bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alterations of Gut Microbiota and the Brain-Immune-Intestine Axis in Patients With Relapsing-Remitting Multiple Sclerosis After Treatment With Oral Cladribine: Protocol for a Prospective Observational Study
Authors: van Pamelen Jeske , van Olst Lynn , Budding Andries E ,   BIA Study Group, de Vries Helga E , Visser Leo H 
Published: July 2020

Background
Immunological factors are the key to the pathogenesis of multiple sclerosis (MS). Conjointly, environmental factors are known to affect MS disease onset and progression. Several studies have found that the intestinal microbiota in MS patients differs from that of control subjects. One study found a trend toward lower species richness in patients with active disease versus in patients in remission. The microbiota plays an important role in shaping the immune system. Recent studies suggest the presence of an association between the gut microbiota and inflammatory pathways in the central nervous system. However, the function of this brain-immune-intestine axis and its possible value for predicting treatment effect in MS patients is currently unknown.

Objective
Our goal is to examine if the changes in gut and oral microbiota and simultaneous changes in the immune response are a predictor for the treatment response in subjects with active relapsing-remitting MS (RRMS) who are being treated with oral cladribine.

Methods
This is a prospective, observational, multicenter study. Eligible subjects are patients with RRMS, between the ages of 18 and 55 years, who will start treatment with oral cladribine. Patients who used probiotics 1 month prior to the start of oral cladribine will be excluded. At baseline (ie, before start) and after 3, 12, and 24 months, the Expanded Disability Status Scale (EDSS) score will be assessed and fecal, oral, and blood samples will be collected. Also, subjects will be asked to register their food intake for 7 consecutive days following the visits. After 24 months, a magnetic resonance imaging (MRI) assessment of the brain will be performed. Responders are defined as subjects without relapses, without progression on the EDSS, and without radiological progression on MRI.

Results
Inclusion started in January 2019. A total of 30 patients are included at the moment. The aim is to include 80 patients from 10 participating centers during a period of approximately 24 months. Final results are expected in 2024.

Conclusions
The results of the BIA Study will contribute to precision medicine in patients with RRMS and will contribute to a better understanding of the brain-immune-intestine axis.

International Registered Report Identifier (IRRID)
DERR1-10.2196/16162
Artificial Intelligence–Powered Digital Health Platform and Wearable Devices Improve Outcomes for Older Adults in Assisted Living Communities: Pilot Intervention Study
Authors: Wilmink Gerald , Dupey Katherine , Alkire Schon , Grote Jeffrey , Zobel Gregory , Fillit Howard M , Movva Satish 
Published: July 2020

Background
Wearables and artificial intelligence (AI)–powered digital health platforms that utilize machine learning algorithms can autonomously measure a senior’s change in activity and behavior and may be useful tools for proactive interventions that target modifiable risk factors.

Objective
The goal of this study was to analyze how a wearable device and AI-powered digital health platform could provide improved health outcomes for older adults in assisted living communities.

Methods
Data from 490 residents from six assisted living communities were analyzed retrospectively over 24 months. The intervention group (+CP) consisted of 3 communities that utilized CarePredict (n=256), and the control group (–CP) consisted of 3 communities (n=234) that did not utilize CarePredict. The following outcomes were measured and compared to baseline: hospitalization rate, fall rate, length of stay (LOS), and staff response time.

Results
The residents of the +CP and –CP communities exhibit no statistical difference in age (P=.64), sex (P=.63), and staff service hours per resident (P=.94). The data show that the +CP communities exhibited a 39% lower hospitalization rate (P=.02), a 69% lower fall rate (P=.01), and a 67% greater length of stay (P=.03) than the –CP communities. The staff alert acknowledgment and reach resident times also improved in the +CP communities by 37% (P=.02) and 40% (P=.02), respectively.

Conclusions
The AI-powered digital health platform provides the community staff with actionable information regarding each resident’s activities and behavior, which can be used to identify older adults that are at an increased risk for a health decline. Staff can use this data to intervene much earlier, protecting seniors from conditions that left untreated could result in hospitalization. In summary, the use of wearables and AI-powered digital health platform can contribute to improved health outcomes for seniors in assisted living communities. The accuracy of the system will be further validated in a larger trial.
Asociación del acoso psicológico con el desgaste profesional en médicos residentes de la Ciudad de México
Authors: Tafoya Silvia A. , Jaimes-Medrano Aurora L. , Carrasco-Rojas José Antonio , Mujica Maria Luisa , Rodríguez-Machain Ana C. , Ortiz-León Silvia 
Published: July 2020

Introducción: El acoso psicológico en el entorno médico parece ser parte inherente de su entrenamiento, y sus repercusiones entre los residentes han sido desestimadas. Objetivo: Evaluar la asociación del acoso psicológico y el desgaste profesional en médicos residentes de la Ciudad de México. Método: Estudio transversal en el que participaron 251 residentes, 44% hombres y 56% mujeres, con edad promedio de 27.2 (DE ± 3.5) años. La evaluación se realizó siete meses después del inicio del año académico con el Inventario de Burnout de Psicólogos (IBP) adaptado a médicos, el Leymann Inventory of Psychological-Terrorization (LIPT-60) y un cuestionario de datos sociodemográficos. Resultados: El desgaste profesional se explicó en un 23% por las variables de especialidad cursada, año de residencia y frecuencia del acoso psicológico (FEAP) (p < .0001); el género, la intensidad del acoso (IMAP) y el índice global de acoso (IGAP) no fueron significativos dentro de este modelo. Conclusiones: La presencia de acoso tiene consecuencias en la salud mental (cansancio emocional), desempeño (falta de realización personal) de quien lo recibe, así como implicaciones en la relación médico-paciente (despersonalización). Se observa que la frecuencia con que se realiza el acoso es el principal elemento asociado al incremento de síntomas de desgaste profesional.
Inventarisasi Jenis-Jenis Ikan Genus Pangasius Di Sungai Kampar Kiri Provinsi Riau
Authors: Hermirita Silvia , Elvyra Roza 
Published: July 2020

Data yang tersedia dan informasi yang lengkap mengenai jenis-jenis ikan genus Pangasius di perairan Sungai Kampar Kiri masih sangat kurang, maka perlu dilakukan penelitian tentang inventarisasi jenis-jenis ikan genus Pangasius di perairan Sungai Kampar Kiri. Penelitian ini bertujuan untuk mengidentifikasi jenis-jenis ikan genus Pangasius di perairan Sungai Kampar Kiri, Kabupaten Kampar, Provinsi Riau. Sampel ikan dikumpulkan dari nelayan setempat mulai bulan Desember 2017 sampai Desember 2018. Ikan diidentifikasi di Laboratorium Zoologi Jurusan Biologi Universitas Riau. Ikan genus Pangasius yang ditemukan di Perairan Sungai Kampar Kiri yaitu patin getah (P. nasutus), patin putih (P. hypophthalmus), dan patin keramba (P. pangasius).
Reflexões sobre o ensino da língua escrita em tempos de ampliação da escolarização obrigatória
Authors: Lucas Maria Angélica Olivo Francisco , Saito Heloisa Toshie Irie , Lazaretti Lucinéia Maria 
Published: July 2020

No contexto de progressiva democratização da escolarização obrigatória brasileira, envolvendo a ampliação do ensino fundamental e a reorganização da educação infantil, como justificar a importância da aprendizagem da escrita para o desenvolvimento infantil e orientar a implementação de práticas pedagógicas que abrangem esse tipo de linguagem? Em busca de respostas a essa questão, objetivamos com este artigo refletir sobre o ensino e a aprendizagem da língua escrita no universo da educação infantil, de maneira a abordar os processos de letramento e de alfabetização. Para isso, realizamos um estudo bibliográfico acompanhado de análise documental, cujos resultados são expostos em três partes: apresentamos alguns princípios de duas importantes teorias que explicam o processo de aprendizagem da leitura e da escrita – construtivista e histórico-cultural; conceituamos os processos de alfabetização e de letramento, defendendo-os como indissociáveis e interdependentes; refletimos sobre a implementação intencional de práticas pedagógicas de alfabetização e de letramento na educação infantil, atentas às especificidades das crianças desse nível de ensino a partir da análise de algumas orientações teórico-metodológicas presentes em dois documentos oficiais, um de âmbito estadual e outro de âmbito nacional.
Evaluación de eficiencia del sistema domiciliario para abastecimiento de agua segura, corregimiento San Fernando, Nariño
Authors: Ceballos Freire Alvaro Javier 
Published: July 2020

Contextualización: Las zonas rurales colombianas presentan un déficit en cobertura del servicio de abastecimiento de agua segura o los sistemas de tratamiento ya implementados, no son suficientemente eficientes en la remoción de agentes patógenos.
Vacío de conocimiento: Las aguas que se usan para el consumo no se tratan adecuadamente, sumado a la deficiente cobertura de abastecimiento de la misma, y a pesar de que la población realiza por cuenta propia el tratamiento del agua, no se garantiza que esté en óptimas condiciones para su consumo.
Propósito del estudio: El objetivo de esta investigación fue determinar la eficiencia de remoción de un sistema domiciliario no convencional para el abastecimiento de agua segura en el corregimiento de San Fernando – Municipio de Pasto, Colombia.
Metodología: Se desarrollaron tres fases. La primera fase estableció el diagnóstico de la zona de estudio, el cual contempló un mapa de riesgo, caracterización de la fuente de abastecimiento, caracterización físico-espacial, socioeconómica y cultural, selección de muestra de la población y formulación de indicadores; la segunda fase definió la tecnología a implementar a través del análisis multicriterio y el proceso de análisis jerárquico con seis expertos, donde también se diseñó e implementó la estrategia de transferencia participativa para la higiene y el saneamiento, complementada con los procesos de enseñanza y aprendizaje; la tercera fase determinó la eficiencia del sistema de abastecimiento de agua segura implementado.
Resultados y conclusiones: Por medio de tres seguimientos de toma de muestras y la comparación con las muestras de agua cruda obtenidas en la caracterización, se determinó que el sistema de tratamiento es 99% eficiente en la remoción de turbidez, coliformes totales y coliformes fecales, que garantiza el consumo de agua segura en la población.
Por otro lado, es importante considerar que el éxito de las tecnologías no convencionales está ligado a la transferencia social que se aplique a lo largo de su implementación; la apropiación que la comunidad le dé al sistema, es vital para su sostenibilidad en el tiempo y el seguimiento que se realice al proceso por parte de los líderes sociales de la zona.
Strategic Management Forecasts and Accounting Choices: A Case of Employee Downsizing in Japan
Authors: Fujiyama Keishi , Kuroki Makoto 
Published: July 2020

ABSTRACT
Prior research shows that managers make income-decreasing accounting choices around labor negotiations and predicts that managers disclose bad news during labor negotiations. This study extends the literature by investigating whether disclosure and financial statement reporting practices are consistent during employee downsizing years. Using data from Japanese domestic firms during the period 2002–2016, we find that beginning-of-period management forecasts (i.e., disclosure) are positively associated with during-period negative stock returns for downsizing firms but not for non-downsizing firms. Also, downsizing firms report more conservative earnings at the end of the fiscal year (i.e., financial statement reporting). Our supplementary analyses show no difference in an association between management forecast errors and stock returns between downsizing and non-downsizing firms with during-period negative stock returns, nor in an association between discretionary accruals and employee downsizing. These results suggest that managers strategically inform firms' prospects during employee downsizing years.
JEL Classifications: G34; J51; M41.
Data Availability: Data are available from the public sources cited in the text.
Macroeconomic Uncertainty and Quantitative versus Qualitative Inputs to Analyst Risk Forecasts
Authors: Bochkay Khrystyna , Joos Peter R. 
Published: July 2020

ABSTRACT
Risk forecasting is crucial for informed investment decision-making. Moreover, the salience of investment risk increases during economically uncertain times. In this paper, we study how sell-side analysts form expectations of firm risk, under different macroeconomic conditions (low versus high uncertainty) and by distinguishing between quantitative and qualitative information inputs. We find that analysts jointly consider quantitative and qualitative information, but that their reliance on qualitative information—in particular, disclosure tone—increases when macroeconomic uncertainty is high. We also find that analysts mostly rely on disclosure tone when it contradicts quantitative information. These findings highlight how narrative disclosures can provide context for quantitative information. Finally, we find that analysts' specific use of quantitative/qualitative information improves their forecasts as predictors of firm risk. Together, our results illuminate analysts' risk forecasting process—what information they use and how.
JEL Classifications: G01; G11; G20; G24.
National and State-Level Trends in Nontraumatic Lower-Extremity Amputation Among U.S. Medicare Beneficiaries With Diabetes, 2000–2017
Authors: Harding Jessica L. , Andes Linda J. , Rolka Deborah B. , Imperatore Giuseppina , Gregg Edward W. , Li Yanfeng , Albright Ann 
Published: July 2020

OBJECTIVE
Diabetes is a leading cause of nontraumatic lower-extremity amputation (NLEA) in the U.S. After a period of decline, some national U.S. data have shown that diabetes-related NLEAs have recently increased, particularly among young and middle-aged adults. However, the trend for older adults is less clear.

RESEARCH DESIGN AND METHODS
To examine NLEA trends among older adults with diabetes (≥67 years), we used 100% Medicare claims for beneficiaries enrolled in Parts A and B, also known as fee for service (FFS). NLEA was defined as the highest-level amputation per patient per calendar year. Annual NLEA rates were estimated from 2000 to 2017 and stratified by age-group, sex, race/ethnicity, NLEA level (toe, foot, below-the-knee amputation [BKA], or above-the-knee amputation [AKA]), and state. All rates were age and sex standardized to the 2000 Medicare population. Trends over time were assessed using Joinpoint regression and annual percent change (APC) reported.

RESULTS
NLEA rates (per 1,000 people with diabetes) decreased by half from 8.5 in 2000 to 4.4 in 2009 (APC −7.9, P &lt; 0.001). However, from 2009 onward, NLEA rates increased to 4.8 (APC 1.2, P &lt; 0.01). Trends were similar across most age, sex, and race/ethnic groups, but absolute rates were highest in the oldest age-groups, Blacks, and men. By NLEA type, overall increases were driven by increases in rates of toe and foot NLEAs, while BKA and AKA continued to decline. The majority of U.S. states showed recent increases in NLEA, similar to national estimates.

CONCLUSIONS
This study of the U.S. Medicare FFS population shows that recent increases in diabetes-related NLEAs are also occurring in older populations but at a less severe rate than among younger adults (&lt;65 years) in the general population. Preventive foot care has been shown to reduce rates of NLEA among adults with diabetes, and the findings of the study suggest that those with diabetes—across the age spectrum—could benefit from increased attention to this strategy.
Erythrocyte n-6 Polyunsaturated Fatty Acids, Gut Microbiota, and Incident Type 2 Diabetes: A Prospective Cohort Study
Authors: Miao Zelei , Lin Jie-sheng , Mao Yingying , Chen Geng-dong , Zeng Fang-fang , Dong Hong-li , Jiang Zengliang , Wang Jiali , Xiao Congmei , Shuai Menglei , Gou Wanglong , Fu Yuanqing , Imamura Fumiaki , Chen Yu-ming , Zheng Ju-Sheng 
Published: July 2020

OBJECTIVE
To examine the association of erythrocyte n-6 polyunsaturated fatty acid (PUFA) biomarkers with incident type 2 diabetes and explore the potential role of gut microbiota in the association.

RESEARCH DESIGN AND METHODS
We evaluated 2,731 participants without type 2 diabetes recruited between 2008 and 2013 in the Guangzhou Nutrition and Health Study (Guangzhou, China). Case subjects with type 2 diabetes were identified with clinical and biochemical information collected at follow-up visits. Using stool samples collected during the follow-up in the subset (n = 1,591), 16S rRNA profiling was conducted. Using multivariable-adjusted Poisson or linear regression, we examined associations of erythrocyte n-6 PUFA biomarkers with incident type 2 diabetes and diversity and composition of gut microbiota.

RESULTS
Over 6.2 years of follow-up, 276 case subjects with type 2 diabetes were identified (risk 0.10). Higher levels of erythrocyte γ-linolenic acid (GLA), but not linoleic or arachidonic acid, were associated with higher type 2 diabetes incidence. Comparing the top to the bottom quartile groups of GLA levels, relative risk was 1.72 (95% CI 1.21, 2.44) adjusted for potential confounders. Baseline GLA was inversely associated with gut microbial richness and diversity (α-diversity, both P &lt; 0.05) during follow-up and significantly associated with microbiota β-diversity (P = 0.002). α-Diversity acted as a potential mediator in the association between GLA and type 2 diabetes (P &lt; 0.05). Seven genera (Butyrivibrio, Blautia, Oscillospira, Odoribacter, S24-7 other, Rikenellaceae other, and Clostridiales other) were enriched in quartile 1 of GLA and in participants without type 2 diabetes.

CONCLUSIONS
Relative concentrations of erythrocyte GLA were positively associated with incident type 2 diabetes in a Chinese population and also with gut microbial profiles. These results highlight that gut microbiota may play an important role linking n-6 PUFA metabolism and type 2 diabetes etiology.
Post-Harvest Management Practices among Rice Farmers in Imo State Nigeria
Authors: Adeola Egwuonwu Helen 
Published: July 2020

The study analyzed post-harvest management practices among rice farmers in Imo State, Nigeria. This work was inspired by inadequate availability of rice in the market for the masses which reduces food security, with belief that better management processes will reduce food losses. Random sampling procedure was used in selecting 127 rice farmers and data were collected using structured questionnaire was the main tool for data collection. Data collected were analyzed using descriptive (frequency, percentages and mean) and inferential statistics. Farmers identified delay in harvesting (98.42%), lack of technical knowledge (95.27%), dependency on traditional threshing methods (94.48%), incomplete threshing (91.30%), improper handling operations (81.10%) as one of the various causes of post harvest losses in their rice production and processing in the study area. The post harvest management practices adopted by the farmers were as cutting the rice stalk (98.42%), reaping the panicles (94.48%), laying out the paddy-on-stalk (93.70%), stacking it to dry (92.12%) and stacking it to dry recording (89.76%). The result from the multiple regression analysis showed that age, educational level, membership of cooperative, household size, farming experience, household size, farming experience and access to credit were found to have significantly influenced on the number of post harvests management practiced by farmers. Similarly, the farmers were also able to identify various constraints to post harvest management as lack of awareness of good post harvest practices and technology, inadequate machinery, lack of incentives to store rice It was therefore recommended that extension agents should be encouraged to increase their campaign on post harvest management practices of rice and organize more training on minimization of post harvest losses on rice.
Key words: Rice, post harvest losses, post harvest practices, post harvest management.
Project Design and Sustainability of Dairy Goat Projects for Livelihood Improvement in Kenya
Authors: Kikwatha Reuben Wambua , Kyalo Dorothy Ndunge , Mulwa Angeline Sabina , Nyonje Raphael Ondeko 
Published: July 2020

The debate around sustainability of development projects is intriguing, emerging as a contemporary development paradigm. Nevertheless, empirical literature insinuates that sustainability of development projects is seldom realized. Perhaps because the sustainability drivers are not well articulated at the project design stage making sustainability uncertain. This paper calls for a decisive paradigm shift in dairy goat project designs for sustainability. The paper is based on a study conducted in Tharaka Nithi County, Kenya, to investigate the influence of project design factors on the sustainability of dairy goat projects. Design factors considered for this study are the Project Beneficiary Selection Process, Community Capacity, Institutional Linkages and Project Infrastructure. The study was anchored on the structural-functional theory, diffusion of innovations theory and collective action theory. The sample size was 196 respondents sampled using sequential and stratified random sampling. Purposive sampling was used to sample 13 key informants. Further, six focus group discussions each with 8 participants were conducted. Questionnaires, interview guide and FGD guide were used respectively to collect data. Descriptive statistics were computed for all variables and frequencies, percentages, arithmetic mean and standard deviation. Pearson’s Product Moment Correlation (r), simple regression, multiple regression and stepwise regression (R squared), F-tests were used to test hypotheses. Hypothesis (H0) that the combined project design factors have no significant influence on the sustainability of dairy goat projects was tested. Results; r = 0.389 implying a positive slope between project design and sustainability. R- Squared = 0.152, that 15.2% of the variation in sustainability was explained by variation in project infrastructure, community capacity, project beneficiary selection process, and institutional linkages. ANOVA indicated the model was statistically significant at (F (1,183) = 8.176) and the p-value = 0.000≤0.05, shows that there exists a positive correlation and the slope of the population regression line is not zero. therefore, H0 was rejected. The study concludes that combined project design factors are critical and important in enhancing project sustainability and recommends that dairy goat project design should incorporate authentic project beneficiary selection Process, their capacities developed and the project linked to supportive institutions as well as promoting the requisite infrastructure. The study found a gap in literature on the social economic contribution of dairy goats to the community livelihoods, as a measure of sustainability and recommends further study on this area.