bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community intervention for cardiovascular disease risk factors in Kalutara, Sri Lanka
Authors: Gamlath L. , Nandasena S. , Silva P. de , Morrell S. , Linhart C. , Lin S. , Sharpe A. , Nathan S. , Taylor R. 
Published: April 2020

Abstract
Background
The effectiveness of a 2015–17 community intervention to reduce cardiovascular disease (CVD) and type 2 diabetes (T2DM) risk factors is assessed in a Sri Lanka adult population, using a before-and-after study design.

Methods
Four contiguous Public Health Midwife (PHM) areas in Kalutara district (Western Province) were exposed to a Sri Lankan designed community health promotion initiatives (without screening) to lower CVD and T2DM risk factors. Pre- and post-intervention surveys (2014, n=1,019; 2017, n=908) were of 25–64 year males (M) and females (F) from dissimilar randomly selected clusters (villages or settlements) from PHMs, with probability of selection proportional to population size, followed by household sampling, then individual selection to yield equal-probability samples. Differences in resting blood pressure (BP), fasting plasma glucose (FPG), total cholesterol, body mass index and tobacco smoking, adjusting for cluster sampling, age and socio-economic differences, were examined.

Results
Hypertension prevalence declined from 25% to 16% (F) (p<.0001), and 21% to 17% (M). Both mean systolic and diastolic BP declined. T2DM declined from 18% to 13% (F), and 18% to 15% (M), as did mean fasting plasma glucose. Elevated total cholesterol declined from 21% to 15% in women (p=0.003) and mean cholesterol declined. Frequency distributions, medians and means of these continuous CVD risk factors shifted to lower levels, and were mostly statistically significant (p< 0.05).

Conclusions
Community health promotion can lower key CVD and T2DM risk factors. Lowering tobacco consumption in males and obesity remain challenges in Sri Lanka.
EGFR mutation testing and treatment decisions in patients progressing on first- or second-generation epidermal growth factor receptor tyrosine kinase inhibitors
Authors: Chiang Anne C. , Fernandes Ancilla W. , Pavilack Melissa , Wu Jennifer W. , Laliberté François , Duh Mei Sheng , Chehab Nabil , Subramanian Janakiraman 
Published: April 2020

Abstract
Background
The objective of this study was to investigate real-world EGFR mutation testing in patients with metastatic non-small cell lung cancer (NSCLC) upon progression on first−/second-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI), and subsequent treatments received.

Methods
Flatiron Health electronic health records-derived database was used to identify adult patients with metastatic NSCLC treated with first−/second-generation EGFR-TKI from 11/2015–09/2017, with start of first EGFR-TKI defined as the index date. Patients were stratified by receipt of EGFR-TKI as first-line (1 L) or later-line (2 L+) treatment. Mutation testing and subsequent therapies following first−/second-generation EGFR-TKI were described.

Results
Overall, 782 patients (1 L = 435; 2 L+ =347) were included. Median age was 69.0 years, 63.6% were female, 56.3% were white, 87.1% were treated in community-based practices, and 30.1% of patients died during the study period; median follow-up was 309.0 days. Among the 294 (1 L = 160; 2L+ =134) patients who received subsequent therapies, treatments included chemotherapy only (1 L = 15.6%; 2L+ =21.6%), immunotherapy only (1 L = 13.8%; 2 L+ =41.0%), and targeted therapies (1 L = 70.0%; 2 L+ =36.6%). Specifically, 40 (25.0%) 1 L patients and 7 (5.2%) 2 L+ patients received osimertinib as subsequent therapy. Before the start of subsequent therapy, EGFR T790M resistance mutation testing was performed in 88 (29.9%) patients (1 L = 63 [39.4%]; 2 L+ =25 [18.7%]). Of these patients, 25 (28.4%) were T790M positive, among whom 24 (96.0%) received osimertinib.

Conclusions
A third of patients received subsequent therapies on disease progression; only 30% of these were tested for EGFR-TKI resistance mutation, prior to receiving subsequent therapies. These results highlight the importance of choosing treatments in the 1 L setting that optimize benefits for patients with EGFR-mutated NSCLC.
Cumulative psychosocial factors are associated with cardiovascular disease risk factors and management among African Americans in the Jackson Heart Study
Authors: Sims Mario , Glover Lá Shauntá M. , Gebreab Samson Y. , Spruill Tanya M. 
Published: April 2020

Abstract
Background
Racial disparities in cardiovascular disease (CVD) have been attributed in part to negative psychosocial factors. Prior studies have demonstrated associations between individual psychosocial factors and CVD risk factors, but little is known about their cumulative effects.

Methods
Using the Jackson Heart Study, we examined the cross-sectional associations of cumulative psychosocial factors with CVD risk factors among 5306 African Americans. We utilized multivariable Poisson regression to estimate sex-stratified prevalence ratios (PR 95% confidence interval-CI) of obesity, hypertension and diabetes prevalence and hypertension and diabetes control with negative affect (cynicism, anger-in, anger-out, depressive symptoms and cumulative negative affect) and stress (global stress, weekly stress, major life events-MLEs and cumulative stress), adjusting for demographics, socioeconomic status, and behaviors.

Results
After full adjustment, high (vs. low) cumulative negative affect was associated with prevalent obesity among men (PR 1.36 95% CI 1.16–1.60), while high (vs. low) cumulative stress was similarly associated with obesity among men and women (PR 1.24 95% CI 1.01–1.52 and PR 1.13 95% CI 1.03–1.23, respectively). Psychosocial factors were more strongly associated with prevalent hypertension and diabetes among men than women. For example, men who reported high cynicism had a 12% increased prevalence of hypertension (PR 1.12, 95% CI 1.03–1.23). Psychosocial factors were more strongly associated with lower hypertension and diabetes control for women than men. Women who reported high (vs. low) cynicism had a 38% lower prevalence of hypertension control (PR 0.62, 95% CI 0.46–0.84).

Conclusions
Cumulative psychosocial factors were associated with CVD risk factors and disease management among African Americans. The joint accumulation of psychosocial factors was more associated with risk factors for men than women.
A prospective study on the effect of self-reported health and leisure time physical activity on mortality among an ageing population: results from the Tromsø study
Authors: Opdal Ida Marie , Larsen Lill Sverresdatter , Hopstock Laila Arnesdatter , Schirmer Henrik , Lorem Geir Fagerjord 
Published: April 2020

Abstract
Background
The prevailing Western ideal of ageing in place, with the option to stay at home as one ages, has led to the development of physical activity guidelines for people of advanced age to increase their quality of life and promote their functional abilities. This study investigates the effect of self-reported health and physical activity on mortality and examines how levels of age-specific physical activity affect self-reported health trajectories in an ageing cohort.

Methods
The sample cohort of the population-based Tromsø Study consists of 24,309 participants aged 25–97 years at baseline. This study involved a survival analysis from 1994 to 2015 and included those who completed two or more surveys (n = 12,241) between 1994 and 2008. The purpose was to examine the relationship between physical activity and self-reported health throughout life using a random coefficient model analysis.

Results
Being sedentary was associated with an increased risk of mortality in the ageing cohort. Subjects who reported neither light physical activity nor hard physical activity had a 57% (OR 1.57, 1.07–2.31) increased risk of all-cause death. Both hard (OR 2.77, 2.35–3.26) and light (OR 1.52, 1.32–1.76) physical activity were positively associated with self-reported health. The effect was age dependent. Vigorous physical activity was most beneficial for individuals younger than 40 years old, while moderate physical activity levels prolonged the period in which good self-reported health was likely.

Conclusions
Poor self-reported health and being sedentary were independently associated with an increased risk of mortality in the participants. Furthermore, physical activity prolonged the period of good self-reported health among older adults in two ways: physical activity habits from early adulthood and onwards were beneficial to self-reported health at an advanced age, and self-reported health was dependent on engagement in moderate intensity physical activity after approximately 65 years of age.
Organ/space infection is a common cause of high output stoma and outlet obstruction in diverting ileostomy
Authors: Hara Yutaro , Miura Takuya , Sakamoto Yoshiyuki , Morohashi Hajime , Nagase Hayato , Hakamada Kenichi 
Published: April 2020

Abstract
Background
The objectives of this study are to identify causes of high-output stoma (HOS) and outlet obstruction (OO), which are major complications of diverting ileostomy.

Methods
A retrospective analysis was performed in 103 patients who underwent colorectal surgery and diverting ileostomy between December 2015 and November 2018.

Results
HOS was found in 32 patients (31.1%) and OO in 19 (18.4%). Organ/space surgical site infection (SSI), anastomotic leakage and OO were significant HOS-related factors in univariate analysis, and OO (odds ratio [OR] 3.39, p = 0.034) was a independent HOS-related factor in multivariate analysis. Organ/space SSI and male were significant OO-related factors in univariate analysis, and organ/space SSI (OR 3.77, p = 0.018) was a independent OO-related factor in multivariate analysis. The white blood cell (WBC) count on postoperative day (POD) 3 was significantly higher in the HOS group compared to the non-HOS group (9765 vs. 8130 /mL, p < 0.05), and the WBC count (9400 vs. 7475 /mL, p < 0.05) and C-reactive protein level (6.01 vs. 2.92 mg/L, p < 0.05) on POD 6 were significantly higher in the OO group compared to the non-OO group.

Conclusion
Organ/space infection is involved in the common pathology of HOS and OO. Decreased intestinal absorption due to intestinal edema caused by organ/space SSI and relative stenosis at the abdominal wall-penetrating site are major causes of HOS and OO.
Phytoremediation effect of Medicago sativa colonized by Piriformospora indica in the phenanthrene and cadmium co-contaminated soil
Authors: Li Liang , Zhu Pengyue , Wang Xiaoyang , Zhang Zhenhua 
Published: April 2020

Abstract
Background
The coexistence of polycyclic aromatic hydrocarbons (PAHs) and heavy metals has deleterious effects on environmental quality. Few reports have studied the mechanisms of plant inoculation with Piriformospora indica to remediate PAH-metal co-contaminated soil by analyzing the chemical speciation of the contaminants. This study investigated the influence of the inoculation of Medicago sativa with P. indica to remediate soil co-contaminated with phenanthrene (a kind of PAH) and cadmium (a heavy metal) by analyzing plant growth, physiological parameters and chemical speciation in rhizosphere and nonrhizosphere soils.

Results
The presence of P. indica significantly increased plant tolerance, chlorophyll a, chlorophyll b, maximum quantum efficiency of PSII photochemistry and electron transport rate values in phenanthrene- and/or cadmium-contaminated soil. P. indica inoculation in M. sativa roots increased fluorescein diacetate activities in soils contaminated with phenanthrene, cadmium or both, especially in the nonrhizosphere. The presence of phenanthrene prevented the inoculated plant from accumulating cadmium to some extent, whereas the presence of cadmium did not prevent the degradation of phenanthrene in either the rhizosphere or the nonrhizosphere after P. indica colonization. Although the low bioavailability of cadmium in the rhizosphere restricted its transportation into the stem, P. indica colonization in plants effectively increased cadmium accumulation in roots in soil co-contaminated with cadmium and phenanthrene.

Conclusions
In conclusion, this work provides a theoretical basis for the use of P. indica combined with M. sativa for the remediation of PAH-metal co-contaminated soil.
The significance of resilience in mental health promotion of marriage immigrant women: a qualitative study of factors and processes
Authors: Jo Yeonjae 
Published: April 2020

Abstract
Background
This study explores a series of processes in which marriage immigrant women achieve positive mental health status after experiencing various marriage- and migrant-related difficulties through the framework of resilience theory. As marriage immigrant women face greater barriers to public health services than non-immigrant women, it is necessary to understand the related factors, process, and context to address these barriers and strengthen available assets.

Methods
A qualitative case study design was used with the phenomenological approach. Eleven mental health promotion program managers and 12 marriage immigrant women from who experienced resilience were recruited from four public-funded multicultural community centers in Seoul and Gyeonggi-do, South Korea, between December 2015 and March 2016. Using data from in-depth semi-structured face-to-face interviews, the author applied theme analysis informed by the resilience theory in order to identify factors that affect resilience and its development process.

Results
Findings indicated that the process of resilience follows enduring difficulties, collapse of stability, access to professional help, professional and social support, and experience of growth. A combination of the staged process of growth, absence of partner support, children as a driving force for change, the need for economic activity, factors affecting difference in growth: satisfaction levels of women’s need for recognition, respect, and reward, and level of spousal support were identified as factors affecting marriage immigrant women’s resilience.

Conclusions
Spouses, children, and economic activity play key roles in resilience in positive and negative ways. The existing information barrier should be addressed at a structural level to improve the mental health of marriage immigrant women, and the optimum time for intervention is suggested within 2 years post-migration. Efforts to build supportive relationships with Korean spouses and meet the women’s needs for recognition, respect, and reward may also help promote these women’s resilience.
Uncovering the mechanism of the effects of Paeoniae Radix Alba on iron-deficiency anaemia through a network pharmacology-based strategy
Authors: Ye Xian-wen , Deng Ya-ling , Xia Lan-ting , Ren Hong-min , Zhang Jin-lian 
Published: April 2020

Abstract
Background
Paeoniae Radix Alba, the root of the plant Paeonia lactiflora Pall, is a common blood-enriching drug in traditional Chinese medicine. Its effectiveness in the clinical treatment of anaemia is remarkable, but its potential pharmacologic mechanism has not been clarified.

Methods
In this study, the potential pharmacologic mechanism of Paeoniae Radix Alba in the treatment of iron-deficiency anaemia was preliminarily elucidated through systematic and comprehensive network pharmacology.

Results
Specifically, we obtained 15 candidate active ingredients from among 146 chemical components in Paeoniae Radix Alba. The ingredients were predicted to target 77 genes associated with iron-deficiency anaemia. In-depth analyses of these targets revealed that they were mostly associated with energy metabolism, cell proliferation, and stress responses, suggesting that Paeoniae Radix Alba helps alleviate iron-deficiency anaemia by affecting these processes. In addition, we conducted a core target analysis and a cluster analysis of protein-protein interaction (PPI) networks. The results showed that four pathways, the p53 signalling pathway, the IL-17 signalling pathway, the TNF signalling pathway and the AGE-RAGE signalling pathway in diabetic complications, may be major pathways associated with the ameliorative effects of Paeoniae Radix Alba on iron-deficiency anaemia. Moreover, molecular docking verified the credibility of the network for molecular target prediction.

Conclusions
Overall, this study predicted the functional ingredients in Paeoniae Radix Alba and their targets and uncovered the mechanism of action of this drug, providing new insights for advanced research on Paeoniae Radix Alba and other traditional Chinese medicines.
Oral delivery of exenatide-loaded hybrid zein nanoparticles for stable blood glucose control and β-cell repair of type 2 diabetes mice
Authors: Bao Xiaoyan , Qian Kang , Yao Ping 
Published: April 2020

Abstract
Background
Exenatide is an insulinotropic peptide drug for type 2 diabetes treatment with low risk of hypoglycemia, and is administrated by subcutaneous injection. Oral administration is the most preferred route for lifelong treatment of diabetes, but oral delivery of peptide drug remains a significant challenge due to the absorption obstacles in gastrointestinal tract. We aimed to produce exenatide-loaded nanoparticles containing absorption enhancer, protectant and stabilizer using FDA approved inactive ingredients and easy to scale-up method, and to evaluate their long-term oral therapeutic effect in type 2 diabetes db/db mice.

Results
Two types of nanoparticles, named COM NPs and DIS NPs, were fabricated using anti-solvent precipitation method. In COM NPs, the exenatide was complexed with cholic acid and phosphatidylcholine to increase the exenatide loading efficiency. In both nanoparticles, zein acted as the cement and the other ingredients were embedded in zein nanoparticles by hydrophobic interaction. Casein acted as the stabilizer. The nanoparticles had excellent lyophilization, storage and re-dispersion stability. Hypromellose phthalate protected the loaded exenatide from degradation in simulated gastric fluid. Cholic acid promoted the intestinal absorption of the loaded exenatide via bile acid transporters. The exenatide loading efficiencies of COM NPs and DIS NPs were 79.7% and 53.6%, respectively. The exenatide oral pharmacological availability of COM NPs was 18.6% and DIS NPs was 13.1%. COM NPs controlled the blood glucose level of the db/db mice well and the HbA1c concentration significantly decreased to 6.8% during and after 7 weeks of once daily oral administration consecutively. Both DIS NPs and COM NPs oral groups substantially increased the insulin secretion by more than 60% and promoted the β-cell proliferation by more than 120% after the 7-week administration.

Conclusions
Both COM NPs and DIS NPs are promising systems for oral delivery of exenatide, and COM NPs are better in blood glucose level control than DIS NPs. Using prolamin to produce multifunctional nanoparticles for oral delivery of peptide drug by hydrophobic interaction is a simple and effective strategy.
Primary lymph node gastrinoma: a case report and review of the literature
Authors: Cavalcanti Elisabetta , Stasi Elisa , Coletta Sergio , Lorusso Dionigi , Rinaldi Caterina Mammone , Armentano Raffaele 
Published: April 2020

Abstract
Background
Gastrinoma is a rare form of neuroendocrine neoplasm. The presence of a primary lymph node localization of gastrinoma is a much debated and controversial topic in the literature, as regards whether these cases represent metastatic disease from an as yet unidentified primary tumor, or the de novo occurrence of a gastrinoma in a lymph node.

Case presentation
We report the case of a 24-year-old male with intense epigastric pain treated at the beginning with high dose proton pump inhibitors. Further workup with CT and subsequent laparotomy revealed a single peripancreatic lymph node. Histological examination highlighted a well-differentiated neuroendocrine tumor.

Conclusion
This case underlines that the primitive lymph node gastrinoma is a distinct nosological entity with a precise location in the context of rare neuroendocrine tumors that should be considered when specific symptoms are associated with the identification of isolated lymph nodes, after excluding any possible primitive locations of neoplastic localization.
Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents
Authors:   On behalf of the IDEFICS and I. Family Consortia, Cheng Lan , Pohlabeln Hermann , Ahrens Wolfgang , Lauria Fabio , Veidebaum Toomas , Chadjigeorgiou Charalambos , Molnár Dénes , Eiben Gabriele , Michels Nathalie , Moreno Luis A. , Page Angie S. , Pitsiladis Yannis , Hebestreit Antje 
Published: April 2020

Abstract
Background
The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration.

Methods
Calcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status.

Results
The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups.

Conclusions
Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.