bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promoting traditional foods for human and environmental health: lessons from agroecology and Indigenous communities in Ecuador
Authors: Deaconu Ana Laura , Mercille Geneviève , Batal Malek 
Published: August 2020

Abstract
Background: The displacement of traditional dietary practices is associated with negative nutritional consequences for rural Indigenous people, who already face the brunt of both nutritional inadequacies and excesses. Traditional food (TF) consumption and production practices can improve nutritional security by mitigating disruptive dietary transitions, providing nutrients and improving agricultural resilience. Meanwhile, traditional agricultural practices regenerate biodiversity to support healthy ecosystems. In Ecuador, Indigenous people have inserted TF agricultural and dietary practices as central elements of the country’s agroecological farming movement. This study assesses factors that may promote TF practices in rural populations and explores the role of agroecology in strengthening such factors.

Methods: Mixed methods include a cross-sectional comparative survey of dietary, food acquisition, production and socioeconomic characteristics of agroecological farmers (n=61) and neighboring reference farmers (n=30) in Ecuador’s Imbabura province. Instruments include 24-hour dietary recall and a food frequency questionnaire of indicator traditional foods. We triangulate results using eight focus group discussions with farmers’ associations.

Results: Compared to their neighbors, agroecological farmers produce and consume more TFs, and particularly underutilized TFs. Farm production diversity, reliance on non-market foods and agroecology participation act on a pathway in which TF production diversity predicts higher TF consumption diversity and ultimately TF consumption frequency. Age, income, market distance and education are not consistently associated with TF practices. Focus group discussions corroborate survey results and also identify affective (e.g. emotional) and commercial relationships in agroecological spaces as likely drivers of stronger TF practices.

Conclusions: Traditional food practices in the Ecuadorian highlands are not relics of old, poor and isolated populations but rather an established part of life for diverse rural people. However, many TFs are underutilized. Sustainable agriculture initiatives may improve TF practices by integrating TFs into production diversity increases and into consumption of own production. Agroecology may be particularly effective because it is a self-expanding global movement that not only promotes the agricultural practices that are associated with TF production, but also appears to intensify affective sentiments toward TFs and inserts TFs in commercial spaces. Understanding how to promote TFs is necessary in order to scale up their potential to strengthen nutritional health.
Cohort Profile: The Nigerian HIV Geriatric Cohort Study
Authors: Dakum Patrick , Avong Yohanna Kambai , Odutola Michael Kolawole , Okuma James , Kayode Gbenga Ayodele , Nta Iboro Ekpo , Ndembi Nicaise , Mensah Charles , Khamofu Hadiza , Okonkwo Prosper , Okpanachi John Oko , Ezeanolue Echezona 
Published: August 2020

Abstract
Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup to learn how elderly people living with HIV (EPLHIV) in Nigeria fare, despite not being prioritized by the national treatment program, and to deepen knowledge for their differentiated care and achieve better outcomes. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018.Methods: Patient-level data spanning the period 2004 to 2018, obtained from comprehensive HIV treatment hospitals, that are supported by four major PEPFAR-implementing partners in Nigeria were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified treatment records, demographic and clinical data of EPLHIV ≥50-year-old at ART initiation during the review period was extracted, merged into a single REDcap® database, and described using STATA 13.Results: A total of 101,652 unique EPLHIV entries were analysed. This cohort’s data was of 53,608(52.7%) women, 51,037(71.4%) of EPLHIV identified as married and 33,446(51.1%) unemployed. Mean age was 57.1 years (SD=6.9) with average duration on ART as 4.6 years (SD=3.5). ART profile showed that 88,792(95.7%) were on 1st-line and 55,905 (64.9%) were on TDF-based regimens. Mean-body mass index (BMI) was 23.0 kg/m2 (SD=5.4 kg/m2) with 56,010(55.1%), 19,619(19.3%) and 8844(8.7%) showing normal (18.5kg/m2–24.9kg/m2), overweight (BMI 25 -<30kg/m2) and obese (BMI ≥30kg/m2) ranges respectively. Prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 21,550(21.2%). EPLHIV Mean CD4 count was 420cells/μL (SD=285cells/μL) and 83,660(82.3%) had a viral load result showing <1000copies/ml. As for treatment outcomes, available records showed that 54.1% were active-in-treatment, 28.4% were lost-to-follow-up and 6.8% died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths.Conclusions: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.
Assessing and coping with the financial burden of Computed Tomography utilization in Limbe, Cameroon: a sequential explanatory mixed-methods study
Authors: Tambe Joshua , Mbuagbaw Lawrence , Ongolo-Zogo Pierre , Nguefack-Tsague Georges , Edjua Andrew , Mbome-Njie Victor , Minkande Jacqueline Ze 
Published: August 2020

Abstract
Background There has been a significant increase in computed tomography (CT) utilization in the past two decades with the major challenges being a high exposure to ionizing radiation and rising costs. In this study we assess the risk of financial hardship after CT utilization and elaborate on how users adapt and cope in a sub-Saharan context with user fee for services and no national health insurance policy.Methods We carried out a sequential explanatory mixed methods study with a quantitative hospital-based survey of CT users followed by in-depth interviews of some purposively selected participants who reported risk of financial hardship after CT utilization. Data was summarized using frequencies, percentages and 95% confidence intervals. Logistic regression was used in multivariable analysis to determine predictors of risk of financial hardship. Identified themes from in-depth interviews were categorized. Quantitative and qualitative findings were integrated.Results A total of 372 participants were surveyed with a male to female sex ratio of 1:1.2. The mean age (standard deviation) was 52(17) years. CT scans of the head and facial bones accounted for 63% (95%CI: 59% - 68%) and the top three indications were suspected stroke (27% [95%CI: 22% - 32%]), trauma (14% [95%CI: 10% - 18%]) and persistent headaches (14% [95%CI: 10% - 18%]). Seventy-two percent (95%CI: 67% - 76%) of the respondents reported being at risk of financial hardship after CT utilization and predictors in the multivariable analysis were a low socioeconomic status (aOR: 0.19 [95%CI: 0.10 - 0.38]; p<0.001), being unemployed or retired (aOR: 11.75 [95%CI: 2.59 – 53.18]; p=0.001) and not having any form of health insurance (aOR: 3.59 [95%CI: 1.31 - 9.85]; p=0.013). Coping strategies included getting financial support from family and friends, borrowing money and obtaining discounts from the hospital administration and staff.Conclusion No health insurance, being unemployed or retired and a low socioeconomic status are associated to risk of financial hardship after CT utilization. Diverse coping strategies are utilized to lessen the financial burden, some with negative consequences. Minimizing out-of-pocket payments for CT and/or the direct cost can reduce this financial burden and improve access to CT.
Directional preference of otolith-related neurons in vestibular nucleus
Authors: Nguyen Nguyen , Kim Kyu-Sung , Kim Gyutae 
Published: August 2020

Abstract
Background: Due to the paired structure of two labyrinths, their neural communication is conducted through the interconnected commissural pathway. Using the tight link, the neural responding characteristics are formed in vestibular nucleus, and these responses are initially generated by the mechanical movement of the hair cells in the semicircular canals and otoliths. Although the mechanism to describe the neuronal responses to the head movements was evident, few direct experimental data were provided, especially the directional preference of otolith-related neurons as one of critical responses to elucidate the function of the neurons in vestibular nucleus (VN). Experimental Approach: The directional preference of otolith-related neurons was investigated in VN. Also, a chemically induced unilateral labyrinthectomy (UL) was performed to identify the origin of the directional preference. For the model evaluation, static and dynamic behavioral tests were performed. Following the evaluation, an extracellular neural activity was recorded for the neuronal responses to the horizontal head rotation and the linear head translation. Results: Seventy seven neuronal activities were recorded from thirty SD rats (270-450 g, male), and total population was divided into three groups; left UL (20), sham (35), right UL (22). Based on the directional preference, two sub-groups were again classified as contra- and ipsi-preferred neurons. There was no significance in the number of those sub-groups (contra-: 15/35, 43%; ipsi-: 20/35, 57%) in the sham (p=0.155). However, more ipsi-preferred neurons (19/22, 86%) were observed after right UL (p=6.056×10-5) while left UL caused more contra-preferred neurons (13/20, 65%) (p=0.058). In particular, the convergent neurons mainly led this biased difference in the population (ipsi-: 100% after right UL & contra-: 89% after left UL) (p<0.002). Conclusion: The directional preference was evenly maintained under a normal vestibular function, and its unilateral loss biased the directional preference of the neurons, depending on the side of lesion. Moreover, the dominance of the directional preference was mainly led by the convergent neurons which had the neural information related with head rotation and linear translation.
The injury mechanisms and injury pyramids among children and adolescents in Zhuhai City, China
Authors: Yin Xiling , Dai Wencan , Du Yukai , Li Deyun 
Published: August 2020

Abstract
Background: The unclear mechanisms and severity of injuries in the injury pyramids for Chinese children and adolescents prevent the prioritization of interventions. This study aimed to describe the injury mechanisms and injury pyramids in this population to provide a priority for injury prevention strategies. Methods: Death, hospitalization, and outpatient/emergency department visit data from patients aged 0~17 years with injuries were obtained from January 1, 2013, to December 31, 2017, in Zhuhai City, China. The injury mechanism ratios were calculated, and the injury pyramid ratios were drawn in proportion using injury mortality and the incidence of both injury hospitalizations and outpatient/emergency department injury visits. Results: The top three mechanisms for injuries in children and adolescents treated in outpatient/emergency departments were falls (52.02%), animal bites (14.57%), and blunt injuries (10.60%). The top three mechanisms for injury hospitalizations were falls (37.33%), road traffic injuries (17.87%), and fire/burns (14.29%), while the top three mechanisms for injury deaths were drowning (32.91%), road traffic injuries (20.25%) and falls (13.92%). The incidence rate of outpatient/emergency department injury visits for children and adolescents was 11,210.87/100,000; the incidence rate of injury hospitalization was 627.09/100,000, and the injury death rate was 10.70/100,000. For each injury death, there were 59 injury hospitalizations and 1,047 outpatient/emergency injury visits. Conclusions: The injury mechanisms were different for injury-related outpatient/emergency department visits, hospitalizations, and deaths among children and adolescents. The injury mechanisms by sex at different stages of child development, and interventions should be formulated based on this finding. The ratios of the injury pyramids varied by age, sex, region, and injury mechanisms; minor nonfatal injuries were more common in children and adolescents. The differences in the severity and extent of the injuries suggested that injury interventions in children and adolescents still have a long way to go.
The enhancing antibiofilm activity of curcumin on Streptococcus mutans strains from severe early childhood caries
Authors: Li Bingchun , Pan Ting , Lin Huancai , Zhou Yan 
Published: August 2020

Abstract
Background

Streptococcus mutans ( S. mutans ) is one of the main cariogenic bacteria for caries. It was found that the clinical strains of S. mutans isolated from caries active population have stronger cariogenic ability than the isolates from caries-free (CF) people. Previous studies have found that curcumin can inhibit biofilm formation of S. mutans UA159. The objective of this study is to explore the antibiofilm effect of curcumin on the clinical isolates of S. mutans from severe early childhood caries(SECC).

Results

The isolates from SECC group had more biomass than CF group (t=4.296, P<0.001). The acidogenicity and aciduricity of the strains from two groups showed no significant difference. After treatment with curcumin, the viability of biofilm was reduced to 61.865%±7.108% in SECC and to 84.059%±10.227% in CF group at 24 h (P<0.05). The net reduction of live bacteria and total bacteria in the SECC group was significantly higher than that of the CF group (live bacteria t=3.305, P=0.016; total bacteria t=2.378, P=0.045) at 5min. For 24h, the net reduction of live bacteria and total bacteria in the SECC group was significantly higher than that of the CF group (live bacteria t=3.305, P=0.016; total bacteria t=2.378, P=0.045). The reduction of biofilm thickness reduced significantly in 5min (t = 4.110, P = 0.015) and in 24h (t=3.453, P =0.014). Long-term (24h) curcumin treatment inhibited the amount of EPS in SECC group from (25.980±1.156) μm 3 /μm 2 to (20.136±1.042) μm 3 /μm 2 , the difference was statistically significant (t=7.510, P<0.001). The gene of gtfC, gtfD, ftf, gbpB, fruA and srtA in the CF group and the gtfB, gtfC, gtfD, ftf, gbpB, srtA in SECC group were respectively reduced after 5min curcumin treatment. After 24h treatment, the gtfB, gtfC, gtfD, ftf, gbpB, fruA and srtA in both two groups were downregulation, all the differences were statistically significant.

Conclusions

Curcumin has antibiofilm activity on clinical strains of S. mutans , especially for those isolated from SECC.
Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support
Authors: Fernemark Hanna , Skagerstrom Janna , Seing Ida , Ericsson Carin , Nilsen Per 
Published: August 2020

Abstract
Background Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.
“Tele-Urology”: Is the COVID-19 Pandemic a Wake-up Call?
Authors: Almannie Raed , Almuhaideb Mana , Alzahrani Meshari , Binsaleh Saleh , Alyami Fahad 
Published: August 2020

Abstract
Background: The purpose of this research is to measure the current use of telemedicine technologies among urologists, their readiness to adopt the same, and to assess the barriers preventing such usage. Methods: 228 board-certified urologists completed our self-designed survey. An analysis was done to assess the increase in the use of telemedicine and the urologists’ telemedicine experience responses. Data analysis was done using SPSS software.Results: There has been a tremendous increase in the use of telemedicine among urologists during the coronavirus disease (COVID-19) pandemic. Most of the respondents of this study performed general urology as part of their daily practice (59.6%). Prior to the pandemic, 53.9% of the participants had never used any means of telemedicine. However, during the pandemic, 72.4% of urologists who had never used telemedicine began using the same. Almost all of the respondents agreed that physical examination is difficult when using telemedicine, which resulted in the highest mean value among the questionnaire items. Urologists below 35 years old agreed, to a larger extent, that telemedicine saves them more time and is simple to use than urologists from other age groups.Conclusion: During the COVID-19 pandemic, most urologists adopted telemedicine technology rapidly. Adopting telemedicine in the future could have several benefits. However, the limitations of telemedicine should be respected in order to avoid compromising patient safety.
Psychometric Properties of the Chinese Version of the Personality Inventory for DSM-5 Brief Form in Undergraduate Students and Clinical Patients
Authors: Zhang Panwen , Ouyang Zirong , Fang Shulin , He Jiayue , Fan Lejia , Luo Xingwei , Zhang Jianghua , Xiong Yan , Luo Fusheng , Wang Xiaosheng , Yao Shuqiao , Wang Xiang 
Published: August 2020

Abstract
Background: The Personality Inventory for DSM-5 Brief Form (PID-5-BF) is a 25-item measuring tool evaluating maladaptive personality traits for diagnosis of personality disorders(PDs). As a promising scale, its impressive psychometric properties has been verified in some countries, however, there has no studies about the utility of PID-5-BF in Chinese settings. The current study aimed to examine cultural applicability of the Chinese version of PID-5-BF among undergraduate students and clinical patients.Methods: 7155 undergraduate students and 302 clinical patients completed the Chinese version of PID-5-BF. 228 students were chosen randomly for test-retest reliability at a 4-week interval. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to discover the most suitable construct in Chinese, measurement invariance(MI), internal consistency and external validity were also calculated. Results: An exploratory six-factor model was supported more suitable in both samples(Undergraduate sample: CFI = 0.905, TLI = 0.888, RMSEA = 0.044, SRMR = 0.039; Clinical sample: CFI = 0.904, TLI = 0.886, RMSEA = 0.044, SRMR = 0.063), adding a new factor“Interpersonal Relationships”. Measurement invariance across non-clinical and clinical sample was established(configural, weak, strong MI, and partial strict MI). Aside from acceptable internal consistency(Undergraduate sample: alpha=0.84, MIC=0.21; Clinical sample: alpha=0.82, MIC=0.16) and test-retest reliability(0.73), the association with 220-item PID-5 was significant(r = 0.93, p < 0.01), and six PDs measured by Personality diagnostic questionnaire-4+ (PDQ-4+) was correlated with expected domains of PID-5-BF. Conclusions: The Chinese version of the PID-5-BF showed satisfactory psychometric properties, which is a convenient and useful screening tool for personality disorders.
Clinical features of patients with hepatic portal venous gas
Authors: Fujii Manato , Yamashita Suguru , Tanaka Mayuko , Tashiro Jo , Takenaka Yoshiharu , Yamasaki Kazuki , Masaki Yukiyoshi 
Published: August 2020

Abstract
Background: Hepatic portal venous gas (HPVG) is a rare clinical condition that is caused by a variety of underlying diseases. However, the factors that would permit accurate identification of bowel ischemia, requiring surgery, in patients with HPVG have not been fully investigated.Methods: Thirty patients that had been diagnosed with HPVG using computed tomography between 2010 and 2019 were allocated to two groups on the basis of clinical and intraoperative findings: those with (Group 1; n = 12 [40%]) and without (Group 2; n = 18 [60%]) bowel ischemia. Eleven patients underwent emergency surgery, and bowel ischemia was identified in eight of these (73%). Four patients in Group 1 were diagnosed with bowel ischemia, but treated palliatively because of their general condition. We compared the characteristics and outcomes of Groups 1 and 2 and identified possible prognostic factors for bowel ischemia.Results: At admission, patients in Group 1 more commonly showed the peritoneal irritation sign, had lower base excess, higher lactate, and higher C-reactive protein, and more frequently had comorbid intestinal pneumatosis. Of the eight bowel ischemia surgery patients, four (50%) died, mainly because of anastomotic leak following bowel resection and primary anastomosis (3/4, 75%). All except one patient in Group 2, who presented with aspiration pneumonia, responded better to treatment.Conclusions: Earlier identification and grading of bowel ischemia according to the findings at admission should benefit patients with HPVG by reducing the incidence of unnecessary surgery and increasing the use of safer procedures, such as prophylactic stoma placement.