bluuebunny/crossref_metadata_2025_split huggingface dataset:
Body Mass Index and Leptin Are Related to Cognitive Performance Over 10 Years in Women With and Without HIV Infection
Authors: Macaluso Francesca , Weber Kathleen M , Rubin Leah H , Dellinger Elaine , Holman Susan , Minkoff Howard , Keating Sheila , Merlin Lisa R , Gustafson Deborah R 
Published: October 2021

Abstract

Context
It is not yet understood whether people living with HIV infection have an increased risk of Alzheimers Disease and Related Dementias due to enhanced survivorship with highly effective antiretroviral therapies and/or increasing adiposity with aging.

Objective
This work aimed to determine whether body mass index (BMI) and leptin were longitudinally associated over 10 years with neuropsychological performance (NP) among middle-aged women with HIV (WWH) vs without HIV.

Methods
Women’s Interagency HIV Study (WIHS) participants (301 WWH, 113 women without HIV from Brooklyn, New York City, and Chicago had baseline and 10-year BMI and fasting plasma leptin levels using commercial enzyme-linked immunosorbent assay (ng/mL); and demographically adjusted NP T scores (attention/working memory, executive function [EF], processing speed, memory, learning, verbal fluency, motor function, global) at 10-year follow-up. Multivariable linear regression analyses, stratified by HIV serostatus, examined associations between BMI, leptin, and NP.

Results
Over 10 years, women (baseline age 39.8 ± 9.2 years, 73% Black, 73% WWH) transitioned from average overweight (29.1 ± 7.9) to obese (30.5 ± 7.9) BMI. Leptin increased 11.4 ± 26.4 ng/mL (P &lt; .001). Higher baseline BMI and leptin predicted poorer 10-year EF among all women (BMI β = –6.97, 95% CI (–11.5 to –2.45) P = .003; leptin β = –1.90, 95% CI (–3.03 to –0.76), P = .001); higher baseline BMI predicted better memory performance (β = 6.35, 95% CI (1.96-10.7), P = .005). Greater 10-year leptin increase predicted poorer EF (P = .004), speed (P = .03), and verbal (P = .02) and global (P = 0.005) performance among all women, and WWH. Greater 10-year BMI increase predicted slower processing speed (P = .043) among all women; and among WWH, poorer EF (P = .01) and global (P = .04) performance.

Conclusion
In middle-aged WIHS participants, 10-year increases in BMI and leptin were associated with poorer performance across multiple NP domains among all women and WWH. Trajectories of adiposity measures over time may provide insight into the role of adipose tissue in brain health with aging.
A Modern Approach to Dyslipidemia
Authors: Berberich Amanda J , Hegele Robert A 
Published: October 2021

Abstract
Lipid disorders involving derangements in serum cholesterol, triglycerides, or both are commonly encountered in clinical practice and often have implications for cardiovascular risk and overall health. Recent advances in knowledge, recommendations, and treatment options have necessitated an updated approach to these disorders. Older classification schemes have outlived their usefulness, yielding to an approach based on the primary lipid disturbance identified on a routine lipid panel as a practical starting point. Although monogenic dyslipidemias exist and are important to identify, most individuals with lipid disorders have polygenic predisposition, often in the context of secondary factors such as obesity and type 2 diabetes. With regard to cardiovascular disease, elevated low-density lipoprotein cholesterol is essentially causal, and clinical practice guidelines worldwide have recommended treatment thresholds and targets for this variable. Furthermore, recent studies have established elevated triglycerides as a cardiovascular risk factor, whereas depressed high-density lipoprotein cholesterol now appears less contributory than was previously believed. An updated approach to diagnosis and risk assessment may include measurement of secondary lipid variables such as apolipoprotein B and lipoprotein(a), together with selective use of genetic testing to diagnose rare monogenic dyslipidemias such as familial hypercholesterolemia or familial chylomicronemia syndrome. The ongoing development of new agents—especially antisense RNA and monoclonal antibodies—targeting dyslipidemias will provide additional management options, which in turn motivates discussion on how best to incorporate them into current treatment algorithms.
Popol Wujs: Culture, Complexity, and the Encoding of MayaCosmovisión
Authors: Alvarado Rafael C. , Barriente Aldo Ismael , Bigelow Allison Margaret 
Published: October 2021

AbstractThe Popol Wuj is one of the most important, commonly studied, and widely circulated Indigenous literary works from colonial Mesoamerica. By some accounts, there are 1,200 editions of the work published in thirty world languages, all of which trace back to a single manuscript—itself a copy of an earlier Mayan work. To protect their work from being destroyed by colonial officials or Inquisitional authorities, the original K’iche’ authors of the Popol Wuj had to embed their ways of knowing in a language and narrative structure that could not be detected by Spanish readers. Each edition of the Popol Wuj therefore helps to uncover different elements of the cosmovisión that is embedded in the text. This article draws from recent collaborative efforts to prepare a digital critical edition of the Popol Wuj based on the editorial standards and scholarly conventions of the Text Encoding Initiative (TEI). By comparing and contrasting the advantages and drawbacks of this edition relative to printed works and digital editions, we suggest how methods from the digital humanities can shed new light on texts like the Popol Wuj.
Unfolding is the driving force for mitochondrial import and degradation of the Parkinson's disease-related protein DJ-1
Authors: Queliconi Bruno Barros , Kojima Waka , Kimura Mayumi , Imai Kenichiro , Udagawa Chisato , Motono Chie , Hirokawa Takatsugu , Tashiro Shinya , Caaveiro Jose M. M. , Tsumoto Kouhei , Yamano Koji , Tanaka Keiji , Matsuda Noriyuki 
Published: October 2021

ABSTRACT
Diverse genes associated with familial Parkinson's disease (familial Parkinsonism) have been implicated in mitochondrial quality control. One such gene, PARK7 encodes the protein DJ-1, pathogenic mutations of which trigger its translocation from the cytosol to the mitochondrial matrix. The translocation of steady-state cytosolic proteins like DJ-1 to the mitochondrial matrix upon missense mutations is rare, and the underlying mechanism remains to be elucidated. Here, we show that the protein unfolding associated with various DJ-1 mutations drives its import into the mitochondrial matrix. Increasing the structural stability of these DJ-1 mutants restores cytosolic localization. Mechanistically, we show that a reduction in the structural stability of DJ-1 exposes a cryptic N-terminal mitochondrial-targeting signal (MTS), including Leu10, which promotes DJ-1 import into the mitochondrial matrix for subsequent degradation. Our work describes a novel cellular mechanism for targeting a destabilized cytosolic protein to the mitochondria for degradation.
Simple models highlight differences in the walking biomechanics of young children and adults
Authors: Rose Vivian L. , Arellano Christopher J. 
Published: October 2021

ABSTRACT
Adults conserve metabolic energy during walking by minimizing the step-to-step transition work performed by the legs during double support and by utilizing spring-like mechanisms in their legs, but little is known as to whether children utilize these same mechanisms. To gain a better understanding, we studied how children (5–6 years) and adults modulate the mechanical and metabolic demands of walking at their preferred speed, across slow (75%), preferred (100%) and fast (125%) step frequencies. We quantified (1) the positive mass-specific work done by the trailing leg during step-to-step transitions and (2) the leg's spring-like behavior during single support. On average, children walked with a 36% greater net cost of transport (COT; J kg−1 m−1) than adults (P=0.03), yet both groups increased their net COT at varying step frequencies. After scaling for speed, children generated ∼2-fold less trailing limb positive scaled mechanical work during the step-to-step transition (P=0.02). Unlike adults, children did not modulate their trailing limb positive work to meet the demands of walking at 75% and 125% of their preferred step frequency. In single support, young children operated their stance limb with much greater compliance than adults ( versus 11.35; P=0.023). Our observations suggest that the mechanics of walking in children aged 5–6 years are fundamentally distinct from the mechanics of walking in adults and may help to explain a child's higher net COT. These insights have implications for the design of assistive devices for children and suggest that children cannot be simply treated as scaled-down versions of adults.
Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
Authors: Bobillo-Perez Sara , Girona-Alarcon Monica , Sole-Ribalta Anna , Guitart Carmina , Felipe Aida , Hernandez Lluisa , Balaguer Monica , Cambra Francisco Jose , Jordan Iolanda 
Published: October 2021

Objectives
Procalcitonin is a useful biomarker for predicting bacterial infection after cardiac surgery. However, sometimes procalcitonin rises following cardiac surgery without a confirmation of bacterial infection. The aim was to analyse procalcitonin levels in children without a bacterial infection after cardiac surgery.

Study design
This is a prospective, observational study of children <18 years old admitted to the pediatric intensive care unit after cardiac surgery.

Results
1,042 children were included, 996 (95.6%) without a bacterial infection. From them, severe complications occurred in 132 patients (13.3%). Procalcitonin increased differentially depending on the type of complication. Patients who presented a poor outcome (n = 26, 2.6%) had higher procalcitonin values in the postoperative period than the rest of patients (<24 hours: 5.8 ng/mL vs. 0.6 ng/mL; 24–48 hours, 5.1 ng/mL vs. 0.8 ng/mL, and 48–72 hours, 5.3 ng/mL vs. 1.2 ng/mL), but these values remained stable over time (p = 0.732; p = 0.110). The AUC for procalcitonin for predicting poor outcome was 0.876 in the first 24 hours. The cut-off point to predict poor outcome was 2 ng/mL in the first 24 hours (sensitivity 86.9%, specificity 77.3%). Patients with bacterial infection (n = 46) presented higher values of procalcitonin initially, but they decreased in the 48–72 hours period (<24 hours: 4.9 ng/mL; 24–48 hours, 5.8 ng/mL, and 48–72 hours, 4.5 ng/mL).

Conclusions
A procalcitonin value<2 ng/mL may indicate the absence of infection and poor outcome after cardiac surgery. The evolution of the values of this biomarker might help to discern between infection (where procalcitonin will decrease) and poor outcome (where procalcitonin will not decrease).
Impact of image averaging on vessel detection using optical coherence tomography angiography in eyes with macular oedema and in healthy eyes
Authors: Le Boité Hugo , Chetrit Mardoche , Erginay Ali , Bonnin Sophie , Lavia Carlo , Tadayoni Ramin , Couturier Aude 
Published: October 2021

Purpose
To assess the repeatability of multiple automatic vessel density (VD) measurements and the effect of image averaging on vessel detection by optical coherence tomography angiography (OCTA).

Methods
An observational study was conducted in a series of healthy volunteers and patients with macular oedema. Five sequential OCTA images were acquired for each eye using the OptoVue HD device. The effect of the averaging of the 5 acquisitions on vessel detection was analysed quantitatively using a pixel-by-pixel automated analysis. In addition, two independent retina experts qualitatively assessed the change in vessel detection in averaged images segmented in 9 boxes and compared to the first non-averaged image.

Results
The automatic VD measurement in OCTA images showed a good repeatability with an overall mean intra-class correlation coefficient (ICC) of 0.924. The mean ICC was higher in healthy eyes compared to eyes with macular oedema (0.877 versus 0.960; p < 0.001) and in the superficial vascular plexus versus the deep vascular complex (0.967 versus 0.888; p = 0.001). The quantitative analysis of the effect of the averaging showed that averaged images had a mean gain of 790.4 pixels/box, located around or completing interruptions in the vessel walls, and a mean loss of 727.2 pixels/box. The qualitative analysis of the averaged images showed that 99.6% of boxes in the averaged images had a gain in vessel detection (i.e., vessels detected in the averaged image but not in the non-averaged image). The loss of pixels was due to a reduction in background noise and motion artifacts in all cases and no case of loss of vessel detection was observed.

Conclusion
The automatic VD measurement using the OptoVue HD device showed a good repeatability in 5 acquisitions in a row setting. Averaging images increased vessel detection, and in about a third of boxes, decreased the background noise, both in healthy eyes and, in a greater proportion, in eyes with macular oedema.
The private versus public contribution to the biomedical literature during the COVID-19, Ebola, H1N1, and Zika public health emergencies
Authors: Beall Reed F. , Moradpour Javad , Hollis Aidan 
Published: October 2021

Background
The private versus public contribution to developing new health knowledge and interventions is deeply contentious. Proponents of commercial innovation highlight its role in late-stage clinical trials, regulatory approval, and widespread distribution. Proponents of public innovation point out the role of public institutions in forming the foundational knowledge undergirding downstream innovation. The rapidly evolving COVID-19 situation has brought with it uniquely proactive public involvement to characterize, treat, and prevent this novel health treat. How has this affected the share of research by industry and public institutions, particularly compared to the experience of previous pandemics, Ebola, H1N1 and Zika?

Methods
Using Embase, we categorized all publications for COVID-19, Ebola, H1N1 and Zika as having any author identified as affiliated with industry or not. We placed all disease areas on a common timeline of the number of days since the WHO had declared a Public Health Emergency of International Concern with a six-month lookback window. We plotted the number and proportion of publications over time using a smoothing function and plotted a rolling 30-day cumulative sum to illustrate the variability in publication outputs over time.

Results
Industry-affiliated articles represented 2% (1,773 articles) of publications over the 14 months observed for COVID-19, 7% (278 articles) over 7.1 years observed for Ebola, 5% (350 articles) over 12.4 years observed for H1N1, and 3% (160 articles) over the 5.7 years observed for Zika. The proportion of industry-affiliated publications built steadily over the time observed, eventually plateauing around 7.5% for Ebola, 5.5% for H1H1, and 3.5% for Zika. In contrast, COVID-19’s proportion oscillated from 1.4% to above 2.7% and then declined again to 1.7%. At this point in the pandemic (i.e., 14 months since the PHEIC), the proportion of industry-affiliated articles had been higher for the other three disease areas; for example, the proportion for H1N1 was twice as high.

Conclusions
While the industry-affiliated contribution to the biomedical literature for COVID is extraordinary in its absolute number, its proportional share is unprecedentedly low currently. Nevertheless, the world has witnessed one of the most remarkable mobilizations of the biomedical innovation ecosystem in history.
Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
Authors: Enria Luisa , Bangura Joseph S. , Kanu Hassan M. , Kalokoh Joseph A. , Timbo Alie D. , Kamara Mohamed , Fofanah Maligie , Kamara Alhassan N. , Kamara Adikalie I. , Kamara Morlai M. , Suma Ibrahim Sorie , Kamara Osman M. , Kamara Alusine M. , Kamara Alhajie O. , Kamara Abu B. , Kamara Emmah , Lees Shelley , Marchant Mark , Murray Mariama 
Published: October 2021

Background
Vaccine hesitancy is a complex, contested social phenomenon and existing research highlights the multifaceted role of trust in strengthening vaccine confidence. However, understanding public engagement with vaccination through the lens of (mis)trust requires more contextual evidence on trust’s qualitative determinants. This includes expanding the geographic focus beyond current studies’ focus on High Income Countries. Furthermore, obstacles remain in effectively integrating social science findings in the design of vaccine deployment strategies, and in ensuring that those who implement interventions and are affected by them are directly involved in producing knowledge about vaccination challenges.

Methods
We piloted a community-led ethnographic approach, training Community Health Workers (CHWs) in Kambia District, Sierra Leone, in qualitative social science methods. Methods included participant observation, participatory power mapping and rumour tracking, focus group discussions and key stakeholder interviews. CHWs, with the support of public health officials and professional social scientists, conducted research on vaccination challenges, analysed data, tested new community engagement strategies based on their findings and elicited local perspectives on these approaches.

Results
Our findings on vaccine confidence in five border communities highlighted three key themes: the impact of prior experiences with the health system on (mis)trust; relevance of livelihood strategies and power dynamics for vaccine uptake and access; and the contextual nature of knowledge around vaccines. Across these themes, we show how expressions of trust centered on social proximity, reliability and respect and the role of structural issues affecting both vaccine access and confidence. The pilot also highlighted the value and practical challenges to meaningfully co-designed research.

Conclusion
There is scope for broader application of a community-led ethnographic approach will help redesign programming that is responsive to local knowledge and experience. Involving communities and low-cadre service providers in generating knowledge and solutions can strengthen relationships and sustain dialogue to bolster vaccine confidence.
Healthcare worker stress, anxiety and burnout during the COVID-19 pandemic in Singapore: A 6-month multi-centre prospective study
Authors: Teo Irene , Chay Junxing , Cheung Yin Bun , Sung Sharon C. , Tewani Komal G. , Yeo Li Fang , Yang Grace Meijuan , Pan Fang Ting , Ng Jin Ying , Abu Bakar Aloweni Fazila , Ang Hui Gek , Ayre Tracy Carol , Chai-Lim Crystal , Chen Robert Chun , Heng Ai Ling , Nadarajan Gayathri Devi , Ong Marcus Eng Hock , See Brian , Soh Chai Rick , Tan Boon Kiat Kenneth , Tan Bien Soo , Tay Kenny Xian Khing , Wijaya Limin , Tan Hiang Khoon 
Published: October 2021

Aim
The long-term stress, anxiety and job burnout experienced by healthcare workers (HCWs) are important to consider as the novel coronavirus disease (COVID-19) pandemic stresses healthcare systems globally. The primary objective was to examine the changes in the proportion of HCWs reporting stress, anxiety, and job burnout over six months during the peak of the pandemic in Singapore. The secondary objective was to examine the extent that objective job characteristics, HCW-perceived job factors, and HCW personal resources were associated with stress, anxiety, and job burnout.

Method
A sample of HCWs (doctors, nurses, allied health professionals, administrative and operations staff; N = 2744) was recruited via invitation to participate in an online survey from four tertiary hospitals. Data were gathered between March-August 2020, which included a 2-month lockdown period. HCWs completed monthly web-based self-reported assessments of stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7), and job burnout (Physician Work Life Scale).

Results
The majority of the sample consisted of female HCWs (81%) and nurses (60%). Using random-intercept logistic regression models, elevated perceived stress, anxiety and job burnout were reported by 33%, 13%, and 24% of the overall sample at baseline respectively. The proportion of HCWs reporting stress and job burnout increased by approximately 1·0% and 1·2% respectively per month. Anxiety did not significantly increase. Working long hours was associated with higher odds, while teamwork and feeling appreciated at work were associated with lower odds, of stress, anxiety, and job burnout.

Conclusions
Perceived stress and job burnout showed a mild increase over six months, even after exiting the lockdown. Teamwork and feeling appreciated at work were protective and are targets for developing organizational interventions to mitigate expected poor outcomes among frontline HCWs.
Micronutrient intake status and associated factors among children aged 6–23 months in the emerging regions of Ethiopia: A multilevel analysis of the 2016 Ethiopia demographic and health survey
Authors: Gebremedhin Tsegaye , Aschalew Andualem Yalew , Tsehay Chalie Tadie , Dellie Endalkachew , Atnafu Asmamaw 
Published: October 2021

Background
Micronutrient (MN) deficiency among children is recognised as a major public health problem in Ethiopia. The scarcity of MNs in Ethiopia, particularly in pastoral communities, might be severe due to poor diets mitigated by poor healthcare access, drought, and poverty. To reduce MNs deficiency, foods rich in vitamin A (VA) and iron were promoted and programs like multiple micronutrient powder (MNP), iron and vitamin A supplements (VAS) and or deworming have been implemented. Nationally for children aged 6–23 months, consumption of four or more food groups from diet rich in iron and VA within the previous 24 hours, MNP and iron supplementation within seven days, and VAS and >75% of deworming within the last 6 months is recommend; however, empirical evidence is scarce. Therefore, this study aimed to assess the recommended MN intake status of children aged 6–23 months in the emerging regions of Ethiopia.

Methods
Data from the Ethiopia Demographic and Health Survey 2016 were used. A two-stage stratified sampling technique was used to identify 1009 children aged 6–23 months. MN intake status was assessed using six options: food rich in VA or iron consumed within the previous 24 hours, MNP or iron supplementation with the previous seven days, VAS or deworming within six months. A multilevel mixed-effect logistic regression analysis was computed, and a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to identify the individual and community-level factors.

Results
In this analysis, 37.3% (95% CI: 34.3–40.3) of children aged 6–23 months had not received any to the recommended MNs sources. The recommended MNs resulted; VAS (47.2%), iron supplementation (6.0%), diet rich in VA (27.7%), diet rich in iron (15.6%), MNP (7.5%), and deworming (7.1%). Antenatal care visit (AOR: 1.9, 95% CI: 1.4–2.8), work in the agriculture (AOR: 2.2, 95% CI: 1.3–3.8) and children aged 13 to 23 months (AOR: 1.7, 95% CI: 1.2–2.4) were the individual-level factors and also Benishangul (AOR: 2.2, 95% CI: 1.3–4.9) and Gambella regions (AOR: 1.9, 95% CI: 1.0–3.4) were the community-level factors that increased micronutrient intake whereas residence in rural (AOR: 0.4, 95% CI: 0.1–0.9) was the community-level factors that decrease micronutrient intake.

Conclusions
Micronutrient intake among children aged 6–23 months in the pastoral community was low when compared to the national recommendation. After adjusting for individual and community level factors, women’s occupational status, child’s age, antenatal visits for recent pregnancy, residence and region were significantly associated with the MN intake status among children aged 6–23 months.