bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overweight and Obesity, Weight Perception, and Weight Management Practices among Supplemental Nutrition Assistance Program Education (SNAP‐Ed) Participants in Georgia
Authors: Bailey Claudette , Lee Jung Sun , Olubajo Babatunde 
Published: June 2021

Under the Healthy, Hunger‐Free Kids Act of 2010, the SNAP‐Ed program has been reestablished as the nutrition education and obesity prevention program; however, little is known about weight perception and weight‐related practices among SNAP‐Ed eligible individuals, who are disproportionately affected by obesity. This study examined overweight and obesity, weight perception, and weight management strategies in a sample of SNAP‐Ed participants in Georgia (southeastern United States) (n=261, mean age 54.9±20.8, 76.6% female, 70.9% non‐Hispanic black). Body weight, height, and weight‐related practices were assessed based on data from self‐administered paper surveys collected by trained paraprofessionals at program entry. Almost three‐quarters of the sample was overweight (31.4%) or obese (42.2%), and 54.8% reported at least one diagnosis of selected diet‐related chronic conditions including high blood pressure, high cholesterol, diabetes, and heart disease. Among those who reported overweight and obese body weight status, only 60.1% perceived themselves as being overweight. Overweight and obese participants who accurately perceived their weight were more likely to desire weight loss and to have attempted to lose weight than those who did not perceive themselves as overweight. In particular, overweight/obese participants reporting at least one of the selected diagnoses were more likely to desire weight loss than those who reported none (OR 3.5; CI 1.9, 6.6; p<0.0001). About 43% of the study sample reported having attempted weight loss within the previous 12 months, and the most common weight loss strategies were eating less food (61.2%), eating less junk food (59.5%), exercising (59.5%), drinking a lot of water (57.7%), and eating more fruits, vegetables, and salads (54.6%). The findings from this study show a much higher burden of obesity among SNAP‐Ed participants in Georgia than in the general population and highlight the importance and urgency of developing a culturally tailored obesity prevention program to meet their unique needs as part of SNAP‐Ed programming.Support or Funding InformationThis study was funded by USDA SNAP‐Ed.
Calcium Absorption Among Racially Diverse Pregnant Women
Authors: Lesser Mary N. R. , Nguyen Leyna , King Janet C. , O'Brien Kimberly O. , Fung Ellen B. 
Published: June 2021

Longitudinal studies of calcium metabolism during pregnancy (PG) have shown that maternal calcium (Ca) absorption increases progressively from the first to the third trimester to meet the needs of the developing fetus. This increase in calcium absorption is directly related to maternal Ca intake. However, even with this increase in absorption, maternal and fetal needs may not be met in women with chronically low Ca intakes (<500 mg/day). Low Ca intakes are not uncommon among women in the USA and may result in maternal bone mobilization. Studies of Ca intake and absorption among racially diverse pregnant women are limited. Thus, this cross‐sectional study was done to determine the effect of racial differences on Ca absorption during the third trimester of pregnancy. Forty women, 10 each from four racial groups (African‐American (AA), Asian, Caucasian, Latina) were recruited between 30–36 weeks gestation. The following outcomes were measured: Ca intake from validated FFQ, Ca absorption, 24 hour urinary Ca excretion, 25OH vitamin D, and bone resorption as assessed by C‐terminal telopeptide (CTx). Ca absorption was measured from a standardized breakfast meal providing 330 mg Ca using the dual stable isotope technique (44Ca oral & 42Ca IV). To date, 34 women have completed the study (6 AA, 8 Asian, 10 Caucasian, 10 Latina) and are presented herein. Preliminary results show that of the 4 groups, only Latina and AA women met the pregnancy Ca RDA. Fasting serum Ca averaged 10.4 ± 0.6 mg/dL in the group as a whole, and it was not associated with CTx or race (r=0.0019, p=NS). Ca absorption ranged from 28.6–80.6% in the whole group of 34 women, and it was not associated with the habitual Ca intake. However, there is an interaction between race, Ca intake and Ca absorption, suggesting that women of different race absorb Ca differently based on Ca intake. 25OH vitamin D was significantly higher (p=0.053) in Caucasian women (29.9 ± 6.5 ng/mL) compared to Asian women (21.3 ± 6.0 ng/mL), and it was inversely related to Ca absorption (p=0.044). 24 hour urinary Ca excretion averaged 163.6 ± 85.5 ug/mL in the whole group; it did not differ by racial group, but it was positively related to Ca absorption (p=0.016). Our preliminary results suggest that in this group of racially diverse women, Ca metabolism is highly variable (intake, absorption, and excretion), which has a larger influence on Ca metabolism parameters than any potential effect due to race.Support or Funding InformationSupported by USDA #2009‐02925
Multi‐omics of the Soil Microbiome
Authors: Jansson Janet K 
Published: June 2021

TheArctic is characterized by vast amounts of carbon stored in permafrost and isan important focal point for the study of climate change as increasing temperature may accelerate microbially‐mediated release of carbon stored inpermafrost into the atmosphere as CO2 and CH4. Yet surprisingly, very little is known about the vulnerability of permafrost andresponse of microorganisms in the permafrost to their changing environment. To address these knowledge gaps we used omics technologiesto explore permafrost microbial communities, to reveal hitherto unknown soilmicrobial populations and to link them to specific soil biogeochemical processes. For these projects we employed an omics pipeline that includes metagenomics, metatranscriptomics and metaproteomics to determine the phylogenetic and functional gene compositions and their expression in complex, non‐sterile soil samples collected from the field at several locations in Alaska. These studies have presented several challenges due to the unprecedented large size of the datasets and the insufficiency of available bioinformatic tools & databases to analyze, correlate and integrate thedata. To address these challenges we developed a novel functional gene databaseand used different assembly and analysis algorithms to determine key featuresin the datasets. The data reveal the microbial diversity, composition andfunctional potential in permafrost and how the microbial communities respond toclimate change impacts.Support or Funding InformationMicrobiomes in Transition, LDRD, Pacific Northwest National Laboratories, Richland, Washington
Role of Hippocampal Neurogenesis in Drug Addiction
Authors: Silva Roberto Javier Morales , Galinato Melissa H , Mandyam Chitra 
Published: June 2021

Methamphetamine, a psychostimulant and neurotoxic drug, has been shown to inhibit neurogenesis in the hippocampal region of the brain. The hippocampus is responsible for functions such as short‐term and long‐term memory, spatial orientation, and connecting emotions and senses. Also the hippocampus is involved in forming context‐specific memories associated with reinstatement of drug‐seeking. Neurogenesis is the process of stem‐like precursor cells that proliferate into preneuronal progenitor cells that then differentiate into immature neurons that become granule cell neurons in the dentate gyrus. This process is impaired by methamphetamine and other drugs of abuse. The objective of this study is to determine the role of spontaneous neurogenesis in the dentate gyrus in drug addiction. To address this, we took a genetic approach using GFAP‐TK transgenic animals to conditionally inhibit the process of neurogenesis. GFAP‐TK+ and TK− (wild‐type controls) were submitted to intravenous surgery to implant a catheter to the jugular vein for intravenous drug self‐administration. The self‐administration behavior was divided in 5 phases: drug acquisition, forced abstinence from drug (withdrawal), extinction, and context‐ and cue‐ induced reinstatement. During withdrawal GFAP‐TK+ animals received valganciclovir diet (valcyte) to inhibit the proliferation and differentiation of neural precursor cells in the dentate gyrus. Controls received vehicle diet. One hour following reinstatement session, TK+ and TK− animals were sacrificed and the brain was processed for immunohistochemistry. Valcyte treatment in TK+ rats reduced the number of Ki‐67 and NeuroD cells in the hippocampus compared to vehicle TK− controls. In parallel, TK+ rats showed impaired lever discrimination during extinction sessions and context‐induced reinstatement, but not cue‐induced reinstatement, indicating enhanced motivation to seek methamphetamine in the absence of the drug. These results indicate that hippocampal neurogenesis plays a role in extinguishing drug seeking behavior and suppresses motivation during context induced reinstatement.Support or Funding InformationThe study was supported by funds from the National Institute on Drug Abuse (DA022473 and DA034140 to CDM) and National Science Foundation (DGE‐1144086) to MG
Radiation Reduction Strategies in Pediatric Orthopaedics
Authors: Sawyer Jeffrey R. 
Published: June 2021

Introduction:
Pediatric orthopaedic patients have the potential for significant radiation exposure from the use of imaging studies, such as computed tomography and bone scintigraphy. With the potential for long-term treatment, such as is required for scoliosis or osteogenesis imperfecta, patients are at even greater risk of radiation-induced carcinogenesis.

Discussion:
Although an association between radiation and cancer risk is evident, causation is difficult to prove because comorbidities or genetic predispositions may play a role in the higher baseline rates of malignancy later in life. Efforts have been made over the years to reduce exposure using more modern imaging techniques and simple radiation reduction strategies. Educational efforts and clinical practice guidelines are decreasing the rate of computed tomography scan use in pediatrics. Although considerable work is being done on the development of radiation-free imaging modalities, imaging that uses ionizing radiation will, in the near term, be necessary in specific circumstances to provide optimal care to pediatric orthopaedic patients.

Conclusion:
Knowledge of the ionizing radiation exposure associated with commonly used tests as well as radiation-reduction strategies is essential for the optimal and safe care of pediatric orthopaedic patients.
Hip and Pelvic Floor Muscle Strength in Women With and Without Urgency and Frequency-Predominant Lower Urinary Tract Symptoms
Authors: Foster Stefanie N. , Spitznagle Theresa M. , Tuttle Lori J. , Sutcliffe Siobhan , Steger-May Karen , Lowder Jerry L. , Meister Melanie R. , Ghetti Chiara , Wang Jinli , Mueller Michael J. , Harris-Hayes Marcie 
Published: June 2021

Background:
Urgency and frequency are common lower urinary tract symptoms (UF-LUTS) in women. There is limited evidence to guide physical therapist-led treatment.

Objectives:
To compare hip and pelvic floor muscle strength between women with and without UF-LUTS. We hypothesized women with UF-LUTS would demonstrate (1) diminished hip external rotator and abductor strength and (2) equivalent pelvic floor strength and diminished endurance compared with controls.

Study Design:
A matched case-control study.

Methods:
Women with UF-LUTS (cases) and controls were matched on age, body mass index, and vaginal parity. An examiner measured participants' (1) hip external rotator and abductor strength via dynamometry (maximum voluntary effort against fixed resistance) and (2) pelvic floor muscle strength (peak squeeze pressure) and endurance (squeeze pressure over a 10-second hold) via vaginal manometry. Values were compared between cases and controls with paired-sample t tests (hip) or Wilcoxon signed rank tests (pelvic floor).

Results:
In 21 pairs (42 women), hip external rotation (67.0 ± 19.0 N vs 83.6 ± 21.5 N; P = .005) and hip abduction strength (163.1 ± 48.1 N vs 190.1 ± 53.1 N; P = .04) were significantly lower in cases than in controls. There was no significant difference in pelvic floor strength (36.8 ± 19.9 cmH2O vs 41.8 ± 21.0 cmH2O; P = .40) or endurance (234.0 ± 149.6 cmH2O × seconds vs 273.4 ± 149.1 cmH2O × seconds; P = .24).

Conclusion:
Women with UF-LUTS had weaker hip external rotator and abductor muscles, but similar pelvic floor strength and endurance compared with controls. Hip strength may be important to assess in patients with UF-LUTS; further research is needed.
Association between aspartate aminotransferase-to-alanine aminotransferase ratio and insulin resistance among US adults
Authors: Visaria Aayush , Pai Suraj , Cheung Maggie , Ahlawat Sushil 
Published: June 2021

Objective
To determine whether a low aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT ratio) is associated with insulin resistance among those without liver dysfunction.

Methods
In this cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) 2011–2016, we included 2747 (1434 male and 1313 nonpregnant female) adults ≥20 years without evidence of liver dysfunction (ALT<30 in male and <19 in female, negative viral serologies, no excess alcohol consumption, no elevated transferrin saturation, AST/ALT <2). Serum AST/ALT ratio was categorized into sex-specific quartiles (female: <1.12, 1.12–1.29, 1.29–1.47, ≥1.47 and male: <0.93, 0.93–1.09, 1.09–1.26, ≥1.26). The primary outcome was insulin resistance, as determined by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index score ≥3. Covariate-adjusted odds ratios (ORs) were estimated. Study analysis completed from 13 March 2020 to 21 April 2021.

Results
Among the 2747 individuals, 33% had insulin resistance. Those in the lowest quartile (Q1) of AST/ALT had 75% higher adjusted odds of insulin resistance compared to the highest quartile (Q4) [aOR (95% confidence interval (CI), 1.75 (1.20–2.57)]. This association was more pronounced in those with elevated BMI [Q1 vs. Q4; BMI ≥ 25: 2.29 (1.58–3.33), BMI < 25: 0.66 (0.26–1.69); NAFLD per Fatty Liver Index ≥ 60: 2.04 (1.21–3.44), No NAFLD: 1.68 (0.94–3.01)].

Conclusion
Lower AST/ALT ratio is associated with increased insulin resistance among those with healthy-range ALT, especially in those with BMI greater than or equal to 25 kg/m2.
Neutrophil–lymphocyte ratio and the risk of hepatocellular carcinoma in patients with hepatitis B-caused cirrhosis
Authors: Shi Ke , Li Ping , Xue Dongying , Liu Yao , Zhang Qun , Ping Ranchong , Wang Xianbo 
Published: June 2021

Aim
The neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic marker of hepatocellular carcinoma (HCC); however, the relationship between NLR and risk of HCC occurrence has yet to be systematically elucidated. We aimed to investigate the association between NLR and HCC risk in patients with hepatitis B-caused cirrhosis (HBC) undergoing antiviral therapy.

Methods
A total of 1599 patients with HBC receiving entecavir or tenofovir at three tertiary hospitals between June 2014 and November 2017 were included. Cox proportional hazards regression was used to identify the association between NLR and risk of HCC occurrence by adjusting for potential risk factors. The cumulative incidence of HCC was evaluated using Kaplan–Meier analysis.

Results
At study enrollment, the median NLR was 2.0 (interquartile range, 1.4–3.0). The 3-year cumulative probabilities of HCC were 4.8, 8.4, 13.2, and 18.0% across the NLR quartiles, respectively (P < 0.001). Compared with the lowest quartile, higher NLR correlated with an increased HCC occurrence [NLR 1.4–2.0: adjusted hazard ratio (aHR), 1.18 (95% confidence interval (CI), 1.11–1.25); NLR 2.0–3.0: aHR, 2.09 (95% CI, 1.19–3.66); NLR > 3.0: aHR, 2.80 (95% CI, 1.59–4.95); P for trend = 0.001] in the fully adjusted models. In the subgroup analysis, elevated NLR was associated with increased HCC risk, regardless of stratification criteria.

Conclusion
Elevated NLR is an independent risk factor for HCC occurrence in patients with HBC undergoing antiviral therapy.
Quality and Cost in Community Health Centers
Authors: Carey Kathleen , Luo Qian , Dor Avi 
Published: June 2021

Background:
Quantifying health care quality has long presented a challenge to identifying the relationship between provider level quality and cost. However, growing focus on quality improvement has led to greater interest in organizational performance, prompting payers to collect various indicators of quality that can be combined at the provider level.

Objective:
To explore the relationship between quality and average cost of medical visits provided in US Community Health Centers (CHCs) using composite measures of quality.

Research Design:
Using the Uniform Data System collected by the Bureau of Primary Care, we constructed composite measures by combining 9 process and 2 outcome indicators of primary care quality provided in 1331 US CHCs during 2015–2018. We explored different weighting schemes and different combinations of individual quality indicators constructed at the intermediate domain levels of chronic condition control, screening, and medication management. We used generalized linear modeling to regress average cost of a medical visit on composite quality measures, controlling for patient and health center factors. We examined the sensitivity of results to different weighting schemes and to combining individual quality indicators at the overall level compared with the intermediate domain level.

Results:
Both overall and domain level composites performed well in the estimations. Average cost of a medical visit was negatively associated with quality, although the magnitude of the effect varied across weighting schemes.

Conclusion:
Efforts toward improvement of primary health care quality delivered in CHCs need not involve greater cost.
Common pediatric infestations: update on diagnosis and treatment of scabies, head lice, and bed bugs
Authors: Ogbuefi Nonye , Kenner-Bell Brandi 
Published: June 2021

Purpose of the review
This review will update pediatric providers on the recent data regarding the epidemiology, diagnosis, and treatment of common skin infestations affecting children and adolescents.

Recent findings
Standard superficial skin biopsy for scabies and the vacuum method for head lice can increase diagnostic accuracy and efficiency. There is growing resistance to some of the traditional treatments for scabies and head lice, and progress has been made in finding newer and potentially more effective treatments, such as oral moxidectin for scabies and abametapir for head lice. Recent studies have established the safety of traditional treatments, such as permethrin and oral ivermectin in infants and small children.

Summary
Permethrin and ivermectin are both considered safe and effective for children and adolescents with scabies. Permethrin is generally considered safe in infants less than two months of age. Proper application of permethrin is critical, and providers should emphasize proper application technique. Treatment of head lice should only be initiated with active infestations. Resistance to permethrin continues to increase and other options are now available, including an over-the-counter topical ivermectin formulation. Identification and eradication of bed bug infestations are crucial in preventing bedbug bites.
Mast cell stabilizer ketotifen fumarate reverses inflammatory but not neuropathic-induced mechanical pain in mice
Authors: Meloto Carolina B. , Ingelmo Pablo , Perez Eduardo Vega , Pitt Rebecca , González Cárdenas Víctor Hugo , Mohamed Nada , Sotocinal Susana G. , Bourassa Valerie , Lima Lucas Vasconcelos , Ribeiro-da-Silva Alfredo , Mogil Jeffrey S. , Diatchenko Luda 
Published: June 2021

Abstract

Introduction:
Mast cell (MC) activation could establish a positive feedback loop that perpetuates inflammation and maintains pain. Stabilizing MCs with ketotifen fumarate (KF) may disrupt this loop and relieve pain.

Objective:
We aimed to test the effect of treatment with KF in pain assays in mice and in a case series of patients with chronic widespread pain.

Methods:
The analgesic effect of KF was tested in CD-1 mice injected with formalin, complete Freund's adjuvant, or subjected to spared nerve injury. In addition, wild-type (C57BL/6) and MC-deficient (C57BL/6-Kit
W-sh/W-sh) mice were injected with formalin or complete Freund's adjuvant and treated with KF. Patients with chronic widespread pain (n = 5; age: 13–16 years) who failed to respond to standard of care participated in a 16-week treatment trial with KF (6 mg/d). Ketotifen fumarate's therapeutic effect was evaluated using the patient global impression of change.

Results:
In the mouse experiments, KF produced dose- and MC-dependent analgesic effects against mechanical allodynia in the acute and chronic inflammatory pain but not neuropathic pain assays. In the patient case series, 4 patients reported that activity limitations, symptoms, emotions, and overall quality of life related to their pain condition were “better” or “a great deal better” since beginning treatment with KF. This was accompanied by improvements in pain comorbid symptoms.

Conclusion:
Treatment with KF is capable of reducing established inflammatory-induced mechanical nociception in an MC-dependent manner in mice, and it may be beneficial for the treatment of chronic pain conditions.
HIV Viral Suppression and Pre-exposure Prophylaxis in HIV and Syphilis Contact Tracing Networks: An Analysis of Disease Surveillance and Prescription Claims Data
Authors: Billock Rachael M. , Samoff Erika , Lund Jennifer L. , Pence Brian W. , Powers Kimberly A. 
Published: June 2021

Background:
HIV and syphilis contact tracing networks offer efficient platforms for HIV treatment and prevention interventions, but intervention coverage within these networks has not been characterized.

Setting:
HIV and syphilis sexual contact tracing networks among men who have sex with men (MSM) in North Carolina (NC).

Methods:
Using surveillance data, we identified 2 types of “network events” that occurred between January 2013 and June 2017 among MSM in NC: being diagnosed with early syphilis or being named as a recent sexual contact of a person diagnosed with HIV or early syphilis. We estimated prevalent and incident HIV viral suppression among persons diagnosed with HIV before the network event, and we assessed the effect of contact tracing services on a 6-month cumulative incidence of viral suppression among previously HIV-diagnosed, virally unsuppressed persons. Using linked prescription claims data, we also evaluated prevalent and incident pre-exposure prophylaxis (PrEP) use in an insured subset of HIV-negative network members.

Results:
Viral suppression prevalence among previously HIV-diagnosed persons was 52.6%. The 6-month cumulative incidence of viral suppression was 35.4% overall and 13.1 (95% confidence interval: 8.8 to 17.4) percentage points higher among persons reached than among those not reached by contact tracing services. Few HIV-negative persons had prevalent (5.4%) or incident (4.1%) PrEP use in the 6 months before or after network events, respectively.

Conclusions:
Suboptimal viral suppression and PrEP use among MSM in NC in HIV/syphilis contact tracing networks indicate a need for intensified intervention efforts. In particular, expanded services for previously HIV-diagnosed persons could improve viral suppression and reduce HIV transmission within these networks.