engineers to act ethically in accordance with universal ethical principles and the existing codes of ethics. Computer ethics adds the intellectual property rights, and also the use of personal data. The paper shows a general review of ethics, its history, its evolution, with an emphasis on engineering education. It also mentions the big data issue in ethics.
Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth
Authors: Naciu Anda Mihaela , Verri Martina , Crescenzi Anna , Taffon Chiara , Longo Filippo , Frasca Luca , Tabacco Gaia , Monte Lavinia , Palermo Andrea , Crucitti Pierfilippo , Cesareo Roberto 
Published: February 2021

Summary
We present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect.

Learning points:

HVPTC is an aggressive variant of PTC, usually associated with radioactive iodine refractoriness, and a higher mortality rate compared to classic PTC. However, there is a marked individual variability in this association.

HVPTC usually appears as small unifocal lesion but a multinodular goiter presentation may occur.

The present case highlights that despite of the histology, our patient achieved a high ablation success rate after radioactive iodine therapy.