bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essential fatty acids and Barratt impulsivity in gambling disorder
Authors: Sanchez-Paez Patricia , Perez-Templado Josefa , Saiz-Ruiz Jeronimo , Pastor Oscar , Ibañez Angela 
Published: March 2020

Abstract
Background
Polyunsaturated fatty acids (PUFA) have been long implicated in the etiopathogenesis of mental illnesses, including disorders characterized by high impulsivity. The objective of most of the studies in this field is to determine the effect of omega-3 supplementation on the impulsive symptoms. In contrast, studies analyzing basal PUFA composition in patients with impulsive behaviors are very scarce, results are not yet conclusive, and to date, no publication has specifically evaluated this in gambling disorder. Therefore, the main purpose of this research is to examine the relationship between basal PUFA composition of plasma and erythrocyte membrane and impulsivity in subjects with gambling disorder.

Methods
It is an observational and cross-sectional study. The sample consisted of fifty-five men with gambling disorder, who voluntarily accepted to participate. Basal composition of PUFA in plasma and erythrocyte membrane was assessed by gas chromatography and mass spectrometry. Trait impulsivity was measured by the Barratt Impulsiveness Scale version 11 (BIS-11).

Results
Arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratio in the erythrocyte membrane was negatively correlated with total scores in BIS-11. It was also observed that impulsive gamblers had a higher proportion of EPA and a lower value of AA/EPA and AA/docosahexaenoic acid (DHA) ratio in erythrocyte membrane than non-impulsive gamblers.

Conclusions
These results support the hypothesis that alteration of basal PUFA composition exists in disorders characterized by high impulsivity, although the direction of this is still unknown. Unfortunately, the empirical literature on this field is non-existent at the time and we have no direct means to support or refute these outcomes. Further research is needed to determine the relationship between essential fatty acids and disorders characterized by high impulsivity.
Modulating NMDA receptors to treat MK-801-induced schizophrenic cognition deficit: effects of clozapine combining with PQQ treatment and possible mechanisms of action
Authors: Zhou Xingqin , Cai Gangming , Mao Shishi , Xu Dong , Xu Xijie , Zhang Rongjun , Yao Zhiwen 
Published: March 2020

Abstract
Background
Clozapine has remarkable efficacy on both negative and cognitive symptoms of schizophrenia due to its slight activation of NMDA receptor. In fact, much evidence to the contrary. NMDAR is a complex containing specific binding sites, which are regulated to improve negative symptoms and cognitive deficits associated with individuals affected by schizophrenia.
PQQ is a powerful neuroprotectant that specifically binds with NMDA receptors in the brain to produce beneficial physiological and cognitive outcomes. The aim of this study was to enhance NMDAR function and improve cognitive ability in schizophrenia by PQQ combined with clozapine.

Methods
Rats were divided into four groups (n = 5) including control (saline), model (MK-801, 0.5 mg·kg− 1·d− 1), atypical antipsychotic (MK-801 (0.5 mg·kg− 1·d− 1) + Clozapine (1.0 mg·kg− 1·d− 1), and co-agonist NMDA receptor (MK-801 (0.5 mg·kg− 1·d− 1) + Clozapine (0.5 mg·kg− 1·d− 1) + PQQ (1.0 μg·kg− 1·d− 1) group. Each group of rats was injected subcutaneously every day for 6 weeks. Behavior test, including stereotyped behavior, locomotor hyperactivity, learning and memory, was performed. The Western blot assay was performed to analyze the expression of GSK-3β, Akt, NMDAR1, and MGLUR in rat hippocampus.

Results
Results indicated that clozapine and PQQ combination therapy can improve MK801-induced schizophrenia behavior including stereotyped behavior, locomotor hyperactivity and cognitive impairment. Furthermore, we found that modulating NMDA receptors could ameliorate the memory impairments in Mk-801 induced schizophrenia rats by reducing the expression of NMDAR1 and MGLUR3, decreasing hippocampal tau hyperphosphorylation and inhibiting apoptosis through Akt /GSK-3β signaling pathway.

Conclusions
These findings suggest that combination therapy for enhancing NMDA receptors may be able to rescue cognition deficit in schizophrenia. More studies are needed to better elucidate these mechanisms.
Approaches, barriers, and facilitators to abortion-related work in U.S. health departments: perspectives of maternal and child health and family planning professionals
Authors: Berglas Nancy F. , Wingo Erin , Woodruff Katie , Roberts Sarah C. M. 
Published: March 2020

Abstract
Background
Public health agencies in the United States have engaged in abortion-related activities for nearly 50 years. Prior research indicates that, while most state health departments engage in some abortion-related work, their efforts reflect what is required by law rather than the breadth of core public health activities. In contrast, local health departments appear to engage in abortion-related activities less often but, when they do, initiate a broader range of activities.

Methods
This study aimed to: 1) describe the abortion-related activities undertaken by maternal and child health (MCH) and family planning professionals in state and local health departments; 2) understand how health departments approach their programmatic work on abortion, and 3) examine the facilitators and barriers to whether and how abortion work is implemented. Between November 2017 and June 2018, we conducted key informant interviews with 29 professionals working in 22 state and local health departments across the U.S. Interview data were thematically coded and analyzed using an iterative approach.

Results
MCH and family planning professionals described a range of abortion-related activities undertaken within their health departments. We identified three approaches to this work: those mandated strictly by law or policy; those initiated when mandated by law but informed by public health principles (e.g., scientific accuracy, expert engagement, lack of bias, promoting access to care) in implementation; and those initiated by professionals within the department to meet identified needs. More state health departments engaged in activities when mandated, and more local health departments initiated activities based on identified needs. Key barriers and facilitators included political climate, funding opportunities and restrictions, and departmental leadership.

Conclusions
Although state health departments are tasked with implementing legally-required abortion-related activities, some agencies bring public health principles to their mandated work. Efforts are needed to engage public health professionals in developing and implementing best practices around engaging in abortion-related activities.
Culture competence and mental health across different immigrant and refugee groups
Authors: Oppedal Brit , Keles Serap , Cheah Charissa , Røysamb Espen 
Published: March 2020

Abstract
Background
Over the last decades, due to high rates of immigration, many high-income countries have witnessed demographic shifts towards more cultural diversity in the population. Socio-economic deprivation and traumatic experiences pre-migration contribute to a high risk for mental health problems among immigrant background youth. Moreover, when adapting to the multi-cultural contexts of the resettlement countries they face several acculturation demands, which may also affect their mental health in adaptive or hazardous ways. One of these acculturation tasks involves developing the cultural competence necessary to thrive and participate socially within the heritage and the majority cultural domains. From a public mental health perspective, it is important to have thorough knowledge about acculturation-related risk and protective factors. However, this responsibility has been challenged by a lack of acculturation measures that are theoretically linked to mental health, and target the cultural competencies of immigrant background youth. Therefore, the current study aimed at examining if a construct of peer-related culture competence, operationalized in the Youth Culture Competence Scale (YCCS), captured the same competence-phenomenon across different language, age, and immigrant groups in two immigrant-receiving countries. The scale includes two dimensions: one of heritage, and one of majority peer-related culture competence.

Methods
Self-report questionnaire data were collected from 895 unaccompanied refugees and 591 immigrant background high school students in Norway, and from 321 immigrant university students in the United States. To examine if the measure assessed the same phenomenon of peer-related culture competence across these three multi-ethnic samples with an age range from 13 to 28, we examined its measurement equivalence. Additionally, we examined if the association between peer-related culture competence and depressive symptoms was similar in these groups.

Results
Confirmatory factor analyses supported the proposed two factor structure of the YCCS across the three samples. The structural equation model assessing the effects of heritage and majority culture competence on depressive symptoms confirmed that each culture competence dimension had a unique association with depressive symptoms across the samples.

Conclusions
We conclude that the YCCS is a robust acculturation measure that may be included in public health studies of mental health among multi-ethnic refugee and immigrant samples of varied ages.
Self-management practice, associated factors and its relationship with health literacy and patient activation among multi-morbid COPD patients from rural Nepal
Authors: Yadav Uday Narayan , Lloyd Jane , Hosseinzadeh Hassan , Baral Kedar Prasad , Bhatta Narendra , Harris Mark Fort 
Published: March 2020

Abstract
Background
Chronic Obstructive Pulmonary Disease (COPD) is a progressive and debilitating condition that affects individuals’ quality of life. COPD self-management and supports provided by carers is key to the quality of life people living with COPD. Health literacy (HL) and Patient Activation (PA) are main drivers of self-management practices (SMPs). However, their contribution remains to be fully explored. This study aimed to examine the level of self-management practices, and the relationship with socio-demographic factors, HL and PA among multi-morbid COPD patients from rural Nepal.

Methods
This is a cross-sectional study conducted between July 2018 and January 2019. Patients completed a survey, including Self-management Practices questionnaire (SMPQ), five domains of the Health Literacy Questionnaire (HLQ), and Patient Activation Measure (PAM). The relationship between HL, PAM, and SMPs was examined using univariate statistics. Multivariable analysis was conducted to identify the factors associated with SMPs.

Results
A total of 238 patients responded to the study. The mean score of SMPQ was 45.31(SD = 9.00). The HLQ and PAM scores were positively correlated with the total score of SMPQ. Low level of SMPs were found to be positively associated with being uneducated (β = − 0.43, p = .001), having a low family income (β = − 5.22, p = .002), and, negatively associated with the presence of more than one co-morbidity (β = 3.58, p = 0.007) after controlling for other socio-demographic variables in the multivariable analysis.

Conclusion
The overall SMPs among this sample of Nepalese with COPD were low. Our findings highlight the need to implement a self-management intervention program involving patient activation and health literacy-focused activities for COPD, creating a support system for patients from low-income families and low education.
Knowledge about cervical cancer and HPV immunization dropout rate among Brazilian adolescent girls and their guardians
Authors: Santos Ana Carolina da Silva , Silva Nayara Nascimento Toledo , Carneiro Cláudia Martins , Coura-Vital Wendel , Lima Angélica Alves 
Published: March 2020

Abstract
Background
Infections with Human Papillomavirus (HPV) are the main cause of cervical cancer. Since 2014, the HPV vaccine was introduced in the Brazilian National Vaccination Calendar. The purpose of this study was to assess the knowledge of adolescent girls and their mothers/guardians about HPV and HPV vaccine, identify the factors associated with this knowledge, and evaluate immunization dropout rate.

Methods
This was a cross-sectional study involving adolescent girls and their mothers/guardians. Participants underwent an interview that addressed sociodemographic data, sexual and gynecological history, and knowledge about HPV, HPV vaccine and cervical cancer. The third quartile of the total score was established as a cutoff for assessing knowledge. Adolescents who correctly answered more than four questions and mothers/guardians who obtained more than five correct responses were categorized into high knowledge. Poisson regression analysis was performed to identify variables associated with low knowledge. Vaccination records were used to assess immunization dropout rates. Any adolescent who did not complete the two-dose vaccination schedule was considered dropout.

Results
A total of 666 adolescent girls and 623 mothers/guardians were interviewed. Low knowledge was observed in 76.7% of adolescents and 79.8% of mothers/guardians. Most were unaware of the causal relationship between HPV and cervical cancer, signs and symptoms of HPV infection, and had limited knowledge about the HPV vaccine. Factors associated with low knowledge of adolescents were aged 12 years [IRR 1.2 (95% CI 1. 1-1.3)] or less [IRR 1.3 (95% CI (1. 2-1.4)]; household income lower than US$750 [IRR 1.7 (95% CI 1. 1-2.6)] and household income between US$751 and US$1500 [IRR 1.6 (95% CI 1.0–2.6)]. Among mothers/guardians, low knowledge was related to having completed elementary school or less [IRR 1.5 (95% CI 1. 2-2.0)]; and household income lower than US$750 [IRR 1.2 (95% CI 1.0–1.4)]. Knowledge of adolescents and mothers/guardians was not associated with vaccine uptake. HPV immunization dropout rate was considered high (32.3%).

Conclusion
Knowledge about HPV and cervical cancer as well as vaccine uptake was low. Results highlight the need for educational interventions about HPV and cervical cancer. These actions may contribute to improve adherence to HPV vaccination.
Potential effect of different nutritional labels on food choices among mothers: a study protocol
Authors: Seyedhamzeh Shirin , Nedjat Saharnaz , Hosseini Hedayat , Shakibazedeh Elham , Viera Anthony J. , Dorosty Motlagh Ahmadreza 
Published: March 2020

Abstract
Background
The prevalence of non-communicable diseases (NCDs) is increasing in the world. Healthy food choice and adequate physical activity are key factors in preventing NCDs. Food labeling is a strategy that can inform consumers to choose healthier foods at the point of purchase. In this study, we intend to examine the status of existing labels and to clarify their strengths and weaknesses. Then, for the first time in Iran, we will design a type of physical activity equivalent calorie label and will test it on some food groups of packaged products including dairy products, sweetened beverages, cakes, and biscuits.

Methods
This study will be conducted in two phases. In phase 1, nutrition fact labels and traffic light labels will be assessed through focus group discussions and interviews among different groups of mothers, industrialists and nutrition and food industry specialists as to determine strengths and weaknesses of the current labels on packaged products. Then, the initial layout of the physical activity calorie equivalent label will be drawn with respect to the viewpoints received from mothers. Thereafter, we will include the scientific opinions to it for creating the first draft of our new label. In phase 2, a total of 500 mothers of students 6–12 years old randomly assigned to five groups. The study groups will be as follows: (1) without nutrition label group, (2) current traffic light label group, (3) current traffic light label group in which, a brochure will be used to inform mothers, (4) physical activity calorie equivalent label group, and (5) physical activity calorie equivalent label group in which a brochure will be used to inform mothers. Some samples of dairy products, beverages, cakes, and biscuits will be presented. ANOVA and multiple linear regressions will be used to examine the association between the label type and the main consequence (energy of the selected products) and secondary outcome (time).

Discussion
The effect of the new food labels will be evaluated based on the differences between the calories of selected food groups.

Trial registeration
Iranian Registery of Clinical Trials [IRCT]20,181,002,041,201 N1.
Predicting the microbial cause of community-acquired pneumonia: can physicians or a data-driven method differentiate viral from bacterial pneumonia at patient presentation?
Authors: Lhommet Claire , Garot Denis , Grammatico-Guillon Leslie , Jourdannaud Cassandra , Asfar Pierre , Faisy Christophe , Muller Grégoire , Barker Kimberly A. , Mercier Emmanuelle , Robert Sylvie , Lanotte Philippe , Goudeau Alain , Blasco Helene , Guillon Antoine 
Published: March 2020

Abstract
Background
Community-acquired pneumonia (CAP) requires urgent and specific antimicrobial therapy. However, the causal pathogen is typically unknown at the point when anti-infective therapeutics must be initiated. Physicians synthesize information from diverse data streams to make appropriate decisions. Artificial intelligence (AI) excels at finding complex relationships in large volumes of data. We aimed to evaluate the abilities of experienced physicians and AI to answer this question at patient admission: is it a viral or a bacterial pneumonia?

Methods
We included patients hospitalized for CAP and recorded all data available in the first 3-h period of care (clinical, biological and radiological information). For this proof-of-concept investigation, we decided to study only CAP caused by a singular and identified pathogen. We built a machine learning model prediction using all collected data. Finally, an independent validation set of samples was used to test the pathogen prediction performance of: (i) a panel of three experts and (ii) the AI algorithm. Both were blinded regarding the final microbial diagnosis. Positive likelihood ratio (LR) values > 10 and negative LR values < 0.1 were considered clinically relevant.

Results
We included 153 patients with CAP (70.6% men; 62 [51–73] years old; mean SAPSII, 37 [27–47]), 37% had viral pneumonia, 24% had bacterial pneumonia, 20% had a co-infection and 19% had no identified respiratory pathogen. We performed the analysis on 93 patients as co-pathogen and no-pathogen cases were excluded. The discriminant abilities of the AI approach were low to moderate (LR+ = 2.12 for viral and 6.29 for bacterial pneumonia), and the discriminant abilities of the experts were very low to low (LR+ = 3.81 for viral and 1.89 for bacterial pneumonia).

Conclusion
Neither experts nor an AI algorithm can predict the microbial etiology of CAP within the first hours of hospitalization when there is an urgent need to define the anti-infective therapeutic strategy.
Serum osteocalcin level is associated with the mortality in Chinese patients with Fibrodysplasia ossificans progressiva aged ≤18 years at diagnosis
Authors: She Dunmin , Li Ran , Fang Ping , Zong Guannan , Xue Ying , Zhang Keqin 
Published: March 2020

Abstract
Background
Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic disorder characterized by extraskeletal heterotopic ossification. It is well recognized that FOP can lead to a devastating condition of disability. However, the mortality rate of FOP patients in China and risk factors for mortality are still largely unclear.

Methods
We conducted a retrospective research on a cohort of 65 cases of FOP patients in China from 2008 to 2018. We reviewed medical records of these FOP patients to retrieve information such as date of birth/death, gender, clinical features, genotypes and biochemical parameters and analyze the correlation of these parameters with the mortality.

Results
92.3% (60/65 cases) patients were classic FOP patients, 3.1% (2/65 cases) were FOP-plus and 4.6% (3/65 cases) were FOP variants. 9 cases of this cohort were dead during the ten-year period, and the overall mortality rate was 13.8%. c.617G > A mutation was confirmed in all non-survivors. In FOP patients≤18 years at diagnosis, non-survivors demonstrated significantly lower blood osteocalcin and alkaline phosphatase levels compared with survivors (P < 0.05), and spearman correlation and logistic regression analysis indicated that serum osteocalcin and alkaline phosphatase levels were negatively correlated with the mortality. Furthermore, the receiver-operating characteristic curve analysis showed serum osteocalcin had the largest area under the curve of 0.855 among four biochemical parameters, and serum osteocalcin < 65.9 ng/ml displayed a good capacity to discriminate the non-survivors from survivors in FOP patients aged 18 years and younger at diagnosis.

Conclusions
Our findings showed that the mortality rate of FOP was 13.8% in China. Serum OC level was negatively correlated with the mortality in Chinese FOP patients ≤18 years at diagnosis.
American foulbrood in a honeybee colony: spore-symptom relationship and feedbacks between disease and colony development
Authors: Stephan Jörg G. , de Miranda Joachim R. , Forsgren Eva 
Published: March 2020

Abstract
Background
The most severe bacterial disease of honeybees is American foulbrood (AFB). The epidemiology of AFB is driven by the extreme spore resilience, the difficulty of bees to remove these spores, and the considerable incidence of undetected spore-producing colonies. The honeybee collective defence mechanisms and their feedback on colony development, which involves a division of labour at multiple levels of colony organization, are difficult to model. To better predict disease outbreaks we need to understand the feedback between colony development and disease progression within the colony. We therefore developed Bayesian models with data from forty AFB-diseased colonies monitored over an entire foraging season to (i) investigate the relationship between spore production and symptoms, (ii) disentangle the feedback loops between AFB epidemiology and natural colony development, and (iii) discuss whether larger insect societies promote or limit within-colony disease transmission.

Results
Rather than identifying a fixed spore count threshold for clinical symptoms, we estimated the probabilities around the relationship between spore counts and symptoms, taking into account modulators such as brood amount/number of bees and time post infection. We identified a decrease over time in the bees-to-brood ratio related to disease development, which should ultimately induce colony collapse. Lastly, two contrasting theories predict that larger colonies could promote either higher (classical epidemiological SIR-model) or lower (increasing spatial nest segregation and more effective pathogen removal) disease prevalence.

Conclusions
AFB followed the predictions of the SIR-model, partly because disease prevalence and brood removal are decoupled, with worker bees acting more as disease vectors, infecting new brood, than as agents of social immunity, by removing infected brood. We therefore established a direct link between disease prevalence and social group size for a eusocial insect. We furthermore provide a probabilistic description of the relationship between AFB spore counts and symptoms, and how disease development and colony strength over a season modulate this relationship. These results help to better understand disease development within honeybee colonies, provide important estimates for further epidemiological modelling, and gained important insights into the optimal sampling strategy for practical beekeeping and honeybee research.