bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of visceral fat and abdominal obesity by single-frequency bioelectrical impedance and CT: a cross-sectional study
Authors: Xu Zhengyang , Liu Yandong , Yan Chengxi , Yang Ruopei , Xu Li , Guo Zhe , Yu Aihong , Cheng Xiaoguang , Ma Lin , Hu Chunhong , Guglielmi Giuseppe , Hind Karen 
Published: October 2021

ObjectivesThe measurement of visceral fat (VF) is clinically important for the identification of individuals at high risk of visceral obesity-related health conditions. Bioelectrical impedance analysis (BIA) is a widely available and frequently used body composition assessment method, but there have been few validation studies for the measurement of VF. This validation study investigated agreement between BIA and CT for the assessment of VF in adults.DesignCross-sectional study.SettingBetween 2015 and 2016 in China.ParticipantsA total of 414 adults (119 men and 295 women) aged 40–82 years.Primary and secondary outcome measuresCT-visceral fat area (VFA) was derived at the L2-3 and umbilicus level and VFA cut-offs for visceral obesity applied. BIA measurements of visceral fat level were compared with CT VFA findings using scatter plots and receiver operator characteristic (ROC) curves.ResultsScatter plots showed poor agreement between BIA and CT-derived visceral fat measurements in both sexes (R=0.387–0.636). ROC curves gave optimum figures for sensitivity and specificity of 65% and 69% in women and 76% and 70% in men, respectively, for BIA to discriminate between adults with normal levels of VF and those with visceral obesity determined by CT.ConclusionBIA has limited accuracy for the assessment of VF in adults in practice when compared with the criterion method.
Which biopsychosocial factors are associated with the development of chronic musculoskeletal pain? Protocol for an umbrella review of systematic reviews
Authors: Dunn Michael , Rushton Alison B , Mistry Jai , Soundy Andrew , Heneghan Nicola R 
Published: October 2021

IntroductionRecent systematic reviews have identified many biopsychosocial factors associated with the development of chronic musculoskeletal pain (CMP). Despite often being specific to a particular musculoskeletal condition, findings are similar across systematic reviews. Research is needed to aggregate these findings to identify consistent factors across musculoskeletal disorders that are associated with the development of CMP. The objective of this study is to provide a meta-level synthesis of all biopsychosocial factors associated with the development of CMP.Methods and analysisAn umbrella review and meta-level narrative synthesis±meta-analysis has been designed informed by Joanna Briggs Institute and Cochrane guidance. This protocol is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-P. Sources will include Ovid Medline, Embase, Web of Science Core Collection, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, PsycINFO, CINAHL, PEDro, PROSPERO, Google Scholar and grey literature. Inclusion criteria: any systematic review which investigates biopsychosocial factors which may be associated with the development of CMP through prospective longitudinal methods. The outcome is musculoskeletal pain lasting beyond 3 months. Two independent reviewers will be involved in all stages; screening, selection, data extraction and risk of bias evaluation using the Assessing the Methodological Quality of Systematic Reviews-2 guidelines. A meta-level narrative synthesis will be conducted based on (a) factors associated with development of CMP, (b) the range of musculoskeletal disorders for which the same/similar findings have been established and (c) the quality of studies informing these findings. Where possible, meta-analysis will be performed. The Grading of Recommendations, Assessment, Development and Evaluation guidelines will be followed to determine the level of evidence for each biopsychosocial factor.Ethics and disseminationThis umbrella review does not require ethical approval. Findings will be presented at conferences and published in a peer reviewed journal.PROSPERO registration numberCRD42020193081.
Reducing antibiotic prescribing by enhancing communication of general practitioners with their immigrant patients: protocol for a randomised controlled trial (PARCA study)
Authors: Lescure Dominique , van der Velden Janneke , Nieboer Daan , van Oorschot Wilbert , Brouwer Rob , Huijser van Reenen Natascha , Tjon-A-Tsien Aimée , Erdem Özcan , Vos Margreet , van der Velden Alike , Richardus Jan Hendrik , Voeten Hélène 
Published: October 2021

IntroductionAlthough antibiotic use and antimicrobial resistance in the Netherlands is comparatively low, inappropriate prescription of antibiotics is substantial, mainly for respiratory tract infections (RTIs). General practitioners (GPs) experience pressure from patients with an immigration background to prescribe antibiotics and have difficulty communicating in a culturally sensitive way. Multifaceted interventions including communication skills training for GPs are shown to be most effective in reducing antibiotic prescription. The PARCA study aims to reduce the number of antibiotic prescriptions for RTIs through implementing a culturally sensitive communication intervention for GPs and evaluate it in a randomised controlled trial (RCT).Methods and analysisA non-blinded RCT including 58 GPs (29 for each arm). The intervention consists of: (1) An E-learning with 4 modules of 10–15 min each; (2) A face-to-face training session in (intercultural) communication skills including role plays with a training actor and (3) Availability of informative patient-facing materials that use simple words (A2/B1 level) in multiple languages. The primary outcome measure is the number of dispensed antibiotic courses qualifying for RTIs in primary care, per 1000 registered patients. The secondary outcome measure is the number of all dispensed antibiotic courses, per 1000 registered patients. The intervention arm will receive the training in Autumn 2021, followed by an observation period of 6 winter months for which numbers of antibiotics will be collected for both trial arms. The GPs/practices in the control arm can attend the training after the observation period.Ethics and disseminationThe study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, University Medical Center Rotterdam (MEC-2020-0142). The results of the trial will be published in international peer-reviewed scientific journals and will be disseminated through national and international congresses. The project is funded by The Netherlands Organisation for Health Research and Development (ZonMw).Trial registration numberNL9450.
Advance care planning in older dialysis patients: health care literacy qualitative study
Authors: O Riordan Julien , Kane P M , Noble Helen , Smyth Andrew 
Published: October 2021

ObjectivesLow health literacy among older adults is associated with limited engagement in end-of-life care plans, more hospitalisations and excess mortality. Frequently, older patients derive no survival benefit from dialysis and quality of life often deteriorates with dialysis. Older dialysis patients’ values and wishes are often unknown during key healthcare decision-making and many endure medically intensive end-of-life interventions . The objectives of this study were to examine older dialysis patients’ understanding of haemodialysis, their engagement in end-of-life care planning and their satisfaction with life on haemodialysis.Methods15 older dialysis patients participated in qualitative semi-structured interviews in two haemodialysis units . Thematic saturation was reached. Thematic analysis, applied inductively, distilled the data.ResultsThemes identified included disempowerment which reflected limited health literacy, poor advance care planning compromised well-being and haemodialysis compromised their core values.ConclusionHealth literacy among older dialysis patients appeared poor, patient empowerment was limited and participation in shared decision-making and advance care planning suboptimal. Consequently, complex healthcare decision-making, including haemodialysis may jeopardise patients’ core values. These findings have significant implications for the validity of the informed consent process prior to dialysis initiation. Improved health literacy through enhanced patient education and better communication skills for clinicians are necessary to promote patient participation in shared decision-making. Clinician training to facilitate discussion of patients’ values and wishes will help guide clinicians and patients towards healthcare decisions most concordant with individual core values. This will optimise patient-centred care.
GATM-Mediated Creatine Biosynthesis Enables Maintenance of FLT3-ITD–Mutant Acute Myeloid Leukemia
Authors: Zhang Yuan , Newsom Kimberly J. , Zhang Mei , Kelley Jeffry S. , Starostik Petr 
Published: October 2021

Abstract

FMS-like tyrosine kinase 3 (FLT3) is one of the most frequently mutated genes in acute myeloid leukemia (AML), with the most common mutation being internal tandem duplications (ITD). The presence of FLT3-ITD in AML carries a particularly poor prognosis and renders therapeutic resistance. New druggable targets are thus needed in this disease. In this study, we demonstrate the effects of de novo creatine biosynthesis upregulation by FLT3-ITD on AML sustainability. Our data show that FLT3-ITD constitutively activates the STAT5 signaling pathway, which upregulates the expression of glycine amidinotransferase (GATM), the first rate-limiting enzyme of de novo creatine biosynthesis. Pharmacologic FLT3-ITD inhibition reduces intracellular creatinine levels through transcriptional downregulation of genes in the de novo creatine biosynthesis pathway. The same reduction can be achieved by cyclocreatine or genetic GATM knockdown with shRNA and is reflected in significant decrease of cell proliferation and moderate increase of cell apoptosis in FLT3-ITD–mutant cell lines. Those effects are at least partially mediated through the AMPK/mTOR signaling pathway. This study uncovers a previously uncharacterized role of creatine metabolic pathway in the maintenance of FLT3-ITD–mutant AML and suggests that targeting this pathway may serve as a promising therapeutic strategy for FLT3-ITD–positive AML.

Implications:
FLT3-ITD mutation in AML upregulates de novo creatine biosynthesis that we show can be suppressed to diminish the proliferation and survival of blast cells.
Sex Differences in Cardiovascular Research: A Scientometric Analysis
Authors: Millenaar Dominic , Dillmann Markus , Fehlmann Tobias , Flohr Alexander , Mehran Roxana , Al‐Lamee Rasha , Lauder Lucas , Ukena Christian , Böhm Michael , Keller Andreas , Mahfoud Felix 
Published: October 2021

Background
We sought to investigate sex‐specific differences in authorship of cardiovascular research over the past decade.

Methods and Results

All 387 463 cardiovascular publications between 2010 and 2019 were retrieved from Web of Science. Articles increased from 19 960 to 29 604 articles per year (
P
>0.001). The number of articles written by female first authors increased by 76.3% (6434–11 343 articles) and by 35.0% for male first authors (13 526–18 261) (
P
<0.001). The first author was more likely to be a female author in articles with female last authors. The median impact factor (IF) for articles by female first authors was lower (2.46 [interquartile range, 7 1.11–4.03] versus 2.51 [interquartile range, 1.17–4.10];
P
<0.001). Female authorship articles reached the highest IF in North America (average IF, 3.7), with the lowest in Africa (average IF, 1.8).

Conclusions
Publications in cardiovascular research have increased over the past decade, particularly by female authors. Female researchers are cited less often compared with their male peers. The IF remains lower for articles by female researchers.
Improving the predictive capability of Framingham Risk Score for the risk of myocardial infarction based on coronary artery calcium score in healthy Singaporeans
Authors: Yeo Ching Yee Ivory , Allen John Carson Jr , Huang Weiting , Tan Wei Ying , Kong Siew Ching , Yeo Khung Keong 
Published: October 2021

Introduction:
Cardiovascular disease was the top cause of deaths and disability in Singapore in 2018, contributing extensively to the local healthcare burden. Primary prevention identifies at-risk individuals for the swift implementation of preventive measures. This has been traditionally done using the Singapore-adapted Framingham Risk Score (SG FRS). However, its most recent recalibration was more than a decade ago. Recent changes in patient demographics and risk factors have undermined the accuracy of SG FRS, and the rising popularity of wearable health metrics has led to new data types with the potential to improve risk prediction.

Methods:
In healthy Singaporeans enrolled in SingHEART study (absence of any clinical outcomes), we investigated improvements in SG FRS to predict myocardial infarction risk based on high/low classification of the Agatston score (surrogate outcome). Logistic regression, receiver operating characteristic and net reclassification index (NRI) analyses were conducted.

Results:
We demonstrated a significant improvement in the area under curve (AUC) of SG FRS (AUC = 0.641) after recalibration and incorporation of additional variables (fasting blood glucose and wearable-derived activity levels) (AUC = 0.774) (P < 0.001). SG FRS++ significantly increases accuracy in risk prediction (NRI = 0.219, P = 0.00254).

Conclusion:
Existing Singapore cardiovascular disease risk prediction guidelines should be updated to improve risk prediction accuracy. Recalibrating existing risk functions and utilising wearable metrics that provide a large pool of objective health data can improve existing risk prediction tools. Lastly, activity levels and prediabetic state are important factors for coronary heart disease risk stratification, especially in low-risk individuals.
Feasting with Buddhist Women: Food Literacy in Religious Belonging
Authors: Kolata Paulina , Gillson Gwendolyn 
Published: October 2021

Abstract
This ethnographic study shows that women’s knowledge and practices involving food in Japanese Buddhist contexts circulate as gendered currency. It emphasizes how what we term “food literacy” cultivates aesthetic and affective senses of belonging among Buddhist practitioners. We argue that this embodied knowledge helps women negotiate their experiences of Buddhism and show how these experiences articulate the complexities of their bounded and self-disciplining Buddhist selves. Women use food literacy to teach, learn, and practice the way Buddhism feels and etch it into their own and others’ emotional, social, and material bodies. By recognizing women as stewards of religion, particularly through food literacy, we also elucidate how women’s uses of mundane practices illuminate food literacy as a value carrier that generates belonging through food. Such practices can equally become sites of failure to connect if the intended recipients do not share understandings or appreciations of the aesthetic and affective dimensions of it.
Plato, Xenophon, and the Laws of Lycurgus
Authors: Schofield Malcolm 
Published: October 2021

Abstract
The relation between the opening section of Plato’s Laws and Xenophon’s Constitution of the Lacedaemonians usually goes unnoticed. This paper draws attention to its importance for understanding Plato’s project in the dialogue. It has three sections. In the first, it will be shown that the view proposed by Plato’s Athenian visitor that Lycurgus made virtue in its entirety the goal of his statecraft was anticipated in Xenophon’s treatise. It has to be treated as an interpretation of the Spartan politeia, alternative to that advanced by Cleinias and Megillus, and accepted by (for example) Aristotle, which Plato could expect or at any rate hope to be taken seriously as such. In the second, the argument will focus on the contents of the legislative programme the Athenian says he had hoped to hear Cleinias ascribe to the Cretan and Spartan lawgivers. The case will be made that Plato can expect recognition by the reader (as by the Athenian’s interlocutors) that the programme is properly Spartan and Cretan by virtue of its echoes of the programme attributed to Lycurgus by Xenophon. Finally, the third section will argue that in making law primarily concerned with fostering the proper development, conduct, and treatment of human beings at every stage of the life cycle, above all by provision for sound customary practices (ἐπιτηδεύματα) and the like, Plato adopts the approach to law making taken by Xenophon’s Lycurgus.
The Birth of Unlawful Freedom in Plato’s Laws 3
Authors: de Nicolay René 
Published: October 2021

Abstract
Plato’s pronouncements about political freedom in the Laws have sparked renewed interest in the literature. The present paper takes a new angle on that vexed question. It focusses on Plato’s account of the birth of unlawful freedom, or ‘theatrocracy’, at the end of book 3. By studying the transition from moderate to excessive freedom, it wishes to shed light on what sets the two apart. The paper provides a causal analysis of the key passage (700a3–701c2), suggesting four compatible and complementary explanations for the process it describes. The first is presented as the main one, but it is made more likely by the addition of the three others.
Law and Legislator in the Philosophy of Julian the Emperor
Authors: O’Meara Dominic J. 
Published: October 2021

Abstract
This paper surveys the conceptions of law and of legislation to be found in the philosophy of Julian the Emperor. A hierarchy of levels of law is described, going from transcendent divine orders and paradigmatic laws down to the laws of nature, laws innate in human souls and regional laws. Julian’s ideal legislator is discussed, as inspired by transcendent, paradigmatic laws and as subordinate to law and its protector. An example of Julian’s legislation is discussed. Attention is paid to Julian’s use of Plato’s Republic, Statesman, and Laws.
Explaining Resistance to Early Nineteenth-Century British Emigrants to New South Wales
Authors: Burkett Melanie 
Published: October 2021

Abstract
In the 1830s, the British government commenced a programme of relocating poor labourers to its Australian colony of New South Wales, a practice known as ‘assisted migration’. Though intended to address the colony’s labour shortage, the new arrivals were met with hostility by the colonial elite, who claimed the immigrants were immoral and unsuitable as workers. While migration historians have shown these judgements to be largely unfair, the forces underpinning these perceptions await a thorough interrogation. This article examines colonial public rhetoric about immigration to reveal attitudes shaped by a tangle of overlapping and reinforcing political, economic, and cultural factors. Ultimately, the colonial elite wanted to control who could enter their community, both physically and socially, which became a temporally persistent pattern vital to the settler colonial project.
Impact of Giant Sea Salt Aerosol Particles on Precipitation in Marine Cumuli and Stratocumuli: Lagrangian Cloud Model Simulations
Authors: Dziekan Piotr , Jensen Jørgen B. , Grabowski Wojciech W. , Pawlowska Hanna 
Published: October 2021

Abstract
The impact of giant sea salt aerosols released from breaking waves on rain formation in marine boundary layer clouds is studied using large-eddy simulations (LES). We perform simulations of marine cumuli and stratocumuli for various concentrations of cloud condensation nuclei (CCN) and giant CCN (GCCN). Cloud microphysics are modeled with a Lagrangian method that provides key improvements in comparison to previous LES of GCCN that used Eulerian bin microphysics. We find that GCCN significantly increase precipitation in stratocumuli. This effect is strongest for low and moderate CCN concentrations. GCCN are found to have a smaller impact on precipitation formation in cumuli. These conclusions are in agreement with field measurements. We develop a simple parameterization of the effect of GCCN on precipitation, accretion, and autoconversion rates in marine stratocumuli.
Significance Statement
Breaking sea waves release salt particles into the atmosphere. Cloud droplets formed on these salt particles can grow larger than droplets formed on other smaller particles. Therefore, sea salt particles can be important for rain formation over oceans. To investigate this effect, we performed idealized computer simulations of stratocumulus and cumulus clouds. Sea salt particles were modeled with an unprecedented precision thanks to the use of an emerging modeling method. In our simulations sea salt particles significantly enhance rain formation in stratocumuli, but not in cumuli. Our study has implications for climate models, because stratocumuli are important for Earth’s energy budget and for rain enhancement experiments.
Emotional Threat Perception and Its Association with Neurocognition in Social Anxiety Disorder
Authors: Mathai Anjali Thomas , Rai Shweta , Behere Rishikesh V. 
Published: October 2021

Background: The negative appraisal of emotional stimuli is a feature of social anxiety disorder (SAD). People with SAD demonstrate deficits in neurocognitive performance while performing tasks of attention. However, the relationship between attentional control, working memory, and threat perception in SAD has not been studied well. The present study aimed to identify patterns of threat perception in relation to performance on attention and visuospatial working memory tasks in individuals with SAD. Methods: Subjects with SAD ( n = 27) and a healthy comparative (HC) group ( n = 26) completed tasks of sustained and focused attention, visuospatial working memory, computerized emotion identification, and pictorial emotional Stroop. Results: The SAD group had decreased performance in the domains of sustained (P = 0.001) and focused attention (P = 0.04). They also had an enhanced threat perception as demonstrated by greater reaction time to anger (P = 0.03), lower emotion recognition accuracy (P = 0.05), and higher over-identification of the threat to neutral and nonthreatening faces. However, the Stroop effect was not demonstrated across the groups. No group difference was seen in the performance on the visuospatial working memory tasks. Lower focused attention was significantly correlated with higher emotional threat perception (ETP; P = 0.001) in the SAD group. Conclusion: People with SAD have greater deficits in attention processing and ETP. The attention deficits were associated with enhanced ETP in social anxiety. The link between threat perception and cognitive functions would aid in a better understanding of SAD and in planning appropriate intervention.