bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric pancreatic trauma in North Queensland: a 10-year retrospective review
Authors: Everson Emily , Buschel Helen , Carroll James , Palamuthusingam Pranavan 
Published: February 2023

Abstract
Purpose
To establish the incidence of pancreatic trauma in North Queensland to the region’s only tertiary paediatric referral centre, and to determine the patient’s outcomes based on their management.

Methods
A single centre, retrospective cohort study of patients < 18 years with pancreatic trauma from 2009 to 2020 was performed. There were no exclusion criteria.

Results
Between 2009 and 2020 there were 145 intra-abdominal trauma cases, 37% from motor vehicle accidents (MVA), 18.6% motorbike or quadbike, and 12.4% bicycle or scooter accidents. There were 19 cases of pancreatic trauma (13%), all from blunt trauma and with associated injuries. There were 5 AAST grade I, 3 grade II, 3 grade III, 3 grade IV injuries, and 4 with traumatic pancreatitis. Twelve patients were managed conservatively, 2 were managed operatively for another reason, and 5 were managed operatively for the pancreatic injury. Only 1 patient with a high grade AAST injury was successfully managed non-operatively. Complications included pancreatic pseudocyst (n = 4/19; 3 post-op), pancreatitis (n = 2/19; 1 post op), and post-operative pancreatic fistula (POPF) (n = 1/19).

Conclusion
Due to North Queensland’s geography, diagnosis and management of traumatic pancreatic injury is often delayed. Pancreatic injuries requiring surgery are at high risk for complications, prolonged length of stay, and further interventions.
Developmental predictors of young adult borderline personality disorder: a prospective, longitudinal study of females with and without childhood ADHD
Authors: O’Grady Sinclaire M. , Hinshaw Stephen P. 
Published: February 2023

Abstract
Background
Research on the precursors of borderline personality disorder (BPD) reveals numerous child and adolescent risk factors, with impulsivity and trauma among the most salient. Yet few prospective longitudinal studies have examined pathways to BPD, particularly with inclusion of multiple risk domains.

Methods
We examined theory-informed predictors of young-adult BPD (a) diagnosis and (b) dimensional features from childhood and late adolescence via a diverse (47% non-white) sample of females with (n = 140) and without (n = 88) carefully diagnosed childhood attention-deficit hyperactivity disorder (ADHD).

Results
After adjustment for key covariates, low levels of objectively measured executive functioning in childhood predicted young adult BPD diagnostic status, as did a cumulative history of childhood adverse experiences/trauma. Additionally, both childhood hyperactivity/impulsivity and childhood adverse experiences/trauma predicted young adult BPD dimensional features. Regarding late-adolescent predictors, no significant predictors emerged regarding BPD diagnosis, but internalizing and externalizing symptoms were each significant predictors of BPD dimensional features. Exploratory moderator analyses revealed that predictions to BPD dimensional features from low executive functioning were heightened in the presence of low socioeconomic status.

Conclusions
Given our sample size, caution is needed when drawing implications. Possible future directions include focus on preventive interventions in populations with enhanced risk for BPD, particularly those focused on improving executive functioning skills and reducing risk for trauma (and its manifestations). Replication is required, as are sensitive measures of early emotional invalidation and extensions to male samples.
Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: a 2-year longitudinal study
Authors: Li Zhen , Cao Lianmeng , Zhou Ziyu , Han Maozhi , Fu Chang 
Published: February 2023

Abstract
Background
This study aimed to investigate the proportion of prehypertension cases progressing to hypertension among Chinese middle-aged and elderly populations over a 2-year period and related influencing factors.

Methods
Data were obtained from the China Health and Retirement Longitudinal Study, and 2,845 individuals who were ≥ 45 years old and prehypertensive at baseline were followed from 2013–2015. Structured questionnaires were administered, and blood pressure (BP) and anthropometric measurements were performed by trained personnel. Multiple logistic regression analysis was done to investigate factors associated with prehypertension progressing to hypertension.

Results
Over the 2-year follow-up, 28.5% experienced progression of prehypertension to hypertension; this occurred more frequently in men than women (29.7% vs. 27.1%). Among men, older age (55–64 years: adjusted odds ratio [aOR] = 1.414, 95% confidence interval [CI]:1.032–1.938; 65–74 years: aOR = 1.633, 95%CI: 1.132–2.355; ≥ 75 years: aOR = 2.974, 95%CI: 1.748–5.060), obesity (aOR = 1.634, 95%CI: 1.022–2.611), and number of chronic diseases (1: aOR = 1.366, 95%CI: 1.004–1.859; ≥ 2: aOR = 1.568, 95%CI: 1.134–2.169) were risk factors for progression to hypertension whereas being married/cohabiting (aOR = 0.642, 95% CI: 0.418–0.985) was a protective factor. Among women, risk factors included older age (55–64 years: aOR = 1.755, 95%CI: 1.256–2.450; 65–74 years: aOR = 2.430, 95%CI: 1.605–3.678; ≥ 75 years: aOR = 2.037, 95% CI: 1.038–3.995), married/cohabiting (aOR = 1.662, 95%CI: 1.052–2.626), obesity (aOR = 1.874, 95%CI: 1.229–2.857), and longer naps (≥ 30 and < 60 min: aOR = 1.682, 95%CI: 1.072–2.637; ≥ 60 min: aOR = 1.387, 95%CI: 1.019–1.889).

Conclusions
Chinese middle-aged and elderly individuals experienced a risk of prehypertension progressing to hypertension over a 2-year period, although the influencing factors differed by sex; this should be considered in interventions.
Factors influencing COVID-19 health protective behaviours in Zambian university students with symptoms of low mood
Authors: Ncheka Joyce M. , Menon J. Anitha , Davies E Bethan , Paul Ravi , Mwaba Sydney O. C. , Mudenda John , Wharrad Heather , Toutounchi Parisa , Glazebrook Cris 
Published: February 2023

Abstract
Background
Health protective behaviours are crucial in the prevention of the spread of COVID-19, particularly in university students who typically live and study in large groups. Depression and anxiety are common in students and can impact young people’s motivations to follow health advice. The study aims to assess the relationship between mental health and COVID-19 health-protective behaviours in Zambian university students with symptoms of low mood.

Methods
The study was a cross-sectional, online survey of Zambian university students. Participants were also invited to take part in a semi-structured interview to explore views about COVID-19 vaccination. Invitation emails were sent explaining the study aims and directed students who self-identified as having low mood in the past two weeks to an online survey. Measures included COVID-19 preventive behaviours, COVID-19-related self-efficacy, and Hospital and Anxiety Depression scale.

Results
A total of 620 students (n=308 female, n=306 male) participated in the study, with a mean participant age of 22.47±3.29 years (range 18–51). Students reported a mean protective behaviour score of 74.09/105 and 74% scored above the threshold for possible anxiety disorder. Three-way ANOVA showed lower COVID-19 protective behaviours in students with possible anxiety disorder (p=.024) and those with low self-efficacy (p<0.001). Only 168 (27%) said they would accept vaccination against COVID-19, with male students being twice as likely to be willing to accept COVID-19 vaccination (p<0.001). Of 50 students interviewed. 30 (60%) expressed fears about the vaccination and 16 (32%) were concerned about a lack of information. Only 8 (16%) participants expressed doubts about effectiveness.

Conclusion
Students who self-identify as having symptoms of depression have high levels of anxiety. The results suggest that interventions to reduce anxiety and promote self-efficacy might enhance students’ COVID-19 protective behaviours. Qualitative data provided insight into the high rates of vaccine hesitancy in this population.
Tuberculosis in older adults: case studies from four countries with rapidly ageing populations in the western pacific region
Authors: Teo Alvin Kuo Jing , Rahevar Kalpeshsinh , Morishita Fukushi , Ang Alicia , Yoshiyama Takashi , Ohkado Akihiro , Kawatsu Lisa , Yamada Norio , Uchimura Kazuhiro , Choi Youngeun , Chen Zi , Yi Siyan , Yanagawa Manami , Oh Kyung Hyun , Viney Kerri , Marais Ben , Kim Heejin , Kato Seiya , Liu Yuhong , Ong Catherine W.M. , Islam Tauhid 
Published: February 2023

Abstract
Background
The Western Pacific Region has one of the fastest-growing populations of older adults (≥ 65 years) globally, among whom tuberculosis (TB) poses a particular concern. This study reports country case studies from China, Japan, the Republic of Korea, and Singapore reflecting on their experiences in managing TB among older adults.

Findings
Across all four countries, TB case notification and incidence rates were highest among older adults, but clinical and public health guidance focused on this population was limited. Individual country reports illustrated a range of practices and challenges. Passive case finding remains the norm, with limited active case finding (ACF) programs implemented in China, Japan, and the Republic of Korea. Different approaches have been trialled to assist older adults in securing an early diagnosis, as well as adhering to their TB treatment. All countries emphasised the need for person-centred approaches that include the creative application of new technology and tailored incentive programs, as well as reconceptualisation of how we provide treatment support. The use of traditional medicines was found to be culturally entrenched among older adults, with a need for careful consideration of their complementary use. TB infection testing and the provision of TB preventive treatment (TPT) were underutilised with highly variable practice.

Conclusion
Older adults require specific consideration in TB response policies, given the burgeoning aging population and their high TB risk. Policymakers, TB programs and funders must invest in and develop locally contextualised practice guidelines to inform evidence-based TB prevention and care practices for older adults.
Experiences of teachers and community-based health workers in addressing adolescents’ sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia
Authors: chilambe Kunda , Mulubwa Chama , Zulu Joseph Mumba , Chavula Malizgani Paul 
Published: February 2023

Abstract
Background
Adolescents in low-and-middle-income countries like Zambia face a high burden of sexual, reproductive, health and rights problems including coerced sex, teenage pregnancies, and early marriages. The Zambia government through the Ministry of Education has integrated comprehensive sexuality education (CSE) in the education and school system to contribute towards addressing adolescent sexual, reproductive, health and rights (ASRHR) problems. This paper sought to explore teachers and community based health workers (CBHWs) experiences in addressing ASRHR problems in rural health systems in Zambia.

Methodology
The study was conducted under the Research Initiative to Support the Empowerment of Girls (RISE) community randomized trial that aimed to measure the effectiveness of economic and community interventions in reducing early marriages, teenage pregnancies, and school dropout in Zambia. We conducted 21 qualitative in-depth interviews with teachers and CBHWs involved in the implementation of CSE in communities. Thematic analysis was used to analyse teachers and CBHWs´ roles, challenges, and opportunities in promoting ASRHR services.

Results
The study identified teachers and CBHWs roles, and challenges experienced in promoting ASRHR and suggested strategies to enhance delivery of the intervention. The role of teachers and CBHWs in addressing ASRHR problems included mobilizing the community for meetings, providing SRHR counseling services to both adolescents and guardians, and strengthening referrals to SRHR services if needed. The challenges experienced included stigmatization associated with difficult experiences such as sexual abuse and pregnancy, shyness among girls to participate when discussing SRHR in the presence of the boys and myths about contraception. The suggested strategies for addressing the challenges included creating safe spaces for adolescents to discuss SRHR issues and engaging adolescents in coming up with the solution.

Conclusion
This study provides significant insight on the important roles that teachers and CBHWs can play in addressing adolescents SRHR related problems. Overall, the study emphasizes the need to fully engage adolescents in addressing adolescent SRHR problems.
The integrative panel of fatty acid desaturase-2 (FADS2) rs174583 gene polymorphism and dietary indices (DQI-I and HEI) affects cardiovascular risk factors among obese individuals
Authors: Mahmoudinezhad Mahsa , Khosravaniardakani Sheida , Saljoughi Badelou Leila , Fayyazishishavan Ehsan , Kahroba Houman , Farhangi Mahdieh Abbasalizad 
Published: February 2023

Abstract
Background
Recent studies have shown that dietary intakes and gene variants have a critical role in the obesity related comorbidities. This study aimed to evaluate the effects of the interactions between Fatty acid desaturase 2 (FADS2) gene rs174583 polymorphism and two dietary indices on cardiometabolic risk factors.

Methods
This cross-sectional study was carried out on 347 obese adults aged 20-50 years old in Tabriz, Iran. Healthy eating index (HEI) and Diet quality index-international (DQI-I) were evaluated by a validated semi-quantitative 147-item Food frequency questionnaire (FFQ). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine FADS2 gene variants. Multivariate analysis of covariance (MANCOVA) was used to identify gene-diet interactions on metabolic parameters.

Results
Waist circumference (WC) and serum triglyceride (TG) levels were significantly higher among carriers of TT genotype of FADS2 gene (P < 0.05). In addition, the interactions between FADS2 gene rs174583 polymorphism and DQI-I had significant effects on weight (P interaction = 0.01), fat mass (P interaction = 0.04), fat free mass (P interaction = 0.03), and Body mass index (BMI) (P interaction = 0.02); the highest level of these parameters belonged to TT carriers. Similarly, the interactions between FADS2 gene variants and HEI had significant effects on insulin (P interaction < 0.001), Homeostasis model assessment of insulin resistance (HOMA-IR) (P interaction < 0.001), Quantitative insulin check index (QUICKI) (P interaction = 0.001), and alpha Melanocyte stimulating hormone (α-MSH) (P interaction = 0.03).

Conclusion
In this study, for the first time, we reported the effects of gene-diet interactions on metabolic traits. Compliance with dietary indices (DQI-I and HEI) ameliorated the adverse effects of gene variants on metabolic risk factors, especially in heterogeneous genotypes. Further prospective cohort studies are needed to confirm these results.
Cytotoxicity of the methanol extracts and compounds of Brucea antidysenterica (Simaroubaceae) towards multifactorial drug-resistant human cancer cell lines
Authors: Youmbi Laetitia M. , Makong Yves S. D. , Mbaveng Armelle T. , Tankeo Simplice B. , Fotso Ghislain W. , Ndjakou Bruno L. , Wansi Jean D. , Beng Veronique P. , Sewald Norbert , Ngadjui Bonaventure T. , Efferth Thomas , Kuete Victor 
Published: February 2023

Abstract
Background
Cancer remains a global health concern and constitutes an important barrier to increasing life expectancy. Malignant cells rapidly develop drug resistance leading to many clinical therapeutic failures. The importance of medicinal plants as an alternative to classical drug discovery to fight cancer is well known. Brucea antidysenterica is an African medicinal plant traditionally used to treat cancer, dysentery, malaria, diarrhea, stomach aches, helminthic infections, fever, and asthma. The present work was designed to identify the cytotoxic constituents of Brucea antidysenterica on a broad range of cancer cell lines and to demonstrate the mode of induction of apoptosis of the most active samples.

Methods
Seven phytochemicals were isolated from the leaves (BAL) and stem (BAS) extract of Brucea antidysenterica by column chromatography and structurally elucidated using spectroscopic techniques. The antiproliferative effects of the crude extracts and compounds against 9 human cancer cell lines were evaluated by the resazurin reduction assay (RRA). The activity in cell lines was assessed by the Caspase-Glo assay. The cell cycle distribution, apoptosis via propidium iodide (PI) staining, mitochondrial membrane potential (MMP) through 5,5′,6,6′-tetrachloro-1,1′,3,3′-tetraethylbenzimidazolylcarbocyanine iodide (JC-1) staining, and the reactive oxygen species (ROS) via 2´,7´-dichlorodihydrofluoresceine diacetate (H2DCFH-DA) staining, were investigated by flow cytometry.

Results
Phytochemical studies of the botanicals (BAL and BAS) led to the isolation of seven compounds. BAL and its constituents 3, (3-(3-Methyl-1-oxo-2-butenyl))1H indole (1) and hydnocarpin (2), as well as the reference compound, doxorubicin, had antiproliferative activity against 9 cancer cell lines. The IC50 values varied from 17.42 µg/mL (against CCRF-CEM leukemia cells) to 38.70 µg/mL (against HCT116 p53−/− colon adenocarcinoma cells) for BAL, from 19.11 µM (against CCRF-CEM cells) to 47.50 µM (against MDA-MB-231-BCRP adenocarcinoma cells) for compound 1, and from 4.07 µM (against MDA-MB-231-pcDNA cells) to 11.44 µM (against HCT116 p53+/+ cells) for compound 2. Interestingly, hypersensitivity of resistant cancer cells to compound 2 was also observed. BAL and hydnocarpin induced apoptosis in CCRF-CEM cells mediated by caspase activation, the alteration of MMP, and increased ROS levels.

Conclusion
BAL and its constituents, mostly compound 2, are potential antiproliferative products from Brucea antidysenterica. Other studies will be necessary in the perspective of the discovery of new antiproliferative agents to fight against resistance to anticancer drugs.
The CASPER preparation program innovation: increasing self-perceived competence and confidence of underrepresented applicants on the novel CASPER Snapshot and CanMEDS roles
Authors: Mahmood Farhan , Oguntala Julianah O. , Henoud Claudine , Pierre-Louis Libny Lahelle , Fuad Asli , Okafor Ike 
Published: February 2023

Abstract
Background
Underrepresented Minorities in Medicine (URMMs) may face financial and social limitations when matriculating into medical schools. Performance on situational judgment tests such as Computer-based Assessment for Sampling Personal Characteristics (CASPER) can be enhanced by coaching and mentorship. The CASPER Preparation Program (CPP) coaches URMMs to prepare for the CASPER test. During the coronavirus 2019 pandemic (COVID-19), CPP implemented novel curricula on the CASPER Snapshot and CanMEDS roles.

Methods
Pre and post-program questionnaires were completed by the students, which assessed their: 1) confidence in understanding the CanMEDS roles, and 2) perceived confidence in performing well and their familiarity and preparedness with the CASPER Snapshot. With a second post-program questionnaire, participants’ scores on the CASPER test as well as medical school application outcome were also assessed.

Results
Participants reported a significant increase in the URMMs’ knowledge, self-perceived competency to complete the CASPER Snapshot, and their anxiety significantly decreased. The level of confidence in understanding CanMEDS roles for a career in healthcare increased as well. The majority (91%) agreed that the feedback received from tutors was adequate and the virtual component of the program was beneficial during COVID-19. 51% of students scored in the highest quartile on the CASPER test and 35% received an offer of admission from CASPER-requiring medical schools.

Conclusion
Pathway coaching programs have the potential to increase confidence and familiarity amongst URMMs for the CASPER tests and CanMEDS roles. Similar programs should be developed with the aim to increase the chances of URMMs matriculating into medical schools.
Key ethical issues encountered during COVID-19 research: a thematic analysis of perspectives from South African research ethics committees
Authors: Burgess Theresa , Rennie Stuart , Moodley Keymanthri 
Published: February 2023

Abstract
Background
The COVID-19 pandemic presents significant challenges to research ethics committees (RECs) in balancing urgency of review of COVID-19 research with careful consideration of risks and benefits. In the African context, RECs are further challenged by historical mistrust of research and potential impacts on COVID-19 related research participation, as well as the need to facilitate equitable access to effective treatments or vaccines for COVID-19. In South Africa, an absent National Health Research Ethics Council (NHREC) also left RECs without national guidance for a significant duration of the COVID-19 pandemic. We conducted a qualitative descriptive study that explored the perspectives and experiences of RECs regarding the ethical challenges of COVID-19 research in South Africa.

Methods
We conducted in-depth interviews with 21 REC chairpersons or members from seven RECs at large academic health institutions across South Africa that were actively involved in the review of COVID-19 related research from January to April 2021. In-depth interviews were conducted remotely via Zoom. Interviews (60–125 min) were conducted in English using an in-depth interview guide, until data saturation was achieved. Audio-recordings were transcribed verbatim and field notes were converted into data documents. Line-by-line coding of transcripts was performed, and data were organised into themes and sub-themes. An inductive approach to thematic analysis was used to analyse data.

Results
Five main themes were identified, namely: rapidly evolving research ethics landscape, extreme vulnerability of research participants, unique challenges to informed consent, challenges to community engagement during COVID-19, and overlapping research ethics and public health equity issues. Sub-themes were identified for each main theme.

Conclusions
Numerous, significant ethical complexities and challenges were identified by South African REC members in the review of COVID-19 related research. While RECs are resilient and adaptable, reviewer and REC member fatigue were major concerns. The numerous ethical issues identified also highlight the need for research ethics teaching and training, especially in informed consent, as well as the urgent requirement for the development of national guidelines for research ethics during public health emergencies. Further, comparative analysis between different countries is needed to develop the discourse around African RECs and COVID-19 research ethics issues.