bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eating and feeding behaviours in children in low‐income areas in Nairobi, Kenya
Authors: Mutoro Antonina N. , Garcia Ada L. , Kimani‐Murage Elizabeth W. , Wright Charlotte M. 
Published: June 2020

AbstractChild eating and caregiver feeding behaviours are critical determinants of food intake, but they are poorly characterized in undernourished children. We aimed to describe how appetite, food refusal and force‐feeding vary between undernourished and healthy children aged 6–24 months in Nairobi and identify potential variables for use in a child eating behaviour scale for international use. This cross‐sectional study was conducted in seven clinics in low‐income areas of Nairobi. Healthy and undernourished children were quota sampled to recruit equal numbers of undernourished children (weight for age [WAZ] or weight for length [WLZ] Z scores ≤2SD) and healthy children (WAZ > 2SD). Using a structured interview schedule, questions reflecting child appetite, food refusal and caregiver feeding behaviours were rated using a 5‐point scale. Food refusal and force‐feeding variables were then combined to form scores and categorized into low, medium and high. In total, 407 child–caregiver pairs, aged median [interquartile range] 9.98 months [8.7 to 14.1], were recruited of whom 55% were undernourished. Undernourished children were less likely to ‘love food’ (undernourished 78%; healthy 90% p = < 0.001) and more likely to have high food refusal (18% vs. 3.3% p = <0.001), while their caregivers were more likely to use high force‐feeding (28% vs. 16% p = 0.03). Undernourished children in low‐income areas in Nairobi are harder to feed than healthy children, and force‐feeding is used widely. A range of discriminating variables could be used to measure child eating behaviour and assess the impact of interventions.
A microbial mandala for environmental monitoring: Predicting multiple impacts on estuarine prokaryote communities of the Bay of Biscay
Authors: Lanzén Anders , Mendibil Iñaki , Borja Ángel , Alonso‐Sáez Laura 
Published: June 2020

AbstractRoutine monitoring of benthic biodiversity is critical for managing and understanding the anthropogenic impacts on marine, transitional and freshwater ecosystems. However, traditional reliance on morphological identification generally makes it cost‐prohibitive to increase the scale of monitoring programmes. Metabarcoding of environmental DNA has clear potential to overcome many of the problems associated with traditional monitoring, with prokaryotes and other microorganisms showing particular promise as bioindicators. However, due to the limited knowledge regarding the ecological roles and responses of environmental microorganisms to different types of pressure, the use of de novo approaches is necessary. Here, we use two such approaches for the prediction of multiple impacts present in estuaries and coastal areas of the Bay of Biscay based on microbial communities. The first (Random Forests) is a machine learning method while the second (Threshold Indicator Taxa Analysis and quantile regression splines) is based on de novo identification of bioindicators. Our results show that both methods overlap considerably in the indicator taxa identified, but less for sequence variants. Both methods also perform well in spite of the complexity of the studied ecosystem, providing predictive models with strong correlation to reference values and fair to good agreement with ecological status groups. The ability to predict several specific types of pressure is especially appealing. The cross‐validated models and biotic indices developed can be directly applied to predict the environmental status of estuaries in the same geographical region, although more work is needed to evaluate and improve them for use in new regions or habitats.
Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States
Authors: Iheduru‐Anderson Kechi 
Published: June 2020

AbstractThe purpose of this study was to examine the perceptions of Black African‐born nurses (BABN) with non‐native accents regarding their nursing career advancement in the United States. Data were collected using individual interviews. Fifteen nurses originally from three sub‐Saharan African countries were included in the study. The findings were reported under six themes: perceived low level of intelligence, not suitable to lead, making fun of/belittling, prejudging without evidence, downgrading, and accent modification. The finding indicated that participants believed that their race and accent influenced their professional nursing opportunities. These results are relevant to BABNs, nurse educators, and healthcare organization leaders. BABNs are capable of participating in nursing leadership and education despite their non‐native accent.
Effect of Cholecystectomy on the Occurrence of Knee Osteoarthritis
Authors: Zeng Ling‐yuan , Yang Shu‐yan , Zhang Zhi‐qiang , Wang Tao , Wang Yu‐ze , Wei Xiao‐chun 
Published: June 2020

ObjectiveTo evaluate the effect of cholecystectomy on the occurrence of knee osteoarthritis (KOA).MethodsThe present study was a case‐control study with a retrospective, cross‐sectional, and longitudinal study design. The clinical data for knee osteoarthritis in the Second Hospital of Shanxi Medical University from January 2016 to September 2018 was analyzed. Clinical data, including gender, age, height, weight, smoking, alcohol abuse, prior medical history, and previous surgical history, were recorded. A logistic regression model was used for the univariate and multivariate analysis.ResultsA total of 1659 patients with KOA (KOA group) and 1195 limb fracture patients (control group) were included in this study. Among the 1659 patients with KOA, 388 patients were male and 1271 were female, while among the 1195 patients in the control group, 638 patients were male and 557 patients were female. The period between cholecystectomy and knee osteoarthritis onset ranged from 0.5 years to 17 years; the average interval time was 8.73 ± 2.11 years. The age at disease onset was significantly older when compared to the control group, while the body mass index in the KOA group was significantly higher when compared to the control group (P < 0.05). There were 97 patients undergoing cholecystectomy in the KOA group and there were 15 patients undergoing cholecystectomy in the control group. The proportion of cholecystectomy in the two groups was statistically significant. After the univariate analysis, there was a statistically significant difference in distribution between the two groups (P < 0.05). The multivariate logistic regression analysis revealed that there was a significant difference in the distribution of these two groups (P < 0.05), indicating that cholecystectomy is associated with the occurrence of KOA.ConclusionThere is a close relationship between cholecystectomy and KOA. However, the specific mechanism remains unknown and should be further researched.
Different serum protein factor levels in first‐episode drug‐naive patients with schizophrenia characterized by positive and negative symptoms
Authors: Dai Nan , Jie Huijin , Duan Yong , Xiong Peng , Xu Xiufeng , Chen Peng , Kang Minmin , Li Ming , Li Ting , Huang Zhengyuan , Chen Hongxu 
Published: June 2020

AimThe clinical features of schizophrenia can be mainly divided into two symptom domains: positive and negative. Patients in each symptom domain respond differently to treatments, and their prognoses vary accordingly. Serum protein factors, such as nerve growth factor (NGF), neurotrophin‐3 (NT‐3), interleukin‐6 (IL‐6), interleukin‐1 beta (IL‐1β), and the calcium‐binding protein, S100β, have been reported to be involved in the pathogenesis of schizophrenia. However, their roles in the positive and negative symptom domains have not been determined. In this study, we investigated whether the serum levels of these five protein factors differed among first‐episode drug‐naive schizophrenia patients in each symptom domain and in healthy controls.MethodsDouble‐antibody sandwich ELISA were used to quantify the amounts of the five protein factors in serum.ResultsCompared with the levels in the controls (n = 60), increased serum levels of IL‐6, IL‐1β, and S100β and decreased serum levels of NGF and NT‐3 were observed in first‐episode drug‐naive schizophrenia patients. Additionally, the serum levels of IL‐6 and IL‐1β were significantly higher in schizophrenia patients characterized by negative symptoms (negative group, n = 37) than in those characterized by positive symptoms (positive group, n = 46). Based on multivariate regression analyses, serum levels of IL‐1β were positively associated with the Negative Symptom subscore of the Positive and Negative Syndrome Scale in the negative group and in all patients with schizophrenia.ConclusionThe two subtypes of schizophrenia may have different pathological mechanisms. Patients characterized by negative symptoms probably have more serious disturbances in neuroimmunology.
Pathology of clear cell carcinoma of the ovary: A basic view based on cultured cells and modern view from comprehensive approaches
Authors: Kato Noriko 
Published: June 2020

Clear cell carcinoma (CCC) is a distinct histologic type of ovarian carcinoma.CCC is more frequent in Japan than in the Western world. CCC is chemo‐resistant and often associated with paraneoplastic thromboembolism. Histologically, CCC is characterized by both cancer cells and stromas, being concordant with the cytological features. Clear cells contain abundant glycogen. Hepatocyte nuclear factor‐1β is a specific marker of CCC, and is likely to be involved in glucose metabolism. Extracellular matrix (ECM)‐deposited stroma and plasma cell‐rich inflammatory stroma are characteristic stromas of CCC. Studies using CCC cell lines showed that CCC cells produce ECMs and stimulate plasma cell differentiation in a paracrine manner. Most CCCs, as well as endometrioid carcinomas, originate from ovarian endometriosis. This is supported by molecular genetic data, although it remains unclear why different histologic types originate from the same precursor. CCC and endometrioid carcinoma are Lynch syndrome‐associated ovarian carcinomas. Recent comprehensive studies indicate that CCC is distinct not only in terms of histology but also in genomics, epigenomics and transcriptomics. This review summarizes the pathology of ovarian CCC along with a basic view based on cultured cells, and refers to recent genetic and omic data.
Rethinking Loyalty and Competence in Presidential Appointments
Authors: Waterman Richard W. , Ouyang Yu 
Published: June 2020

AbstractStudies in presidential appointments, particularly principal‐agent models, posit that presidents employ a top‐down strategy to control the bureaucracy, one that promotes loyalty over competence. However, many studies have two critical limitations: (1) treating loyalty and competence as binary constructs and (2) focusing only on presidential nomination and Senate confirmation (PAS) appointments. In this article, the authors construct a continuous measure of loyalty and competence to determine how much loyalty or competence an appointee offers a president and examine other appointment tools—Senior Executive Service (SES), Schedule C, and presidential appointments—that allow presidents to influence different levels of the bureaucracy. Findings show that presidents are more likely to reward competence with their PAS and SES appointments. In addition, few appointees score high on both loyalty and competence, explaining why presidents generally must make a trade‐off between loyalty and competence.
Farmer organizations and maize productivity in rural Burkina Faso: The effects of the diversion strategy on cotton input loans
Authors: Traore Salimata 
Published: June 2020

AbstractThis study analyzes the impact of the diversion strategy of cotton inputs on maize productivity among farmer organization (FO) members in Burkina Faso, based on an endogenous treatment effect model. This impact is assessed by measuring the effects of the producers’ strategy of using part of their cotton inputs for growing other crops, such as maize. The data from a 2014 multisectoral survey in Burkina Faso were used. The main result is that maize productivity is 59.11% lower for FO members who divert their cotton inputs. We suggest the development of financing systems for cereals, similar to those in the cotton sector, and the establishment of monitoring the use of input credits.
Has the Euro Shrunk the Band? Relative Purchasing Power Parity Convergence in a Currency Union*
Authors: Macedoni Luca 
Published: June 2020

AbstractI study the effects of entry to the European Monetary Union (EMU) on relative purchasing power parity (PPP) convergence using monthly disaggregated price indices from 32 European countries from 1999 to 2016. I examine the entry of Cyprus, Malta, Slovakia, and Slovenia to the EMU, and I estimate the bands of inaction of relative prices before and after entry using a threshold autoregressive model. I find a positive effect of the EMU on relative PPP convergence: after entry, the bands of inaction with EMU members fell by 17 percent. Cross‐sectional evidence supports the theoretical prediction that bands of inaction are related to transaction costs.
A prospective observational study of acute traumatic coagulopathy in traumatic bleeding from the battlefield
Authors: Woolley Tom , Gwyther Robert , Parmar Kiran , Kirkman Emrys , Watts Sarah , Midwinter Mark , Lucca Juandir Dalle , Hunt Beverley J 
Published: June 2020

BACKGROUNDAcute trauma coagulopathy (ATC) after military trauma has not been comprehensively studied. ATC is defined as a prolonged prothrombin time ratio (PTr) or reduced clot amplitude (A5) in viscoelastic testing. Compared to civilian trauma, military trauma has more injuries from explosions and gunshot wounds (GSWs), potentially leading to a different pathophysiology for traumatic coagulopathy. This study aimed to characterize military ATC on admission to a military hospital in Afghanistan and to explore any differences due to the mechanism of injury.METHODSSeverely injured military casualties were enrolled in the study. Blood samples were taken on admission and after routine testing, waste plasma was prepared, frozen, and transported to the United Kingdom for in‐depth hemostatic analysis.RESULTSSeventy‐seven percent of casualties had ATC defined by a PTr greater than 1.2 and 19% when defined by rotational thromboelastometry (ROTEM) A5 less than 36 mm. Coagulation factor depletion correlated with degree of shock, particularly factor V (p < 0.01), factor X (p < 0.01), and fibrinogen levels (p < 0.01). Thrombin generation was well preserved. Fibrinolytic biomarkers were raised correlating with the degree of shock (p < 0.01), and 8% of casualties had hyperfibrinolysis on ROTEM analysis. Plasmin‐antiplasmin complexes (p < 0.01) and d‐dimer levels (p = 0.01) were higher and clot firmness lower (p = 0.02) in those injured by explosion compared to GSW's.CONCLUSIONSATC was present and correlated with shock, similar to civilian trauma. Thrombin generation remained adequate. Fibrinogen and factor V levels were disproportionately low but still sufficient to allow clot formation. Fibrinolysis is a key feature, probably due to a tissue plasminogen activator surge at the time of injury. Blast injuries are associated with a greater activation of fibrinolysis than GSWs.
The use of low‐titer group O whole blood is independently associated with improved survival compared to component therapy in adults with severe traumatic hemorrhage
Authors: Shea Susan M. , Staudt Amanda M. , Thomas Kimberly A. , Schuerer Douglas , Mielke James E. , Folkerts Danielle , Lowder Ethan , Martin Callista , Bochicchio Grant V. , Spinella Philip C. 
Published: June 2020

BACKGROUNDThere is a resurgence in the use of low‐titer group O whole blood (LTOWB) for hemorrhagic shock. We hypothesized the use of LTOWB compared to component therapy (CT) would be independently associated with improved 24‐hour mortality.STUDY DESIGN AND METHODSIn this prospective observational study, trauma patients 18 years of age or older with massive transfusion protocol activations were included from August 17, 2018, to May 14, 2019. The primary outcome was 24‐hour mortality. Secondary outcomes included 72‐hour blood product totals, multiple organ dysfunction scores (MODS), and 28‐day mortality. Multivariable logistic regression (MVLR) and Cox regression were performed to determine independent associations.RESULTSThere were no clinically meaningful differences in measures of injury severity between study groups (CT, n = 42; LTOWB, n = 44). There was no difference in MODS between study groups. The unadjusted mortality was not statistically different between the study groups (9/42 [21%] for CT vs. 7/44 [16%] for LTOWB; p = 0.518). In the MVLR model, LTOWB increased the odds of 24‐hour survival by 23% (odds ratio 0.81, 95% confidence interval 0.69‐0.96; p = 0.017). Adjusted survival curve analysis indicated improved survival at both 24 hours and 28 days for LTOWB patients (p < 0.001). Further stratification showed an association between LTOWB use and survival when maximum clot firmness (MCF) was 60 mm or less (p = 0.009).CONCLUSIONSThe use of LTOWB is independently associated with improved 24‐hour and 28‐day survival, and does not increase organ dysfunction at 72 hours. Use of LTOWB most impacted survival of patients with reduced clot firmness (MCF ≤60 mm). Collectively, these data support the clinical use and continued study of LTOWB for hemostatic resuscitation.
Long-term changes in carbohydrate tolerance, insulin secretion and action in African-American patients with obesity and history of hyperglycemic crises
Authors: Vellanki Priyathama , Stefanovski Darko , Anzola Isabel I , Smiley Dawn D , Peng Limin , Umpierrez Guillermo E 
Published: June 2020

IntroductionMany African-Americans (AA) with obesity with newly diagnosed diabetes presenting with diabetic ketoacidosis (DKA) or severe hyperglycemia (SH) discontinue insulin therapy and achieve near-normoglycemia remission (hemoglobin A1c (HbA1c) <7%, fasting blood glucose (FBG) <130 mg/dL) and able to be managed on oral antidiabetic agents (OAD) during follow-up. Using combined data from two randomized controlled trials, we assessed long-term carbohydrate tolerance and changes in insulin sensitivity and insulin secretion.Research design and methodsSeventy-five participants with DKA (n=33) and SH (n=42) underwent 2-hour 75 g oral glucose tolerance test (OGTT) after insulin discontinuation and every 6 months until hyperglycemia relapse (FBG ≥130 mg/dL, HbA1c >7% or two random BG ≥180 mg/dL) while treated with OAD (metformin, sitagliptin or pioglitazone) or placebo. Glucose tolerance status was defined as per the American Diabetes Association. Sensitivity index (Si) was calculated by oral minimal model, insulin secretion as the incremental area under the curve of insulin (IncreAUCi) and disposition index (DI) as Si×IncreAUCi.ResultsDuring remission, OGTT showed normal glucose tolerance (NGT) (n=9 (12%)), prediabetes (n=34 (45%)) and diabetes (n=32 (43%)). DI and Siwere higher in patients with NGT versus prediabetes versus diabetes (p<0.001), while IncreAUCiwas not significantly different among NGT, prediabetes and diabetes (p=0.14). Achieving NGT status did not prolong near-normoglycemia remission. OAD treatment significantly prolonged hyperglycemia relapse-free survival (log-rank p=0.0012) compared with placebo and was associated with lower hyperglycemia relapse (HR: 0.45, 95% CI: (0.21 to 0.96), p=0.04).ConclusionsIn AA patients with obesity with history of DKA and SH, near-normoglycemia remission is associated with improved insulin secretion and action with half of patients achieving NGT or prediabetes, and only half having diabetes on OGTT. NGT and prediabetes on OGTT were not associated with prolonged hyperglycemia relapse-free survival.Trial registration numberNCT01099618,NCT00426413.
Cryotherapy associated with tailored land-based exercises for knee osteoarthritis: a protocol for a double-blind sham-controlled randomised trial
Authors: Ogura Dantas Lucas , Serafim Jorge Ana Elisa , Regina Mendes da Silva Serrão Paula , Aburquerque-Sendín Francisco , de Fatima Salvini Tania 
Published: June 2020

IntroductionThere is an unmet need to develop tailored therapeutic exercise protocols applying different treatment parameters and modalities for individuals with knee osteoarthritis (KOA). Cryotherapy is widely used in rehabilitation as an adjunct treatment due to its effects on pain and the inflammatory process. However, disagreement between KOA guidelines remains with respect to its recommendation status. The aim of this study is to verify the complementary effects of cryotherapy when associated with a tailored therapeutic exercise protocol for patients with KOA.Methods and analysisThis study is a sham-controlled randomised trial with concealed allocation and intention-to-treat analysis. Assessments will be performed at baseline and immediately following the intervention period. To check for residual effects of the applied interventions, 3-month and 6-month follow-up assessments will be performed. Participants will be community members living with KOA divided into three groups: (1) the experimental group that will receive a tailored therapeutic exercise protocol followed by a cryotherapy session of 20 min; (2) the sham control group that will receive the same regimen as the first group, but with sham packs filled with dry sand and (3) the active treatment control group that will receive only the therapeutic exercise protocol. The primary outcome will be pain intensity according to a Visual Analogue Scale. Secondary outcomes will be the Western Ontario & McMaster Universities Osteoarthritis Index; the Short-Form Health Survey 36; the 30-s Chair Stand Test; the Stair Climb test; and the 40-m fast-paced walk test.Ethics and disseminationThe trial was approved by the Institutional Ethics Committee of Federal University of São Carlos, São Paulo, Brazil. Registration approval number: CAAE: 65966617.9.0000.5504. The results will be published in peer-reviewed journals.Trial registration numberNCT03360500
Older patients are more likely to breach the 4-hour target in Scotland
Authors: Quinn Jonathan , Buchanan Scott , Myint Phyo Kyaw , Ellis Graham 
Published: June 2020

ObjectiveTo determine if age is a factor in a patients’ likelihood of breaching the 4 hour time target to admission/discharge in emergency departments (EDs) within NHS Scotland.MethodsWe used data from the Information Service Division Scotland to analyse all ED attendances in Scotland between January 2015 and September 2018 (n=5 596 642). We assessed the likelihood of time to admission/discharge being within 4 hours, 8 hours and 12 hours for all age categories (reference category 20 to 24 years). Univariable logistic regressions were carried out for sex, Scottish Index of Multiple Deprivation level and both major (potentially life threatening) and minor (not immediately life threatening) incidences.ResultsThe likelihood of breaching the 4-hour target increased linearly with age from 15 to 19 years upward. Patients ≥85 years were significantly (p<0.001) more likely to have breached than patients aged 20 to 24 years (OR 3.80, 95% CI: 3.73 to 3.86). When considering major incidents, patients aged ≥85 years were more likely to have breached than those aged 20 to 24 years (OR 2.05, 95% CI: 2.01 to 2.09, p<0.001). The same was true of minor incidents (OR 2.85, 95% CI: 2.73 to 2.98, p<0.001).ConclusionsOlder age is associated with a higher probability of breaching waiting time targets in a linear fashion within NHS Scotland, which is consistent with previous single hospital or regional studies. This association may be due to the higher proportion of elderly patients being admitted or a more systemic issue, but regardless, the elderly are being put more at risk.