bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolomics reveal alterations in arachidonic acid metabolism in Schistosoma mekongi after exposure to praziquantel
Authors: Chienwichai Peerut , Tipthara Phornpimon , Tarning Joel , Limpanont Yanin , Chusongsang Phiraphol , Chusongsang Yupa , Adisakwattana Poom , Reamtong Onrapak 
Published: September 2021

Background
Mekong schistosomiasis is a parasitic disease caused by the blood-dwelling fluke Schistosoma mekongi. This disease contributes to human morbidity and mortality in the Mekong region, posing a public health threat to people in the area. Currently, praziquantel (PZQ) is the drug of choice for the treatment of Mekong schistosomiasis. However, the molecular mechanisms of PZQ action remain unclear, and Schistosoma PZQ resistance has been reported occasionally. Through this research, we aimed to use a metabolomic approach to identify the potentially altered metabolic pathways in S. mekongi associated with PZQ treatment.

Methodology/Principal findings
Adult stage S. mekongi were treated with 0, 20, 40, or 100 μg/mL PZQ in vitro. After an hour of exposure to PZQ, schistosome metabolites were extracted and studied with mass spectrometry. The metabolomic data for the treatment groups were analyzed with the XCMS online platform and compared with data for the no treatment group. After low, medium (IC50), and high doses of PZQ, we found changes in 1,007 metabolites, of which phosphatidylserine and anandamide were the major differential metabolites by multivariate and pairwise analysis. In the pathway analysis, arachidonic acid metabolism was found to be altered following PZQ treatment, indicating that this pathway may be affected by the drug and potentially considered as a novel target for anti-schistosomiasis drug development.

Conclusions/Significance
Our findings suggest that arachidonic acid metabolism is a possible target in the parasiticidal effects of PZQ against S. mekongi. Identifying potential targets of the effective drug PZQ provides an interesting viewpoint for the discovery and development of new agents that could enhance the prevention and treatment of schistosomiasis.
Individual and community-level determinants of knowledge of ovulatory cycle among women of childbearing age in Ethiopia: A multilevel analysis based on 2016 Ethiopian Demographic and Health Survey
Authors: Dagnew Baye , Teshale Achamyeleh Birhanu , Dagne Henok , Diress Mengistie , Tesema Getayeneh Antehunegn , Dewau Reta , Molla Meseret Derbew , Yeshaw Yigizie 
Published: September 2021

Background
Knowledge of the ovulatory cycle (KOC) aids women to refrain and engage in sexual intercourse to avoid and to get pregnancy, respectively. The effect of community-level factors on KOC was not yet known in Ethiopia. Therefore, we aimed to investigate the community- and individual-level determinants of KOC among women of childbearing age.

Methods
We used the 2016 Ethiopian Demographic and Health Survey, and total weighted samples of 15,683 women were included. Intra-class correlation, median odds ratio, and deviance were executed for model comparison in which a model with the lowest deviance was the best model i.e. model III in this case. A multivariable multilevel logistic regression model was employed to identify community- and individual-level factors of correct KOC. In the ultimate model, an adjusted odds ratio (AOR) with a 95% confidence interval was reported and variables with a p<0.05 were considered as statistically significant.

Results
In this study, 3,698 [23.58% (95% CI; 22.92–24.25)] participants had correct KOC. Women’s age in years, i.e. 20–24 (AOR = 1.46;1.28–1.68) 25–29 (AOR = 1.72; 1.49–1.99), 30–34 (AOR = 2.21; 1.89–2.58), 35–39 (AOR = 1.78; 1.51–2.09), 40–44 (AOR = 1.97; 1.65–2.37), and 45–49 (AOR = 1.78; 1.44–2.19), knowledge of contraceptive methods (AOR = 3.08; 2.07–4.58), increased women’s educational level, i.e. higher (AOR = 4.24; 3.54–5.07), secondary (AOR = 2.89; 2.48–3.36), and primary (AOR = 1.57; 1.39–1.78), higher household’s wealth index, i.e. richest (AOR = 1.71; 1.35–2.16), richer (AOR = 1.42; 1.16–1.72), middle (AOR = 1.29; 1.07–1.56), and poorer (AOR = 1.24; 1.03–1.48), current contraceptive use (AOR = 1.26; 1.13–1.39), menstruating in the last six weeks (AOR = 1.13; 1.03–1.24), women’s media exposure (AOR = 1.20; 1.07–1.35), and being in the community with a high level of media exposure (AOR = 1.53; 1.24–1.88) were statistically significant with KOC.

Conclusions
Knowledge of the ovulatory cycle was low in this study, which demands health education for women of childbearing age. Special attention should be given to teenagers, those with lower educational, and lower economic status. Besides, the strengthening of media campaigns could increase women’s KOC, which is crucial for preventing unintended pregnancy.
Classifying muscle parameters with artificial neural networks and simulated lateral pinch data
Authors: Kearney Kalyn M. , Harley Joel B. , Nichols Jennifer A. 
Published: September 2021

Objective
Hill-type muscle models are widely employed in simulations of human movement. Yet, the parameters underlying these models are difficult or impossible to measure in vivo. Prior studies demonstrate that Hill-type muscle parameters are encoded within dynamometric data. But, a generalizable approach for estimating these parameters from dynamometric data has not been realized. We aimed to leverage musculoskeletal models and artificial neural networks to classify one Hill-type muscle parameter (maximum isometric force) from easily measurable dynamometric data (simulated lateral pinch force). We tested two neural networks (feedforward and long short-term memory) to identify if accounting for dynamic behavior improved accuracy.

Methods
We generated four datasets via forward dynamics, each with increasing complexity from adjustments to more muscles. Simulations were grouped and evaluated to show how varying the maximum isometric force of thumb muscles affects lateral pinch force. Both neural networks classified these groups from lateral pinch force alone.

Results
Both neural networks achieved accuracies above 80% for datasets which varied only the flexor pollicis longus and/or the abductor pollicis longus. The inclusion of muscles with redundant functions dropped model accuracies to below 30%. While both neural networks were consistently more accurate than random guess, the long short-term memory model was not consistently more accurate than the feedforward model.

Conclusion
Our investigations demonstrate that artificial neural networks provide an inexpensive, data-driven approach for approximating Hill-type muscle-tendon parameters from easily measurable data. However, muscles of redundant function or of little impact to force production make parameter classification more challenging.
Risk factors associated with the development of delirium in general ICU patients. A prospective observational study
Authors: Lobo-Valbuena Beatriz , Gordo Federico , Abella Ana , Garcia-Manzanedo Sofía , Garcia-Arias Maria-Mercedes , Torrejón Inés , Varillas-Delgado David , Molina Rosario 
Published: September 2021

Objective
We aimed to analyze risk factors related to the development of delirium, aiming for early intervention in patients with greater risk.

Material and methods
Observational study, including prospectively collected patients treated in a single general ICU. These were classified into two groups, according to whether they developed delirium or not (screening performed using CAM-ICU tool). Demographics and clinical data were analyzed. Multivariate logistic regression analyses were performed to quantify existing associations.

Results
1462 patients were included. 93 developed delirium (incidence: 6.3%). These were older, scored higher on the Clinical Frailty Scale, on the risk scores on admission (SAPS-3 and SOFA), and had a greater number of organ failures (OF). We observed more incidence of delirium in patients who (a) presented more than two OF (20.4%; OR 4.9; CI95%: 2.9–8.2), and (b) were more than 74 years old albeit having <2 OF (8.6%; OR 2.1; CI95%: 1.3–3.5). Patients who developed delirium had longer ICU and hospital length-of-stays and a higher rate of readmission.

Conclusions
The highest risk observed for developing delirium clustered in patients who presented more than 2 OF and patients over 74 years old. The detection of patients at high risk for developing delirium could imply a change in management and improved quality of care.
Minimum inhibitory concentrations of commonly used antibiotics against Helicobacter Pylori: A multicenter study in South China
Authors: Huang Xueping , Liu Yuan , Lin Zhihui , Wu Baihe , Nong Gaohui , Chen Yushan , Lu Yuping , Ji Xinhua , Zhou Xiang , Suo Biao , Chen Qiuzhao , Wei Jinqi 
Published: September 2021

Aim
To determine the minimum inhibitory concentrations (MICs) of commonly used antibiotics against Helicobacter Pylori (H. pylori) in South China and compare their resistance rates by using EUCAST breakpoints and other breakpoints.

Methods
Patients who had not previously received H. pylori treatment in clinical centers in South China were enrolled in this study from 2017 to 2020. Gastric biopsies were obtained for H. pylori culture. The MICs of amoxicillin (AMX), clarithromycin (CLA), metronidazole (MTZ), levofloxacin (LEV), tetracycline (TET) and furazolidone (FZD) were tested by broth microdilution method and assessed by two different breakpoints. ATCC43504 standard strain served as a control.

Results
A total of 208 H. pylori strains were isolated from patients’ biopsy samples. The MICs of AMX, CLA, MTZ, LEV, TET and FZD for H. pylori were 0.0156-256mg/L (MIC50 0.125mg/L, MIC90 4mg/L), 0.0156- >256 mg/L (MIC50 0.0312mg/L, MIC90 64mg/L), 0.0156- >256mg/L (MIC50 8mg/L, MIC90 256mg/L), 0.0156-256mg/L (MIC50 0.25mg/L, MIC90 16mg/L), 0.0156-256mg/L (MIC50 0.0625mg/L, MIC90 4mg/L), and 0.0156- >256mg/L (MIC50 0.0312mg/L, MIC90 2mg/L), respectively. The MICs of AMX, CLA, MTZ, LEV, TET and FZD for ATCC43504 strain were 0.25mg/L, 0.0625mg/L, 64mg/L, 0.5mg/L, 1mg/L and 0.25mg/L, respectively. The resistance rate of FZD was 11.05%. The overall resistance rates according to EUCAST breakpoints and other breakpoints were 57.21% and 14.90% for AMX (p<0.001), 38.94% and 38.94% for CLA (p = 1), 39.42% and 50.96% for MTZ (p<0.001), 12.98% and 10.58% for TET (p = 0.025), 35.10% and 35.10% for LEV (p = 1), respectively.

Conclusions
Our results demonstrate that AMX, FZD, and TET, but not MTZ, CLR or LEV, showed good anti-H. pylori activity in vitro in South China. When different breakpoints were used, similar results were found with CLA, and LEV, but not with AMX, MTZ, or TET.
Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial
Authors: Bakesiima Ritah , Beyeza-Kashesya Jolly , Tumwine James K. , Chalo Rose Nabirye , Gemzell-Danielsson Kristina , Cleeve Amanda , Larsson Elin C. 
Published: September 2021

Background
The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch.

Objective
To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda.

Methods
A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care.

Results
Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition.

Conclusion
Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents’ fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.
The influence of culture on care receivers’ satisfaction and aggressive tendencies in the emergency department
Authors: Lisak Alon , Efrat-Treister Dorit , Glikson Ella , Zeldetz Vladimir , Schwarzfuchs Dan 
Published: September 2021

Introduction
Reducing aggressive tendencies among care receivers in the emergency department has great economic and psychological benefits for care receivers, staff, and health care organizations. In a study conducted in a large multicultural hospital emergency department, we examined how cultural factors relating to ethnicity interact to enhance care receivers’ satisfaction and reduce their aggressive tendencies. Specifically, we explored how care receivers’ cultural affiliation, individual cultural characteristics, and the cultural situational setting interact to increase care receivers’ satisfaction and reduce their aggressive tendencies.

Method
Data were collected using survey responses from 214 care receivers. We use structural equation models and the bootstrap method to analyze the data.

Results
Care receivers’ openness to diversity (an individual cultural characteristic) was positively related to their satisfaction that was associated with lower aggressive tendencies, only when they were affiliated with a cultural minority group and when the cultural situational setting included language accessibility.

Conclusion
Our results demonstrate that cultural affiliation, individual cultural characteristics, and cultural situational setting can affect care receivers’ satisfaction and aggressive tendencies in a multicultural emergency department context. In particular, high cultural openness of care receivers, and making information accessible in their native language, increased satisfaction and reduced aggressive tendencies among cultural minority care receivers in our study.
Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient’s perspective in Johannesburg, South Africa
Authors: Bisnauth Melanie A. , Davies Natasha , Monareng Sibongile , Buthelezi Fezile , Struthers Helen , McIntyre James , Rees Kate 
Published: September 2021

Background
Retention in care is required for optimal clinical outcomes in people living with HIV (PLHIV). Although most PLHIV in South Africa know their HIV status, only 70% are on antiretroviral therapy (ART). Improved retention in care is needed to get closer to sustained ART for all. In January 2019, Anova Health Institute conducted a campaign to encourage patients who had interrupted ART to return to care.

Methods
Data collection was conducted in one region of Johannesburg. This mixed methods study consisted of two components: 1) healthcare providers entered data into a structured tool for all patients re-initiating ART at nine clinics over a nine-month period, 2) Semi-structured interviews were conducted with a sub-set of patients. Responses to the tool were analysed descriptively, we report frequencies, and percentages. A thematic approach was used to analyse participant experiences in-depth.

Results
562 people re-initiated ART, 66% were women, 75% were 25–49 years old. The three most common reasons for disengagement from care were mobility (30%), ART related factors (15%), and time limitations due to work (10%). Reasons for returning included it becoming easier to attend the clinic (34%) and worry about not being on ART (19%). Mobile interview participants often forgot their medical files and expressed that managing their ART was difficult because they often needed a transfer letter to gain access to ART at another facility. On the other hand, clinics that had flexible and extended hours facilitated retention in care.

Conclusion
In both the quantitative data, and the qualitative analysis, changing life circumstances was the most prominent reason for disengagement from care. Health services were not perceived to be responsive to life changes or mobility, leading to disengagement. More client-centred and responsive health services should improve retention on ART.
Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014
Authors: George Carmen , Bancroft Carolyn , Salt Shine Krystal , Curley Cameron S. , Curley Caleigh , de Heer Hendrik Dirk , Yazzie Del , Eddie Regina , Antone-Nez Ramona , Shin Sonya Sunhi 
Published: September 2021

Introduction
In 2014, the Navajo Nation Healthy Diné Nation Act (HDNA) was passed, combining a 2% tax on foods of ‘minimal-to-no-nutritional value’ and waiver of 5% sales tax on healthy foods, the first-ever such tax in the U.S. and globally among a sovereign tribal nation. The aim of this study was to measure changes in pricing and food availability in stores on the Navajo Nation following the implementation of the HDNA.

Methods
Store observations were conducted in 2013 and 2019 using the Nutrition Environment Measurement Survey-Stores (NEMS-S) adapted for the Navajo Nation. Observations included store location, type, whether healthy foods or HDNA were promoted, and availability and pricing of fresh fruits and vegetables, canned items, beverages, water, snacks and traditional foods. Differences between 2013 and 2019 and by store type and location were tested.

Results
The matched sample included 71 stores (51 in the Navajo Nation and 20 in border towns). In 2019, fresh produce was available in the majority of Navajo stores, with 71% selling at least 3 types of fruit and 65% selling at least 3 types of vegetables. Compared with border town convenience stores, Navajo convenience stores had greater availability of fresh vegetables and comparable availability of fresh fruit in 2019. The average cost per item of fresh fruit decreased by 13% in Navajo stores (from $0.88 to $0.76) and increased in border stores (from $0.63 to $0.73), resulting in comparable prices in Navajo and border stores in 2019. While more Navajo stores offered mutton, blue corn and wild plants in 2019 compared to 2013, these changes were not statistically significant.

Discussion
The findings suggest modest improvements in the Navajo store environment and high availability of fruits and vegetables. Navajo stores play an important role in the local food system and provide access to local, healthy foods for individuals living in this rural, tribal community.
Association of maternal obesity with fetal and neonatal death: Evidence from South and South-East Asian countries
Authors: Haque Rezwanul , Keramat Syed Afroz , Rahman Syed Mahbubur , Mustafa Maimun Ur Rashid , Alam Khorshed 
Published: September 2021

Background
Obesity prevalence is increasing in many countries in the world, including Asia. Maternal obesity is highly associated with fetal and neonatal deaths. This study investigated whether maternal obesity is a risk factor of fetal death (measured in terms of miscarriage and stillbirth) and neonatal mortality in South and South-East Asian countries.

Methods
This cross-sectional study pooled the most recent Demographic and Health Surveys (DHS) from eight South and South-East Asian countries (2014–2018). Multivariate logistic regression was deployed to check the relationships between maternal obesity with fetal and neonatal deaths. Finally, multilevel logistic regression model was employed since the DHS data has a hierarchical structure.

Results
The pooled logistic regression model illustrated that maternal obesity is associated with higher odds of miscarriage (adjusted odds ratio [aOR]: 1.26, 95% CI: 1.20–1.33) and stillbirths (aOR: 1.46, 95% CI: 1.27–1.67) after adjustment of confounders. Children of obese mothers were at 1.18 (aOR: 1.18, 95% CI: 1.08–1.28) times greater risk of dying during the early neonatal period than mothers with a healthy weight. However, whether maternal obesity is statistically a significant risk factor for the offspring’s late neonatal deaths was not confirmed. The significant association between maternal obesity with miscarriage, stillbirth and early neonatal mortality was further confirmed by multilevel logistic regression results.

Conclusion
Maternal obesity in South and South-East Asian countries is associated with a greater risk of fetal and early neonatal deaths. This finding has substantial public health implications. Strategies to prevent and reduce obesity should be developed before planning pregnancy to reduce the fetal and neonatal death burden. Obese women need to deliver at the institutional facility centre that can offer obstetrics and early neonatal care.
Nrf2 signaling promotes cancer stemness, migration, and expression of ABC transporter genes in sorafenib-resistant hepatocellular carcinoma cells
Authors: Gao Luping , Morine Yuji , Yamada Shinichiro , Saito Yu , Ikemoto Tetsuya , Tokuda Kazunori , Takasu Chie , Miyazaki Katsuki , Shimada Mitsuo 
Published: September 2021

Background and aim
As a multiple tyrosine kinase inhibitor, sorafenib is widely used to treat hepatocellular carcinoma (HCC), but patients frequently face resistance problems. Because the mechanism controlling sorafenib-resistance is not well understood, this study focused on the connection between tumor characteristics and the Nrf2 signaling pathway in a sorafenib-resistant HCC cell line.

Methods
A sorafenib-resistant HCC cell line (Huh7) was developed by increasing the dose of sorafenib in the culture medium until the target concentration was reached. Cell morphology, migration/invasion rates, and expression of stemness-related and ATP-binding cassette (ABC) transporter genes were compared between sorafenib-resistant Huh7 cells and parental Huh7 cells. Next, a small interfering RNA was used to knock down Nrf2 expression in sorafenib-resistant Huh7 cells, after which cell viability, stemness, migration, and ABC transporter gene expression were examined again.

Results
Proliferation, migration, and invasion rates of sorafenib-resistant Huh7 cells were significantly increased relative to the parental cells with or without sorafenib added to the medium. The expression levels of stemness markers and ABC transporter genes were up-regulated in sorafenib-resistant cells. After Nrf2 was knocked down in sorafenib-resistant cells, cell migration and invasion rates were reduced, and expression levels of stemness markers and ABC transporter genes were reduced.

Conclusion
Nrf2 signaling promotes cancer stemness, migration, and expression of ABC transporter genes in sorafenib-resistant HCC cells.