bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutrition Care for Poorly Nourished Outpatients Reduces Resource Use and Lowers Costs
Authors: Hong Kurt , Sulo Suela , Wang William , Kim Susan , Huettner Laura , Taroyan Rose , Kerr Kirk W. , Kaloostian Carolyn 
Published: May 2021

Background and Objectives: Over 25% of United States (US) community-dwelling, older adults are at nutritional risk. Health and cost burdens of poor nutrition can be lowered by nutrition programs for hospital inpatients, but few studies have looked at the impact on outpatients. The objective of our study was to assess outcomes of a nutrition focused quality improvement program (QIP) on healthcare resource use and costs in poorly nourished outpatients. Methods: This pre-post QIP study was implemented at 3 US healthcare system clinics. Included patients (n = 600) were ≥45 years old, had ≥2 chronic conditions, and were enrolled over a 15-month interval. For comparison, historical (n = 600) and concurrent control (n = 600) groups were used. Assessment of poor nutritional status was performed during each patient’s baseline visit. Healthcare resource use (hospitalizations, emergency department visits, and outpatient clinic visits), medication use, and costs were determined for a 90-day interval. Results: QIP patients (mean age 61.6 years) were predominantly female (62.5%) and overweight/obese (81.7%). The proportion of QIP outpatients presenting for healthcare services was significantly reduced compared to both historical and concurrent controls—relative risk reduction (RRR) versus historical (11.6%, P < .001) and versus concurrent (8.9%, P = .003). Of those who presented, RRR for healthcare resource use by QIP was significant in comparison with historical (12.9%, P = .022) but not concurrent controls. No significant differences were observed for medication usage. Lower resource use among QIP patients yielded total cost savings of $290 923 or per-patient savings of $485. Conclusions: Nutrition QIPs in outpatient clinics are feasible and can reduce healthcare resource use and cut costs. Such findings underscore benefits of nutritional interventions for community-dwelling outpatients with poor nutritional status.
Effects of Individual and Neighborhood Characteristics on Childhood Blood Lead Testing and Elevated Blood Lead Levels, A Pennsylvania Birth Cohort Analysis
Authors: Chen Yeh-Hsin , Ma Zhen-Qiang , Watkins Sharon M. 
Published: May 2021

Background: Despite declining lead exposure among U.S. children, childhood blood lead level (BLL) undertesting and elevation remains a public health issue. This study explores the impacts of maternal, infant, and neighborhood characteristics on the receipt of lead testing and having elevated BLLs (EBLLs) among children under age two. Methods: Pennsylvania infants born in 2015 and 2016 were followed to 24 months. Birth certificate data were linked to 2015 through 2018 blood lead surveillance data and neighborhood data on household income, poverty, and the burden of houses built before 1970. Generalized linear mixed models were used to examine the individual and neighborhood characteristics independently and/or interactively affecting the likelihood of lead testing and of having EBLLs. Results: A total of 48.6% of children were tested for BLLs, and 2.6% of them had confirmed EBLLs. The likelihood of lead testing and of having EBLLs among non-Hispanic black children was respectively 7% and 18% higher than white children. Children born to mothers with the lowest educational attainment (<high school), with self-payment as a payment source for delivery, and without WIC enrollment were at higher risk of undertesting. Children living in neighborhoods of the lowest quartile of household income and the highest quartile of poverty and old housing were more likely to have EBLLs. Different neighborhood characteristics modified the associations between some individual factors (such as race/ethnicity, payment source for delivery, and WIC enrollment) and the odds of undertesting and of having EBLLs. Conclusion: This cohort analysis provides more accurate estimates of lead screening rates and the percentages of EBLLs than cross-sectional analysis. Some maternal and infant demographics significantly impact the risk of undertesting and of having EBLLs, and some of the effects vary across different neighborhood characteristics. These findings can help lead prevention programs to target screening and treatment resources to children with specific characteristics.
Assessing Biomarkers of Breast Cancer Risk in Underserved Women in a Midwestern County
Authors: DeWitt Marla A. , Croghan Ivana T. , Vachon Celine M. , Thacher Thomas D. , Venegas Pont Marcia R. , Neal Lonzetta , Stan Daniela L. , Jenkins Sarah M. , Pruthi Sandhya 
Published: May 2021

Objective: The primary aim of this study was to evaluate the feasibility of collecting risk factor information and accessing digitized mammographic data in a medically marginalized population. A secondary aim was to examine the association between vitamin D status and mammographic density. Methods: Breast-screening examinations were provided for age-appropriate patients, and a referral for no-cost screening mammography was offered. Study participants were asked to undergo 25-hydroxyvitamin D testing at mammography and 1-year follow-up. Results: Of 62 women approached, 35 (56%) consented to participate. Of 32 participants who had baseline mammography, the median mammographic density measured by VolparaDensity (Volpara Solutions Limited) was 5.7%. After 1 year, 9 women obtained follow-up mammograms, with a median density of 5.7%. Vitamin D status was measured for 31 participants at baseline and 13 participants in the following year. Insufficient vitamin D status (<30 ng/mL) was noted in 77% at each time point. Mammographic density was not significantly correlated with vitamin D status ( P = .06). Conclusions: On the basis of this small pilot study, vitamin D insufficiency is common in this study population. Owing to the small sample size, an association between vitamin D insufficiency and breast density was not clear. Additional unexpected findings included substantial barriers in initial access to care and longitudinal follow-up in this population. Further study of these issues is needed.
Hand Hygiene Habits and Prevalence of Hand Eczema During the COVID-19 Pandemic
Authors: Techasatian Leelawadee , Thaowandee Wilairat , Chaiyarit Jitjira , Uppala Rattapon , Sitthikarnkha Phanthila , Paibool Watuhatai , Charoenwat Busara , Wongmast Piyathida , Laoaroon Napat , Suphakunpinyo Chanyut , Kiatchoosakun Pakaphan , Kosalaraksa Pope 
Published: May 2021

Purpose: This study aimed to explore the prevalence of and possible risk factors for hand eczema with respect to the dissemination of information about new hand hygiene habits to protect against ongoing COVID-19 cross-transmission. The authors conducted a survey among health care workers (HCWs) and non-HCW populations in Khon Kaen, Thailand. Results: A total of 805 participants participated. The prevalence of hand eczema in the study population was 20.87%. There were several risk factors, including working as a HCW, having a history of previous hand eczema, having underlying atopic dermatitis, wearing gloves in everyday life, and washing hands frequently (more than 10 times/day). Hand hygiene with alcohol-based products was shown to be a risk factor for hand eczema, (OR (95% CI) 1.86 (1.03-3.35), P = .04). Conclusion: In terms of hand eczema prevention, we suggest that the use of alcohol-based products should be discontinued if other handwashing methods are available. The following factors increase the risk of hand eczema: being a HCW, having previous hand eczema, and having underlying atopic dermatitis. Proper strategies in terms of hand eczema prevention should be addressed, especially in this group, since we need to continue performing hand hygiene during the ongoing COVID-19 pandemic.
Effect of the Incorporation of Chitosan and TiO2 Nanoparticles on the Shear Bond Strength of an Orthodontic Adhesive: An In Vitro Study
Authors: Farzanegan Fahimeh , Shafaee Hooman , Darroudi Majid , Rangrazi Abdolrasoul 
Published: May 2021

Aim: This in vitro study was aimed to evaluate the effect of adding different concentrations of chitosan nanoparticles (NPs) and TiO2 NPs on the shear bond strength (SBS) of an orthodontic adhesive. Materials and Methods: In this in vitro study, 72 extracted human premolars were embedded in an acrylic resin and randomly allocated into four groups of 18 specimens. In group 1 (control), brackets were bonded to the tooth with the Transbond XT orthodontic adhesive. In groups 2, 3, and 4, 0.5% chitosan NPs and 0.5% TiO2 NPs, 1% chitosan NPs and 1% TiO2 NPs, and 1.5% chitosan NPs and 1.5% TiO2 NPs were added to Transbond XT, respectively. Then, the brackets were bonded by the modified adhesive. The SBS and adhesive remnant index (ARI) of each group were assessed with a universal testing machine. The SBS test results were analyzed using one-way analysis of variance followed by the posthoc Tukey’s honestly significant difference (HSD) test. The Kruskal–Wallis test was also applied to evaluate the ARI scores. Results: The results showed no statistically significant difference between groups 1, 2, and 3, but SBS decreased significantly in group 4. With increasing the concentration of NPs up to 1% chitosan NPs and 1% TiO2 NPs, SBS did not change significantly. However, in 1.5% chitosan NPs and 1.5% TiO2 NPs, SBS decreased compared to the other three groups. No significant differences were found between the groups in terms of ARI scores. Conclusion: It is concluded that the orthodontic composite containing 1% chitosan NPs and 1% TiO2 NPs has adequate SBS for use in the clinical setting.
Men’s Lacrosse Injuries in the 2018 International World Championship Play
Authors: Cheney Sarah , Casey Ellen , Abutalib Zafir , Tepper Kenneth B. , Dressler Reuven , Sutton Karen Michelle 
Published: May 2021

Background: Limited data exist on injuries in men’s lacrosse at the international level. As lacrosse’s popularity grows rapidly across the globe, health care providers must understand how to treat lacrosse athletes. Purpose: To analyze injury data from the 2018 Men’s World Lacrosse Championship. Study Design: Descriptive epidemiology study. Methods: This study prospectively observed injuries that occurred during the 2018 Men’s World Lacrosse Championship. The medical staff of each team completed injury report forms, and data were categorized into body part injury, type, mechanism, time, and location of injury. Results: Over 11 days, 1019 athletes competed in 170 games, resulting in a total of 7147 athlete-exposures (AEs). A total of 140 injuries were recorded during the tournament for an injury rate of 19.6 per 1000 AEs (95% CI, 16.4-22.7). Overall, there were more contact injuries (n = 99; 70.7%) than noncontact injuries (n = 41; 29.3%) ( P < .0001). Contact injuries most commonly affected the upper extremity, while noncontact injuries most commonly affected the lower extremity. Contusions were the most commonly reported injury type in the tournament (n = 41; 29.3%), followed by ligament sprains (n = 32; 22.9%) and muscle strains (n = 21; 15.0%). Although there was no difference between the first and second half of gameplay, the injury rate increased in the latter portion of each half (the first and third quarters vs the second and fourth quarters) ( P < .0001). A total of 4 injuries required trips to the hospital. Conclusion: Lacrosse has a unique injury profile, as it includes both overhead and collision activity as well as multidirectional, cutting movements. Understanding common injury patterns may help with treatment and prevention. Fatigue may play a role in injury rate, and future research of within-game and within-tournament fatigue should explore this relationship.
Upregulated PD-L1 delays human neutrophil apoptosis and promotes lung injury in an experimental mouse model of sepsis
Authors: Wang Jia-feng , Wang Yun-peng , Xie Jian , Zhao Zhen-zhen , Gupta Sahil , Guo Yu , Jia Song-hui , Parodo Jean , Marshall John C. , Deng Xiao-ming 
Published: May 2021

Abstract
PD-L1 is a ligand for PD-1, and its expression has been shown to be upregulated in neutrophils harvested from septic patients. However, the effect of PD-L1 on neutrophil survival and sepsis-induced lung injury remains largely unknown. In this study, PD-L1 expression correlated negatively with rates of apoptosis in human neutrophils harvested from patients with sepsis. Coimmunoprecipitation assays on control neutrophils challenged with interferon-γ and LPS showed that PD-L1 complexes with the p85 subunit of phosphatidyl 3-kinase (PI3K) to activate AKT-dependent survival signaling. Conditional CRE/LoxP deletion of neutrophil PD-L1 in vivo further protected against lung injury and reduced neutrophil lung infiltration in a cecal ligation and puncture (CLP) experimental sepsis animal model. Compared with wild-type animals, PD-L1–deficient animals presented lower levels of plasma tumor necrosis factor-α and interleukin-6 (IL-6) and higher levels of IL-10 after CLP, and reduced 7-day mortality in CLP PD-L1–knockout animals. Taken together, our data suggest that increased PD-L1 expression on human neutrophils delays cellular apoptosis by triggering PI3K–dependent AKT phosphorylation to drive lung injury and increase mortality during clinical and experimental sepsis.
CALR mutant protein rescues the response of MPL p.R464G variant associated with CAMT to eltrombopag
Authors: Basso-Valentina Francesca , Levy Gabriel , Varghese Leila N. , Oufadem Myriam , Neven Benedicte , Boussard Charlotte , Balayn Nathalie , Marty Caroline , Vainchenker William , Plo Isabelle , Ballerini Paola , Constantinescu Stefan N. , Favier Remi , Raslova Hana 
Published: May 2021

Abstract
Congenital amegakaryocytic thrombocytopenia (CAMT) is a severe inherited thrombocytopenia due to loss-of-function mutations affecting the thrombopoietin (TPO) receptor, MPL. Here, we report a new homozygous MPL variant responsible for CAMT in 1 consanguineous family. The propositus and her sister presented with severe thrombocytopenia associated with mild anemia. Next-generation sequencing revealed the presence of a homozygous MPLR464G mutation resulting in a weak cell-surface expression of the receptor in platelets. In cell lines, we observed a defect in MPLR464G maturation associated with its retention in the endoplasmic reticulum. The low cell-surface expression of MPLR464G induced very limited signaling with TPO stimulation, leading to survival and reduced proliferation of cells. Overexpression of a myeloproliferative neoplasm–associated calreticulin (CALR) mutant did not rescue trafficking of MPLR464G to the cell surface and did not induce constitutive signaling. However, it unexpectedly restored a normal response to eltrombopag (ELT), but not to TPO. This effect was only partially mimicked by the purified recombinant CALR mutant protein. Finally, the endogenous CALR mutant was able to restore the megakaryocyte differentiation of patient CD34+ cells carrying MPLR464G in response to ELT.
Profile hidden Markov model sequence analysis can help remove putative pseudogenes from DNA barcoding and metabarcoding datasets
Authors: Porter T. M. , Hajibabaei M. 
Published: May 2021

AbstractBackgroundPseudogenes are non-functional copies of protein coding genes that typically follow a different molecular evolutionary path as compared to functional genes. The inclusion of pseudogene sequences in DNA barcoding and metabarcoding analysis can lead to misleading results. None of the most widely used bioinformatic pipelines used to process marker gene (metabarcode) high throughput sequencing data specifically accounts for the presence of pseudogenes in protein-coding marker genes. The purpose of this study is to develop a method to screen for nuclear mitochondrial DNA segments (nuMTs) in large COI datasets. We do this by: (1) describing gene and nuMT characteristics from an artificial COI barcode dataset, (2) show the impact of two different pseudogene removal methods on perturbed community datasets with simulated nuMTs, and (3) incorporate a pseudogene filtering step in a bioinformatic pipeline that can be used to process Illumina paired-end COI metabarcode sequences. Open reading frame length and sequence bit scores from hidden Markov model (HMM) profile analysis were used to detect pseudogenes.ResultsOur simulations showed that it was more difficult to identify nuMTs from shorter amplicon sequences such as those typically used in metabarcoding compared with full length DNA barcodes that are used in the construction of barcode libraries. It was also more difficult to identify nuMTs in datasets where there is a high percentage of nuMTs. Existing bioinformatic pipelines used to process metabarcode sequences already remove some nuMTs, especially in the rare sequence removal step, but the addition of a pseudogene filtering step can remove up to 5% of sequences even when other filtering steps are in place.ConclusionsOpen reading frame length filtering alone or combined with hidden Markov model profile analysis can be used to effectively screen out apparent pseudogenes from large datasets. There is more to learn from COI nuMTs such as their frequency in DNA barcoding and metabarcoding studies, their taxonomic distribution, and evolution. Thus, we encourage the submission of verified COI nuMTs to public databases to facilitate future studies.
Historical biogeography, systematics, and integrative taxonomy of the non-Ethiopian speckled pelage brush-furred rats (Lophuromys flavopunctatus group)
Authors: Onditi Kenneth Otieno , Demos Terrence C. , Kerbis Peterhans Julian , Chen Zhong-Zheng , Bryja Josef , Lavrenchenko Leonid A. , Musila Simon , Verheyen Erik , Van de Perre Frederik , Akaibe Benjamin Dudu , de la Sancha Noé U. , Jiang Xue-Long 
Published: May 2021

Abstract
Background
The speckled-pelage brush-furred rats (Lophuromys flavopunctatus group) have been difficult to define given conflicting genetic, morphological, and distributional records that combine to obscure meaningful accounts of its taxonomic diversity and evolution. In this study, we inferred the systematics, phylogeography, and evolutionary history of the L. flavopunctatus group using maximum likelihood and Bayesian phylogenetic inference, divergence times, historical biogeographic reconstruction, and morphometric discriminant tests. We compiled comprehensive datasets of three loci (two mitochondrial [mtDNA] and one nuclear) and two morphometric datasets (linear and geometric) from across the known range of the genus Lophuromys.

Results
The mtDNA phylogeny supported the division of the genus Lophuromys into three primary groups with nearly equidistant pairwise differentiation: one group corresponding to the subgenus Kivumys (Kivumys group) and two groups corresponding to the subgenus Lophuromys (L. sikapusi group and L. flavopunctatus group). The L. flavopunctatus group comprised the speckled-pelage brush-furred Lophuromys endemic to Ethiopia (Ethiopian L. flavopunctatus members [ETHFLAVO]) and the non-Ethiopian ones (non-Ethiopian L. flavopunctatus members [NONETHFLAVO]) in deeply nested relationships. There were distinctly geographically structured mtDNA clades among the NONETHFLAVO, which were incongruous with the nuclear tree where several clades were unresolved. The morphometric datasets did not systematically assign samples to meaningful taxonomic units or agree with the mtDNA clades. The divergence dating and ancestral range reconstructions showed the NONETHFLAVO colonized the current ranges over two independent dispersal events out of Ethiopia in the early Pleistocene.

Conclusion
The phylogenetic associations and divergence times of the L. flavopunctatus group support the hypothesis that paleoclimatic impacts and ecosystem refugia during the Pleistocene impacted the evolutionary radiation of these rodents. The overlap in craniodental variation between distinct mtDNA clades among the NONETHFLAVO suggests unraveling underlying ecomorphological drivers is key to reconciling taxonomically informative morphological characters. The genus Lophuromys requires a taxonomic reassessment based on extensive genomic evidence to elucidate the patterns and impacts of genetic isolation at clade contact zones.
The symbiotic relationship between Caenorhabditis elegans and members of its microbiome contributes to worm fitness and lifespan extension
Authors: Haçariz Orçun , Viau Charles , Karimian Farial , Xia Jianguo 
Published: May 2021

Abstract
Background
A healthy microbiome influences host physiology through a mutualistic relationship, which can be important for the host to cope with cellular stress by promoting fitness and survival. The mammalian microbiome is highly complex and attributing host phenotypes to a specific member of the microbiome can be difficult. The model organism Caenorhabditis elegans and its native microbiome, discovered recently, can serve as a more tractable, experimental model system to study host-microbiome interactions. In this study, we investigated whether certain members of C. elegans native microbiome would offer a benefit to their host and putative molecular mechanisms using a combination of phenotype screening, omics profiling and functional validation.

Results
A total of 16 members of C. elegans microbiome were screened under chemically-induced toxicity. Worms grown with Chryseobacterium sp. CHNTR56 MYb120 or Comamonas sp. 12022 MYb131, were most resistant to oxidative chemical stress (SiO2 nanoparticles and juglone), as measured by progeny output. Further investigation showed that Chryseobacterium sp. CHNTR56 positively influenced the worm’s lifespan, whereas the combination of both isolates had a synergistic effect. RNAseq analysis of young adult worms, grown with either isolate, revealed the enrichment of cellular detoxification mechanisms (glutathione metabolism, drug metabolism and metabolism of xenobiotics) and signaling pathways (TGF-beta and Wnt signaling pathways). Upregulation of cysteine synthases (cysl genes) in the worms, associated with glutathione metabolism, was also observed. Nanopore sequencing uncovered that the genomes of the two isolates have evolved to favor the specific route of the de novo synthesis pathway of vitamin B6 (cofactor of cysl enzymes) through serC or pdxA2 homologs. Finally, co-culture with vitamin B6 extended worm lifespan.

Conclusions
In summary, our study indicates that certain colonizing members of C. elegans have genomic diversity in vitamin B6 synthesis and promote host fitness and lifespan extension. The regulation of host cellular detoxification genes (i.e. gst) along with cysl genes at the transcriptome level and the bacterium-specific vitamin B6 synthesis mechanism at the genome level are in an agreement with enhanced host glutathione-based cellular detoxification due to this interspecies relationship. C. elegans is therefore a promising alternative model to study host-microbiome interactions in host fitness and lifespan.