bluuebunny/crossref_metadata_2025_split huggingface dataset:
WITHDRAWN: Asymmetrical response of summer rainfall in East Asia to CO2 forcing
Authors: Song Se-Yong , Yeh Sang-Wook , An Soon-Il , Kug Jong-Seong , Min Seung-Ki , Son Seok-Woo , Shin Jongsoo 
Published: January 2021

Abstract
Understanding the regional hydrological response to varying CO2 concentration is critical for cost-benefit analysis of mitigation and adaptation polices in the near future. To characterize summer monsoon rainfall change in East Asia due to a change in the CO2 pathway, we used the Community Earth System Model (CESM) with 28 ensemble members in which the CO2 concentration increases at a rate of 1% per year until its quadrupling peak, i.e., 1,468 ppm (ramp-up period), followed by a decrease of 1% per year until the present-day climate conditions, i.e., 367 ppm (ramp-down period). Although the CO2 concentration change is symmetric in time, the rainfall response is not symmetric. The amount of summer rainfall in East Asia is much larger during a ramp-down period than during a ramp-up period when the two periods of the same CO2 concentration are compared. This asymmetrical rainfall response is mainly due to an enhanced El Niño-like warming pattern as well as an increase in the meridional sea surface temperature gradient in the western North Pacific during a ramp-down period. These sea surface temperature patterns enhance the atmospheric teleconnections to East Asia and the local meridional circulations around East Asia, resulting in more rainfall over East Asia during the ramp-down period. This result implies that the removal of CO2 does not guarantee the return of regional rainfall to the previous climate state with the same CO2 concentration.
Multimorbidity in Pregnancy: An Exploratory Study Among Women Attending Antenatal Clinics in Odisha, India
Authors: Pati Sanghamitra , Puri Parul , Mahapatra Pranab , Pati Sandipana , Swain Subhashisa 
Published: January 2021

Abstract
Background: In recent years, the interplay of non-communicable diseases (NCDs) in pregnancy has gained global prominence, with documented risk for maternal and newborn wellbeing; especially, multimorbidity, the coexistence of two or more chronic conditions, is being recognized as a maternal health challenge. At the same time, pregnancy has remained as an exclusion criterion in most of the multimorbidity estimation studies resulting in deficient understanding of the problem in this vulnerable population. We aimed to estimate the prevalence of multimorbidity and identify its correlates among females presenting to antenatal care clinics, and assessed the outcomes in terms of health care utilization and expenditure.Method: An exploratory cross-sectional study was conducted among 127 pregnant women attending three antenatal clinics of Bhubaneswar, Odisha from January – June 2016. Data was collected using “multimorbidity assessment questionnaire for antenatal care” (MAQ ANC) specifically developed and validated for the purpose. Multimorbidity was defined as two or more of the enlisted morbidities. Descriptive analysis was performed to determine prevalence and correlates. Outcomes were measured by number of healthcare visit, medications and healthcare expenditure. Result: Multimorbidity was present in 15% of antenatal women. Anemia (58.62%), hypertension (21%), acid peptic diseases (21%) and thyroid (17.24%) were leading chronic conditions. A statistically significant association was found (p-value <0.05, Pearson’s chi-square test) between multimorbidity and medical consultation, medicines consumed, and functional limitation. Health care expenditure was significantly higher among multimorbidity group, of which nearly half was incurred on diagnostics. Conclusion: Multimorbidity is an emerging issue in pregnancy. Our findings suggest inclusion of comprehensive multimorbidity assessment in routine antenatal screening. The preconception care needs to establish linkages between maternal and reproductive health with NCD prevention, and identify ways to reduce health care utilization and expenditure Longitudinal studies to assess the trajectory and impact of multimorbidity on maternal and infant health are warranted.
Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report
Authors: Xu Qiteng , Ren Yueyi , Hu Yifei , Duan Shuhua , Chen Rui , Yuan Junhui 
Published: January 2021

Abstract
BackgroundThe totally implantable venous access port (TIVAP) is a secure and practical choice for children undergoing long-term chemotherapy. Nevertheless, various complications still need to be treated cautiously. Among the complications, the migration of catheters to the thoracic cavity is a very rare (but potentially severe) condition that may necessitate device reimplantation. Furthermore, this migration may even be life-threatening if it is not detected in time.Case presentationA 1-year-old girl undergoing palliative chemotherapy underwent TIVAP placement via the right internal jugular vein. During the operating procedure, the catheter tip was located in the right atrium, which was confirmed by the use of C-arm. Prophylactic intravenous antibiotics were then adopted with routine aspiration and with flushing being conducted each time before administration. Massive right pleural effusion and migration of the catheter tip to the right thoracic cavity were detected on the 2nd day after implantation, which resulted in the removal and reimplantation of the TIVAP device.ConclusionsThe migration of the catheter into the thoracic cavity should be considered a possible complication of TIVAP implantation in children. Early detection and reimplantation may provide opportunities for the prevention of further severe complications.
Is clear cell carcinoma of abdominal wall surgery scar associated with endometriosis a poor prognosis? A case report and literature review
Authors: Liang Xuzhi , Zeng Hao , Tang Zhe , Liao Jiejie , Fan Jiangtao 
Published: January 2021

Abstract
BackgroundClear cell carcinoma of abdominal wall surgery scar is a rare condition that can have many potential causes, and its early diagnosis is difficult after undergoing obstetrical and gynecological surgery unless performing tumor biopsy. So far, about 45 cases have been reported in the literature. This paper provides a case report and literature review of clear cell carcinoma on abdominal wall surgical scar.Case presentationWe described the case of a 47-year-old woman reporting two lumps in the scar of abdomen. Her medical history was marked by a previous Caesarean section and two excisions of benign endometriosis nodules at the scar. Physical examination found a mass of about 6×5×5 cm on the left side of the scar with mucoid on the surface and a fixed abdominal wall mass of about 10×10×8 cm in the 2 transverse fingers under the umbilicus. Histological examination proved a clear cell carcinoma result. The patient received tumor excision and first-line chemotherapy with complete remission. A review of the literature showed that 91.3% of the cases had had a Caesarean section. Besides, approximately 34.2% of women died 5–48 months after diagnosis. The average age of women was 46.5 years and the average tumor size was 10 cm.ConclusionThe abdominal wall mass of middle-aged women is closely related to the scar left by the previous Cesarean section and must be investigated in time and properly. Preoperative diagnosis is difficult and often incorrect, and there is no specific marker for malignant transformation. Treatment usually includes surgery, chemotherapy, and radiotherapy, but the prognosis is poor.
Mental Health and its Relationship with Social Support in Iranian Students during the COVID-19 Pandemic
Authors: Ghafari Reza , Mirghafourvand Mojgan , Rouhi Mahsa , Osouli-Tabrizi Shirin 
Published: January 2021

Abstract
Background In addition to physical problems, the COVID-19 crisis continues to impose serious psychological adverse effects on people's mental health, which plays a major role in the efficiency of every community. Students, especially medical students, suffer more stress as a result of exposure to COVID induced stressors. It is, therefore, essential to measure mental health and its correlation with social support in medical students during the COVID pandemic. The present study was conducted to determine mental health status of students and its correlation with social support. MethodsThis cross-sectional study was conducted in 2020 on 280 students of Tabriz University of Medical Sciences in Iran using random sampling. Socio-demographic profile scale, Mental Health Test (GHQ-28) and the Scale of Perceived Social Support (PRQ-85) were used to collect data. Participants completed the questionnaires online. Results To determine the relationship between mental health and perceived social support, a general linear model was utilized considering the potential confounding variables.Mean (standard deviation) of total mental health score 26.5 (12.5) was in the acceptable range of 0 to 63. 56% students suffered from a mental disorder. Mean (standard deviation) of social support score 128.2(21.0) was within the range 25 to175. According to the Pearson's correlation coefficient, there was a significant inverse correlation between social support score and total mental health score and all its subscales [p<0.001; r=-0.294 to -0.536]. According to the general linear model, mental health score decreased significantly with social support score [p=0.0001;-0.32 to-0.20; CI 95%; B=0.26].ConclusionsGiven the inverse relationship between social support and mental health, it is suggested to increase the level of social support for students at all times, especially during the stressful COVID-19 pandemic to improve their mental health.
RNA Seq Analysis Reveal Differential Expression of Genes Associated With Metabolic Reprogramming, Defense and Signaling in Two Contrasting Indigenous Aromatic Rice Cultivars Differing in Redox Regulatory Properties Under Drought Stress
Authors: Dey Nivedita , Bhattacharjee Soumen 
Published: January 2021

Abstract
Background: Though there are at present seventy indigenous aromatic rice cultivars being cultivated in West Bengal, India, the information regarding their genetic regulation of drought tolerance are scanty. Previous work from this laboratory has screened indigenous aromatic rice cultivars Badshabhog and Jamainadu as drought tolerant redox competent and drought susceptible redox incompetent germplasms respectivelybased on redox metabolomic investigation. In this backdrop, the present work comprehended to compare two indigenous aromatic rice cultivars for unfolding genetic regulation of drought stress. Results: The result of comparative transcriptomic study through RNA-seq analysis in general revealed significant cultivar specific expression of genes under post-imbibitional dehydration stress as well as genes that are expressed in both the experimental cultivars (Oryza sativa L., cultivars Badshabhog and Jamainadu) with differential transcript abundance. 3482 and 3866 genes were found to be significantly down-regulated and up-regulated respectively when we compared between post-imbibitional dehydration stress-raised indigenous aromatic rice cultivars Badshabhog and Jamainadu. Transcripts selected for heatmap generation with proper annotation revealed 50 genes that are significantly expressed genes which are mainly involved in redox functions, signaling, membrane trafficking, replication and protein synthesis etc. On the contrary, genes which got highly expressed in Badshabhog found to be mainly concerned with carbondioxide concentrating mechanism (NADH-dependent malic enzyme), peroxysomal biogenesis, protein modification, protein synthesis, mitochondrial electron transport chain functioning, inercellular protein transport, histone demethylation associated with developmental process, regulation of apoptosis etc. Further Badshabhog exhibited greater GO (gene ontology) distribution so far as signaling, antioxidant functioning, biological and metabolic regulation, transcriptional and translational regulation etc. with significantly higher percentage of antioxidant genes. KEGG (kyoto encyclopedia of genes and genomes) pathway analysis showed several signal transduction pathways (abscisic acid, brassinosteroid, salicylic acid, jasmonic acid and ethylene) being influenced by drought stress. Conclusion: The overall result of comparative transcriptomic investigation suggests that indigenous aromatic rice cultivars Badshabhog and Jamainadu explored varying strategies to deal with post-imbibitional dehydration stress. The cultivar Badshabhog exhibited a significantly greater molecular reprogramming presumably more through up-regulation of metabolic and energy demanding processes along with implementing better signaling strategies, antioxidative defense mechanism, DNA repair and transcriptional regulation vis-a-vis the cultivar Jamainadu.
Association of Gut Microbiome and Vitamin D in Knee Osteoarthritis Patients
Authors: Ramasamy Boopalan , Magne Fabien , Tripathy Sujit Kumar , Venugopal Giriprasad , Mukherjee Diptasree , Balamurugan Ramadass 
Published: January 2021

Abstract
Background: A Few preclinical studies have shown that Knee osteoarthritis (KOA) is linked to gut microbiome dysbiosis and chronic inflammation. This pilot study was designed to look at the gut microbiome composition in KOA patients and normal individuals with or without vitamin D deficiency (VDD, serum vitamin D <30 ng/ml). Methods: This pilot study was conducted prospectively in 24 participants. The faecal samples of all the participants were taken for DNA extraction. The V3-V4 region of 16s rRNA was amplified and the library was prepared and sequenced on the Illumina Miseq platform. Results: The mean (±SD) age was 45.5 (±10.2) years with no defined co-morbidities. Of 447 total Operational Taxonomic Units (OTUs), a differential abundance of 16 nominally significant OTUs between the groups were observed. Linear discriminate analysis (LEfSe) revealed a significant difference in bacteria among the study groups. Pseudobutyrivibrio and Odoribacter were specific for VDD while Parabacteroides, Butyricimonas, and Gordonibacter were abundant in the KOA_VDD group and Peptococcus, Intestimonas, Delftia, and Oribacterium were abundant in the KOA group. About 80% of bacterial species were common among different groups and hence labeled as core bacterial species. However, the core microbiome of KOA and VDD groups were not seen in the KOA_VDD group, suggesting that these bacterial groups were affected by the interaction of the KOA and VDD factors. Conclusion: Parabacteroides, Butyricimonas, Pseudobutyrivibrio, Odoribacter, and Gordonibacter are the predominant bacteria in vitamin D deficient patients with or without KOA. Together these results indicate an association between the gut microbiome, vitamin D, and knee osteoarthritis.
Premature Neonatal Gut Microbial Community Patterns Supporting An Epithelial TLR-Mediated Pathway For Necrotizing Enterocolitis
Authors: Shaw Alexander G , Sim Kathleen , Rose Graham , Wooldridge David J. , Li Ming-Shi , Misra Raju V. , Gharbia Saheer , Kroll J. Simon 
Published: January 2021

Abstract
Background: Necrotising enterocolitis (NEC) is a devastating bowel disease, primarily affecting premature infants, with a poorly understood aetiology. Prior studies have found associations in different cases with an overabundance of particular elements of the faecal microbiota (in particular Enterobacteriaceae or Clostridium perfringens), but there has been no explanation for the different results found in different cohorts. Immunological studies have indicated that stimulation of the TLR4 receptor is involved in development of NEC, with TLR4 signalling being antagonised by the activated TLR9 receptor. We speculated that differential stimulation of these two components of the signalling pathway by different microbiota might explain the dichotomous findings of microbiota-centered NEC studies. Here we used shotgun metagenomic sequencing and qPCR to characterise the faecal microbiota community of infants prior to NEC onset and in a set of matched controls. Logistic regression was used to segregate cases from control samples using both microbial and clinical data.Results: We found that the infants suffering from NEC fell into two groups based on their microbiota; one with relatively low levels of CpG DNA in bacterial genomes and the other with high abundances of organisms expressing LPS. The identification of these characteristic communities was reproduced using an external metagenomic validation dataset. We suggest that these two patterns represent the stimulation of a common pathway at extremes; the LPS leading to overstimulation of TLR4, whilst low levels of CpG fail to sufficiently stimulate TLR9. Conclusions: The identified microbial community patterns support the concept of NEC resulting from TLR-mediated pathways. Identification of these signals suggests characteristics of the gastrointestinal microbial community to be avoided to prevent NEC. Potential pre- or pro-biotic treatments may be designed to optimise TLR signalling.
Posttraumatic Subperiosteal Orbital Hematoma With Intracranial Hemorrhage in A Male Infant
Authors: Lee Yeon Jeong , Yoo Yungju 
Published: January 2021

Abstract
Background: To the best of our knowledge, there has been no report of subperiosteal orbital hematoma combined with intracerebral hemorrhage in pediatric patients.Case presentation: A healthy 9-month-old boy with left superior tarsal conjunctival prolapse was admitted to the emergency room after left periorbital blunt trauma. Computer tomography of the brain showed a left orbital roof fracture and subperiosteal orbital hematoma with acute intracerebral hemorrhage. He received emergency craniotomy. Three days after the craniotomy, the subperiosteal hematoma and proptosis increased. An anterior orbitotomy with orbital subperiosteal hematoma evacuation and drain placement were performed. Nine months after surgery, the left blepharoptosis and conjunctival prolapse improved and fix and follow were good in his both eyes. However, a new-onset intermittent exotropia and left hypotropia were detected. Conclusions: Orbital subperiosteal hematoma must be considered in the differential diagnosis of acute unilateral proptosis after trauma. In infants and children, a thorough work-up to detect concomitant intracerebral hemorrhage is necessary. Prompt surgical removal of hematoma is recommended to prevent complications
External Beam Partial Breast Irradiation Versus Whole Breast Irradiation for in Early Breast Cancer：A Systematic Review and Meta-Analysis
Authors: Dai Peiling , Chen Kai , Li Lan , Wang Li , Xia Yaoxiong , Hou Yu , Zhang Lan , Chang Li , Li wenhui 
Published: January 2021

Abstract
PurposePostoperative radiotherapy can reduce the recurrence of breast cancer. Postoperative radiotherapy is divided into whole breast irradiation (WBI) and partial breast irradiation (PBI) for early breast cancers. Due to the characters of saving time, money, and easy to deliver, external beams PBI (EB PBI) is brought into focus. However, the researches on outcomes, safety, and efficacy between EB PBI and WBI are still insufficient. We concluded a meta-analysis for LRR, regional node recurrence, contralateral breast cancer, distant recurrence, mortality, less acute skin toxicity (˃ 1 grade), late skin toxicity and the cosmetic score of external beam partial breast irradiation (EB PBI) and whole breast irradiation(WBI) to develop a radiotherapy plan for early low recurrence risk breast cancer patients. MethodWe searched Pubmed、Embase、Cochrane Library、Clinicaltrals. Study eligibility criteria are as below: (1) RCTs for EB PBI vs WBI; (2) Histologically confirmed breast cancer; (3) AJCC staged Tis-2N0-1M0; (4) ≥ 40 years old; (5) Tumor size ≤ 3 cm;(6) microscopically clear margins ≤ 5 cm; (7) Mean follow-up time༞5 years. All data is used by Cochrane’s Review Manager 5.3 (RevMan) to process.ResultsThere were 4 RCT studies included in our study with 1999 patients in EB PBI group and 1999 patients in EB PBI. There was no statistic difference between PBI and WBI groups in local recurrence rates (RR = 1.15; 95% CI, 0.76 to 1.74; p = 0.52; I2 = 0%), regional node recurrence(RR = 1.00; 95% CI, 0.49 to 2.04, p = 0.99, I2 = 0%), contralateral breast cancer (RR = 0.79; 95% CI, 0.54 to 1.16; p = 0.23; I2 = 0%), distant recurrence(RR = 1.00; 95% CI, 0.63 to 1.59; p = 1.00; I2 = 0%), non-breast second cancer (RR = 1.03; 95% CI, 0.50 to 2.16; p = 0.93; I2 = 83%), mortality(RR = 0.96; 95% CI, 0.60 to 1.55; p = 0.88, I2 = 54%). EB PBI had worse cosmetic score (RR = 1.56; 95% CI, 1.04 to 2.34; p = 0.003, I2 = 84%), less acute skin toxicity (˃ 1 grade) (RR = 0.17; 95% CI, 0.07 to 0.42; p༜ 0.0001, I2 = 87%) and late skin toxicity(RR = 0.65; 95% CI, 0.48 to 0.88; p = 0.005; I2 = 27%) than WBI.ConclusionEB PBI has similar LRR, regional node recurrence, contralateral breast cancer, distant recurrence, non-breast second cancer and mortality with WBI. But EB PBI has worse cosmetic score, less acute skin toxicity (˃ 1 grade) and late skin toxicity than WBI.
The Lecture is Not Dead: Combined Peer Assisted Flipped Class, an Alternative to Classical Lecture in Basic Medical Education
Authors: Shawky Noha Osama , EL-Bab Mohamed Fath , Waly Nermien 
Published: January 2021

Abstract
Student engagement at lectures is declining especially for basic sciences. Lecture is main method of physiology teaching. It has been increasingly challenging to employ new educational methodologies in teaching physiology for several economical and technical reasons. Our objective was to enhance lecture attendance and increasing student engagement in physiology lectures. Combined peer assisted learning (PAL) and flipped classroom (FC) strategies (PAFC) was employed in the teaching of neurophysiology course for second year medical students. Course Material and reading assignments were provided ahead of class on instructor and departmental websites. Twenty Students participated in lectures preparation and presentation under instructor’s supervision. Class members participation was conducted via pre-class reading assignments, in class discussions and instructor guided questions. Method evaluation was conducted using both course surveys, quizzes, end of course evaluations and lecture attendance. lecture attendance showed about 30 % increase compared to anatomy class conducted in classical lecture format. Course surveys revealed a 77% of students were satisfied with the new methodology while 23% preferred the traditional method. All PAFC participants expressed their positive feedback when interviewed after the course had ended and their comments was documented. End of course evaluations showed that class results were Comparable to anatomy course taught in traditional method (same class and conducted at the same time). In conclusion, PAFC can be beneficial in teaching basic science courses for medical students. It can enhance lecture attendance and student satisfaction. Also, it can provide an affordable alternative method to improve medical education in institutes with limited resources.