bluuebunny/crossref_metadata_2025_split huggingface dataset:
Micronutrient Status of Palestinian School Children Following Salt and Flour Fortification: A cross-sectional Study
Authors: Massad Salwa George , Gebre-Medhin Mehari , Dary Omar , Abdalla Marwah , Holleran Steve , Karmally Wahida , Bordelois Paula , Khammash Umaiyeh , Deckelbaum Richard J. 
Published: July 2020

Abstract
Background: In 1996 and in 2006, Palestine initiated salt iodization and multiple micronutrient fortification of wheat flour, respectively as a strategy to prevent deficiencies of these nutrients. In 2009, we assessed the impact of these interventions on the health and nutritional status of schoolchildren residing in the West Bank. Methods: We surveyed a sample of 22 schools run by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the Palestinian Government. We randomly selected students from the first (mean age 6.7 years [SD 0.5]), sixth (11.8 years [0.6]), and ninth grades (14.8 years [0.6]). Data were obtained from 1484 (99%) of 1500 students planned for enrollment. Results: Our results suggest that iodine intake appears adequate; there was essentially no iodine deficiency. As to the status of other micronutrients, the main nutritional micronutrient risks for schoolchildren in the West Bank continue to be low serum levels of iron, zinc and vitamin B-12; folate levels were seemingly high. The overall prevalence of anemia was 9.6%, but there were pockets of anemia in certain districts. Almost 42% of the anemia in our sample was explained by iron deficiency. There were significant differences in iron deficiency between girls and boys; 29.5% vs. 15.7%, respectively (p=0.0001). There were no cases of lead toxicity in the studied sample.Conclusions: Wheat flour and salt fortification has had a major influence on improving the micronutrient status of Palestinian children, for some but not all micronutrients. The recommended key blood and biochemical parameters to be incorporated in the surveillance system are iron, zinc, and vitamin B12.
Increasing system-wide implementation of opioid prescribing guidelines in primary care: findings from a non-randomized stepped-wedge quality improvement project.
Authors: Zgierska Aleksandra E , Robinson James M , Lennon Robert P , Smith Paul D , Nisbet Kate , Ales Mary W , Boss Deanne , Tuan Wen-Jan , Vidaver Regina M , Hahn David L 
Published: July 2020

Abstract
Background: Clinician utilization of practice guidelines can reduce inappropriate opioid prescribing and harm in chronic non-cancer pain; yet, implementation of “opioid guidelines” is subpar. We hypothesized that a multi-component quality improvement (QI) augmentation of “routine” system-level implementation efforts would increase clinician adherence to the opioid guideline-driven policy recommendations. Methods: Opioid policy was implemented system-wide in 26 primary care clinics. A convenience sample of 9 clinics received the QI augmentation (one-hour academic detailing; 2 online educational modules; 4-6 monthly one-hour practice facilitation sessions) in this non-randomized stepped-wedge QI project. The QI participants were volunteer clinic staff. The target patient population was adults with chronic non-cancer pain treated with long-term opioids. The outcomes included the clinic-level percentage of target patients with a current treatment agreement (primary outcome), rates of opioid-benzodiazepine co-prescribing, urine drug testing, depression and opioid misuse screening, and prescription drug monitoring database check; additional measures included daily morphine-equivalent dose (MED), and the percentages of all target patients and patients prescribed ≥90mg/day MED. T-test, mixed-regression and stepped-wedge-based analyses evaluated the QI impact, with significance and effect size assessed with two-tailed p<0.05, 95% confidence intervals and/or Cohen’s d. Results: Two-hundred-fifteen QI participants, a subset of clinical staff, received at least one QI component; 1,255 patients in the QI and 1,632 patients in the 17 comparison clinics were prescribed long-term opioids. At baseline, more QI than comparison clinic patients were screened for depression (8.1% vs 1.1%, p=0.019) and prescribed ≥90mg/day MED (23.0% vs 15.5%, p=0.038). The stepped-wedge analysis did not show statistically significant change in outcomes in the QI clinics, when accounting for the comparison clinics’ trends. The Cohen’s d values favored the QI clinics in all outcomes except opioid-benzodiazepine co-prescribing. Subgroup analysis showed that patients prescribed ≥90mg/day MED in the QI compared to comparison clinics improved urine drug screening rates (38.8% vs 19.1%, p=0.02), but not other outcomes (p³0.05). Conclusions: Augmenting routine policy implementation with targeted QI intervention, delivered to volunteer clinic staff, did not additionally improve clinic-level, opioid guideline-concordant care metrics. However, the observed effect sizes suggested this approach may be effective, especially in higher-risk patients, if broadly implemented.Trial Registration – Not applicable
Inferring an animal's environment through biologging: quantifying the environmental contribution to animal movement
Authors: Eikelboom Jasper A.J. , de Knegt Henrik J. , Klaver Maayke , Langevelde Frank van , Wal Tamme van der , Prins Herbert H.T. 
Published: July 2020

Abstract
Background: Animals respond to environmental variation by changing their movement in a multifaceted way. Recent advancements in biologging increasingly allow for detailed measurements of the multifaceted nature of movement, from descriptors of animal movement trajectories (e.g., using GPS) to descriptors of body part movements (e.g., using tri-axial accelerometers). Because this multivariate richness of movement data complicates inference on the environmental contribution to animal movement, studies generally use simplified movement descriptors in statistical analyses. However, doing so limits the inference on the environmental contribution to movement, as this requires that the multivariate richness of movement data can be fully considered in an analysis. Methods: We propose a data-driven analytic framework to quantify the environmental contribution to animal movement that can accommodate the multifaceted nature of animal movement. Instead of fitting a simplified movement descriptor to a suite of environmental variables, our proposed framework centres on predicting an environmental variable from the full set of multivariate movement data, i.e., the reverse of the route of causal inference. The measure of fit of this prediction is taken to be the metric that quantifies how much of the environmental variation relates to the multivariate variation in animal movement. We demonstrate the usefulness of this framework through a case study about the contribution of grass availability and time since milking to cow movements using machine learning algorithms. Results: We show that on a one-hour timescale 37% of the variation in grass availability and 33% of time since milking contributed to cow movements. Grass availability contributed mostly to the cows’ neck movement during grazing, while time since milking contributed mostly to the movement through the landscape and the shared variation of accelerometer and GPS data (e.g., activity patterns). Furthermore, this framework proved to be insensitive to spurious correlations between environmental variables in quantifying the contribution to animal movement. Conclusions: Not only is our proposed framework well-suited to study the environmental contribution to animal movement; we argue that it can also be applied in any field that uses multivariate biologging data, e.g., animal physiology, to study the relationships between animals and their environment.
Help seeking, trust and intimate partner violence: social connections amongst displaced and non-displaced Yezidi women and men in the Kurdistan region of northern Iraq
Authors: Strang Alison , O’Brien Oonagh , Sandilands Maggie , Horn Rebecca 
Published: July 2020

Abstract
Background: Conflict and displacement impact the social fabric of communities through the disruption of social connections and the erosion of trust. Effective humanitarian assistance requires understanding the social capital that shapes patterns of help seeking in these circumstances - especially with stigmatised issues such as violence against women (VAW) and intimate partner violence (IPV). Methods: A novel social mapping methodology was adopted amongst a Yezidi population displaced by ISIS occupation and a neighbouring settled Yezidi population in the Kurdistan region of northern Iraq in late 2016. Six participatory workshops were conducted to identify available resources with respect to: meeting basic needs, dispute resolution and VAW. Subsequently, 51 individual interviews were conducted (segmented by gender and settlement status) to identify connectedness to, and trust in, the resources identified, with a focus on IPV against women. 90% of participants reported God as a key source of help in the previous six months, representing the most widely cited resource. Following God, the most accessed and trusted resources were family and community, with NGO (non-governmental organisation) provision being the least. Women drew more strongly upon familial resources than men (=5.73, df=1, p=0.017). There was reduced trust in resources in relation to seeking help with IPV. A distinction between trust to provide emotional support and trust to resolve issues was identified. Settled women were 1.6 times more likely to trust community members and government services and 3.7 times more likely to trust NGOs than displaced women. Conclusions: Mapping social connections and trust provides valuable insight into the social capital available to support help seeking in populations of humanitarian concern. For these Yezidi populations, family, religious and community resources were the most widely utilised and trusted. Trust was mostly reserved for family and their main religious leader regarding IPV against women. Lack of trust appeared to be a major barrier to stronger engagement with available NGO provision, particularly amongst displaced women. The role of faith and religious resources for this population is clearly significant, and warrants an explicitly faith-sensitive approach to humanitarian assistance.
Early Patellofemoral Articular Cartilage Degeneration in a Rat Model of Patellar Instability is Associated with Activation of the NF-κB Signaling Pathway
Authors: Lin Wei , Dai Yike , Yang Guangmin , Niu Jinghui , Li Ming , Wang Fei 
Published: July 2020

Abstract
Background: Patellar instability (PI) often increases the possibility of lateral patellar dislocation and early osteoarthritis. The molecular mechanism of early articular cartilage degeneration during patellofemoral osteoarthritis (PFOA) still requires further investigation. However, it is known that the NF-κB signaling pathway plays an important role in articular cartilage degeneration. The aim of this study was to investigate the relationship between the NF-κB signaling pathway and patellofemoral joint cartilage degeneration. Methods: We established a rat model of PI-induced PFOA. Female 4-week-old Sprague-Dawley rats (n=120) were randomly divided into two groups: the PI (n=60) and control group (n=60). The distal femurs of the PI and control group were isolated and compared 4, 8, and 12 weeks after surgery. The morphological structure of the trochlear cartilage and subchondral bone were evaluated by micro-computed tomography and histology. The expression of NF-κB, matrix metalloproteinase (MMP)-13, collagen X, and TNF-ɑ were evaluated by immunohistochemistry and quantitative polymerase chain reaction. Results: In the PI group, subchondral bone loss and cartilage degeneration were found 4 weeks after surgery. Compared with the control group, the protein and mRNA expression of NF-κB and TNF-ɑ were significantly increased 4, 8, and 12 weeks after surgery in the PI group. In addition, the markers of cartilage degeneration MMP-13 and collagen X were more highly expressed in the PI group compared with the control group at different time points after surgery.Conclusions: This study has demonstrated that early patellofemoral joint cartilage degeneration can be caused by PI in growing rats, accompanied by significant subchondral bone loss and cartilage degeneration. In addition, the degeneration of articular cartilage may be associated with the activation of the NF-κB signaling pathway and can deteriorate with time as a result of PI.
Osteopontin promoter polymorphisms and risk of urolithiasis: a candidate gene association and meta-analysis study
Authors: Amar Ali , Afzal Ayesha , Hameed Athar , Ahmad Mumtaz , Khan Abdul Rafay , Najma Humaira , Abid Aiysha , Khaliq Shagufta 
Published: July 2020

Abstract
Background: Urolithiasis is a worldwide urological problem with significant contribution of genetic factors. Pakistan, which resides within the Afro-Asian stone belt, has a high reported prevalence (12%) of urolithiasis. Osteopontin (SPP1) is a urinary macromolecule with a suggested critical role in modulating renal stone formation, genetic polymorphisms of which may determine individual risk of developing urolithiasis. However, results of previous studies regarding SPP1 polymorphisms and susceptibility to urolithiasis have apparent inconsistencies with no data available for local population. Methods: A total of 235 urolithiasis patients and 243 healthy controls, all of Pakistani ancestry, underwent genotyping for six SPP1 genetic polymorphisms in an effort to investigate potential association with urolithiasis using indigenous candidate gene association study design. Further, a comprehensive meta-analysis following a systematic literature search was also done to ascertain an evidence based account of any existent association regarding SPP1 promoter polymorphisms and risk of developing urolithiasis.Results: Three SPP1 promoter polymorphisms, rs2853744:G>T, rs11730582:T>C and rs11439060:delG>G, were found to be significantly associated with risk of urolithiasis in indigenous genetic association study (OR = 3.14; p = 0.006, OR = 1.78; p = 0.006 and OR = 1.60; p = 0.012, respectively). We also observed a 1.68-fold positive association of a tri-allelic haplotype of these SPP1 promoter polymorphisms (G-C-dG) with risk of urolithiasis (OR = 1.68; p = 0.0079). However, no association was evident when data were stratified according to gender, age at first presentation, stone recurrence, stone multiplicity, parental consanguinity and family history of urolithiasis. The overall results from meta-analysis, which included 4 studies, suggested a significant association of SPP1 rs2853744:G>T polymorphism with susceptibility of urolithiasis (OR = 1.37; p = 0.004), but not for other SPP1 polymorphic variants analyzed. Conclusions: In conclusion, we report significant association of 3 SPP1 polymorphisms with urolithiasis for the first time from South Asia, however, this association persisted only for SPP1 rs2853744:G>T polymorphism after meta-analysis of pooled studies. Further studies with a larger sample size will be required to validate this association and assess any potential usefulness in diagnosis and prognosis of renal stone disease.
Nasal carriage of Staphylococcus aureus in farm animals and breeders in North of Morocco
Authors: Mourabit Nadira , Arakrak Abdelhay , Bakkali Mohammed , Zian Zeineb , Bakkach Joaira , Laglaoui Amin 
Published: July 2020

Abstract
Background : The objectives of this study were to determine for the first time, in Morocco, the nasal carriage rate, antimicrobial susceptibility profiles and virulence genes of S. aureus isolated from animals and breeders in close contact. Methods : From 2015 to 2016, 421 nasal swab samples were collected from 26 different livestock areas in Tangier. Antimicrobial susceptibility phenotypes were determined by disk diffusion according to EUCAST 2015. The presence of nuc , mec A, mec C, lukS/F-PV, and tst genes were determined by Polymerase Chain Reaction (PCR) for all isolates. Results : The overall S. aureus nasal carriage rate was low in animals (9.97%) and high in breeders (60%) with a statistically significant difference, (OR= 13.536; 95% CI = 7.070- 25.912; p< 0.001). In general, S. aureus strains were susceptible to the majority of antibiotics and the highest resistance rates were found against tetracycline (16.7% in animals and 10% in breeders). No Methicillin-Resistant S. aureus (MRSA) was detected in animals and breeders. A high rate of tst and lukS/F-PV genes has been recovered only from animals (11.9% and 16.7%, respectively). Conclusion : Despite the lower rate of nasal carriage of S. aureus and the absence of MRSA strains in our study, S. aureus strains harbored a higher frequency of tst and lukS/F-PV virulence genes, which is associated to an increased risk of infection dissemination in humans. This highlights the need for further larger and multi-center studies to better define the transmission of the pathogenic S. aureus between livestock, environment, and humans.
Rates, predictors and mortality of sepsis-induced acute kidney injury: systematic review and meta-analysis
Authors: Liu Jie feng , Xie Hebin , ye ziwei , Li Fen , Wang Lesan 
Published: July 2020

Abstract
Background: Due to the high incidence and mortality of sepsis-associated acute kidney injury, a significant number of studies have explored the causes of sepsis-associated acute kidney injury (AKI). However, the opinions on relevant predictive risk factors remain inconclusive. This study aimed to provide a systematic review and a meta-analysis to determine the predisposing factors for sepsis-associated AKI.Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed, and Web of Science, databases, with an end-date of 25th May 2019. Valid data were retrieved in compliance with specific inclusion and exclusion criteria.Result: Forty-seven observational studies were included for analysis, achieving a cumulative patient number of 55,911. The highest incidence of AKI was caused by septic shock. Thirty-one potential risk factors were included in the meta-analysis. Analysis showed that 20 factors were statistically significant. The odds ratio (OR) and 95% confidence interval (CI), as well as the prevalence of the most frequently-seen predisposing factors for sepsis-associated AKI, were as follows: septic shock [2.88 (2.36-3.52), 60.47%], hypertension [1.43 (1.20-1.70), 38.39%], diabetes mellitus [1.59 (1.47-1.71), 27.57%], abdominal infection [1.44 (1.32-1.58), 30.87%], the administration of vasopressors [2.95 (1.67-5.22), 64.61%], the administration of vasoactive drugs [3.85 (1.89-7.87), 63.22%], mechanical ventilation [1.64 (1.24-2.16), 68.00%], positive results from blood culture [1.60 (1.35-1.89), 41.19%], and a history of smoking [1.60 (1.09-2.36), 43.09%]. Other risk factors included cardiovascular diseases, coronary artery diseases, liver diseases, unknown infections, the administration of diuretics and ACEI/ARB, infection caused by gram-negative bacteria, and organ transplantation.Conclusion: Risk factors of S-AKI arise from a wide range of sources, making it difficult to predict and prevent this condition. Comorbidities, and certain drugs, are the main risk factors for S-AKI. Our review can provide guidance on the application of interventions to reduce the risks associated with sepsis-associated acute kidney injury and can also be used to tailor patient-specific treatment plans and management strategies in clinical practice.
Expression and clinical significance of LAG-3, FGL1, PD-L1 and CD8+T cells in hepatocellular carcinoma using Multiplex Quantitative Analysis
Authors: Guo Mengzhou , Yuan Feifei , Qi Feng , Sun Jialei , Rao Qianwen , Zhao Zhiying , Huang Peixin , Fang Tingting , Yang Biwei , jinglin xia 
Published: July 2020

Abstract
Background: fibrinogen-like protein 1 (FGL1) - Lymphocyte activating gene 3 (LAG-3) pathway is a promising immunotherapeutic target and has synergistic effect with programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1). However, the prognostic significance of FGL1-LAG-3 pathway and the correlation with PD-L1 in hepatocellular carcinoma (HCC) remain unknown. Methods: The levels of LAG-3, FGL1, PD-L1 and cytotoxic T (CD8 + T) cells in 143 HCC patients were assessed by multiplex immunofluorescence. Associations between the marker's expression and clinical significances were studied. Results: We found FGL1 and LAG-3 densities were elevated while PD-L1 and CD8 were decreased in HCC tissues compared to adjacent normal liver tissues. High levels of FGL1 were strongly associated with high densities of LAG-3 + cells but not PD-L1. CD8 + T cells densities had positive correlation with PD-L1 levels and negative association with FGL1 expression. Elevated densities of LAG-3 + cells and low levels of CD8 + T cells were correlated with poor disease outcome. Moreover, LAG-3 + cells deteriorated patient stratification based on the abundance of CD8 + T cells. Patients with positive PD-L1 expression on tumor cells (PD-L1 TC + ) tended to have an improved survival than that with negative PD-L1 expression on tumor cells (PD-L1 TC - ). Furthermore, PD-L1 TC - in combination with high densities of LAG-3 + cells showed the worst prognosis, and PD-L1 TC + patients with low densities of LAG-3 + cells had the best prognosis. Conclusions: LAG-3, FGL1, PD-L1 and CD8 have distinct tissue distribution and relationships with each other. High levels of LAG-3 + cells and CD8 + T cells represent unfavorable and favorable prognostic biomarkers for HCC respectively.
Selective logging enhances ecosystem multifunctionality via increase of functional diversity in a Pinus yunnanensis forest in Southwest China
Authors: Huang Xiaobo , Li Shuaifeng , Su Jianrong 
Published: July 2020

Abstract
Background: The impacts of selective logging on ecosystem multifunctionality (EMF) remain largely unexplored. In this study, we analyzed the response of nine variables related to four ecosystem functions (i.e. nutrient cycling, soil carbon stocks, decomposition, and wood production) to five selective logging intensities in a Pinus yunnanensis-dominated forest. We included a control group with no harvest to evaluate the potential shifts in EMF of the P. yunnanensis forests. We also assessed the relationship between above- and belowground biodiversity and EMF under these different selective logging intensities. Additionally, we evaluated the effects of biotic and abiotic factors on EMF using a structural equation modeling (SEM) approach. Results: Individual ecosystem functions (EFs) all had a significant positive correlation with selective logging intensity. Different EFs showed different patterns with the increase of selective logging intensity. We found that EMF tended to increase with logging intensity, and that EMF significantly improved when the stand was harvested at least twice. Both functional diversity and soil moisture had a significant positive correlation with EMF, but soil fungal operational taxonomic units (OTUs) had a significant negative correlation with EMF. Based on SEM, we found that selective logging improved EMF mainly by increasing functional diversity. Conclusion: Our study demonstrates that selective logging is a good management technique from an EMF perspective, and thus provide us with potential guidelines to improve forest management in P. yunnanensis forests in this region. The functional diversity is maximized through reasonable selective logging measures, so as to enhance EMF.