bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional status of school children living in Northern part of Sri Lanka
Authors: Sathiadas M. G. , Antonyraja Annieston , Viswalingam Arunath , Thangaraja Kasthuri , Wickramasinghe V. P. 
Published: January 2021

Abstract
Background
Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school children. This study was undertaken to identify the prevalence of wasting, stunting and obesity among school children from Northern Sri Lanka and associated socio-demographic factors.

Methods
A community based cross-sectional study was carried out using multistage stratified proportionate cluster among healthy children attending schools in the Northern part of the country. Height and weight were measured, and Body Mass Index (BMI) calculated [weight (kg)/Height (m) 2]. BMI-for-age z-score (BAZ) and Height for age Z (HAZ) scores were determined and WHO growth references were used to categorise the nutritional status. Correlation between various nutritional problems with Maternal education, household income, number of family members and the residential area was assessed.

Results
A total of 1012 children were recruited, and the mean age and standard deviation were 11.12±1.77 yrs. Girls in the age ranges of 9–14 were heavier and taller when compared to the boys compatible with the pubertal growth spurt. Stunting based on the height for age was seen in 10.9% of boys and 11.8% of girls. Wasting based on BMI for age WHO standard (WHO 2007) was seen in 30.6% of boys and 29.1% of the girls. The prevalence of overweight was 11% and Obesity was 6.3% of the population. Obesity was predominantly seen in boys (4.2%) and it was significantly higher when compared to the girls (2.1%) (p < 0.001). Obesity in older boys (> 10 years) was significantly more than the younger ones (p < 0.01). Maternal education and family income had a significant impact on the prevalence of wasting, stunting and obesity whereas the family size contributed to the wasting and obesity (p< 0.001).

Conclusion
Findings suggest that stunting, wasting, overweight and obesity are prevalent among 6–16-year-old leading to concerns in public health. The nutritional status significantly varies according to the geographical location, maternal education and the household income.
A new tool in percutaneous anterior odontoid screw fixation
Authors: Wang Yan , Li Min , Cui Guanxing , Li Jing , Guo Zhiliang , Zhang Dahai , Teng Haijun , Lu Haijiang 
Published: January 2021

AbstractBackgroundPercutaneous anterior odontoid screw fixation for odontoid fractures remains challenging due to the complex anatomy of the craniocervical junction. We designed a new guide instrument to help with the placement of guide wire, which have achieved satisfying surgical results. The objective of this study is to evaluate the safety and efficacy of this new tool in percutaneous anterior odontoid screw fixation.MethodsTwenty-nine patients with odontoid fracture were retrospectively evaluated. All patients underwent percutaneous anterior odontoid screw fixation with the traditional guide instrument (n = 13) or the new guide instrument we designed (n = 16). The following clinical outcomes were compared between the two groups: operation time, radiograph times, incision length, blood loss, postoperative hospitalization, postoperative complications, bony union, fixation failure, and reoperation. Radiographs or CT scans were performed at 3, 6 and 12 months after surgery.ResultsThere were no significant differences in preoperative demographic data between the two groups. The operation time (56.62 ± 8.32 Vs 49.63 ± 7.47,P = 0.025) and radiograph times (26.54 ± 6.94 Vs 20.50 ± 5.02,P = 0.011) of the designed guide instrument group were significantly lower than those of the traditional guide instrument group. There were no significant differences in incision length (16.08 ± 3.07 Vs 15.69 ± 2.73,P = 0.720), blood loss (16.08 ± 4.96 Vs 17.88 ± 5.98,P = 0.393), postoperative hospitalization (7.15 ± 1.91 Vs 6.88 ± 2.36,P = 0.734), postoperative complications (7.7% Vs 12.5%,P = 1), and bony union (92.3% Vs 93.8%,P = 1) between the two groups. No fixation failure or reoperation occurred in either group.ConclusionsThe top of our designed guide instrument is a wedge-shaped tip with 30° inclination, which has a large contact area with the anterior surface of the cervical vertebra. According to our retrospective study, the guide instrument can reduce the operation time and radiograph times. It has potential clinical value, which needs further testing with a higher level of research design.
Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft
Authors: Lu Yi , Chang Ke-Chung , Chang Che-Ning , Chang Dun-Hao 
Published: January 2021

Abstract
Background
Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect.

Case report
We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully.

Conclusions
Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.
The Mitigating Toxic Stress study design: approaches to developmental evaluation of pediatric health care innovations addressing social determinants of health and toxic stress
Authors: McCrae Julie S. , Robinson Jo Ann L. , Spain Angeline K. , Byers Kaela , Axelrod Jennifer L. 
Published: January 2021

Abstract
Background
Health care administrators must establish and promote effective partnerships with community agencies to address social determinants of health, including reducing exposure of infants and young children to chronic stress. Because infants’ experiences are inextricably tied to their caregivers, an important target for mitigating “toxic” stress exposure in early childhood is through reducing parents’ experiences of chronic stress in addition to protecting children from direct experiences of harm such as physical or sexual abuse. Conducting screening to identify when children are exposed to early life adversity is a first step; connecting families to needed support services is an essential component to addressing identified challenges. This paper presents the methodology of a three-year study of health care systems innovations designed to engage and support parents of infants to prevent and mitigate children’s toxic stress exposures.

Methods
Key study features included: 1) multi-component study in five U.S. communities and nine pediatric health care clinics and the families they serve, 2) a developmental evaluation approach to describe how innovations are experienced over time at three levels—community systems, pediatric providers, and families, and 3) rapid cycle feedback conducted with communities, clinics and families to co-interpret data and findings. Data sources included: 1) focus groups and interviews with community stakeholders, clinic staff, and families, 2) electronic health record and Medicaid services data extracted to assess health care quality, utilization, and financial impact, and 3) clinic-recruitment of 908 parents of infants in a longitudinal survey. Results. The sample is briefly characterized based on responses to the enrollment phase of the parent survey.

Conclusions
We discuss the study design elements’ contribution to generating evidence needed by innovators, communities, and clinics to modify and sustain investments in these innovations to prevent or mitigate the effects of exposure to toxic stress on young children.
Feruloyl esterase (FAE-1) sourced from a termite hindgut and GH10 xylanases synergy improves degradation of arabinoxylan
Authors: Mafa Mpho S. , Malgas Samkelo , Pletschke Brett I. 
Published: January 2021

AbstractCereal feedstocks have high arabinoxylan content as their main hemicellulose, which is linked to lignin by hydroxycinnamic acids such as ferulic acid. The ferulic acid is linked to arabinoxylan by ester bonds, and generally, the high substitution of ferulic acid leads to a loss of activity of xylanases targeting the arabinoxylan. In the current study, a feruloyl esterase (FAE-1) from a termite hindgut bacteria was functionally characterised and used in synergy with xylanases during xylan hydrolysis. The FAE-1 displayed temperature and pH optima of 60 ℃ and 7.0, respectively. FAE-1 did not release reducing sugars from beechwood xylan (BWX), wheat arabinoxylan (WAX) and oat spelt xylan (OX), however, displayed high activity of 164.74 U/mg protein on p-nitrophenyl-acetate (pNPA). In contrast, the GH10 xylanases; Xyn10 and XT6, and a GH11 xylanase, Xyn2A, showed more than two-fold increased activity on xylan substrates with low sidechain substitutions; BWX and OX, compared to the highly branched substrate, WAX. Interestingly, the FAE-1 and GH10 xylanases (Xyn10D and XT6) displayed a degree of synergy (DS) that was higher than 1 in all enzyme loading combinations during WAX hydrolysis. The 75%XT6:25%FAE-1 synergistic enzyme combination increased the release of reducing sugars by 1.34-fold from WAX compared to the control, while 25%Xyn10D:75%FAE-1 synergistic combination released about 2.1-fold of reducing sugars from WAX compared to controls. These findings suggest that FAE-1 can be used in concert with xylanases, particularly those from GH10, to efficiently degrade arabinoxylans contained in cereal feedstocks for various industrial settings such as in animal feeds and baking.
A differentially private distributed data mining scheme with high efficiency for edge computing
Authors: Sun Xianwen , Xu Ruzhi , Wu Longfei , Guan Zhitao 
Published: January 2021

AbstractA wide range of data mining applications benefit from the low latency offered by edge computing. However, edge computing suffers from limited computing resources, which inhibits the applications of the computationally expensive data mining methods. In the edge-cloud environment, usually, the participants turn to collaboratively train machine-learning models that yield more accurate prediction results. However, data owners may not be willing to sharing the own data for the privacy concerns. To handle such disparate goals, we focus on tree-based distributed data mining scheme with differential privacy, which is computationally friendly. The basic idea of our approach is based on a distributed ensemble strategy. Each participant builds an elegant decision model based on their own data, which has a good tradeoff between the computation and the accuracy of the data distribution, and shares it with other participants after being injected with the elaborate noise. Then the useful knowledge transferred from the decision models is acquired by other participants in an adaptive ensemble strategy. Both the theoretical analysis and the experiments show that our scheme provides an efficient data mining manner that can achieve a good prediction accuracy while providing rigorous privacy guarantee over the distributed data.
Effectiveness of different types of mental simulation in the weight loss process based on a perseverance study among people with different BMI
Authors: Styk Wojciech , Zmorzyński Szymon , Klinkosz Waldemar 
Published: January 2021

Abstract
Background
Most of the world’s population lives in countries in which overweight and obesity kill more people than does underweight. The weight loss process can be supported by mental simulations, which are used to help individuals to effectively strive towards various goals. The aim of this study was to determine the impact of different types of mental simulations on perseverance, resistance to distractors and the ability to inhibit irrelevant thoughts or memories in people with different body mass indexes (BMI).

Methods
The study included 252 participants. They performed process simulations and outcome simulations, using instructions presented to them during the experiment. Perseverance and resistance to distractors were determined using a computer maze-solving task. Two indicators of perseverance were analysed: number of maze tasks solved and total time spent on solving the test. Mean time spent on a single task was used as a measure of resistance to distractors and the ability to inhibit irrelevant thoughts and memories.

Results
The results of the analyses showed that the type of mental simulation used had an effect on the indicators of perseverance. Process simulation subjects completed more tasks and spent more time solving the test than outcome simulation subjects. A relationship was found between the subjects’ BMI and the investigated indicators. Individuals who were underweight, overweight or obese scored lower on all three indicators compared to subjects with normal BMI. In people with a BMI above normal, mental simulations increased resistance to distractors and the ability to inhibit thoughts sidetracking them from the task at hand. It is possible that increasing the resistance to distractors is responsible for the effectiveness of mental simulations in the weight loss process.

Conclusion
Our results can be applied in developing interventions for people who suffer from overweight and obesity. Psychological interventions based on mental simulations can be used to assist individuals in physical activity, leading to an improvement in health, but it has to be underlined that the mechanism of their action may vary from person to person.
Incidence and time-varying predictors of HIV and sexually transmitted infections among male sex workers in Mexico City
Authors: Ganley Karla Y. , Wilson-Barthes Marta , Zullo Andrew R. , Sosa-Rubí Sandra G. , Conde-Glez Carlos J. , García-Cisneros Santa , Lurie Mark N. , Marshall Brandon D. L. , Operario Don , Mayer Kenneth H. , Galárraga Omar 
Published: January 2021

AbstractBackgroundMale sex workers are at high-risk for acquisition of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico City.MethodsFrom January 2012 to May 2014, male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia, gonorrhea, syphilis, hepatitis, and HIV at baseline, 6-months, and 12-months. Incidence rates with 95% bootstrapped confidence limits were calculated. We examined potential time-varying predictors using generalized estimating equations for a population averaged model.ResultsAmong 227 male sex workers, median age was 24 and baseline HIV prevalence was 32%. Incidence rates (per 100 person-years) were as follows: HIV [5.23; 95% confidence interval (CI): 2.15–10.31], chlamydia (5.15; 95%CI: 2.58–9.34), gonorrhea (3.93; 95%CI: 1.88–7.83), syphilis (13.04; 95%CI: 8.24–19.94), hepatitis B (2.11; 95%CI: 0.53–4.89), hepatitis C (0.95; 95%CI: 0.00–3.16), any STI except HIV (30.99; 95%CI: 21.73–40.26), and any STI including HIV (50.08; 95%CI: 37.60–62.55). In the multivariable-adjusted model, incident STI (excluding HIV) were lower among those who reported consistently using condoms during anal and vaginal intercourse (odds ratio = 0.03, 95%CI: 0.00–0.68) compared to those who reported inconsistently using condoms during anal and vaginal intercourse.ConclusionsIncidence of STIs is high among male sex workers in Mexico City. Consistent condom use is an important protective factor for STIs, and should be an important component of interventions to prevent incident infections.
Impact of multiple policy interventions on the screening and diagnosis of drug-resistant tuberculosis patients: a cascade analysis on six prefectures in China
Authors: Ding Xiao-Yan , Mao Wen-Hui , Lu Wei , Yu Hao , Liu Qiao , Lu Peng , Jiang Hui , Zhang Xing , Lu Feng , Xu Jie , Zhong Chong-Qiao , Hu Jin-Liu , Jiang Wei-Xi , Guo Lei , Tang Sheng-Lan , Zhu Li-Mei 
Published: January 2021

Abstract
Background
The detection of drug-resistant tuberculosis (DR-TB) is a major health concern in China. We aim to summarize interventions related to the screening and detection of DR-TB in Jiangsu Province, analyse their impact, and highlight policy implications for improving the prevention and control of DR-TB.

Methods
We selected six prefectures from south, central and north Jiangsu Province. We reviewed policy documents between 2008 and 2019, and extracted routine TB patient registration data from the TB Information Management System (TBIMS) between 2013 and 2019. We used the High-quality Health System Framework to structure the analysis. We performed statistical analysis and logistic regression to assess the impact of different policy interventions on DR-TB detection.

Results
Three prefectures in Jiangsu introduced DR-TB related interventions between 2008 and 2010 in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) and the Bill & Melinda Gates Foundation (Gates Foundation). By 2017, all prefectures in Jiangsu had implemented provincial level DR-TB policies, such as use of rapid molecular tests (RMT), and expanded drug susceptibility testing (DST) for populations at risk of DR-TB. The percentage of pulmonary TB cases confirmed by bacteriology increased from 30.0% in 2013 to over 50.0% in all prefectures by 2019, indicating that the implementation of new diagnostics has provided more sensitive testing results than the traditional smear microscopy. At the same time, the proportion of bacteriologically confirmed cases tested for drug resistance has increased substantially, indicating that the intervention of expanding the coverage of DST has reached more of the population at risk of DR-TB. Prefectures that implemented interventions with support from the Global Fund and the Gates Foundation had better detection performance of DR-TB patiens compared to those did not receive external support. However, the disparities in DR-TB detection across prefectures significantly narrowed after the implementation of provincial DR-TB polices.

Conclusions
The introduction of new diagnostics, including RMT, have improved the detection of DR-TB. Prefectures that received support from the Global Fund and the Gates Foundation had better detection of DR-TB. Additionally, the implementation of provincial DR-TB polices led to improvements in the detection of DR-TB across all prefectures.
Implications of Multigene Panel Testing on Psychosocial Outcomes: A Comparison of Patients With Pancreatic and Breast or Ovarian Cancer
Authors: Koptiuch Cathryn , Espinel Whitney F. , Kohlmann Wendy K. , Zhao Jingsong , Kaphingst Kimberly A. 
Published: January 2021

PURPOSE National Comprehensive Cancer Network guidelines for germline genetic testing have included pancreatic cancer in the context of additional family cancer history for many years but this was not recommended for patients with pancreatic ductal adenocarcinoma (PDAC) independent of a family history until 2019. This hypothesis-generating study reports the results from multigene panel testing for PDAC patients at an academic medical center. PATIENTS AND METHODS This prospective longitudinal feasibility study examined responses to genetic counseling and multigene panel testing among PDAC and breast or ovarian cancer (BrOv) patients between October 2016 and November 2017. Pre- and post-test surveys assessed perceptions of genetic risk and testing, recall, comprehension, and emotional reactions to results using open-ended and closed-ended items. RESULTS Forty-six BrOv and 33 PDAC patients were enrolled, and 44 BrOv and 31 PDAC participants underwent genetic testing. Seven pathogenic variants were identified in six BrOv participants (13.6%), and three pathogenic variants were identified in three PDAC participants (9.7%). The majority of both cohorts expressed similar attitudes about the importance of genetic testing for their personal and family medical management and expressed accurate understanding of implications of their results. Although sample size was small, there were no significant differences between the BrOv and PDAC cohorts for positive or negative emotions. CONCLUSION This study points to high rates of positive emotions and low rates of negative emotions following genetic test results, suggesting that the emotional reactions to genetic test results are similar for patients with BrOv and PDAC, despite poor prognosis with PDAC diagnoses. Because of the unique needs of the PDAC population following diagnosis, a multidisciplinary approach to germline genetic testing following diagnosis may result in best patient and family member outcomes.
Prevalence and Spectrum of DICER1 Mutations in Adult-onset Thyroid Nodules with Indeterminate Cytology
Authors: Chong Anne-Sophie , Nikiforov Yuri E , Condello Vincenzo , Wald Abigail I , Nikiforova Marina N , Foulkes William D , Rivera Barbara 
Published: January 2021

Abstract

Context
DICER1 mutations are found in multinodular goiter and differentiated thyroid carcinoma in children, and can be a manifestation of DICER1 syndrome, but the prevalence of DICER1 mutations and their significance in adult-onset thyroid nodules is unknown.

Objective
Determine (1) the prevalence of DICER1 hotspot mutations in thyroid nodules; (2) the frequency of a second DICER1 pathogenic variant in thyroid nodules with DICER1 hotspot mutations; (3) the prevalence of other thyroid cancer driver mutations in thyroid nodules with and without DICER1 hotspot mutations.

Methods
Population-based study of 14 993 consecutive fine needle aspiration biopsies of thyroid nodules evaluated by ThyroSeq v3. From 214 DICER1 hotspot–positive cases, we selected 61, matched to DICER1 hotspot–negative nodules. We performed full sequencing of all exons and exon–intron boundaries of DICER1.

Setting
Commercial and university-based laboratories in the United States and Canada.

Results
Among 14 993 thyroid nodules, 214 (1.4%) revealed a DICER1 hotspot mutation. A second pathogenic/likely pathogenic variant in DICER1 was found in 45/59 (76%) DICER1 hotspot–positive nodules studied while no other DICER1 variant was identified in the DICER1 hotspot–negative group by full DICER1 sequencing. Other alterations in thyroid-related genes were significantly more frequent in DICER1 hotspot–negative nodules (32/61) than in DICER1 hotspot-–positive nodules (4/59) (P &lt; .0001).

Conclusion
DICER1 alterations occur in a proportion of adult thyroid nodules and appear mutually exclusive with alterations in other thyroid cancer–related genes. DICER1 hotspot mutations occur with a second hit in most cases and could suggest occult DICER1 syndrome in adults with thyroid nodules.