bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food insecurity status and associated factors among rural households in the north of Iran
Authors: Shakiba Maryam , Salari Arsalan , Mahdavi-Roshan Marjan 
Published: March 2021

Background: Iran has been experiencing an accelerated change in the nutrition and health of its people, which has led to considerable variations in the country’s nutritional status. Little is known about the food insecurity status in the north of Iran. Aim: The present study aimed to investigate the food insecurity status and factors associated with it in a rural area in the north of Iran. Methods: This cross-sectional study was conducted among 573 rural households in Guilan Province in the north of Iran. The food insecurity status of the households was measured using the Household Food Insecurity Access Scale. Data on the demographic characteristics of the households and their depression status were collected by interviewing the heads of the households. The socioeconomic status index of the households was constructed using factor analysis, and a multivariate ordinal logistic regression model was used to estimate the adjusted odds ratio of the independent predictors of food insecurity. Results: The results indicated that approximately half of the households (50.8%) had experienced mild (43.2%), moderate (6.5%) or severe (1.1%) food insecurity. The multivariate model showed that sex, age, depression status of the head of the household and having a patient with a chronic condition in the household were independently associated with food security status. Conclusions: This study showed that food insecurity was highly prevalent among rural households in the north of Iran. The study concludes that interventions with the aim of reducing the prevalence of food insecurity, depression and chronic diseases in the area can be effective in improving the nutritional status of the households.
Posterior Tibial Loading Results in Significant Increase of Peak Contact Pressure in the Patellofemoral Joint During Anterior Cruciate Ligament Reconstruction: A Cadaveric Study
Authors: Huang Wenhan , Ong Michael Tim-Yun , Man Gene Chi-Wai , Liu Yang , Lau Lawrence Chun-Man , Yung Patrick Shu-Hang 
Published: March 2021

Background: Inappropriate posterior tibial loading and initial graft tension during anterior cruciate ligament (ACL) reconstruction may cause altered patellofemoral joint (PFJ) contact mechanics, potentially resulting in pain and joint degeneration. Hypothesis: PFJ contact pressure would increase with the increases in posterior tibial loading and graft tension during ACL reconstruction. Study Design: Controlled laboratory study. Methods: Nine fresh-frozen, nonpaired human cadaveric knees were tested in a customized jig from 0° to 120° of knee flexion. First, the knee was tested in the ACL-intact state. Second, reconstruction of the ACLs using different posterior tibial loadings and graft tensions were performed. The posterior tibial loading was evaluated at 2 levels: 33.5 and 67 N. Graft tension was assessed at 3 levels: low tension (20 N), medium tension (60 N), and high tension (80 N). Maximum values of peak contact pressure in the medial and lateral patellar facets were compared between ACL-intact and ACL-reconstructed knees. The PFJ kinematics between ACL-intact knees and ACL-reconstructed knees were compared during knee flexion at 30°, 60°, 90°, and 120°. Results: Reconstruction of ACLs with both low and high posterior tibial loading resulted in significant increases of peak contact pressure in the medial (range of differences, 0.46-0.92 MPa; P < .05) and lateral (range of differences, 0.51-0.83 MPa; P < .05) PFJ compared with the ACL-intact condition. However, no significant differences in PFJ kinematics were identified between ACL-reconstructed knees and ACL-intact knees. In ACL-reconstructed knees, it was found that a high posterior tibial loading resulted in high peak contact pressure on the medial patellar side (range of differences, 0.37-0.46 MPa; P < .05). No significant difference in peak contact pressure was observed among the differing graft tensions. Conclusion: In this cadaveric model, ACL reconstruction resulted in significant increases of peak contact pressure in the PFJ facet when compared with the ACL-intact condition. A high posterior tibial loading can lead to high medial PFJ peak contact pressure. Graft tension was found to not significantly affect PFJ contact pressure during ACL reconstruction. Clinical Relevance: An excessive posterior tibial loading during ACL reconstruction resulted in increased PFJ contact pressures at time of surgery. These data suggest that a low posterior tibial loading might be preferred during ACL reconstruction surgery to reduce the PFJ contact pressure close to that of the ACL-intact condition.
Dietary Diversity in Nepal: A Latent Class Approach
Authors: Shively Gerald , Evans Alecia 
Published: March 2021

Background: Nutritional status has important implications for labor productivity, lifetime earnings, and country-wide economic development. Dietary diversity is an important contributor to nutrition. Objective: To identify how patterns of food consumption are related to dietary diversity and to measure the potential for policy interventions to influence diet complexity. Methods: Household dietary diversity scores were constructed using data from 11 809 rural and urban households surveyed in Nepal between 2013 and 2016. Diversity scores were based on 7-day recall information on food purchases and food consumed directly from agricultural production. Reported consumption from 14 food groups was mapped into 4 distinct dietary patterns via latent class analysis. Ordered probit regressions were used to identify factors associated with observed diet patterns. Results: Diets are heterogeneous and map into 4 clusters along a continuum of complexity. Three identified diets are vegetarian and 1 is nonvegetarian. Diet complexity is associated with geography and socioeconomic features of the sample. On average, poor and agricultural households have less complex diets and households receiving remittances have more complex and higher quality diets. Road density is positively correlated with diet complexity. We find evidence of modest reductions in diet quality over the sample period. Conclusions: Results confirm heterogeneous dietary behavior of Nepalese households. The identified patterns could be used to more effectively target policies directed at nutrition education or efforts to improve health by diversifying and improving the nutritional quality of household diets, for example, through supplemental feeding programs, home garden promotion, or targeted food assistance programs.
Quercetin suppresses cell survival and invasion in oral squamous cell carcinoma via the miR-1254/CD36 cascade in vitro
Authors: Chen L , Xia J-S , Wu J-H , Chen Y-G , Qiu C-J 
Published: March 2021

Objective: This study aimed to investigate the effects of quercetin on the proliferation and invasion in oral squamous cell carcinoma (OSCC) and examine its effect on the activation of the miR-1254/CD36 signaling pathway. Methods: Proliferation and invasion experiments were performed in the OSCC cell line CAL-27 in which miR-1254 was overexpressed or inhibited. The levels of miR-1254 and CD36 were determined using quantitative real-time polymerase chain reaction and Western blotting assays. Results: Quercetin significantly suppressed the proliferation and invasion of CAL-27 cells in a dose-dependent manner, while up-regulating miR-1254 and down-regulating CD36. The overexpression of miR-1254 also considerably down-regulated CD36 and enhanced the ability of quercetin to inhibit CAL-27 cell survival and invasion. Conversely, the inhibition of miR-1254 significantly up-regulated CD36 and antagonized the inhibitory effects of quercetin. Conclusion: Our study suggests that quercetin might suppress the progression of OSCC by activating the miR-1254/CD36 signaling pathway, indicating its potential as a treatment against OSCC.
The Surprise Question and Serious Illness Conversations: A pilot study
Authors: Le Kathy , Lee Jenny , Desai Sameer , Ho Anita , van Heukelom Holly 
Published: March 2021

Background: Serious Illness Conversations aim to discuss patient goals. However, on acute medicine units, seriously ill patients may undergo distressing interventions until death. Objectives: To investigate the feasibility of using the Surprise Question, “Would you be surprised if this patient died within the next year?” to identify patients who would benefit from early Serious Illness Conversations and study any changes in the interdisciplinary team’s beliefs, confidence, and engagement as a result of asking the Surprise Question. Design: A prospective cohort pilot study with two Plan-Do-Study-Act cycles. Participants/context: Fifty-eight healthcare professionals working on Acute Medicine Units participated in pre- and post-intervention questionnaires. The intervention involved asking participants the Surprise Question for each patient. Patient charts were reviewed for Serious Illness Conversation documentation. Ethical considerations: Ethical approval was granted by the institutions involved. Findings: Equivocal overall changes in the beliefs, confidence, and engagement of healthcare professionals were observed. Six out of 23 patients were indicated as needing a Serious Illness Conversation; chart review provided some evidence that these patients had more Serious Illness Conversation documentation compared with the 17 patients not flagged for a Serious Illness Conversation. Issues were identified in equating the Surprise Question to a Serious Illness Conversation. Discussion: Appropriate support for seriously ill patients is both a nursing professional and ethical duty. Flagging patients for conversations may act as a filtering process, allowing healthcare professionals to focus on conversations with patients who need them most. There are ethical and practical issues as to what constitutes a “serious illness” and if answering “no” to the Surprise Question always equates to a conversation. Conclusion: The barriers of time constraints and lack of training call for institutional change in order to prioritise the moral obligation of Serious Illness Conversations.
Impact of flow pattern, body mass index, and age on intraprocedural fluoroscopic time and radiation dose during sacroiliac joint injections
Authors: Tiegs-Heiden Christin A , Murthy Naveen S , Geske Jennifer R , Diehn Felix E , Lehman Vance T , Liebo Greta B , Verdoorn Jared T , Carr Carrie M , McKenzie Gavin A 
Published: March 2021

Purpose Understanding all factors that may impact radiation dose and procedural time is crucial to safe and efficient image-guided interventions, such as fluoroscopically guided sacroiliac (SI) joint injections. The purpose of this study was to evaluate the effect of flow pattern (intra- vs. periarticular), patient age, and body mass index (BMI) on radiation dose and fluoroscopy time. Methods A total of 134 SI joint injections were reviewed. Injectate flow pattern, age, and BMI were analyzed in respect to fluoroscopy time (minutes), radiation dose (kerma area product (KAP); µGy m2), and estimated skin dose (mGy). Results BMI did not affect fluoroscopy time, but increased BMI resulted in significantly higher skin and fluoroscopy doses ( p < 0.001). There was no association between fluoroscopy time and flow pattern. Higher skin dose was associated with intraarticular flow ( p = 0.0086), and higher KAP was associated with periarticular flow ( p = 0.0128). However, the odds ratios were close to 1. There was no significant difference between fluoroscopy time or dose based on patient age. Conclusion Increased BMI had the largest impact on procedural radiation dose and skin dose. Flow pattern also showed a statistically significant association with radiation dose and skin dose, but the clinical difference was small. Proceduralists should be aware that BMI has the greatest impact on fluoroscopy dose and skin dose during SI joint injections compared to other factors.
Prophylactic placement of inferior vena cava filters and the risk of death or venous thromboembolism in severe trauma patients: a retrospective study comparing two hospitals with different approaches
Authors: Trung Tran Thien , Bjarnason Haraldur , McDonald Jennifer , Skaga Nils Oddvar , Houghton Damon E , Kim Brian , Stavem Knut , Kløw Nils Einar 
Published: March 2021

Background Prophylactic use of inferior vena cava filters to prevent pulmonary embolism in trauma is controversial. The practice varies between hospitals and countries, in part due to conflicting evidence and guidelines. Purpose To compare the effects of pulmonary embolism, deep venous thrombosis and mortality in two hospitals using prophylactic inferior vena cava filter placement or prophylactic anticoagulation alone. Material and Methods Patients presenting with severe trauma were recruited from two level-1 trauma centres between January 2008 and December 2013. Recruited patients from an US hospital having prophylactic inferior vena cava filter inserted were compared to a Scandinavian hospital using prophylactic anticoagulation alone. Inclusion criteria were age >15 years, Injury Severity Score >15 and survival >24 h after hospital admission. Patients with venous thromboembolism diagnosed prior to inferior vena cava filter placement were excluded. A Cox proportional hazard regression model was used with adjustment for immortal time bias and predictor variables. Results In total, 951 patients were reviewed, 282 from an US hospital having inferior vena cava filters placed and 669 from a Scandinavian hospital without inferior vena cava filters. The mean age was 45.9 vs. 47.4 years and the mean Injury Severity Score was 29.8 vs. 25.9, respectively. Inferior vena cava filter placement was not associated with the hazard of pulmonary embolism (Hazard ratio=0.43; 95% confidence interval (CI) 0.12, 1.45; P=0.17) or mortality (Hazard ratio=1.16; 95% CI 0.70, 1.95; P=0.56). However, an increased rate of deep venous thrombosis was observed with inferior vena cava filters in place (Hazard ratio=3.75; 95% CI 1.68, 8.36; P=0.001). Conclusion In severely injured trauma patients, prophylactic inferior vena cava filter placement was not associated with pulmonary embolism or mortality. However, inferior vena cava filters were associated with increased rate of deep venous thrombosis.
Lifestyle Risk Factors, Quality of Life, and Intervention Preferences of Barrett’s Esophagus Patients: A Prospective Cohort Study
Authors: Zhang Xiaotao , Anandasabapathy Sharmila , Abrams Julian , Othman Mohamed , Badr Hoda J 
Published: March 2021

Background and Aims Lifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett’s Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population. Methods Patients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported on lifestyle risk factors, adherence determinants (e.g., perceived benefits/barriers, risk, intentions), QOL, and intervention preferences. Results Most patients (56%) had uncontrolled reflux, were overweight/obese (65.1%), and had low dietary fiber intake (91%). Many (45%) reported poor QOL. Patients’ perceived risk of developing esophageal cancer was high, but their behavior change intentions were low. Despite receiving lifestyle counseling from physicians, there were no significant changes in patients’ QOL or lifestyle risk factors over time. Nonetheless, patients indicated strong interest in internet (62.6%) and multimedia programs (57.9%) addressing acid reflux and weight control. Conclusion BE patients reported uncontrolled reflux, poor QOL, and multiple lifestyle risk factors that did not change over time. Despite low levels of intention for making lifestyle changes, patients were interested receiving more information about controlling acid reflux, suggesting a potential teachable moment and opportunity for web-based and multimedia multiple behavior interventions that seek to control acid reflux symptoms through weight loss and a high fiber diet.
Health Economic Evaluations of Hip and Knee Interventions in Orthopaedic Sports Medicine: A Systematic Review and Quality Assessment
Authors: Primeau Codie A. , Zomar Bryn O. , Somerville Lyndsay E. , Joshi Ishita , Giffin J. Robert , Marsh Jacquelyn D. 
Published: March 2021

Background: The economic burden of musculoskeletal diseases is substantial and growing. Economic evaluations compare costs and health benefits of interventions simultaneously to help inform value-based care; thus, it is crucial to ensure that studies are using appropriate methodology to provide valid evidence on the cost-effectiveness of interventions. This is particularly the case in orthopaedic sports medicine, where several interventions of varying costs are available to treat common hip and knee conditions. Purpose: To summarize and evaluate the quality of economic evaluations in orthopaedic sports medicine for knee and hip interventions and identify areas for quality improvement. Study Design: Systematic review; Level of evidence, 3. Methods: The Medline, AMED, OVID Health Star, and EMBASE databases were searched from inception to March 1, 2020, to identify economic evaluations that compared ≥2 interventions for hip and/or knee conditions in orthopaedic sports medicine. We assessed the quality of full economic evaluations using the Quality of Health Economic Studies (QHES) tool, which consists of 16 questions for a total score of 100. We classified studies into quartiles based on QHES score ( extremely poor quality to high quality) and we evaluated the frequency of studies that addressed each of the 16 QHES questions. Results: A total of 93 studies were included in the systematic review. There were 41 (44%) cost analyses, of which 21 (51%) inappropriately concluded interventions were cost-effective. Only 52 (56%) of the included studies were full economic evaluations, although 40 of these (77%) fell in the high-quality quartile. The mean QHES score was 83.2 ± 19. Authors consistently addressed 12 of the QHES questions; questions that were missed or unclear were related to statistical uncertainty, appropriateness of costing methodology, and discussion of potential biases. The most frequently missed question was whether the cost perspective of the analysis was stated and justified. Conclusion: The number of studies in orthopaedic sports medicine is small, despite their overall good quality. Yet, there are still many highly cited studies based on low-quality or partial economic evaluations that are being used to influence clinical decision-making. Investigators should follow international health economic guidelines for study design and critical appraisal of studies to further improve quality.
Cytokine-like protein 1–induced survival of monocytes suggests a combined strategy targeting MCL1 and MAPK in CMML
Authors: Sevin Margaux , Debeurme Franck , Laplane Lucie , Badel Séverine , Morabito Margot , Newman Hanna L. , Torres-Martin Miguel , Yang Qin , Badaoui Bouchra , Wagner-Ballon Orianne , Saada Véronique , Sélimoglu-Buet Dorothée , Kraus-Berthier Laurence , Banquet Sébastien , Derreal Alix , Fenaux Pierre , Itzykson Raphael , Braun Thorsten , Etienne Gabriel , Berthon Celine , Thépot Sylvain , Kepp Oliver , Kroemer Guido , Padron Eric , Figueroa Maria E. , Droin Nathalie , Solary Eric 
Published: March 2021

Abstract
Mouse models of chronic myeloid malignancies suggest that targeting mature cells of the malignant clone disrupts feedback loops that promote disease expansion. Here, we show that in chronic myelomonocytic leukemia (CMML), monocytes that accumulate in the peripheral blood show a decreased propensity to die by apoptosis. BH3 profiling demonstrates their addiction to myeloid cell leukemia-1 (MCL1), which can be targeted with the small molecule inhibitor S63845. RNA sequencing and DNA methylation pattern analysis both point to the implication of the mitogen-activated protein kinase (MAPK) pathway in the resistance of CMML monocytes to death and reveal an autocrine pathway in which the secreted cytokine-like protein 1 (CYTL1) promotes extracellular signal-regulated kinase (ERK) activation through C-C chemokine receptor type 2 (CCR2). Combined MAPK and MCL1 inhibition restores apoptosis of monocytes from patients with CMML and reduces the expansion of patient-derived xenografts in mice. These results show that the combined inhibition of MCL1 and MAPK is a promising approach to slow down CMML progression by inducing leukemic monocyte apoptosis.
A JAK/STAT-mediated inflammatory signaling cascade drives oncogenesis in AF10-rearranged AML
Authors: Chen Bo-Rui , Deshpande Anagha , Barbosa Karina , Kleppe Maria , Lei Xue , Yeddula Narayana , Vela Pablo Sánchez , Campos Alexandre Rosa , Wechsler-Reya Robert J. , Bagchi Anindya , Meshinchi Soheil , Eaves Connie , Jeremias Irmela , Haferlach Torsten , Frank David A. , Ronai Ze’ev , Chanda Sumit , Armstrong Scott A. , Adams Peter D. , Levine Ross L. , Deshpande Aniruddha J. 
Published: March 2021

Abstract
Leukemias bearing fusions of the AF10/MLLT10 gene are associated with poor prognosis, and therapies targeting these fusion proteins (FPs) are lacking. To understand mechanisms underlying AF10 fusion-mediated leukemogenesis, we generated inducible mouse models of acute myeloid leukemia (AML) driven by the most common AF10 FPs, PICALM/CALM-AF10 and KMT2A/MLL-AF10, and performed comprehensive characterization of the disease using transcriptomic, epigenomic, proteomic, and functional genomic approaches. Our studies provide a detailed map of gene networks and protein interactors associated with key AF10 fusions involved in leukemia. Specifically, we report that AF10 fusions activate a cascade of JAK/STAT-mediated inflammatory signaling through direct recruitment of JAK1 kinase. Inhibition of the JAK/STAT signaling by genetic Jak1 deletion or through pharmacological JAK/STAT inhibition elicited potent antioncogenic effects in mouse and human models of AF10 fusion AML. Collectively, our study identifies JAK1 as a tractable therapeutic target in AF10-rearranged leukemias.