bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Heart Failure Stages in Middle‐Aged Black People in the Community: Prevalence and Prognosis in the Atherosclerosis Risk in Communities Study
Authors: Vasan Ramachandran S. , Musani Solomon K. , Matsushita Kunihiro , Beard Walter , Obafemi Olushola B. , Butler Kenneth R. , Chang Patricia P. , Mosley Thomas H. , Fox Ervin 
Published: April 2021

Background
Black individuals have a higher burden of risk factors for heart failure (HF) and subclinical left ventricular remodeling.

Methods and Results

We evaluated 1871 Black participants in the Atherosclerosis Risk in Communities Study cohort who attended a routine examination (1993–1996, median age 58 years) when they underwent echocardiography. We estimated the prevalences of 4 HF stages: (1)
Stage 0
: no risk factors; (2)
Stage A
: presence of HF risk factors (hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, coronary artery disease without clinical myocardial infarction), no cardiac structural/functional abnormality; (3)
Stage B
: presence of prior myocardial infarction, systolic dysfunction, left ventricular hypertrophy, regional wall motion abnormality, or left ventricular enlargement; and (4)
Stage C/D
: prevalent HF. We assessed the incidence of clinical HF, atherosclerotic cardiovascular disease events, and all‐cause mortality on follow‐up according to HF stage. The prevalence of HF Stages 0, A, B, and C/D were 3.8%, 20.6%, 67.0%, and 8.6%, respectively, at baseline. On follow‐up (median 19.0 years), 309 participants developed overt HF, 390 incurred new‐onset cardiovascular disease events, and 651 individuals died. Incidence rates per 1000 person‐years for overt HF, cardiovascular disease events, and death, respectively, were Stage 0, 2.4, 0.8, and 7.6; Stage A, 7.4, 9.7, and 13.5; Stage B 13.6, 15.9, and 22.0. Stage B HF was associated with a 1.5‐ to 2‐fold increased adjusted risk of HF, cardiovascular disease events and death compared with Stages 0/A.

Conclusions
In our large community‐based sample of Black individuals, we observed a strikingly high prevalence of Stage B HF in middle age that was a marker of high cardiovascular morbidity and mortality.
On the Relationships Between the Grammatical Genders of Inanimate Nouns and Their Co-Occurring Adjectives and Verbs
Authors: Williams Adina , Cotterell Ryan , Wolf-Sonkin Lawrence , Blasi Damián , Wallach Hanna 
Published: April 2021

AbstractWe use large-scale corpora in six different gendered languages, along with tools from NLP and information theory, to test whether there is a relationship between the grammatical genders of inanimate nouns and the adjectives used to describe those nouns. For all six languages, we find that there is a statistically significant relationship. We also find that there are statistically significant relationships between the grammatical genders of inanimate nouns and the verbs that take those nouns as direct objects, as indirect objects, and as subjects. We defer deeper investigation of these relationships for future work.
Restructuring Marriage and Family in Industrial Kazakhstan: Axes of Inequality and Conjugality in a Former Soviet Steel Plant
Authors: Trevisani Tommaso 
Published: April 2021

Abstract
This paper addresses how changing patterns of conjugality, family and labour play out in a gender-mixed, multi-ethnic industrial setting built in Soviet times and nowadays owned by foreign corporate capital. Matrimonial relationships among Kazakhstani steel workers have come under sustained pressure as a consequence of privatization and labour restructuring. As a result, workers must accommodate their family lives and partnership prospects to their own precarious situation in an increasingly adverse world of industrial labour. Kazakh, Russian, male, female, precarious and regular workers are differently affected and adopt different strategies. Mirroring workplace related inequalities, marriage and family patterns rooted in distinctive traditions in multi-ethnic Kazakhstan are currently being reshaped. At the same time, marriage and family have become more important in determining workers’ wellbeing at work and beyond.
A Resident-Driven Mobile Evaluation System Can Be Used to Augment Traditional Surgery Rotation Evaluations
Authors: Oberoi Kurun Partap S. , Caine Akia D. , Schwartzman Jacob , Rab Sayeeda , Turner Amber L. , Merchant Aziz M. , Kunac Anastasia 
Published: April 2021

Background The Accreditation Council for Graduate Medical Education requires residents to receive milestone-based evaluations in key areas. Shortcomings of the traditional evaluation system (TES) are a low completion rate and delay in completion. We hypothesized that adoption of a mobile evaluation system (MES) would increase the number of evaluations completed and improve their timeliness. Methods Traditional evaluations for a general surgery residency program were converted into a web-based form via a widely available, free, and secure application and implemented in August 2017. After 8 months, MES data were analyzed and compared to that of our TES. Results 122 mobile evaluations were completed; 20% were solicited by residents. Introduction of the MES resulted in an increased number of evaluations per resident ( P = .0028) and proportion of faculty completing evaluations ( P = .0220). Timeliness also improved, with 71% of evaluations being completed during one’s clinical rotation. Conclusions A resident-driven MES is an inexpensive and effective method to augment traditional end-of-rotation evaluations.
Ramp Lesion Subtypes: Prevalence, Imaging, and Arthroscopic Findings in 2156 Anterior Cruciate Ligament Reconstructions
Authors: Thaunat Mathieu , Ingale Pramod , Penet Alexandre , Kacem Samih , Haidar Ibrahim , Bauwens Paul-Henri , Fayard Jean-Marie 
Published: April 2021

Background: Ramp lesions are defined as a particular type of injury within the posterior horn of the medial meniscus and its meniscocapsular attachments. Five subtypes have been described: type 1, meniscocapsular lesion; type 2, partial superior lesion; type 3, partial inferior lesion or hidden type; type 4, complete tear in the red zone; and type 5, complete double tear. Purpose: (1) To determine the prevalence of different subtypes of ramp lesions in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR). (2) To describe the characteristics of ramp lesions based on imaging and diagnostic arthroscopy. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All patients who underwent arthroscopic ACLRs between November 2015 and November 2018 by 2 senior surgeons at 1 institution were evaluated retrospectively (1) to describe the subtypes of ramp lesions diagnosed intraoperatively using transnotch arthroscopic exploration of the posteromedial compartment and (2) to look for any factors significantly associated with these subtypes. The following parameters were studied: demographics; history and clinical findings including time between injury and surgery, side-to-side laxity, and pivot shift; lesions missed on magnetic resonance imaging (MRI) scans and medial proximal tibial bone contusion visible on MRI scans; and arthroscopic confirmation of ramp lesion (ie, prevalence), associated lateral meniscal tear, or medial chondral tear. Results: Out of 2156 primary or revision arthroscopic reconstructions, 334 ramp lesions were confirmed, giving a prevalence of 15.5%. The subtype distribution was as follows: type 1, 47.9%; type 2, 4.8%; type 3, 11.4%; type 4, 28.7%; type 5, 7.2%. Multivariate analysis showed that gross pivot shift was significantly associated with complete ramp tears (odds ratio, 4.8; 95% CI, 1.7-17.2). Hidden lesions (type 3, inferior partial tear in the red zone) were the most likely to be missed on preoperative MRI (45.9%). Conclusion: In a population undergoing ACLR, the prevalence of ramp lesions was 15.5%. Among the subtypes of ramp lesion, the most common was a meniscocapsular junction tear (type 1). Partial inferior tears (type 3) were the most likely to be missed on preoperative MRI scans. Gross pivot shift was significantly associated with complete ramp tears (types 1, 4, and 5).
Report of a Pilot Program Using a Milk-Free Ready-to-Use Therapeutic Food Made From Soya, Maize, and Sorghum to Treat Severe Acute Malnutrition
Authors: Banda Theresa , Chawanda Khataza , Tsuchida Wakako , Kathumba Slyvester 
Published: April 2021

Background: Globally, ready-to-use therapeutic food (RUTF) with peanut and milk as the primary source of protein is used to treat children having severe acute malnutrition (SAM). Valid Nutrition in collaboration with Ajinomoto Co., Inc has developed a nonmilk RUTF from soybean, maize, and sorghum (SMS-RUTF) and demonstrated its efficacy. Objective: To pilot SMS-RUTF in treatment of SAM within Community-Based Management of Acute Malnutrition (CMAM) program in Malawi, Africa. Methods and Findings: This was implemented from January to July 2018 and its performance was based on the SPHERE criteria and Ministry of Health CMAM guidelines. A total of 742 children were treated with SMS-RUTF. Of these, 94.5% (95% CI: 92.6-96.0) were successfully discharged to supplementary feeding program (SFP) with middle upper arm circumference (MUAC) ≥115 mm or directly to their homes with MUAC ≥125 mm; 3.6% (95% CI: 2.4-5.3) defaulted, 1.9 % (95% CI: 1.0-2.1) died, and 0.0% nonresponders. Analysis of 222 children who were discharged home with MUAC ≥125 mm gave a recovery rate of 88.3% (95% CI: 88.3-92.2), a defaulter rate of 6.8 % (95% CI: 3.8-10.9), a mortality rate of 1.3% (95% CI: 0.3-3.9), and a nonresponders rate of 1.8% (95% CI: 0.5-4.5). These outcomes exceed SPHERE minimum performance standards. The mean (standard deviation) length of stay of children discharged to SFP and discharged directly home were 42.0 (20.9) and 46.1 (21.1) days, respectively. These outcomes are within the recommended average duration of <60 days. Conclusion: The pilot CMAM program using SMS-RUTF recipe that contains no milk or peanuts achieved SPHERE minimum standards. Based on this evidence, SMS-RUTF should be encouraged for treatment of SAM in children between 6 and 59 months in routine CMAM programs in Malawi and globally.
Review of the Micronutrient Situation in Rwanda
Authors: Arsenault Joanne E. , Olney Deanna K. 
Published: April 2021

Background: Rwanda’s commitment to reducing malnutrition is evident in their multisectoral nutrition policy and wide array of nutrition partners. However, the prevalence of micronutrient deficiencies and the suitability of current strategies to address existing deficiencies is unclear. Objective: To review the available evidence related to the prevalence of micronutrient deficiencies across the life cycle and strategies in place to address them. Methods: We reviewed scientific and grey literature on nutritional problems in Rwanda, emphasizing micronutrient deficiencies and anemia, and current strategies to address micronutrient malnutrition. Results: Overall, there is scant evidence related to the types and prevalence of micronutrient deficiencies among populations across the life cycle in Rwanda. Existing evidence is primarily limited to outdated or small regional surveys focusing on iron or vitamin A among women and young children. Surveys have assessed the prevalence of anemia and indicate that anemia is very high among young children and moderately high among other age-groups. However, there are limited data on the context-specific causes of anemia in Rwanda across population groups. Current nutrition strategies mainly target women and young children and are primarily designed to reduce vitamin A deficiency and/or anemia caused by micronutrient deficiencies. Conclusions: Rwanda has many nutrition programs in place that address micronutrient deficiencies in young children and a few for women of reproductive age. However, gaps exist in knowledge of the extent of different types of micronutrient deficiencies among all populations across the life cycle and whether the delivery of nutrients through current programs is meeting actual needs.
The Economics of the Soy Kit as an Appropriate Household Technology for Food Entrepreneurs
Authors: Kim Chungmann , Goldsmith Peter 
Published: April 2021

Background: The ability for women to operate as food entrepreneurs presents opportunities to leverage at-home production technologies that not only support family nutrition but also generate income. To these ends, the Feed the Future Malawi Agriculture Diversification Activity recently launched a development project involving a new technology, the Soy Kit. The Activity, a USAID (United States Agency for International Development) funded effort, sought to improve nutrition utilizing an underutilized local and highly nutritious feedstuff, soybean, through a woman’s entrepreneurship scheme. Objective: The USAID funded effort provides the overarching research question, whether the Soy Kit is a sustainable technology for delivering nutrition and income through a women’s entrepreneurship scheme. If true, then development practitioners will have a valuable tool, and the associated evidence, to address the important crosscutting themes, of nutrition, poverty, entrepreneurship, and women’s empowerment. To answer this research question, the research team first evaluates the underlying production economics of the kit to measure profitability, return on investment, and operational performance. Second, the team qualitatively and quantitatively assesses the kit’s overall appropriateness as a technology for the developing world. Methods: The team follows the schema of Bower and Brown and utilizes descriptive statistics, and financial techniques to conduct an assessment of the economics and technical appropriateness of the Soy Kit technology. Results: The results show a high level of appropriateness across a number of metrics. For example, the payback period from cash flow is under 6 months and the annual return on capital is 163% when entrepreneurs utilize a domestically sourced kit valued at US$80. Conclusion: The technology matches well with the rhythm of household economy, in particular women’s labor availability and resource base. Businesses earn significant returns on capital thus appear to be sustainable without donor subsidy. At the same time, available capital to finance kit entrepreneurs appears to be scarce. More research needs to take place to address the credit access question, in order to make small-scale kit entrepreneur truly self-reliant; the effects on poverty reduction at the household and village level; and nutrition improvement among the consumers.
Design of a novel hybrid control for permanent magnet synchronous generator–based wind energy conversion system
Authors: Feng Wenfeng , Deng Yuwen , Li Huanhuan , Chen Diyi , Li Feng 
Published: April 2021

With the ever-increasing permeation of wind energy into electrical grids, the low operating efficiency and poor stability seem to become major challenges for the power industry because of the stochastic characteristic of wind speeds. Aiming at these problems, this article designs a novel hybrid control method for a permanent magnet synchronous generator–based wind energy conversion system. A port-controlled Hamiltonian with dissipation model is proposed to apply in the models of the machine and grid-side converters of the permanent magnet synchronous generator–based wind energy conversion system. Then, this port-controlled Hamiltonian with dissipation model is used to the energy shaping method of interconnection and damping assignment. The hybrid control strategy, containing the outer-loop proportional–integral control and inner-loop passivity-based control, is finally designed in this article. To achieve the analysis, a Simulink model of the 1.5 MW permanent magnet synchronous generator–based wind energy conversion system is established under various types of wind speeds. A comparative analysis between the proposed hybrid control strategy and conventional proportional–integral vector control is conducted through the electrical behaviors and the harmonic distortion rates. The simulation results verify that the hybrid control strategy has better regulation performance than that of conventional proportional–integral control strategy in terms of maintaining at optimal state and improving system stability. It is also demonstrated that the proposed control strategy optimizes the quality of supplied power, which is of significance to reduce the harmonic pollution of wind energy.
Prenatal exposure to paternal smoking and likelihood for autism spectrum disorder
Authors: Kim Bora , Ha Mina , Kim Young Shin , Koh Yun-Joo , Dong Shan , Kwon Ho-Jang , Kim Young-Suk , Lim Myung-Ho , Paik Ki-Chung , Yoo Seung-Jin , Kim Hosanna , Hong Patricia S , Sanders Stephan J , Leventhal Bennett L 
Published: April 2021

Genetics, environment, and their interactions impact autism spectrum disorder etiology. Smoking is a suspected autism spectrum disorder risk factor due to biological plausibility and high prevalence. Using two large epidemiological samples, we examined whether autism spectrum disorder was associated with prenatal paternal smoking in a Discovery sample ( N = 10,245) and an independent Replication sample ( N = 29,773). Paternal smoking was retrospectively assessed with questionnaires. Likelihood of having autism spectrum disorder was estimated with the Autism Spectrum Screening Questionnaire at three levels: low (<10), intermediate (10–14), and high (⩾15). Ordinal regression was used to examine the relationship between prenatal paternal smoking and likelihood of having autism spectrum disorder, adjusting for confounders. A total of 36.5% of Discovery sample fathers and 63.3% of Replication sample fathers smoked during the pregnancy period; 7% of the Replication sample smoker fathers smoked during the pre-conception period but quit during pregnancy period. Discovery sample prenatal paternal smoking significantly increased the likelihood of having autism spectrum disorder in their offspring (adjusted odds ratio=1.27). This was confirmed in the Replication sample with adjusted odds ratio of 1.15 among smoking pre-conception period + pregnancy period fathers; 14.4% and 11.1% increased high likelihood of autism spectrum disorder was attributable to prenatal paternal smoking in Discovery sample and Replication sample, respectively. Smoking prevention, especially in pregnancy planning, may decrease autism spectrum disorder risk in offspring. Lay abstract What is Already Known about This Subject: Genetics, (including de novo mutations), environmental factors (including toxic exposures), and their interactions impact autism spectrum disorder etiology. Paternal smoking is a candidate risk for autism spectrum disorder due to biological plausibility, high prevalence, and potential intervention. What This Study Adds: This original study and its replication confirms that paternal factors can substantially contribute to autism spectrum disorder risk for their offspring. It specifically indicates that paternal smoking both before and during pregnancy contributes significantly to autism spectrum disorder risk. Implications for practice, research, or policy: Smoking prevention, especially in pregnancy planning, may decrease autism spectrum disorder risk in offspring.
Single Center Experience of Sirolimus Therapy in Head and Neck Low-flow Vascular Malformations
Authors: Pang Calver , Evans Nicholas , Jethwa Poonam , Papadopoulou Anthie , Khalifa Mohamed , Tsui Janice , Hamilton George , Lim Chung Sim , Brookes Jocelyn 
Published: April 2021

Objective: Recently, studies have shown that sirolimus is clinically efficacious in the treatment of some low-flow vascular malformations (LFVM). This study aimed to assess the efficacy and safety of sirolimus in treating complex head and neck (H&N) LFVM that were challenging and/or refractory to standard treatment. Methods: Each patient had baseline and 6-months assessments consisting of clinical history and examination, quality of life (QoL) questionnaires, laboratory investigations, MRI and medical photography. Patients were followed up 1-week and then 1-monthly for 6-months. Wilcoxon signed-rank test was used to compare pre-and 6-months treatment in all 8 domains of RAND 36-Item Short Form Health Survey (SF-36), hospital anxiety and depression scale (HADS), and visual analog score for pain (VAS-P). P < 0.05 was considered significant. Results: Seven patients (median age 43 years, range 23-65 years) were recruited. Six patients completed the six-months course of therapy with 1 patient withdrawing due to intolerable side effects. All six patients reported reduction of swelling with and without other symptom improvement related to the vascular malformations while on treatment. However, at 1-month review after discontinuation of sirolimus, 5 patients reported return of initial symptoms. Overall, patients demonstrated an improvement in QoL six-months treatment but there was no statistical significance (P > 0.05) in all 8 domains of SF-36, HADS and VAS-P. Five patients demonstrated a minimum 10% decrease in lesion size six-months treatment (median 21%, range 13-40%). A Wilcoxon signed-rank test showed that sirolimus treatment did elicit a statistically significant change in lesion size in either direction (Z = -1.992, P = 0.046). The most common side effects found were dyslipidaemia (n-4) and mouth ulcers (n = 2). Conclusion: In our preliminary experience, sirolimus is effective and safe in treating patients with complex H&N LFVM. This provides an alternative treatment where standard treatment is challenging and/or refractory.
Acellular Nerve Allografts in Major Peripheral Nerve Repairs: An Analysis of Cases Presenting With Limited Recovery
Authors: Peters Blair R. , Wood Matthew D. , Hunter Daniel A. , Mackinnon Susan E. 
Published: April 2021

Background: Acellular nerve allografts have been used successfully and with increasing frequency to reconstruct nerve injuries. As their use has been expanded to treat longer gap, larger diameter nerve injuries, some failed cases have been reported. We present the histomorphometry of 5 such cases illustrating these limitations and review the current literature of acellular nerve allografts. Methods: Between 2014 and 2019, 5 patients with iatrogenic nerve injuries to the median or ulnar nerve reconstructed with an AxoGen AVANCE nerve allograft at an outside hospital were treated in our center with allograft excision and alternative reconstruction. These patients had no clinical or electrophysiological evidence of recovery, and allograft specimens at the time of surgery were sent for histomorphological examination. Results: Three patients with a median and 2 with ulnar nerve injury were included. Histology demonstrated myelinated axons present in all proximal native nerve specimens. In 2 cases, axons failed to regenerate into the allograft and in 3 cases, axonal regeneration diminished or terminated within the allograft. Conclusions: The reported cases demonstrate the importance of evaluating the length and the function of nerves undergoing acellular nerve allograft repair. In long length, large-diameter nerves, the use of acellular nerve allografts should be carefully considered.
An unusual case of LUTS in an adolescent man: a case report and literature review
Authors: Wilson Jacob , Nettleton Jeremy , Patel Biral 
Published: April 2021

Congenital prostatic cysts are rare and it is unusual for these patients to present with symptoms. We report the case of a 17-year-old man who presented with obstructive lower urinary tract symptoms and was found to have a prostatic cyst and other abnormalities of the genitourinary system. The patient subsequently underwent transurethral aspiration of the cyst with good effect. A brief review of the embryology behind these lesions along with a review of the literature is provided. Level of evidence: Not applicable for this multicentre audit.