bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transplantation of Apoptosis‐Resistant Endothelial Progenitor Cells Improves Renal Function in Diabetic Kidney Disease
Authors: Kundu Nabanita , Nandula Seshagiri R. , Asico Laureano D. , Fakhri Mona , Banerjee Jaideep , Jose Pedro A. , Sen Sabyasachi 
Published: March 2021

Background
Diabetic kidney disease is associated with glomerulosclerosis and poor renal perfusion. Increased capillary formation and improved perfusion may help to halt or reverse the injury. Transplanting apoptosis‐resistant p53‐silenced endothelial progenitor cells (p53sh‐EPCs) may help improve vascularization and renal perfusion and could be more beneficial than another stem cell such as the mouse mesenchymal stromal cell (mMSC).

Methods and Results

Hyperglycemia and proteinuria were confirmed at 8 to 10 weeks in streptozotocin‐induced type1 diabetic C57Bl/6 mice, followed by transplantation of 0.3 million p53sh‐EPCs, Null‐EPCs (control), or mMSC under each kidney capsule. Urine was collected weekly for creatinine and protein levels. Blood pressure was measured by direct arterial cannulation and renal perfusion was measured by renal ultrasound. The kidneys were harvested for histology and mRNA expression. Reduction of protein/creatinine (AUC) was observed in p53sh‐EPC‐transplanted mice more than null‐EPC (1.8‐fold,
P
=0.03) or null‐mMSC (1.6‐fold,
P
=0.04, n=4) transplanted mice. Markers for angiogenesis, such as endothelial nitric oxide synthase (1.7‐fold,
P
=0.06), were upregulated post p53sh‐EPC transplantation compared with null EPC. However, vascular endothelial growth factor‐A expression was reduced (7‐fold,
P
=0.0004) in mMSC‐transplanted mice, compared with p53sh‐EPC‐transplanted mice. Isolectin‐B4 staining of kidney section showed improvement of glomerular sclerosis when p53sh‐EPC was transplanted, compared with null‐EPC or mMSC. In addition, mean and peak renal blood velocity (1.3‐fold,
P
=0.01, 1.4‐fold,
P
=0.001, respectively) were increased in p53sh‐EPC‐transplanted mice, relative to null‐EPC transplanted mice.

Conclusions
Apoptosis‐resistant p53sh EPC transplantation could be beneficial in the treatment of diabetic kidney disease by decreasing proteinuria, and improving renal perfusion and glomerular architecture.
Beyond ‘the Stepford Wives Syndrome’
Authors: Burney Saleema Farah 
Published: March 2021

Abstract
Moving away from politicised and institutional agendas, research on Muslims has now begun to document the voices and concerns of individual Muslim women. Based on two years of doctoral fieldwork in and around London, this paper raises methodological dilemmas in the study of Muslim communities. It then presents data showcasing how Muslim women are successfully creating hybrid identities, and navigating new sites and opportunities for mutual exchange with non-Muslims. It argues that their public interactions as religious women living in a liberal secular society provide hope for a plural Britain, built on a convivial and interactive model of integration.
Simulations of ENSO Phase-Locking in CMIP5 and CMIP6
Authors: Chen Han-Ching , Jin Fei-Fei 
Published: March 2021

AbstractThe characteristics of El Niño–Southern Oscillation (ENSO) phase-locking in observations and CMIP5 and CMIP6 models are examined in this study. Two metrics based on the peaking month histogram for all El Niño and La Niña events are adopted to delineate the basic features of ENSO phase-locking in terms of the preferred calendar month and strength of this preference. It turns out that most models are poor at simulating the ENSO phase-locking, either showing little peak strength or peaking at the wrong seasons. By deriving ENSO’s linear dynamics based on the conceptual recharge oscillator (RO) framework through the seasonal linear inverse model (sLIM) approach, various simulated phase-locking behaviors of CMIP models are systematically investigated in comparison with observations. In observations, phase-locking is mainly attributed to the seasonal modulation of ENSO’s SST growth rate. In contrast, in a significant portion of CMIP models, phase-locking is codetermined by the seasonal modulations of both SST growth and phase transition rates. Further study of the joint effects of SST growth and phase transition rates suggests that for simulating realistic winter peak ENSO phase-locking with the right dynamics, climate models need to have four key factors in the right combination: 1) correct phase of SST growth rate modulation peaking at the fall, 2) large-enough amplitude for the annual cycle in growth rate, 3) small amplitude of semiannual cycle in growth rate, and 4) small amplitude of seasonal modulation in SST phase transition rate.
Foster Care, Permanency, and Risk of Prison Entry
Authors: Font Sarah , Berger Lawrence M. , Slepicka Jessie , Cancian Maria 
Published: March 2021

Objective: (1) Examine associations of foster care exit type (e.g., reunification with birth family, adoption, guardianship/permanent relative placement, or emancipation from care) with risk of entry into state prison; (2) Examine racial disparities in those associations. Method: With data on over 10,000 Wisconsin youth who entered foster care in mid- to late-childhood, we present imprisonment rates in young adulthood by race, sex, and foster care exit type. Proportional hazards models with a robust set of covariates compared prison entry rates among the most common exit types—reunification, aging out, and guardianship/permanent relative placement. Results: Nearly 13 percent of the sample experienced imprisonment in young adulthood. Compared with emancipated youth, hazard of imprisonment was 1.58–1.96 times higher among reunified youth. Differences were largely unexplained by observed individual, family, or foster care characteristics. Imprisonment rates were similar for emancipated youth and youth exiting to guardianship/permanent relative placement. Hazard of imprisonment for reunified Black youth was twice that of reunified white youth, but racial differences in prison entry were statistically non-significant among emancipated youth. Conclusion: Efforts to reduce incarceration risk for all youth in foster care are needed. Reunified youth may benefit from services and supports currently provided primarily to emancipated youth.
Consumer Behavior at Supermarkets during Grocery Shopping in Saudi Arabia: A National Observational Study
Authors: Almutairi Lulu A , Althumiri Nora A , Aljadani Rawabi H , Alkhamis Dalal , Almarshad Abdulrahman , Abanmy Abdulaziz , Alhazmi Maram , Aldhewalia Maryam , Almubark Rasha , Alqahtani Amani S , BinDhim Nasser F 
Published: March 2021

Background: Use of nutrition facts labels can be associated with healthier eating behaviors; however, consumers currently face difficulty understanding these labels or do not use them often. Thus, improving healthy grocery shopping behaviors among consumers might increase the overall health of the community. Aim: The study aims to explore consumers’ behavior during grocery shopping and measure their basic knowledge regarding food product labels. Method: A national observational study (cross-sectional) was carried out on a convenience sample of Saudi Arabian residents aged 18 years and above. The data were obtained from all 13 administrative regions in Saudi Arabia at three different major supermarkets in each region. The data were analyzed using descriptive analysis, and binary logistic regression was used to investigate behavior variables. Results: A total of 12,675 participants were observed; of those, 52.2% did not interact with the product before putting it in their shopping cart. The study found that the production date (66.6%) and expiry date (51%) were the most frequently checked aspects of food labels; they were checked more frequently than nutrition facts (29%). Furthermore, there was a low level of dietary knowledge among consumers and a moderate level of believing food packages and media claims. Conclusions: Our results suggest that the Saudi community's understanding of food product information is limited and greater awareness and community education campaigns are required to improve the use of nutritional labels and increase nutritional knowledge.
Pulmonary embolism secondary to deep venous thrombosis: A retrospective and observational study for clinical characteristics and risk stratification
Authors: Chen Xiaoying , Liu Xian , Liu Jinglun , Zhang Dan 
Published: March 2021

Objective To investigate the risk factors, predilection sites in pulmonary embolism (PE) patients caused by deep venous thrombosis (DVT) and explore the value of scoring systems in assessing the risk of PE in DVT patients. Methods A total of 692 DVT patients were enrolled, and divided into no pulmonary embolism (NPE, 226, 32.66%), silent pulmonary embolism (SPE, 330, 47.67%) and featuring pulmonary embolism (FPE, 136, 19.65%) groups. For each group, the differences of clinical data and PE locations were compared, and the risk factors of PE secondary to DVT were analyzed. The predictive value of the scoring system for the diagnosis of PE and FPE was evaluated. Results PE presented more in the bilateral pulmonary arteries (PAs) (249, 53.43%) and has no significant difference in PESI scores in different locations. Gender, DVT locations, and previous surgery were the independent risk factors of PE. DVT locations, previous history of COPD, and previous surgical interventions were the independent risk factors of FPE. The results for areas under the ROC curves were: AUC(Wells) = 0.675, AUC (Revised Geneva) = 0.601, AUC(D-dimer) = 0.595 in the PE group; AUC(Wells) = 0.722, AUC (Revised Geneva) = 0.643, AUC(D-dimer) = 0.557 in the FPE group. Conclusions PE secondary to DVT mostly occurs in the bilateral PAs. Male gender, DVT locations, and previous surgery increased the risk of PE. The Wells scoring system was more advantageous for evaluating the diagnosis of PE in patients with DVT.
Food Skills Education and Low-Income Adults’ Healthy Food Choices
Authors: Pooler Jennifer A. , Srinivasan Mithuna , Wong Karen , Blitstein Jonathan L. 
Published: March 2021

Background The Cooking Matters food skills education program equips low-income families with the skills and knowledge to shop for and cook healthy meals within budget and time constraints. Aims To explore whether participation in Cooking Matters is associated with healthier food choices using a 6-item scale, comprised of a variety of food categories. Methods Cooking Matters participants (n = 332) and a comparison group (n = 336) completed surveys at baseline, 3-, and 6-month follow-up. Results Cooking Matters participants experienced greater improvements in healthy choices overall (p < 0.0001) and for each of the six underlying items at 3 month follow-up. Improvements were sustained at 6-month follow-up overall and for all categories, except low-fat milk (p = 0.1168). Discussion Participation in Cooking Matters was associated with improvements in overall healthy food choices across a variety of food groups and maintained at 6-month follow-up. Enabling healthy food choices is an important step toward improved diet quality.
Guidance and/or Decision Coaching with Patient Decision Aids: Scoping Reviews to Inform the International Patient Decision Aid Standards (IPDAS)
Authors: Rahn Anne Christin , Jull Janet , Boland Laura , Finderup Jeanette , Loiselle Marie-Chantal , Smith Maureen , Köpke Sascha , Stacey Dawn 
Published: March 2021

Introduction In 2005, the International Patient Decision Aid Standards (IPDAS) collaboration identified guidance and decision coaching as important dimensions of patient decision aids (PtDAs) and developed a set of quality criteria. We sought to update definitions, theoretical rationale, and evidence for guidance and/or decision coaching used within or alongside PtDAs for the IPDAS update 2.0. Methods We conducted 2 scoping reviews on guidance and decision coaching, including systematic searches and a hand search of the Cochrane Review on PtDAs. Eligible studies were randomized controlled trials (RCTs) on guidance or decision coaching used with/alongside PtDAs. Data, including conceptual models, were summarized narratively and with meta-analyses when appropriate. Results Of 1022 citations, we found no RCTs that evaluated guidance in PtDAs. The 2013 definition for guidance was endorsed, and we made minimal changes to the description of guidance. Of 3039 citations, we identified 21 RCTs on decision coaching informed by 5 conceptual models stating that people exposed to decision coaching are more likely to progress in making informed decisions consistent with their values. Compared to usual care, decision coaching with PtDAs led to improved knowledge mean difference [MD], 19.5/100; 95% confidence interval [CI], 10.0–29.0; 5 RCTs). Compared to decision coaching alone, PtDAs led to a small improvement in knowledge (MD, 3.6/100; 95% CI, 1.0–6.3; 3 RCTs). There were variable effects on other outcomes. We simplified the decision coaching definition slightly and defined minimal decision coaching elements. Conclusion We found no evidence on which to propose changes in guidance in IPDAS. Decision coaching is continuing to be used alongside PtDAs, but there is inadequate evidence on the added effectiveness compared to PtDAs alone. The decision coaching definition was updated with minimal elements.
Save the Quinolones! Impact of a Non-Restrictive Fluoroquinolone Reduction Initiative on Antibiotic Use and Resistance at an Urban Teaching Hospital
Authors: Smoke Steven M. , Plotkin Slava , Patel Neeki , Hilden Patrick 
Published: March 2021

Background: Many antibiotic stewardship programs have sought to reduce fluoroquinolone use due to their association with a myriad of negative consequences. In hospital settings with fewer resources, initiatives that are less labor intensive may offer a more feasible approach to addressing fluoroquinolone use and improving patient care. Objective: This study assessed the impact of a non-restrictive fluoroquinolone reduction initiative on antibiotic use and resistance. Methods: This was a retrospective pre- and post-interventional ecological study conducted from 2016 to 2017. The fluoroquinolone reduction initiative consisted of education on risks and alternatives. Buttons promoting “Save the Quinolones” were also worn to increase visibility. Outcome measures were the rate of fluoroquinolone use and antibiotic resistance in Staphylococcus aureus, Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, and Pseudomonas aeruginosa before and after the intervention. Results: Overall, fluoroquinolone use decreased throughout the study, but there was a significantly greater rate of decrease in the post-intervention period (monthly decrease of 3.3% (1.3, 5.1) v. 7.4% (5, 9.8) p = 0.043). S. aureus susceptibility to oxacillin increased from 47.2% to 55.2% (difference 8.0, 95%CI 1.2 to 14.7). P. aeruginosa susceptibility to levofloxacin increased from 60% to 70.7% (difference 10.7, 95%CI 0.8 to 20.6). No differences in susceptibility rates of E. coli, P. mirabilis or K. pneumoniae were detected. Conclusion: This non-restrictive fluoroquinolone reduction initiative led to a significant decrease in fluoroquinolone use that was associated with decreased antibiotic resistance in S. aureus and P. aeruginosa.
Occlusal Outcome of Orthodontic Treatment for Patients With Complete Cleft Lip and Palate
Authors: Stonehouse-Smith Daniel , Rahman Aida N.A. Abd , Mooney Jeanette , Bellardie Haydn 
Published: March 2021

Aim: To assess occlusal outcomes of orthodontic treatment for patients with complete cleft lip and palate. Design: Retrospective assessment using the Peer Assessment Rating (PAR) index. Setting: Consecutive patients treated by one consultant orthodontist at a tertiary care cleft center. Participants: One hundred twenty-seven patients with either complete unilateral cleft lip and palate (UCLP) or bilateral cleft lip and palate (BCLP) consecutively treated with fixed appliances. Intervention: Fixed orthodontic appliance treatment and orthognathic surgery when required. Outcomes: The PAR index assessment was carried out by a calibrated-independent assessor. Treatment duration, the number of patient visits, and data on dental anomalies were drawn from patient records and radiographs. Results: One hundred two patients’ study models were assessed after exclusions. Mean start PAR score for UCLP (n = 71) was 43.9 (95% CI, 41.2-46.6, SD 11.5), with a mean score reduction of 84.3% (95% CI, 81.9-86.7, SD 10.1). The UCLP mean treatment time was 23.7 months with 20.1 appointments. Mean start PAR score for BCLP (n = 31) was 43.4 (95% CI, 39.2-47.6, SD 11.4), with a mean score reduction of 80.9% (95% CI, 76.3-85.5, SD 12.5). The BCLP mean treatment time was 27.8 months with 20.5 appointments. Conclusion: These results compare well with other outcome reports, including those for patients without a cleft, and reflect the standard of care provided by an experienced cleft orthodontist. As with high-volume surgeons, orthodontic treatment for this high need group is favorable when provided by a high-volume orthodontist. These findings may be used for comparative audit with similar units providing cleft care.
Efficacy of Non-pharmacological Treatments on Emotional Symptoms of Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis
Authors: Guo Chao , Assumpcao Leonardo , Hu Zhiguo 
Published: March 2021

Background: The present meta-analysis aimed to evaluate the efficacy of various non-pharmacological interventions on comorbid emotional symptoms such as depression, anxiety, and emotional dysregulation (ED) in children and adults with ADHD. Method: Forty-four randomized controlled trials (23 studies with ADHD children and 21 studies with ADHD adults) were included. Risk of bias, heterogeneity assessment, and subgroup analyses were conducted. Results: We found that therapies targeting the relationship between children and others (i.e., parent-training [on ED and depression] and social skills training [on ED]) were efficacious in the treatment of emotional symptoms in children with ADHD at post-intervention. As for adults with ADHD, cognitive behavioral therapy was found to be effective for the improvement of emotional symptoms at both post-intervention and follow-up. Conclusion: Our findings demonstrate that the efficacy of non-pharmacological interventions varies substantially across children and adults with ADHD. These results provide important implications for the selection of non-pharmacological interventions for children with ADHD.
High Seroprevalence of Hepatitis C Virus Antibody in Breast Cancer Patients in Egypt
Authors: Hussein Osama , El-Ghitany Engy Mohamed , Omran Mawadda , Matariek Ghadier , Elbadaly Esraa Ahmed , Hamdy Rana , Gamal Amira , Zayed Mai Mohamed , Nasr Ahmed , Hamdy Omar , Elbasiony Mohamed , Abdelwahab Khaled 
Published: March 2021

Background: Hepatitis C virus (HCV) is a known risk factor for hepatocellular carcinoma. Several epidemiological studies have pointed out to an association of HCV infection with other extrahepatic malignancies. The role of chronic HCV in breast cancer causation is less clear. Egypt is an endemic area of HCV infection with resulting significant morbidity. The association between HCV status and breast cancer risk in Egyptian women is hitherto unknown. Methods: A retrospective study was performed. The prevalence of anti-HCV seropositivity was estimated in a sample of women with a breast cancer diagnosis, retrieved from the hospital records, and was compared to the raw data of a population study in Egypt. Anti-HCV negative and positive patients were compared regarding the disease course and outcome. Results: Retrospective analysis revealed a markedly high prevalence of anti-HCV seropositivity in young breast cancer patients. In patients younger than 45 years, 13.4% were anti-HCV positive. Seropositivity was 6-fold higher in these patients than in adult females of the same age without cancer diagnosis ( P = .003). The biological type, tumor size, nodal status, and disease-free survival were not affected by the patients’ HCV status. Conclusion: Young Egyptian breast cancer patients have a dramatically high prevalence of HCV seropositivity. Further population studies are strongly required to investigate the epidemiological association of these two significant health problems.
What Are the Burden, Causes, and Costs of Early Hospital Readmissions After Kidney Transplantation?
Authors: Famure Olusegun , Kim Esther D. , Au Magdalene , Zyla Roman E. , Huang Johnny W. , Chen Pei Xuan , Li Yanhong , Kim S. Joseph 
Published: March 2021

Introduction: Kidney transplant recipients are at risk for complications resulting in early hospital readmission. This study sought to determine the incidences, risk factors, causes, and financial costs of early readmissions. Design: This single-centre cohort study included 1461 kidney recipients from 1 Jul 2004 to 31 Dec 2012, with at least 1-year follow-up. Early readmission was defined as hospitalization within 30 or 90-days postdischarge from transplant admission. Associations between various parameters and 30 and 90-days posttransplant were determined using multivariable Cox proportional hazards models. The hospital-associated costs of were assessed. Results: The rates of early readmission were 19.4% at 30 days and 26.8% at 90 days posttransplant. Mean cost per 30-day readmission was 11 606 CAD. Infectious complications were the most common reasons and resulted in the greatest cost burden. Factors associated with 30 and 90-days in multivariable models were recipient history of chronic lung disease (hazard ratio or HR 1.78 [95%CI: 1.14, 2.76] and HR 1.68 [1.14, 2.48], respectively), median time on dialysis (HR 1.07 [95% CI: 1.01, 1.13]and HR 1.06 [95% CI: 1.01, 1.11], respectively), being transplanted preemptively (HR 1.75 [95% CI: 1.07, 2.88] and HR 1.66 [95% CI: 1.07, 2.57], respectively), and having a transplant hospitalization lasting of and more than 11 days (HR 1.52 [95% CI: 1.01, 2.27] and HR 1.65 [95% CI: 1.16, 2.34], respectively). Discussion: Early hospital readmission after transplantation was common and costly. Strategies to reduce the burden of early hospital readmissions are needed for all patients.
Trial of a New Diabetes Education Model: Closing the Gap in Health Disparity for People with Diabetes
Authors: Martens Thomas W. , Lima Janet S. , Johnson Elizabeth A. , Conry Jessica A. , Hoppe Jennifer J. , Bergenstal Richard M. , Carlson Anders L. , Davidson Janet L. 
Published: March 2021

Background: Quality measures relating to diabetes care in America have not improved between 2005 and 2016, and have plateaued even in areas that outperform national statistics. New approaches to diabetes care and education are needed and are especially important in reaching populations with significant barriers to optimized care. Methods: A pilot quality improvement study was created to optimize diabetes education in a clinic setting with a patient population with significant healthcare barriers. Certified Diabetes Care and Education Specialists (CDCES) were deployed in a team-based model with flexible scheduling and same-day education visits, outside of the traditional framework of diabetes education, specifically targeting practices with underperforming diabetes quality measures, in a clinic setting significantly impacted by social determinants of health. Results: A team-based and flexible diabetes education model decreased hemoglobin A1C for individuals participating in the project (and having a second A1C measured) by an average of −2.3%, improved Minnesota Diabetes Quality Measures (D5) for clinicians participating in the project by 5.8%, optimized use of CDCES, and reduced a high visit fail rate for diabetes education. Conclusions: Diabetes education provided in a team-based and flexible model may better meet patient needs and improve diabetes care metrics, in settings with a patient population with significant barriers.