bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Functional, Social, and Health Needs of Older Residents in Nonurban Settings: A Community Risk Assessment
Authors: Weaver Raven H. , Burley Mason 
Published: August 2020

Objectives: We examined functional, social, and health needs and service delivery gaps among a geographically expansive and economically diverse population of older adults to identify service priorities. Methods: We conducted analyses based on 1280 respondents aged 60 years and older surveyed for an 8-county needs assessment. Results: We identified three distinct risk profiles using two-step cluster analysis. ANOVA and chi-square analyses revealed significant differences between risk profiles on a range of health and social service needs. Discussion: Identifying high-risk residents can support community providers’ efforts to help older adults age in place. Community-based organizations are well-positioned to respond early to social determinants of health needs. Targeting services and supports that reduce risk, extend independence, and prevent avoidable adverse healthcare situations to improve health and achieve health equity among historically underserved and hard-to-reach populations and prioritizing low-cost community interventions can reduce the need for high-cost interventions (e.g., emergency care and hospitalizations).
Medical Cannabis and Psychiatric Disorders: Implications for Psychiatric Nurses
Authors: Groh Carla J. 
Published: August 2020

Objective: Cannabis use for medical condition has significantly increased over the past 20 years with 33 states and the District of Columbia passing laws legalizing medical cannabis. Five qualifying psychiatric disorders have been identified. The objective of this review article is to present a brief history of medical cannabis, the evidence for the qualifying psychiatric conditions, and to discuss the implications for psychiatric nurses. Method: A review of the literature on the five qualifying psychiatric disorders was conducted. Databases searched included CINAHL, PubMed, Cochrane Library, MedLine Plus, and EMBASE. Keywords were cannabis, medical cannabis, delta-9-tetrahydrocannabinaol, cannabidiol, and psychiatric disorders. Results: The evidence that medical cannabis or cannabinoids is an effective treatment for the qualifying psychiatric disorders (e.g., posttraumatic stress disorder, agitation in Alzheimer’s disease and other dementias, Tourette’s syndrome, anxiety, and obsessive-compulsive disorder) is too weak and of low quality to recommend as an intervention at this time. A discussion of the implications of these findings for psychiatric nurses is offered based on the published guidelines by the American Nurses Association and National Council of State Boards of Nursing. Conclusion: There is a significant gap between evidence supporting the effectiveness of medical cannabis for psychiatric disorders and patient interest and use of cannabis for such conditions as well as other psychiatric symptoms. There are tremendous opportunities for psychiatric nurses to make an impact both clinically and be conducting research in this emerging field. We need to educate ourselves and our patients about the benefits and risks of medical cannabis and to help patients make informed decisions about their health care.
Phonological working memory and non-verbal complex working memory as predictors of future English outcomes in young ELLs
Authors: White Michelle J 
Published: August 2020

Aim of the study: The aim of this longitudinal study was twofold: first, to determine whether the relationship between working memory measures and language performance in young English language learners (ELL) remains constant over the year. The second aim was to determine if performance on working memory tasks predicts future performance on language measures. Methodology: The participants were 27 ELLs between the ages of 5 and 6 years who were in their first year of formal schooling and attended the same mid-low socioeconomic status school in South Africa. The participants were tested three times throughout the year on tasks of working memory and an English assessment battery. Data analysis and results: Mixed effects models and multiple linear regression were used to address the aims of the study. The first aim of the study showed that there are significant correlations between all working memory measures and all language measures in varying strengths across the year. The second research aim further elaborated on this by showing that both phonological working memory and non-verbal complex working memory are implicated in the acquisition of syntax, semantics and pragmatics at different points throughout the year. Implications and originality: Language acquisition in ELLs is not a stand-alone process and working memory measures may be able to predict future language outcomes. This could indicate that working memory measures may be used as an indicator for who may need language intervention, at a time when the ELL only has limited English proficiency and limited English exposure. This research is the first of its kind to originate from Africa, with a sample from low socioeconomic, culturally and linguistically diverse circumstances who are exposed to English consistently for the first time and are tested with working memory tasks with less strong language components.
Association between metal cobalt exposure and the risk of congenital heart defect occurrence in offspring: a multi-hospital case-control study
Authors: Zhang Nannan , Yang Shuihua , Yang Jiaxiang , Deng Ying , Li Shengli , Li Nana , Chen Xinlin , Yu Ping , Liu Zhen , Zhu Jun 
Published: August 2020

Abstract
Background
Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring.

Materials and methods
In order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs.

Results
The median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468–2.299; P < 0.001), respectively. And the median (5–95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211–3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01).

Conclusions
The finding suggested that the occurrence of CHDs may be associated with cobalt exposure.
A genome-wide analysis of copy number variation in Murciano-Granadina goats
Authors: Guan Dailu , Martínez Amparo , Castelló Anna , Landi Vincenzo , Luigi-Sierra María Gracia , Fernández-Álvarez Javier , Cabrera Betlem , Delgado Juan Vicente , Such Xavier , Jordana Jordi , Amills Marcel 
Published: August 2020

Abstract
Background
In this work, our aim was to generate a map of the copy number variations (CNV) segregating in a population of Murciano-Granadina goats, the most important dairy breed in Spain, and to ascertain the main biological functions of the genes that map to copy number variable regions.

Results
Using a dataset that comprised 1036 Murciano-Granadina goats genotyped with the Goat SNP50 BeadChip, we were able to detect 4617 and 7750 autosomal CNV with the PennCNV and QuantiSNP software, respectively. By applying the EnsembleCNV algorithm, these CNV were assembled into 1461 CNV regions (CNVR), of which 486 (33.3% of the total CNVR count) were consistently called by PennCNV and QuantiSNP and used in subsequent analyses. In this set of 486 CNVR, we identified 78 gain, 353 loss and 55 gain/loss events. The total length of all the CNVR (95.69 Mb) represented 3.9% of the goat autosomal genome (2466.19 Mb), whereas their size ranged from 2.0 kb to 11.1 Mb, with an average size of 196.89 kb. Functional annotation of the genes that overlapped with the CNVR revealed an enrichment of pathways related with olfactory transduction (fold-enrichment = 2.33, q-value = 1.61 × 10−10), ABC transporters (fold-enrichment = 5.27, q-value = 4.27 × 10−04) and bile secretion (fold-enrichment = 3.90, q-value = 5.70 × 10−03).

Conclusions
A previous study reported that the average number of CNVR per goat breed was ~ 20 (978 CNVR/50 breeds), which is much smaller than the number we found here (486 CNVR). We attribute this difference to the fact that the previous study included multiple caprine breeds that were represented by small to moderate numbers of individuals. Given the low frequencies of CNV (in our study, the average frequency of CNV is 1.44%), such a design would probably underestimate the levels of the diversity of CNV at the within-breed level. We also observed that functions related with sensory perception, metabolism and embryo development are overrepresented in the set of genes that overlapped with CNV, and that these loci often belong to large multigene families with tens, hundreds or thousands of paralogous members, a feature that could favor the occurrence of duplications or deletions by non-allelic homologous recombination.
Mid-Cenozoic climate change, extinction, and faunal turnover in Madagascar, and their bearing on the evolution of lemurs
Authors: Godfrey Laurie R. , Samonds Karen E. , Baldwin Justin W. , Sutherland Michael R. , Kamilar Jason M. , Allfisher Kristen L. 
Published: August 2020

AbstractBackgroundWas there a mid-Cenozoic vertebrate extinction and recovery event in Madagascar and, if so, what are its implications for the evolution of lemurs? The near lack of an early and mid-Cenozoic fossil record on Madagascar has inhibited direct testing of any such hypotheses. We compare the terrestrial vertebrate fauna of Madagascar in the Holocene to that of early Cenozoic continental Africa to shed light on the probability of a major mid-Cenozoic lemur extinction event, followed by an “adaptive radiation” or recovery. We also use multiple analytic approaches to test competing models of lemur diversification and the null hypothesis that no unusual mid-Cenozoic extinction of lemurs occurred.ResultsComparisons of the terrestrial vertebrate faunas of the early Cenozoic on continental Africa and Holocene on Madagascar support the inference that Madagascar suffered a major mid-Cenozoic extinction event. Evolutionary modeling offers some corroboration, although the level of support varies by phylogeny and model used. Using the lemur phylogeny and divergence dates generated by Kistler and colleagues, RPANDA and TESS offer moderate support for the occurrence of unusual extinction at or near the Eocene-Oligocene (E-O) boundary (34 Ma). TreePar, operating under the condition of obligate mass extinction, found peak diversification at 31 Ma, and low probability of survival of prior lineages. Extinction at the E-O boundary received greater support than other candidate extinctions or the null hypothesis of no major extinction. Using the lemur phylogeny and divergence dates generated by Herrera & Dàvalos, evidence for large-scale extinction diminishes and its most likely timing shifts to before 40 Ma, which fails to conform to global expectations.ConclusionsWhile support for large-scale mid-Cenozoic lemur extinction on Madagascar based on phylogenetic modeling is inconclusive, the African fossil record does provide indirect support. Furthermore, a major extinction and recovery of lemuriforms during the Eocene-Oligocene transition (EOT) would coincide with other major vertebrate extinctions in North America, Europe, and Africa. It would suggest that Madagascar’s lemurs were impacted by the climate shift from “greenhouse” to “ice-house” conditions that occurred at that time. This could, in turn, help to explain some of the peculiar characteristics of the lemuriform clade.
Discussing proton pump inhibitor deprescribing: the views of Danish GPs and older patients
Authors: Thompson Wade , Nissen Malene , Haastrup Peter , Le Jette Videbæk , Lundby Carina , Nielsen Jesper Bo , Jarbøl Dorte Ejg 
Published: August 2020

Abstract
Background
Deprescribing of proton pump inhibitors (PPIs) can be considered in situations where the drug may no longer be necessary; however, this requires a careful discussion between patients and healthcare providers, often general practitioners (GPs). The aim of our study was to explore how GPs discuss PPI deprescribing with patients and compare that to how older patients would like to discuss this decision.

Methods
We conducted a qualitative study using semi-structured interviews with GPs (n = 11) and patients aged ≥65 years who were taking PPIs (n = 4). Analysis of interviews was based on systematic text condensation.

Results
We identified four main themes: (1) Reasons PPI deprescribing comes up, (2) Considering PPI deprescribing, (3) Discussion topics, and (4) Incorporating patient preferences into PPI deprescribing decisions. We found that PPI deprescribing often comes up during consultations for other problems or due to concern about medication burden in general. GPs discussed topics related to symptom control, such as the possibility of rebound symptoms, the need to taper PPIs, and what to do if symptoms returned. This aligned with what patients felt was important to discuss. Some GPs routinely incorporated patient preferences into decisions, whereas others did not.

Conclusion
When discussing PPI deprescribing, the GPs in our study generally focused on topics related to symptom control. There was variability in how and if patient preferences were discussed. Greater focus may be needed on developing mechanisms to elicit and incorporate patient preferences into PPI deprescribing decisions. Future research could also explore more systematic approaches to reassess ongoing PPI use in an effort to curb unnecessary long-term use of PPIs.
Education level as a predictor of survival in patients with multiple myeloma
Authors: Xu Limei , Wang Xiuju , Pan Xueyi , Wang Xiaotao , Wang Qing , Wu Bingyi , Cai Jiahui , Zhao Ying , Chen Lijuan , Li Wuping , Li Juan 
Published: August 2020

Abstract
Background
Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes.

Methods
We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed.

Results
Overall, 69.2% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had a median progression-free survival (PFS) of 67.50 (95% confidence interval (CI): 51.66–83.39) months, which was better than that of patients with low education levels (30.60 months, 95% CI: 27.38–33.82, p < 0.001). Similarly, patients with high education levels had a median overall survival (OS) of 122.27 (95% CI: 117.05–127.49) months, which was also better than that of patients with low education levels (58.83 months, 95% CI: 48.87–62.79, p < 0.001). In the multivariable analysis, patients with high education levels had lower relapse rates and higher survival rates than did those with low education level in terms of PFS and OS (hazard ratio (HR) = 0.50 [95% CI: 0.34–0.72], p < 0.001; HR = 0.32 [0.19–0.56], p < 0.001, respectively).

Conclusions
Low education levels may independently predict poor survival in MM patients in China.
Demographic, behavioral, and cardiovascular disease risk factors in the Saudi population: results from the Prospective Urban Rural Epidemiology study (PURE-Saudi)
Authors: Alhabib Khalid F. , Batais Mohammed A. , Almigbal Turky H. , Alshamiri Mostafa Q. , Altaradi Hani , Rangarajan Sumathy , Yusuf Salim 
Published: August 2020

AbstractBackgroundCardiovascular disease (CVD) is the major cause of death in Saudi Arabia. We aimed to assess associated demographic, behavioral, and CVD risk factors as part of the Prospective Urban Rural Epidemiology (PURE) study.MethodsPURE is a global cohort study of adults ages 35–70 years in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Data were stratified by age, sex, and urban vs rural and summarized as means and standard deviations for continuous variables and as numbers and percentages for categorical variables. Proportions and means were compared between men and women, among age groups, and between urban and rural areas, using Chi-square test and t-tests, respectively.ResultsThe PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, and 25.1% diabetes. In addition, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had a history of periods of stress, 6.8% had permanent stress, 1% had a history of stroke, 0.6% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers and have diabetes and a history of CHD. Women were more likely to be obese, have central obesity, self-report sadness, experience stress, feel permanent stress, and have low education. Compared to participants in urban areas, those in rural areas had higher rates of diabetes, obesity, and hypertension, and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle-aged and older individuals, younger participants more commonly reported an unhealthy diet, permanent stress, and feeling sad.ConclusionThese results of the PURE-Saudi study revealed a high prevalence of unhealthy lifestyle and CVD risk factors in the adult Saudi population, with higher rates in rural vs urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.
An evaluation of posterior cruciate ligament reconstruction surgery
Authors: Razi Mohammad , Ghaffari Saman , Askari Alireza , Arasteh Peyman , Ziabari Elaheh Ziaei , Dadgostar Haleh 
Published: August 2020

Abstract
Background
The nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have made reports on clinical and epidemiological features of PCL injuries valuable. We aimed to report our experiences with PCL injuries in our region.

Methods
Any patient who referred with a diagnosis of PCL rupture from 2004 to 2018 to our center, was included in this report. We evaluated pre- and postoperative outcomes and compared patients with isolated and combined (multi-ligament) PCL injuries.

Results
Overall, 55 patients were included in our study. Majority of patients were men (87.2%). Mean age of patients was 28.12 ± 8.53 years old.
Average follow-up period was 28.83 ± 20.62 months and mean duration between trauma and surgery was 27.8 ± 38.0 months. Most common cause of PCL injury was traffic accidents (70.9%) followed by sports injuries (5.5%). Majority of patients (69.1%) had combined PCL injuries.
Majority of patients underwent single tibial-double femoral tunnel reconstruction (56.4%), followed by single tibial-single femoral tunnel (34.5%) reconstruction. Allografts were used in 60% of patient. Average Cincinnati knee rating scale (CKRC) was 35.87 ± 11.4, which improved significantly after PCL reconstruction (79.45 ± 11.90, p <  0.001). Full range of motion only existed in 29.1% of patient prior to surgery, which improved after surgery (92.7%, p <  0.001).
Three patients had postoperative arthrofibrosis and motion stiffness, 1 had deep vein thrombosis and 3 patients had infections.
Those with isolated PCL injuries had higher pre-operative CKRS (42.05 ± 8.96 vs. 33.10 ± 11.45, p = 0.006) and lower pre-operative posterior drawer test (2.76 ± 0.43 vs. 3.1 ± 0.6, p = 0.042) compared to those with combined injuries.

Conclusion
Today with advances in surgical techniques, considering treatment of collateral ligament injuries, use of stronger allografts and more secure fixation methods, better rehabilitation programs and early range of motion, results of reconstruction of the PCL has become very promising. Accordingly we recommend surgical treatment even for isolated PCL tears, with the goal to prevent functional deficit and to prevent degenerative arthritis.