bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conversations about FGM in primary care: a realist review on how, why and under what circumstances FGM is discussed in general practice consultations
Authors: Dixon Sharon , Duddy Claire , Harrison Gabrielle , Papoutsi Chrysanthi , Ziebland Sue , Griffiths Frances 
Published: March 2021

ObjectivesLittle is known about the management of female genital mutilation (FGM) in primary care. There have been significant recent statutory changes relevant to general practitioners (GPs) in England, including a mandatory reporting duty. We undertook a realist synthesis to explore what influences how and when GPs discuss FGM with their patients.SettingPrimary care in England.Data sourcesRealist literature synthesis searching 10 databases with terms: GPs, primary care, obstetrics, gynaecology, midwifery and FGM (UK and worldwide). Citation chasing was used, and relevant grey literature was included, including searching FGM advocacy organisation websites for relevant data. Other potentially relevant literature fields were searched for evidence to inform programme theory development. We included all study designs and papers that presented evidence about factors potentially relevant to considering how, why and in what circumstances GPs feel able to discuss FGM with their patients.Primary outcome measureThis realist review developed programme theory, tested against existing evidence, on what influences GPs actions and reactions to FGM in primary care consultations and where, when and why these influences are activated.Results124 documents were included in the synthesis. Our analysis found that GPs need knowledge and training to help them support their patients with FGM, including who may be affected, what needs they may have and how to talk sensitively about FGM. Access to specialist services and guidance may help them with this role. Reporting requirements may complicate these conversations.ConclusionsThere is a pressing need to develop (and evaluate) training to help GPs meet FGM-affected communities’ health needs and to promote the accessibility of primary care. Education and resources should be developed in partnership with community members. The impact of the mandatory reporting requirement and the Enhanced Dataset on healthcare interactions in primary care warrants evaluation.PROSPERO registration numberCRD42018091996.
Socioeconomic status and vitamin D deficiency among women of childbearing age: a population-based, case–control study in rural northern China
Authors: Lin Shiqi , Jiang Lifang , Zhang Yuan , Chai Jian , Li Jiajia , Song Xinming , Pei Lijun 
Published: March 2021

ObjectiveTo explore the association between socioeconomic status (SES) and vitamin D deficiency/insufficiency of women of childbearing age in rural northern China.DesignA population-based, case–control study was conducted.SettingFour counties of Henan Province, China from 2009 to 2010.Participants1151 non-pregnant healthy women between 18 and 40 years old.Primary and secondary outcome measuresSerum 25-hydroxyvitamin D (25(OH)D) levels were measured using high-performance liquid chromatography-tandem mass spectrometry. Vitamin D insufficiency was defined as serum 25(OH)D ≥20 ng/mL and <30 ng/mL, deficiency as ≥10 ng/mL and <20 ng/mL, and severe deficiency as <10 ng/mL. SES was measured separately by women’s and their husbands’ education level and occupation, household income and expenditure, as well as aggregately by SES index constructed with principal component analysis.ResultsThe median serum 25(OH)D level was 20.90 (13.60–34.60) ng/mL, and the prevalence of vitamin D insufficiency, deficiency and severe deficiency was 20.16%, 31.80% and 15.99%, respectively. After adjustment, household annual income <¥10 000 was associated with increased risk of vitamin D insufficiency (adjusted OR (aOR): 2.10, 95% CI 1.41 to 3.14), deficiency (aOR: 1.58, 95% CI 1.09 to 2.29) and severe deficiency (aOR: 2.79, 95% CI 1.78 to 4.38); inadequate household income for expenditure was associated with elevated risk of vitamin D insufficiency (aOR: 1.66, 95% CI 1.08 to 2.54) and deficiency (aOR: 1.81, 95% CI 1.26 to 2.62); low SES index was associated with elevated risk of vitamin D insufficiency (aOR: 2.40, 95% CI 1.52 to 3.80) and deficiency (aOR: 1.64, 95% CI 1.08 to 2.50); and both middle and low SES index were associated with increased risk of vitamin D severe deficiency (aOR: 1.70, 95% CI 1.02 to 2.84; aOR: 2.45, 95% CI 1.45 to 4.14).ConclusionsLower SES was associated with higher risk of vitamin D deficiency/insufficiency in women of childbearing age in rural northern China. More should be done to explore potential mechanisms and to narrow down SES inequalities in vitamin D status.
Structured, multifactorial randomised controlled intervention to investigate physical activity levels, body composition and diet in obese and overweight adolescents
Authors: Srivastav Prateek , K Vaishali , Bhat Vinod H , Broadbent Suzanne 
Published: March 2021

IntroductionThere has been a steep increase in the prevalence of adolescent overweight and obesity globally and in India, demonstrating that present prevention strategies are insufficient. Available evidence suggests that multifactorial interventions may improve short-term physical activity (PA), nutrition and psychological behaviour of overweight and obese adolescents but long-term follow-ups and strategies are needed. This study will investigate the effects of a structured multifactorial (school-based and family-based) intervention on adolescent obesity, compared with a single or no intervention.Methods and analysisA pragmatic, clustered randomised controlled trial with 12 weeks of interventions and 3-month, 6-month and 12-month follow-ups will be conducted at multiple participating schools in Karnataka, India. The participants will be overweight and obese male and female adolescents aged 11–16 years and will be randomly assigned by school into three groups: group A (multifactorial intervention, exercise and dietary advice); group B (exercise only); and group C (controls, no interventions). Primary outcome measures are the level of PA and body composition. Secondary outcomes are dietary change, behaviour change, food behaviours, cardiovascular and muscular fitness, quality of life, parental behaviours (physical and mental) and family functioning. Positive intervention results may reduce obesity in adolescents and promote a healthier lifestyle for students and families. A larger, culturally diverse population can benefit from a similar methodology.Ethics and disseminationThe study has been approved by the Institutional Research and Ethics Committee (IEC 536-2018), Kasturba Hospital, Manipal, Udupi District, Karnataka, India. A written and verbal informed consent (supplemental material) will be provided to the participants prior to participation. On completion of the trial, the results can be communicated to adolescents and their parents on request, and will be published at national and international conferences and in peer-reviewed journals.Trial registration numberCTRI/2019/04/018834.
Development, implementation, evaluation and scaling-up of physical activity referral schemes in Germany: protocol for a study using a co-production approach
Authors: Weissenfels Anja , Geidl Wolfgang , Mino Eriselda , Naber Inga , Klamroth Sarah , Gelius Peter , Abu-Omar Karim , Pfeifer Klaus 
Published: March 2021

IntroductionPhysical activity referral schemes (PARSs) are recommended to promote physical activity (PA) among adults at risk of developing or with established non-communicable diseases (NCDs). In Germany, this kind of referral schemes has not yet been implemented systematically and nationwide. In this study protocol, we present the methodological design of a co-production research study aimed at establishing a PARS for adults with NCDs in German primary healthcare.Methods and analysisWe will employ a co-production approach consistently throughout the four project phases: (1) development of the PARS; (2) preparation period; (3) implementation and evaluation; (4) development of a strategic plan for scaling up the PARS to the national level as part of standard care. The first phase will additionally include a status quo analysis of the existing physical activity pathways nationwide as well as an overview of international PARS models. A pragmatic trial design will be used for evaluating the developed PARS. The co-production approach will involve relevant actors in the German healthcare system, namely, healthcare service providers (eg, physicians, exercise professionals), health insurance providers, exercise providers, patients’ representatives, experts in the development and implementation of educational concepts, and scientists from the fields of sports science and public health.Ethics and disseminationThe project has been reviewed and approved by the ethics committee of the Friedrich-Alexander-University Erlangen-Nürnberg (ethics approval number: 331_20 B). Through cooperation agreements, the stakeholders involved gave their consent to participate and were informed about the study in detail. The results of this study will be disseminated by international conference presentations and peer-reviewed publications, and if possible, a manual for the use of the PARS will be provided.
How to manage a high-output stoma
Authors: Nightingale Jeremy M D 
Published: March 2021

A high-output stoma (HOS) or fistula is when small bowel output causes water, sodium and often magnesium depletion. This tends to occur when the output is >1.5 -2.0 L/24 hours though varies according to the amount of food/drink taken orally. An HOS occurs in up to 31% of small bowel stomas. A high-output enterocutaneous fistula may, if from the proximal small bowel, behave in the same way and its fluid management will be the same as for an HOS.The clinical assessment consists of excluding causes other than a short bowel and treating them (especially partial or intermittent obstruction). A contrast follow through study gives an approximate measurement of residual small intestinal length (if not known from surgery) and may show the quality of the remaining small bowel.If HOS is due to a short bowel, the first step is to rehydrate the patient so stopping severe thirst. When thirst has resolved and renal function returned to normal, oral hypotonic fluid is restricted and a glucose-saline solution is sipped. Medication to slow transit (loperamide often in high dose) or to reduce secretions (omeprazole for gastric acid) may be helpful. Subcutaneous fluid (usually saline with added magnesium) may be given before intravenous fluids though can take 10–12 hours to infuse. Generally parenteral support is needed when less than 100 cm of functioning jejunum remains. If there is defunctioned bowel in situ, consideration should be given to bringing it back into continuity.
FGFR1copy number in breast cancer: associations with proliferation, histopathological grade and molecular subtypes
Authors: Bofin Anna M , Ytterhus Borgny , Klæstad Elise , Valla Marit 
Published: March 2021

AimsFGFR1is located on 8p11.23 and regulates cell proliferation and survival. Increased copy number ofFGFR1is found in several cancers including cancer of the breast.ZNF703is located close toFGFR1at 8p11-12 and is frequently expressed in the luminal B subtype of breast cancer. Using tissue samples from a well-described cohort of patients with breast cancer with long-term follow-up, we studied associations betweenFGFR1copy number in primary breast cancer tumours and axillary lymph node metastases, and proliferation status, molecular subtype and prognosis. Furthermore, we studied associations between copy number increase ofFGFR1and copy number ofZNF703.MethodsWe used fluorescence in situ hybridisation forFGFR1and the chromosome 8 centromere applied to tissue microarray sections from a series of 534 breast cancer cases.ResultsWe found increased copy number (≥4) ofFGFR1in 74 (13.9%) of tumours. Only 6 of the 74 cases with increased copy number were non-luminal. IncreasedFGFR1copy number was significantly associated with high Ki-67 status, high mitotic count and high histopathological grade, but not with prognosis. Forty-two (7.9%) cases had mean copy number ≥6. Thirty of these showedZNF708copy number ≥6.ConclusionsOur results show thatFGFR1copy number increase is largely found among luminal subtypes of breast cancer, particularly luminal B (HER2−). It is frequently accompanied by increased copy number ofZNF703. FGFR1copy number increase is associated with high histopathological grade and high proliferation. However, we did not discover an association with prognosis.
Decrease in incidence of sexually transmitted infections symptoms in men who have sex with men enrolled in a quarterly HIV prevention and care programme in West Africa (CohMSM ANRS 12324—Expertise France)
Authors: Yaya Issifou , Diallo Fodié , Kouamé Malan Jean-Baptiste , Agboyibor Mawuényégan Kouamivi , Traoré Issa , Coulibaly Alou , Maiga Kader , Mora Marion , Palvadeau Pamela , Dah Elias Ter Tiero , Mensah Ephrem , Anoma Camille , Dembélé Keita Bintou , Spire Bruno , Laurent Christian 
Published: March 2021

ObjectiveAlthough men who have sex with men (MSM) are at high risk of STI, their access to tailored healthcare services remains limited in West Africa. We assessed the change in STI symptoms incidence over time among MSM enrolled in a quarterly HIV prevention and care programme in four cities in Burkina Faso, Côte d’Ivoire, Mali and Togo.MethodsWe performed a prospective cohort study in MSM followed up between 2015 and 2019. Men aged over 18 who reported anal sex with another man within the previous 3 months were offered quarterly syndromic diagnosis and treatment for STI, as well as HIV testing, peer-led counselling and support. Condoms and lubricants were also provided. The change in STI symptoms incidence during follow-up was investigated using a non-parametric trend test and mixed-effect Poisson regression models.Results816 participants were followed for a total duration of 1479 person-years. 198 participants (24.3%) had at least one STI symptom during follow-up. Overall, STI symptoms incidence was 20.4 per 100 person-years (95% CI 18.4 to 22.6), ranging from 15.3 in Abidjan to 33.1 in Ouagadougou (adjusted incidence rate ratio (aIRR) 2.39, 95% CI 1.55 to 3.69, p<0.001). STI symptoms incidence was 16.8 and 23.0 per 100 person-years in HIV-positive and HIV-negative participants, respectively (aIRR 0.77, 95% CI 0.57 to 1.04, p=0.087). STI symptoms incidence decreased significantly from 29.9 per 100 person-years in the first 6 months to 8.6 at 30–35 months of follow-up (aIRR per 6-month increase 0.84, 95% CI 0.77 to 0.92, p<0.001).ConclusionSTI symptoms incidence decreased over time but the overall burden of STI appeared to be very high in MSM followed up in West Africa. STI services including counselling, diagnosis and treatment should be reinforced. Laboratory tests that allow accurate diagnosis of STI are required. Strengthening STI services will be critical for controlling the HIV and STI epidemics in this vulnerable population and in the general population.Trial registration numberNCT02626286.
‘95% less harmful’? Exploring reactions to quantitative modified risk claims for snus and e-cigarettes
Authors: Wackowski Olivia A , O'Connor Richard J , Diaz Destiny , Rashid Mariam , Lewis M Jane , Greene Kathryn 
Published: March 2021

ObjectivesStudies examining perceptions of ‘modified risk tobacco product’ (MRTP) messages for e-cigarettes and smokeless tobacco have indicated consumers want statistics and quantification of harm reduction. However, limited research exists on reactions to quantitative MRTP messages.DesignWe conducted 12 focus groups in the USA in 2019—6 focused on e-cigarette messages and 6 on snus messages. Eight groups were with current smokers (ages 21–66) and four with young adult (ages 18–25) non-smokers (n=57). Participants discussed messages stating that use of snus and vaping products have been estimated by scientists to be about 90% and 95% less harmful than smoking cigarettes, respectively.ResultsSeveral participants agreed the messages strongly communicated that the products are less harmful than cigarettes, were attention getting and could be ‘convincing’. However, participants expressed scepticism about the source and accuracy of the stated figures, and some noted the claims could be misleading and attractive to young people. Comments also reflected some claim misunderstandings (eg, that e-cigarettes only pose a 5% chance of harm). Participants also agreed that stating e-cigarette risks ‘are unlikely to exceed 5% of cigarette smoking harms’ was confusing and less impactful than the ‘95% less harmful’ wording.ConclusionsQuantitative claims suggesting high levels of reduced risk when comparing e-cigarettes or smokeless tobacco/snus relative to cigarettes may be successful in gaining attention and being persuasive for some audiences, particularly, if from more credible sources. However, message developers, users and evaluators should be mindful of message limitations and aim to mitigate unintended consequences.
Particles, conformal invariance and criticality in pure and disordered systems
Authors: Delfino Gesualdo 
Published: March 2021

Abstract
The two-dimensional case occupies a special position in the theory of critical phenomena due to the exact results provided by lattice solutions and, directly in the continuum, by the infinite-dimensional character of the conformal algebra. However, some sectors of the theory, and most notably criticality in systems with quenched disorder and short-range interactions, have appeared out of reach of exact methods and lacked the insight coming from analytical solutions. In this article, we review recent progress achieved implementing conformal invariance within the particle description of field theory. The formalism yields exact unitarity equations whose solutions classify critical points with a given symmetry. It provides new insight in the case of pure systems, as well as the first exact access to criticality in presence of short range quenched disorder. Analytical mechanisms emerge that in the random case allow the superuniversality of some critical exponents and make explicit the softening of first-order transitions by disorder.

Graphic abstract
May the four be with you: novel IR-subtraction methods to tackle NNLO calculations
Authors: Torres Bobadilla W. J. , Sborlini G. F. R. , Banerjee P. , Catani S. , Cherchiglia A. L. , Cieri L. , Dhani P. K. , Driencourt-Mangin F. , Engel T. , Ferrera G. , Gnendiger C. , Hernández-Pinto R. J. , Hiller B. , Pelliccioli G. , Pires J. , Pittau R. , Rocco M. , Rodrigo G. , Sampaio M. , Signer A. , Signorile-Signorile C. , Stöckinger D. , Tramontano F. , Ulrich Y. 
Published: March 2021

AbstractIn this manuscript, we report the outcome of the topical workshop: paving the way to alternative NNLO strategies (https://indico.ific.uv.es/e/WorkStop-ThinkStart_3.0), by presenting a discussion about different frameworks to perform precise higher-order computations for high-energy physics. These approaches implement novel strategies to deal with infrared and ultraviolet singularities in quantum field theories. A special emphasis is devoted to the local cancellation of these singularities, which can enhance the efficiency of computations and lead to discover novel mathematical properties in quantum field theories.
Collision of particles near a three-dimensional rotating Hořava AdS black hole
Authors: Bécar Ramón , González P. A. , Vásquez Yerko 
Published: March 2021

AbstractWe consider a three-dimensional rotating AdS black hole, which is a solution of Hořava gravity in the low-energy limit that corresponds to a Lorentz-violating version of the BTZ black hole, and we analyze the effect of the breaking of Lorentz invariance on the possibility that the black hole can act as a particle accelerator by analyzing the energy in the center-of-mass (CM) frame of two colliding particles in the vicinity of its horizons. We find that the critical angular momentum of particles increases when the Hořava parameter $$\xi $$
ξ
increases and when the aether parameter b increases. Also, the particles can collide on the inner horizon with arbitrarily high CM energy if one of the particles has a critical angular momentum, possible for the BSW process. Here it is essential that, while for the extremal BTZ black hole the particles with critical angular momentum only can exist on the degenerate horizon, for the Lorentz-violating version of the BTZ black hole the particle with critical angular momentum can exist in a region away from the degenerate horizon. It is worth mentioning that the results exposed in this manuscript can be applied for the covariant version of Hořava gravity, where the covariant definition of the center-of-mass energy is well defined.
Inertial sensing with quantum gases: a comparative performance study of condensed versus thermal sources for atom interferometry
Authors: Hensel T. , Loriani S. , Schubert C. , Fitzek F. , Abend S. , Ahlers H. , Siemß J.-N. , Hammerer K. , Rasel E. M. , Gaaloul N. 
Published: March 2021

Abstract
Quantum sensors based on light pulse atom interferometers allow for measurements of inertial and electromagnetic forces such as the accurate determination of fundamental constants as the fine structure constant or testing foundational laws of modern physics as the equivalence principle. These schemes unfold their full performance when large interrogation times and/or large momentum transfer can be implemented. In this article, we demonstrate how interferometry can benefit from the use of Bose–Einstein condensed sources when the state of the art is challenged. We contrast systematic and statistical effects induced by Bose–Einstein condensed sources with thermal sources in three exemplary science cases of Earth- and space-based sensors.

Graphic abstract
Medical food development by dietetic management of the endocannabinoid system through dietary sources of β-caryophyllene
Authors: Chiruta Victor 
Published: March 2021

Objective: To research the biological impact on the endocannabinoid system (ECS) from dietary sources of [Formula: see text]-caryophyllene (BCP). This will encompass pre-clinical and clinical research for BCP. The bioavailability of BCP will be explored, focusing on bioavailability improvement. This research will establish if there is justification to warrant the development of a medical food for supporting the ECS through dietetic supplementation of BCP. Methods: Research and review papers were identified through the search engines Google Scholar, PubMed, and ScienceDirect. Main keywords included [Formula: see text]-caryophyllene, endocannabinoid system, dietary cannabinoids, cannabinoid type-2 receptor, and bioavailability. Results: The human body is limited in the digestion of BCP from food. This is because BCP is poorly absorbed in the gut. Everyone has different underlying endocannabinoid efficiency and most people do not have the full potential of supporting their ECS through diet. Conclusion: A medical food can be developed to use BCP with a delivery system, so that the bioactive food cannabinoid is readily absorbed. This will deliver dietary support to the ECS, that otherwise would be available from food. This review provides insight into the efficacy of using BCP in medical foods as dietary support for the ECS. Supporting the ECS can assist in maintaining homeostasis, regulating immune function, pain intensity, inflammatory markers, sleep patterns, mood, appetite, and stress susceptibility.
The SolarWinds hack, and a grand challenge for CS education
Authors: Arquilla John , Guzdial Mark 
Published: March 2021

The
Communications
Web site, http://cacm.acm.org, features more than a dozen bloggers in the BLOG@CACM community. In each issue of
Communications
, we'll publish selected posts or excerpts.

twitter

Follow us on Twitter at http://twitter.com/blogCACM
http://cacm.acm.org/blogs/blog-cacm
John Arquilla analyzes the latest in a long line of cyber intrusions, while Mark Guzdial considers how to prepare CS students for professional decision making.