bluuebunny/crossref_metadata_2025_split huggingface dataset:
High prevalence of lack of knowledge and unhealthy lifestyle practices among Saudi population toward Premature Coronary Artery Disease and its risk factors
Authors: Al-khlaiwi Thamir , Alshammari Hessah , Habib Syed Shahid , Alobaid Razan , Alrumaih Lama , Almojel Alaa , Sendi Faye , Almuqbil Shahad , Alkhodair Majdoly 
Published: January 2023

Abstract
Objective
Literature regarding coronary artery disease and awareness of its risk factors is available in Saudi Arabia. However, it is lacking with respect to premature coronary artery disease (PCAD). Therefore, it is of high value to evaluate the lack of knowledge of this underrepresented critical issue and to devise a well-constructed strategy for PCAD. This study aimed to assess the knowledge of PCAD and its risk factors in Saudi Arabia.
Methods
A cross-sectional questionnaire-based study was performed in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia between July 01, 2022, and October 25, 2022. A validated proforma was sent to the Saudi population. The sample size was 1046 participants.
Results
Showed that 46.1% (n = 484) of participants believe that coronary artery disease can occur in people who are under the age of 45, whereas 18.6% (n = 196) do not believe, and 34.8% (n = 366) do not know. There was a highly statistically significant association present between gender and the belief that coronary artery disease can affect people who are under the age of 45, with a p-value < 0.001, with 355 (73.3%) females believing that coronary artery disease can affect people below the age of 45, compared to 129 (26.7%) males. It also showed a highly statistically significant relationship between educational status and the belief that coronary artery disease can affect people who are under the age of 45 (bachelor's degree, 392 participants, representing 81.1% with a p-value of < 0.001). Furthermore, employed participants revealed a notable positive association, with a p-value of 0.049. In addition, health specialty participants appeared to have a positive association, with a p-value less than < 0.001. In addition, it showed that 62.3% (n = 655) are not aware of their lipid profile, 49.1% (n = 516) prefer using vehicles to get to nearby places, 70.1% (n = 737) do not undergo regular medical checkups, 36.3% (n = 382) take medications without consultations, 55.9% (n = 588) do not exercise weekly, E-cigarette smokers 69.5% (n = 112), and astonishingly 77.5% (n = 810) consume fast food weekly.
Conclusions
Saudi Arabia has an evident lack of public knowledge and poor lifestyle practices regarding premature coronary artery disease (PCAD), which demonstrates the need for health authorities to take a more targeted and attentive approach toward PCAD awareness. In addition, extensive media involvement is required to highlight the severity and the risk factors of PCAD to the population.
Divergence in functional traits in seven species of neotropical palms of different forest strata
Authors: Avalos Gerardo , Cambronero Milena , Alvarez-Vergnani Carolina 
Published: January 2023

Abstract
Functional traits are morphological and physiological characteristics that determine growth, reproduction, and survival strategies. The leaf economics spectrum proposes two opposing life history strategies: species with an "acquisitive" strategy grow fast and exploit high-resource environments, while species with a "conservative" strategy emphasize survival and slow growth under low resource conditions. We analyzed interspecific variation in nine functional traits related to biomass allocation and tissue quality in seven Neotropical palm species from three forest strata (understory, subcanopy, and canopy). We expected that the level of resources of a stratum that a species typically exploits would determine the dominance of either the exploitative or conservative strategy, as well as the similarity in functional traits between species. If this is correct, then canopy and subcanopy species will show an acquisitive strategy emphasizing traits targeting a larger size, whereas understory species will show a conservative strategy with traits promoting efficient biomass allocation. Two principal components (57.22% of the variation) separated palm species into: a) canopy and subcanopy species whose traits were congruent with the acquisitive strategy and that emphasized large size (i.e., height, carbon content, and leaf area), and b) understory species whose traits were associated with efficient biomass allocation (i.e., dmf and tissue density). Since palms are one of the most abundant life forms in tropical forests, exploring the variation in functional traits within this group could significantly improve our understanding of plant adaptation to environmental gradients.
Application of Fibula/Iliac Flap Surgical Techniques to Mandibular Defects
Authors: Gao Ning , Fu Kun , Cai Jinghua , He Wei 
Published: January 2023

Abstract
This study group consists of a total of 61 patients who underwent fibula flap and iliac flap surgeries to repair mandibular defects. The EORTC-QLQ-H&N and OHIP-14 have been adopted to investigate and compare the difference of patients’ QOL at 6 and 24 months after surgery. SPSS 20.0 statistical software was used to conduct statistical analysis on the base data of the two groups of patients. Independent sample t test was conducted for EORTC-QLQ-H&N and OHIP-14 scores at two time points in each group.The 61 cases of free flap all survived, with statistically significant difference in the location of the primary tumor between the two groups. The EORTC-QLQ-H&N showed that speech, diet, social contact, and teeth scored higher at 6 months after surgery, but decreased significantly at 24 months after surgery. The OHIP-14 showed that the functional limitation reduced significantly at 24 months after surgery, with statistical significance (p < 0.05) between the groups of iliac flap (19.16 ± 5.33) and fibula flap (33.77 ± 7.71). It is therefore recommended that patients with mandibular defects receive surgery utilizing the iliac flap, while those suffering from a larger range of defects or lesions involving the condyle and chin should receive corrective surgery utilizing the fibular flap.
Scheduling optimization of wind-thermal interconnected low-carbon power system integrated with hydrogen storage
Authors: Wang Haifeng , Ma Xiaoran , Zhao Xingyu , Wang Weijun 
Published: January 2023

Abstract
To improve the consumption of wind energy and reduce carbon emission, this paper proposes a wind-thermal interconnected low-carbon power system integrated with hydrogen storage. An energy scheduling optimization model aiming at minimizing the daily operation cost of the system is constructed considering environmental operation cost quantification, and Whale Optimization Algorithm is used to optimize multiple variables. Finally, in simulation example, various scenarios are set considering the application way of hydrogen and the scenarios with and without the carbon capture and storage (CCS) are optimized respectively. The horizontal comparison results show that the system with hydrogen production (S2) and the system with hydrogen fuel cell (S3) have higher economic operation cost than that of wind-thermal interconnected power system only (S1), but the environmental cost is reduced. The wind curtailment rate decreases from 11.0% (S1) to 3.8% (S2 and S3) without CCS, and from 9.0% (S1) to 2.1% (S2 and S3) with CCS. The longitudinal comparison shows that the thermal power output is reduced and the wind power consumption is improved with CCS. The total operating cost increases, but the environmental cost decreases significantly. Configuring hydrogen storage system in the wind-thermal interconnected power system can effectively promote the consumption of wind energy and reduce the system operation cost, however, the utilization of CCS is economic unfriendly at present.
Sex hormone receptor expression in children with autism spectrum disorder
Authors: Sun Ruoyu , Guo Pi , Sun Tao , Yu Hong , Liao Yanwei , Xie Jieqi , Zeng Jiaying , Xie Xiaoyun , Huang Saijun 
Published: January 2023

Abstract
Background
Sex hormones, especially estrogen, which binds to estrogen receptor β (ERβ), play a vital role in the pathogenesis of mental disorders such as autism spectrum disorder (ASD). The purpose of this study was to analyze the serum levels of hormone receptors, including ERβ, progesterone receptor (PGR) and androgen receptor (AR), and compare these levels between children with ASD and typically developing (TD) children. We also investigated the relationships of ERβ mRNA levels with ASD core symptoms, sleep, and developmental quotients (DQs) from the Gesell Developmental Schedules (GDS) among children with ASD.
Methods
We compared the mRNA levels of ERβ, AR, and PGR between 56 children with ASD and 37 TD children by using quantitative real-time PCR. Then, a correlation analysis was performed to determine the correlations of ERβ mRNA levels with Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), and Children’s Sleep Habits Questionnaire (CHSQ) scores as well as DQs among ASD children.
Results
We found that serum mRNA levels of ERβ in ASD children were significantly lower than those in the TD group. However, we found no correlations of the ERβ mRNA level with CARS, ABC, and CHSQ scores as well as DQs on each GDS domain among ASD children.
Conclusions
Elevated ERβ mRNA levels in peripheral blood may be related to ASD but this association needs to be validated with a larger sample size.
Comparison of surgical and radio-chemotherapy oncology outcomes for cervical adenocarcinoma FIGO2018 stage Ⅱ B
Authors: Wu Minling , Yin Zhaohong , Chen Biliang , Zhao Weidong , Lin Lihong , Liang Wentong , Wang Li , Sun Linxin , Dai Encheng , Ji Mei , Kang Shan , Hao Min , Wang Wuliang , Wang Shaoguang , Lv Qiubo , Cui Zumei , Chen Chunlin , Liu Ping 
Published: January 2023

Abstract

Objective This study aimed to explore the optimal treatment strategy for International Federation of Gynecology and Obstetrics 2018 stage ⅡB cervical adenocarcinoma patients. Methods cervical adenocarcinoma patients who underwent radical hysterectomy and radical radio-chemotherapy were screened from the clinical diagnosis and treatment for cervical cancer in China database. The 5-year overall survival (OS) and disease-free survival (DFS) were compared using the overall population study and propensity score matching. Results 68 FIGO2018 stage Ⅱ B cervical adenocarcinoma patients were eligible for inclusion. In the overall population study, there was no statistical difference in 5-year OS between the surgery group (n = 41) and the radical radio-chemotherapy group (n = 27), but their DFS was better than that of the radical radio-chemotherapy group (OS: 85.7%vs.62.8%, P = 0.058; DFS: 83.7%vs.59.2%, P = 0.035), the difference was statistically significant. Cox multivariate analysis showed that patients with FIGO2018 stage Ⅱ B cervical adenocarcinoma had worse 5-year OS (HR = 2.036, 95%CI: 0.451–9.21, P = 0.355) and DFS (HR = 1.296, 95%CI: 0.344–5.030, P = 0.708). After 1:1PSM, there were no significant differences in OS and DFS between the surgery group (n = 16) and the radical radio-chemotherapy group (n = 16)(OS: 79.8%vs.92.3%, P = 0.292; DFS: 85.6%vs.68.8%, P = 0.228). Cox multivariate analysis showed that treatment was not an independent risk factor for worse 5-year OS (HR = 0.346, 95%CI: 0.035–3.441, P = 0.365) or DFS (HR = 0.399, 95%CI: 0.075–2.216, P = 0.282). In terms of recurrence after treatment in patients with FIGO2018 stage Ⅱ B cervical adenocarcinoma, the results were consistent before and after matching, and there was no statistical difference between the two groups in terms of recurrence, recurrence time, recurrence site after recurrence. Conclusion For patients with FIGO 2018 stage Ⅱ B cervical adenocarcinoma, radical chemoradiotherapy did not result in better oncology outcome.
Phase II Clinical trial of Sequential Treatment with Systemic Chemotherapy and Intraperitoneal Paclitaxel for Gastric and Gastroesophageal Junction Peritoneal Carcinomatosis - STOPGAP Trial
Authors: Senthil Maheswari , Dayyani Farshid 
Published: January 2023

Abstract
Background: Studies from Asia indicate that normothermic intraperitoneal chemotherapy (NIPEC) may confer survival benefit in patients with gastric peritoneal carcinomatosis (PC). However, data regarding this approach is lacking in western population. The current STOPGAP trial is intended to assess 1-year progression-free survival benefit of sequential systemic chemotherapy and paclitaxel NIPEC in patients with gastric/ gastroesophageal junction (GEJ) adenocarcinoma PC.
Methods:This is a prospective, single center, single arm, phase II investigator-initiated clinical trial. Patients with histologically proven gastric/GEJ (Siewert 3) adenocarcinoma with positive peritoneal cytology or PC will be eligible to participate after three months of standard of care systemic chemotherapy and with no evidence of visceral metastasis on restaging scans. The primary treatment is iterative paclitaxel NIPEC with systemic paclitaxel and 5-fluorouracil, which will be administered on days1 and 8 and repeated every three weeks for 4 cycles. Patients will undergo diagnostic laparoscopy both before and after NIPEC to assess peritoneal cancer index (PCI). Patients with PCI less than or equal to 10 in whom complete cytoreduction (CRS) is feasible may opt to undergo CRS with heated intraperitoneal chemotherapy (HIPEC). The primary endpoint is 1-year progression free survival and secondary endpoints are overall survival and patient reported quality of life outcomes measured by EuroQol- 5 dimensions-5 level (EuroQol-5D-5L) questionnaire.
Discussion:If the sequential approach of systemic chemotherapy followed by paclitaxel NIPEC proves beneficial, then this approach could be used in larger, muti-institutional randomized clinical trial of gastric PC.
Trial Registration: The trial was registered on 21/02/2021, under clinical trials.gov; Identifier: NCT04762953
Acetylcysteine and budesonide for the treatment of refractory Mycoplasma pneumoniae pneumonia in children: a clinical observation
Authors: Wang Yanli , Liu Kai , Chen Chuangui , Zhang Chengyun 
Published: January 2023

Abstract
Background To examine the clinical impact of bronchoscope alveolar lavage (BAL) combination with budesonide, ambroxol + budesonide, or acetylcysteine + budesonide in the treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP).
Methods Eighty-two RMPP patients admitted to Pediatrics at The First People's Hospital of Zhengzhou were retrospectively evaluated between August 2016 and August 2019. All patients were administered BAL in addition to intravenous Azithromycin, expectoration, and nebulizer inhalation. The medications added to the BLA separated the patients into the Budesonide group, Ambroxol+budesonide group, and acetylcysteine+budesonide group. Analyzed were the variations in laboratory examination indices, improvement in lung imaging, overall effective rate, and adverse responses in the three groups.
Results The laboratory test indices of patients in all three groups improved significantly relative to pre-treatment levels, and the results were statistically significant. After therapy, there were no significant differences between the three groups in terms of white blood cell (WBC), C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR). Serum lactate dehydrogenase (LDH) and serum ferritin (SF) varied significantly across the three groups (P0.05). In the acetylcysteine + budesonide group, the absorption rate of lung imaging lesions and clinical efficacy were superior to those of the other two groups. There were no significant differences between the three groups in the occurrence of adverse events (P>0.05).
Conclusions BLA-coupled acetylcysteine+ budesonide was superior to the other two groups in enhancing the effectiveness of RMPP in children, which might increase lung opacity absorption and minimize lung inflammation.
Prevalence of Lower Back Pain and its Associations with Lifestyle Behaviors among College Students in Saudi Arabia
Authors: Alshehri Mohammed M , Alqhtani Amjad M , Gharawi Shahd H , Sharahily Raghad A , Fathi Wajd A , Alnamy Shahad G , Alothman Shaima A , Alshehri Yasir S. , Alhowimel Ahmed S. , Alqahtani Bader A. , Alenazi Aqeel M. 
Published: January 2023

Abstract
Research question

Lower back pain (LBP) is a common musculoskeletal disorder that may affect the daily living of students. Recent psychological research showed a relevant connection between LBP and multidimensional health. However, the association between LBP and lifestyle behavior was not established yet in which improving the knowledge in this area of research may help in establishing preventive strategies and optimizing the quality of life of college students.

Methods

A cross-sectional study of 1420 college students in Saudi Arabia was conducted and recruited from May 2021 to November 2021. An established online survey was utilized to assess LBP, sleep quality, sedentary duration, health responsibility, physical activity, nutrition, spiritual growth, interpersonal relationships, and stress management.

Results

LBP was prevalent among college students from Saudi Arabia. There were significant differences between students with and without LBP in age, BMI, sex, marital status, pain severity, overall lifestyle behavior, health responsibility, physical activity, nutrition, stress management, and global sleep quality. After controlling for Age, BMI, sex, and marital status, there were significant associations between pain severity and global sleep quality (ß=.2, p < .001), and sedentary duration (ß=.03, p = .01)

Conclusions

The study helped in defining the prevalence of LBP in college students in Saudi Arabia, and evaluating the association between LBP and lifestyle behaviors. Promoting sleep quality and sedentary behavior may help in establishing preventive strategies of LBP for college students.
Moderate-intensity Aerobic Exercise Training as an Adjunct to Trauma-focused Psychotherapy in Traumatized Refugees and Asylum Seekers: Study Protocol of a Randomized Controlled Trial
Authors: Lüder Charina C. , Michael Tanja , Lass-Hennemann Johanna , Schanz Christian G. , Venhorst Andreas , Meyer Tim , Equit Monika 
Published: January 2023

Abstract
Background
Refugees with exposure to multiple traumatic events are at high risk for developing trauma-related mental disorders, including Posttraumatic Stress Disorder (PTSD) and depression. Narrative Exposure Therapy (NET) is an effective treatment for the core symptoms of PTSD, but many studies did not find that it significantly reduces depressive symptoms. Endurance exercise on the other hand was consistently found to be effective in treating symptoms of depression, thereby making it a promising adjunct to NET. Up to date, no studies exist investigating the combination of NET and endurance exercise in a sample of refugees with PTSD and relevant comorbid depressive symptoms.
Methods/ Design
In the proposed Randomized Controlled Trial (RCT) we aim to investigate whether a combination of NET and Moderate-intensity Aerobic Exercise Training (MAET) enhances treatment outcome for refugees with PTSD and comorbid depressive symptoms. Therefore, we hypothesized a greater improvement in psychopathology in participants who receive the combined treatment.
According to power calculation assuming a moderate adjuvant effect, 68 refugees and asylum seekers with a confirmed PTSD diagnosis and clinically relevant depressive symptoms will be recruited in the proposed study. Participants will be randomly assigned to receive either NET only (NET-group; n = 34) or NET plus MAET (NET+-group; n = 34). All participants will receive ten NET sessions (100 minutes each). Participants in the NET+-group will additionally take part in MAET (running exercises à 45min three times weekly). Primary (PTSD, depression) and secondary (general mental distress, sleep quality, agoraphobia) outcome measures will be assessed before treatment, directly after treatment, and at six-month follow-up. The hypotheses are planned to be tested with multiple 2x3 mixed ANOVA’s.
Discussion
The proposed study will be the first RCT assessing whether NET, which is currently the first-line treatment for PTSD in refugees, can be enhanced by endurance exercise. If the results will be in line with the hypotheses, the psychotherapeutic care of traumatized refugees with PTSD and comorbid depressive symptoms could be improved. Potential challenges include participant recruitment and retention.
Trial registration: The present clinical trial is pre-registered in German Clinical Trials Register (DRKS) on 29 July 2020; DRKS ID: DRKS00022145).
A randomised controlled trial of clinical and cost-effectiveness of the PASS Plus intervention for young children with autism spectrum disorder in New Delhi, India: Study protocol for the COMPASS trial.
Authors: Roy Reetabrata , Leadbitter Kathy , Shields Gemma , Taylor Carol , Aldred Catherine , Juneja Monica , Gulati Sheffali , Vajaratkar Vivek , Davies Linda , Emsley Richard , Patel Vikram , Divan Gauri , Green Jonathan , Team COMPASS 
Published: January 2023

Abstract
Background: Autism Spectrum Disorders (ASD) is a neurodevelopmental disability affecting at least 5 million children in South Asia. Majority of these children are without access to evidence-based care. The UK Pre-school Autism Communication Therapy (PACT) is the only intervention to have shown sustained impact on autism symptoms. It was systematically adapted for non-specialist community delivery in South Asia; as the 'Parent-mediated Autism Social Communication Intervention for non-Specialists (PASS) and extended ‘PASS Plus’ interventions. RCTs of both showed feasibility, acceptability and positive effect on parent and child dyadic outcomes.
Methods: The Communication-centred Parent-mediated treatment for Autism Spectrum Disorder in South Asia (COMPASS) trial is now a scale-up two centre, two arm single (rater) blinded random allocation parallel group study of the PASS Plus intervention in addition to treatment as usual (TAU) compared to TAU alone, plus health economic evaluation – embedded in the India health system. 240 children (approximately 120 intervention/120 TAU) with ASD aged 2-9 years will be recruited from two tertiary care government hospitals in New Delhi, India. Accredited Social Health Activists will be one of the intervention delivery agents. Families will undertake up to 12 communication sessions over 8 months and will be offered the Plus modules which address coexisting problems. The trial’s primary endpoint is at 9 months from randomization, with follow-up at 15 months. The primary outcome is autism symptom severity; secondary outcomes include parent-child communication, child adaptation, quality of life and parental wellbeing. Primary analysis will follow intention-to-treat principles using linear mixed model regressions with group allocation and repeated measures as random effects. The primary cost-effectiveness analysis will use a societal perspective over the 15-month period of intervention and follow-up.
Discussion: If clinically and cost effective, this programme will fill an important gap of scalable interventions delivered by non specialist health workers within the current care pathways for autistic children and their families in low resource contexts. The programme has been implemented through the COVID-19 pandemic when restrictions were in place; intervention delivery and evaluation processes have been adapted to address these conditions.
Trial Registration: ISRCTN; ISRCTN21454676; Registered 22 June 2018; https://www.isrctn.com/ISRCTN21454676?q=21454676;