bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nutrient pattern characterized by vitamin A, C, B6, potassium, and fructose is associated with reduced risk of insulin‐related disorders: A prospective study among participants of Tehran lipid and glucose study
Authors: Teymoori Farshad , Mokhtari Ebrahim , Salehi Pantea , Hosseini-Esfahani Firoozeh , Mirmiran Parvin , Azizi Fereidoun 
Published: January 2021

AbstractBackgroundInsulin-related disorders, including insulin resistance, insulin insensitivity, and insulinemia, is considered early predictors of major chronic disease risk. Using a set of correlated nutrient as nutrient patterns to explore the diet-disease relationship has drawn more attention recently. We aimed to investigate the association of nutrient patterns and insulin markers’ changes prospectively among adults who participated in the Tehran Lipid and Glucose Study (TLGS).MethodsFor the present study, 995 men and women aged 30–75 years, with complete information on insulin and dietary intake in survey III TLGS, were selected and followed three years until survey IV. Dietary intakes at baseline were assessed using a valid and reliable food frequency questionnaire (FFQ). Nutrient patterns were derived using principal component analysis (PCA). We extracted five dominant patterns based on the scree plot and categorized them into quartiles. Linear regression analysis was conducted to investigate the association between Nutrient patterns and three-year insulin markers changes, including fasting insulin, HOMA-IR, and HOMA-S.ResultsThe mean (SD) age and BMI of participants (43.1 % male) were 46.2(10.9) year and 28.0(4.7) kg/m2, respectively. The median (IQR, 25, 75) of 3 years changes of insulin, HOMA-IR and HOMA-S were 0.35 (− 1.71, 2.67) mU/mL, 0.25 (− 0.28, 0.84) and − 6.60 (− 22.8, 7.76), respectively. In the fully adjusted model for potential confounders, per each quartile increment of the fifth nutrient pattern, the β coefficients (95 % CI) of changes in insulin, HOMA-IR, and HOMA-S were − 0.36 (− 0.62, − 0.10); P value = 0.007, -0.10 (-0.19, -0.01); P value = 0.022, and 1.92 (0.18, 3.66); P value = 0.030, respectively. There were no significant association between other nutrient patterns and insulin related indices.ConclusionsPresent study showed that high adherence to a nutrient pattern rich in vitamin A, vitamin C, pyridoxine, potassium, and fructose is inversely associated with 3-years changes in insulin, HOMA-IR, and directly associated with HOMA-S.
Hypoxia promotes the metastasis of pancreatic cancer through regulating NOX4/KDM5A-mediated histone methylation modification changes in a HIF1A-independent manner
Authors: Li Hongzhen , Peng Chunyan , Zhu Chenhui , Nie Shuang , Qian Xuetian , Shi Zhao , Shi Mengyue , Liang Yan , Ding Xiwei , Zhang Shu , Zhang Bin , Li Xihan , Xu Guifang , Lv Ying , Wang Lei , Friess Helmut , Kong Bo , Zou Xiaoping , Shen Shanshan 
Published: January 2021

Abstract
Background
Hypoxia is a characteristic of the tumor microenvironments within pancreatic cancer (PC), which has been linked to its malignancy. Recently, hypoxia has been reported to regulate the activity of important carcinogenic pathways by changing the status of histone modification. NOX4, a member of NADPH oxidase (NOX), has been found to be activated by hypoxia and promote cancer progression in several cancers. But whether it is involved in the epigenetic changes of tumor cells induced by hypoxia is still unclear, and its biological roles in PC also need to be explored.

Methods
A hypoxic-related gene signature and its associated pathways in PC were identified by analyzing the pancreatic cancer gene expression data from GEO and TCGA database. Candidate downstream gene (NOX4), responding to hypoxia, was validated by RT-PCR and western blot. Then, we evaluated the relationship between NOX4 expression and clinicopathologic parameters in 56 PC patients from our center. In vitro and in vivo assays were preformed to explore the phenotype of NOX4 in PC. Immunofluorescence, western blot and chromatin immunoprecipitation assays were further applied to search for a detailed mechanism.

Results
We quantified hypoxia and developed a hypoxia signature, which was associated with worse prognosis and elevated malignant potential in PC. Furthermore, we found that NADPH oxidase 4 (NOX4), which was induced by hypoxia and upregulated in PC in a HIF1A-independent manner, caused inactivation of lysine demethylase 5A (KDM5A), increased the methylation modification of histone H3 and regulated the transcription of EMT-associated gene_ snail family transcriptional repressor 1 (SNAIL1). This served to promote the invasion and metastasis of PC. NOX4 deficiency repressed hypoxia-induced EMT, reduced expression of H3K4ME3 and impaired the invasion and metastasis of PC cells; however, knockdown of KDM5A reversed the poor expression of H3KEME3 induced by NOX4 deficiency, thereby promoting EMT.

Conclusions
This study highlights the prognostic role of hypoxia-related genes in PC and strong correlation with EMT pathway. Our results also creatively discovered that NOX4 was an essential mediator for hypoxia-induced histone methylation modification and EMT in PC cells.
What can we learn from Israel’s rapid roll out of COVID 19 vaccination?
Authors: McKee Martin , Rajan Selina 
Published: January 2021

AbstractIsrael has led the world in rolling out its COVID-19 vaccination program. This experience provides lessons that others can learn from. It is, however, necessary to consider some national specificities, including the small size of the country, its young population, and the political imperative to drive this program forward. Israel also has a number of other advantages, including a strong public health infrastructure. The lessons that can be learnt include the importance of coordinating delivery mechanisms with the inevitable prioritisation of groups within the population, timely deployment of a skilled cadre of health workers, a recognition that not everyone in the population shares in the benefits of digital connectedness, the need to reach out to disadvantaged groups, based on an understanding of the barriers that they face, and the importance of placing COVID-19 vaccination within a comprehensive response to the pandemic.
Tephra deposit inversion by coupling Tephra2 with the Metropolis-Hastings algorithm: algorithm introduction and demonstration with synthetic datasets
Authors: Yang Qingyuan , Pitman E. Bruce , Bursik Marcus , Jenkins Susanna F. 
Published: January 2021

AbstractIn this work we couple the Metropolis-Hastings algorithm with the volcanic ash transport modelTephra2, and present the coupled algorithm as a new method to estimate the Eruption Source Parameters of volcanic eruptions based on mass per unit area or thickness measurements of tephra fall deposits. Outputs of the algorithm are presented as sample posterior distributions for variables of interest. Basic elements in the algorithm and how to implement it are introduced. Experiments are done with synthetic datasets. These experiments are designed to demonstrate that the algorithm works from different perspectives, and to show how inputs affect its performance. Advantages of the algorithm are that it has the ability to i) incorporate prior knowledge; ii) quantify the uncertainty; iii) capture correlations between variables of interest in the estimated Eruption Source Parameters; and iv) no simplification is assumed in sampling from the posterior probability distribution. A limitation is that some of the inputs need to be specified subjectively, which is designed intentionally such that the full capacity of the Bayes’ rule can be explored by users. How and why inputs of the algorithm affect its performance and how to specify them properly are explained and listed. Correlation between variables of interest in the posterior distributions exists in many of our experiments. They can be well-explained by the physics of tephra transport. We point out that in tephra deposit inversion, caution is needed in attempting to estimate Eruption Source Parameters and wind direction and speed at each elevation level, because this could be unnecessary or would increase the number of variables to be estimated, and these variables could be highly correlated. The algorithm is applied to a mass per unit area dataset of the tephra deposit from the 2011 Kirishima-Shinmoedake eruption. Simulation results fromTephra2using posterior means from the algorithm are consistent with field observations, suggesting that this approach reliably reconstructs Eruption Source Parameters and wind conditions from deposits.
Studying a 2 millennia old bronze kettle using easily accessible characterization techniques
Authors: Kotlar Marta , Matijaković Mlinarić Nives , Desnica Vladan , Marušić Katarina 
Published: January 2021

Abstract
A bronze kettle dating from the 1st to 2nd century was found in a riverbed of the Kupa river in Croatia. After excavation it spent another 50 years in a depot of a museum in atmospheric conditions prior to starting the conservation treatment and our studies. A study on the surface layers development was performed to determine the whereabouts of the object through its history. This study is a demonstration of how such analysis can be used to reconstruct what the object went through during its life span. Samples taken from the kettle were observed by optical and scanning electron microscopy (SEM), and analysed by X-ray fluorescence (XRF), X-ray energy dispersive spectroscopy (EDS) and Fourier transform infrared spectroscopy (FTIR).
It was determined that the kettle is made of low-tin bronze, with low amounts of iron, aluminium, calcium and nickel. While being in the riverbed malachite formed on the kettle. After longer exposure to the river Si-oxides and CaCO3 formed on the surface of the kettle, over malachite. It was shown that the kettle probably had a ferrous alloy handle which degraded and disappeared in time. After excavation, the kettle came again in an oxygen-enriched atmosphere and formed new surface layers over the malachite layer. As the museum the kettle has been kept in since excavation is set in a highly industrial area sulphur compounds have been formed on the surface.
Outcomes of surgical treatment in patients with anorectal fistula cancer
Authors: Osone Katsuya , Ogawa Hiroomi , Katayama Chika , Shibasaki Yuta , Suga Kunihiko , Komine Chika , Ozawa Naoya , Okada Takuhisa , Shiraishi Takuya , Katoh Ryuji , Sakai Makoto , Sano Akihiko , Yokobori Takehiko , Matsumura Nozomi , Sohda Makoto , Shirabe Ken , Saeki Hiroshi 
Published: January 2021

Abstract
Background
No standard treatment for anorectal fistula cancer, such as multidisciplinary therapy, has been established due to the rarity of the disease. Herein, we investigated patients with cancer associated with anorectal fistula who underwent surgery to clarify the clinicopathological characteristics and to propose future perspectives for treatment strategies.

Case presentation
Seven patients with cancer associated with anorectal fistula who underwent rectal amputation in our institute were analyzed with regard to clinical characteristics, pathological findings, surgical results, and prognosis. Four cases had Crohn's disease as an underlying cause. All seven cases were diagnosed as advanced stage. Preoperative [18F]-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography/computed tomography (FDG-PET/CT) showed abnormal FDG accumulation in six cases including four mucinous adenocarcinomas. Three cases that received preoperative hyperthermo-chemoradiotherapy achieved pathological R0 resection. Postoperative recurrence was observed in four cases including three with Crohn's disease and one resulting in death.

Conclusions
Anorectal fistula cancer is rare and difficult to be diagnosed at early stages. Mucinous adenocarcinoma associated with anorectal fistula tends to exhibit abnormal FDG accumulation by FDG-PET/CT unlike common colorectal mucinous adenocarcinoma. Preoperative hyperthermo-chemoradiotherapy may be effective in obtaining pathological complete resection.
Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi
Authors: Chorwe-Sungani Genesis , Mwagomba Modesta , Kulisewa Kazione , Chirwa Ellen , Jere Diana , Chipps Jennifer 
Published: January 2021

Abstract
Background
Depression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District. SPADe proposes multistage screening of antenatal depression by midwives which may enable early detection and treatment of pregnant women with depression. Proper treatment of antenatal depression can assist in achieving Sustainable Development Goals (SDGs). However, utilisation of SPADe in clinical practice to screening for depression in antenatal clinics has not been established yet. Therefore, the primary aim of this study is to assess feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. The secondary aim was to assess acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District.

Methods
This will be a feasibility study which will consist of scientific investigations that will support movement of evidence-based, effective health care approach, SPADe, from the clinical knowledge base into routine use. This study will consist three phases: phase 1 will introduce SPADe in antenatal clinics in Blantyre District where screening of depression is almost none existent; phase 2 will implement screening of depression using SPADe in antenatal clinics in Blantyre District; and phase 3 will evaluate the screening of antenatal depression using SPADe to establish its feasibility, acceptability and fidelity in antenatal clinics in Blantyre District.

Discussion
This study will establish and document feasibility, acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. It is expected that midwives will develop more confidence in detecting and dealing with antenatal depression. Consequently, there will be increased numbers of pregnant women detected with depression by midwives and increased accessibility to mental health care by pregnant women in antenatal clinics.
Predictors of pacing induced left ventricular dysfunction and cardiomyopathy assessed by three-dimensional echocardiography and speckle tracking strain
Authors: Dawood Moustafa , Elsharkawy Eman , Abdel-Hay Mohamed Ayman , Nawar Moustafa 
Published: January 2021

Abstract
Background
Long-term RV pacing leads to ventricular dyssynchrony, in the form of LBBB-like morphology, with subsequent detrimental effects on LV structure and function. Three-dimensional echocardiography allowed early detection of volumetric changes associated with PICMP and provided more accurate assessment of mechanical dyssynchrony. Speckle tracking strain is able to identify LV dysfunction even before any reduction in LVEF. Our aim was to study pacing effects on LV function and hemodynamics using 3D echo and speckle tracking strain.

Results
This was a prospective study of 175 consecutive patients without structural heart disease (LVEF > 50%) presented for permanent pacing. Full-volume 3D echocardiography done before implantation, 1 week, and 6 months together with GLS. Patients were followed for 6 months to detect incidence of PIVD (defined as reduction in LVEF > 10% but still above 50%) and PICMP (defined as decrease in LVEF by 10% from baseline in absence of other known causes of cardiomyopathy resulting in EF< 50%). PIVD and PICMP predictors and risk factors were analyzed. Only 50 patients met study criteria. Twenty-five (50%) patients developed LV systolic dysfunction; of these, 19 (38%) developed PIVD and 6 (12%) developed PICMP. Pre-implantation GLS was significantly lower in the 6 patients who subsequently developed PICMP, compared to those who developed PIVD and the preserved EF group (mean GLS − 15.50 vs. − 21.0, − 20.0 respectively; p = 0.005, 0.033, respectively). At 1 week, GLS was significantly lower in the 25 patients who subsequently developed PIVD, compared to those who did not (GLS − 13.0 vs. − 18.0, respectively; p = 0.002). A reduction of baseline GLS by 15% or more at 1 week was associated with the development of PIVD and PICMP (p = < 0.001). A wider native QRS complex was associated with PIVD and PICMP (p = 0.008, 0.018, respectively). The other predictors were found non-significant.

Conclusion
PICMP may be more common than previously reported and it may occur shortly after implantation. Pre-implantation GLS is a sensitive parameter for PICMP. One-week GLS, pre-implantation QRS complex width are early predictors for PICMP and PIVD before any reduction in EF.
Fighting for America's Paradise: The Struggle against Structural Racism
Authors: Hardeman Rachel R. , Hardeman-Jones Simone L. , Medina Eduardo M. 
Published: January 2021

AbstractStructural racism is a fundamental cause of racial inequities in health in the United States. Structural racism is manifested in inequality in the criminal justice system; de facto segregation in education, health care, and housing; and ineffective and disproportionately violent policing and economic disenfranchisement in communities of color. The inequality that Black people and communities of color face is the direct result of centuries of public policy that made Black and Brown skin a liability. The United States is now in an unprecedented moment in its history with a new administration that explicitly states, “The moment has come for our nation to deal with systemic racism . . . and to deal with the denial of the promise of this nation—to so many.” The opportunities for creating innovative and bold policy must reflect the urgency of the moment and seek to dismantle the systems of oppression that have for far too long left the American promise unfulfilled. The policy suggestions made by the authors of this article speak to the structural targets needed for dismantling some of the many manifestations of structural racism so as to achieve health equity.
Medicare's Stewardship Role to Improve Care Delivery: Opportunities for the Biden Administration
Authors: Berenson Robert A. 
Published: January 2021

AbstractMedicare initiatives have been instrumental in improving care delivery and payment as exemplified by its role in broadly expanding the use of telehealth during the COVID-19 pandemic. Medicare innovations have been adopted or adapted in Medicaid and by private payers, while Medicare Advantage plans successfully compete with traditional Medicare only because their payment rates are tied by regulation to those in the traditional Medicare program. However, Medicare has not succeeded in implementing new, value-based payment approaches that also would serve as models for other payers, nor has Medicare succeeded in improving quality by relying on public reporting of measured performance. It is increasingly clear that burdensome attention to measurement and reporting distracts from what could be successful efforts to actually improve care through quality improvement programs, with Medicare leading in partnership with providers, other payers, and patients. Although Congress is unlikely to adopt President Biden's proposals to decrease the eligibility age for Medicare or to adopt a public option based on Medicare prices and payment methods in the marketplaces, the Biden administration has an opportunity to provide overdue, strategic direction to the pursuit of value-based payments and to replace failed pay-for-performance with provider-managed projects to improve quality and reduce health disparities.
When Doctors strike: Making Sense of Professional Organizing in Kenya
Authors: Koon Adam D. 
Published: January 2021

AbstractLittle is known about how the health professions organize in low- and middle-income countries (LMICs). This is particularly troubling as health worker strikes in LMICs appear to be growing more frequent and severe. While some research has been conducted on the impact of strikes, little has explored their social etiology. This article draws on theory from organization and management studies to situate strike behavior in a historical process of sensemaking in Kenya. In this way, doctors seek to expand pragmatic, moral, and cognitive forms of legitimacy in response to sociopolitical change. During the first period (1963–2000), the legacy of colonial biomedicine shaped medical professionalism and tensions with a changing state following independence. The next period (2000–2010) was marked by the rise of corporate medicine as an organized form of resistance to state control. The most recent period (2010–2015) saw a new constitution and devolution of health services cause a fractured medical community to strike as a form of symbolic resistance in its quest for legitimacy. In this way, strike behavior is positioned as a form of legitimation among doctors competing over the identity of medicine in Kenya and is complicating the path to universal health coverage.
Trajectories of Professional Authority: A Comparative Study of Medical Associations and Professional Authority Claims
Authors: Larsen Lars Thorup 
Published: January 2021

AbstractMedical associations not only organize their members' interests but also exercise professional authority within the field of health policy. An important aspect of professional authority is the medical profession's ability to position itself in relation to national health policy and whether its command of professional knowledge enables the profession to claim exclusive authority for reflecting on health policy. This article analyzes and compares how medical associations claim authority over health policy and how they reposition their claims in light of perceived contestations to medical authority in public debates or from the political system. The study is based on a qualitative, descriptive analysis of 975 editorials in the medical associations' lead journals in the United States, the United Kingdom, and Denmark over a period of 60 years. The analysis explores the trajectories of authority claims in the three countries and how professional authority claims may be reconfigured to reflect external changes in health policy institutions. Whereas all the medical associations were highly critical of state-organized health systems in the 1950s and early 1960s, the British and Danish associations seem to shift positions entirely after national health systems are gradually implemented and the associations begin to present themselves as these public institutions' strongest supporters.