bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of hypertension in Ghanaian society: a systematic review, meta-analysis, and GRADE assessment
Authors: Atibila Fidelis , Hoor Gill ten , Donkoh Emmanuel Timmy , Wahab Abdul Iddrisu , Kok Gerjo 
Published: August 2021

Abstract
Background
Hypertension has become an important public health concern in the developing world owing to rising prevalence and its adverse impact on ailing health systems. Despite being a modifiable risk factor for cardiovascular disease, hypertension has not received the needed attention in Ghana as a result of various competing interests for scarce health resources. This systematic review and meta-analysis provides a comprehensive and updated summary of the literature on the prevalence of hypertension in Ghana.

Methods
Major databases such as MEDLINE, EMBASE, and Google Scholar and local thesis repositories were accessed to identify population-based studies on hypertension among Ghanaians. Data extracted from retrieved reports were screened independently by two reviewers. The quality of eligible studies was evaluated and reported. A reliable pooled estimate of hypertension prevalence was calculated utilizing a random-effects model and reported according to the GRADE framework. Additionally, a meta-regression analysis was performed to analyze the contribution of study-level variables to variance in hypertension prevalence.

Results
In general, a total of 45,470 subjects (n = 22,866 males and 22,604 females) were enrolled from urban (n = 12), rural (n = 8), and mixed populations (n = 7). Blood pressure (BP) was measured across studies according to a validated and clinically approved protocol by trained field workers or healthcare workers including nurses and physicians. A combined total of 30,033 participants across twenty studies reporting on the population prevalence of hypertension were pooled with 10,625 (35.4%) identified to satisfy study criteria for elevated BP. The pooled prevalence across 24 studies was 30.3% (95% CI 26.1–34.8%) after fitting a random effects model. Prevalence of hypertension was 30.1% (95% CI 25.6–36.0%) among females and 34.0% (95% CI 28.5–40.0%) among males. Significant differences in pooled estimates across regions emerged from subgroup comparisons of regional estimates with an increasing trend in the north-to-south direction and with increasing age. Compared to rural settings, the burden of hypertension in urban populations was significantly higher. Age structure and population type accounted for 65.0% of the observed heterogeneity in hypertension estimates.

Conclusions
The prevalence of hypertension in Ghana is still high. The gap in hypertension prevalence between rural and urban populations is closing especially in elderly populations. These findings must claim the attention of public health authorities in Ghana to explore opportunities to reduce rural hypertension.

Systematic review registration
The protocol for this review has been published previously with PROSPERO (CRD42020215829).
Gluten in pharmaceutical products: a scoping review
Authors: Lizano-Díez Irene , Mariño Eduardo L. , Modamio Pilar 
Published: August 2021

Abstract
Background
Celiac disease (CD) is one of the most common gluten-related disorders. Although the only effective treatment is a strict gluten-free diet, doubts remain as to whether healthcare professionals take this restriction into consideration when prescribing and dispensing medicines to susceptible patients. This scoping review aimed to find out the current evidence for initiatives that either describe the gluten content of medicines or intend to raise awareness about the risk of prescribing and dispensing gluten-containing medicines in patients with CD and other gluten-related disorders.

Methods
A scoping review was conducted using three search strategies in PubMed/MEDLINE, TripDatabase and Web of Science in April 2021, following the PRISMA extension for scoping reviews (PRISMA-ScR). References from included articles were also examined. Two researchers screened the articles and results were classified according to their main characteristics and outcomes, which were grouped according to the PCC (Population, Concept and Context) framework. The initiatives described were classified into three targeted processes related to gluten-containing medicines: prescription, dispensation and both prescription and dispensation.

Results
We identified a total of 3146 records. After the elimination of duplicates, 3062 articles remained and ultimately 13 full texts were included in the narrative synthesis. Most studies were conducted in the US, followed by Canada and Australia, which each published one article. Most strategies were focused on increasing health professional’s knowledge of gluten-containing/gluten-free medications (n = 8), which were basically based on database development from manufacturer data. A wide variability between countries on provided information and labelling of gluten-containing medicines was found.

Conclusion
Initiatives regarding the presence of gluten in medicines, including, among others, support for prescribers, the definition of the role of pharmacists, and patients’ adherence problems due to incomplete labelling of the medicines, have been continuously developed and adapted to the different needs of patients. However, information is still scarce, and some aspects have not yet been considered, such as effectiveness for the practical use of solutions to support healthcare professionals.
Household food insecurity and coping strategies in Southern Ethiopia
Authors: Melese Mesfin , Tilahun Minyahel , Alemu Mebratu 
Published: August 2021

Abstract
Background
Hunger and undernourishment are the main challenges of today’s world and 960 million people are hungry and undernourished. Food insecurity is an enduring, critical challenge in Ethiopia. Majority of the previous studies overlooked relevant determinant factors which affect the occurrence of food insecurity. This study aims to investigate household level food insecurity determinate factors and coping strategies used in the study area.

Method
Explanatory and descriptive research was designed to assess household food insecurity and coping strategies in Analemmo district of southern Ethiopia. A multi-stage purposive sampling technique was used for the purpose of this study. Two hundred households were selected systematically following list of food insecure households. Econometric models were employed using binary logit model. Household calorie acquisition was calculated to categorize households into food secure and food insecurely status.

Results
The survey result showed that 64% of the respondents were food insecure. Variables such as agro-ecology, age and education status, number of oxen, soil and water conservation, amount of credit, cultivated land size and receiving remittance were negatively but significantly (P < 0.05) affected households' food insecurity level. Female and young groups of the community were more food insecure as compared to others groups. The community was coping food shortage by relying on less preferred and less expensive food followed by participating in off-farm activities and borrowing food. Housesholds in the study area were utilizing less preferred foods to cope up food shortage and starvation.

Conclusion
Efforts of different developmental organizations should give due emphasis to household's wealth level, female-headed household and young and old-aged members of the community. Crop land production supported by modern agricultural technologies and information can reduce agricultural risks, and enhance productivity per unit land.
Counting sea lions and elephants from aerial photography using deep learning with density maps
Authors: Padubidri Chirag , Kamilaris Andreas , Karatsiolis Savvas , Kamminga Jacob 
Published: August 2021

Abstract
Background
The ability to automatically count animals is important to design appropriate environmental policies and to monitor their populations in relation to biodiversity and maintain balance among species. Out of all living mammals on Earth, 60% are livestock, 36% humans, and only 4% are animals that live in the wild. In a relatively short period, development of human civilization caused a loss of 83% of wildlife and 50% of plants. The rate of species extinction is accelerating. Traditional wildlife surveys provide rough population estimates. However, emerging technologies, such as aerial photography, allow to perform large-scale surveys in a short period of time with high accuracy. In this paper, we propose the use of computer vision, through deep learning (DL) architecture, together with aerial photography and density maps, to count the population of Steller sea lions and African elephants with high precision.

Results
We have trained two deep learning models, a basic UNet without any feature extractor (Model-1) and another with the EfficientNet-B5 feature extractor (Model-2). We measured the model’s prediction accuracy, using Root Mean Square Error (RMSE) for the predicted and actual animal count. The results showed an RMSE of 1.88 and 0.60 to count Steller sea lions and African elephants, respectively, regardless of complex background, different illumination conditions, heavy overlapping and occlusion of the animals.

Conclusions
Our proposed solution performed very well in the counting prediction problem, with relatively low training parameters and minimum annotation. The approach adopted, combining DL and density maps, provided better results than state-of-art deep learning models used for counting, indicating that the proposed method has the potential to be used more widely in large-scale wildlife surveying projects and initiatives.
CircCNIH4 inhibits gastric cancer progression via regulating DKK2 and FRZB expression and Wnt/β-catenin pathway
Authors: Shi Qi , Zhou Chuanwen , Xie Rui , Li Miaomiao , Shen Peng , Lu Yining , Ma Shijie 
Published: August 2021

Abstract
Background
Circular RNAs (circRNAs) have been reported to play an important role in tumor progression in various cancer types, including gastric cancer. The aim of this study was to investigate the role of circCNIH4 (hsa_circ_0000190) in gastric cancer and the underlying mechanism.

Methods
The expression levels of circCNIH4 and Wnt antagonist genes were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The protein levels of β-catenin, Ki67, Dickkopf 2 (DKK2) and Frizzled related protein (FRZB) were measured by western blot. Ectopic overexpression or knockdown of circCNIH4, proliferation, apoptosis, migration and invasion by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), flow cytometry and transwell assay in vitro, and in vivo experiment, were employed to assess the role of circCNIH4 in gastric cancer.

Results
CircCNIH4 was downregulated in gastric cancer tissues and cells. Overexpression of circCNIH4 inhibited gastric cancer cell proliferation, migration and invasion and promoted apoptosis by inactivating Wnt/β-catenin pathway in vitro. CircCNIH4 induced the expression of DKK2 and FRZB in gastric cancer cells. Moreover, silencing of DKK2 or FRZB reversed circCNIH4 overexpression-mediated effects on gastric cancer cells. Additionally, circCNIH4 suppressed tumor growth via regulating DKK2 and FRZB expression in gastric cancer in vivo.

Conclusion
Our study demonstrated that circCNIH4 played a tumor-inhibiting role through upregulating DKK2 and FRZB expression and suppressing Wnt/β-catenin pathway in gastric cancer, which might provide a potential biomarker for the diagnosis and treatment of gastric cancer.
Case Studies in Pediatric Lipid Disorders and Their Management
Authors: Ashraf Ambika P , Sunil Bhuvana , Bamba Vaneeta , Breidbart Emily , Brar Preneet Cheema , Chung Stephanie , Gupta Anshu , Khokhar Aditi , Kumar Seema , Lightbourne Marissa , Kamboj Manmohan K , Miller Ryan S , Patni Nivedita , Raman Vandana , Shah Amy S , Wilson Don P , Kohn Brenda 
Published: August 2021

Abstract

Context
Identification of modifiable risk factors, including genetic and acquired disorders of lipid and lipoprotein metabolism, is increasingly recognized as an opportunity to prevent premature cardiovascular disease (CVD) in at-risk youth. Pediatric endocrinologists are at the forefront of this emerging public health concern and can be instrumental in beginning early interventions to prevent premature CVD-related events during adulthood.

Aim
In this article, we use informative case presentations to provide practical approaches to the management of pediatric dyslipidemia.

Cases
We present 3 scenarios that are commonly encountered in clinical practice: isolated elevation of low-density lipoprotein cholesterol (LDL-C), combined dyslipidemia, and severe hypertriglyceridemia. Treatment with statin is indicated when the LDL-C is ≥190 mg/dL (4.9 mmol/L) in children ≥10 years of age. For LDL-C levels between 130 and 189 mg/dL (3.4-4.89 mmol/L) despite dietary and lifestyle changes, the presence of additional risk factors and comorbid conditions would favor statin therapy. In the case of combined dyslipidemia, the primary treatment target is LDL-C ≤130 mg/dL (3.4 mmol/L) and the secondary target non-high-density lipoprotein cholesterol &lt;145 mg/dL (3.7 mmol/L). If the triglyceride is ≥400 mg/dL (4.5 mmol/L), prescription omega-3 fatty acids and fibrates are considered. In the case of triglyceride &gt;1000 mg/dL (11.3 mmol/L), dietary fat restriction remains the cornerstone of therapy, even though the landscape of medications is changing.

Conclusion
Gene variants, acquired conditions, or both are responsible for dyslipidemia during childhood. Extreme elevations of triglycerides can lead to pancreatitis. Early identification and management of dyslipidemia and cardiovascular risk factors is extremely important.
Effect of Metabolite Levels on Type 2 Diabetes Mellitus and Glycemic Traits: A Mendelian Randomization Study
Authors: Sun Yue , Lu Ya-Ke , Gao Hao-Yu , Yan Yu-Xiang 
Published: August 2021

Abstract

Objective
To assess the causal associations of plasma levels of metabolites with type 2 diabetes mellitus (T2DM) and glycemic traits.

Methods
Two-sample mendelian randomization (MR) was conducted to assess the causal associations. Genetic variants strongly associated with metabolites at genome-wide significance level (P &lt; 5 × 10−8) were selected from public genome-wide association studies, and single-nucleotide polymorphisms of outcomes were obtained from the Diabetes Genetics Replication and Meta-analysis consortium for T2DM and from the Meta-Analyses of Glucose and Insulin-related Traits Consortium for fasting glucose, insulin, and glycated hemoglobin (HbA1c). The Wald ratio and inverse-variance weighted methods were used for analyses, and MR-Egger was used for sensitivity analysis.

Results
The β estimates per 1-SD increase of arachidonic acid (AA) level was 0.16 (95% CI, 0.078-0.242; P &lt; 0.001). Genetic predisposition to higher plasma AA levels were associated with higher fasting glucose levels (β 0.10 [95% CI, 0.064-0.134], P &lt; 0.001), higher HbA1c levels (β 0.04 [95% CI, 0.027-0.061]), and lower fasting insulin levels (β -0.025 [95% CI, -0.047 to -0.002], P = 0.033). Besides, 2-hydroxybutyric acid (2-HBA) might have a positive causal effect on glycemic traits.

Conclusions
Our findings suggest that AA and 2-HBA may have causal associations on T2DM and glycemic traits. This is beneficial for clarifying the pathogenesis of T2DM, which would be valuable for early identification and prevention for T2DM.
Mechanisms of Weight Loss After Obesity Surgery
Authors: Akalestou Elina , Miras Alexander D , Rutter Guy A , le Roux Carel W 
Published: August 2021

Abstract
Obesity surgery remains the most effective treatment for obesity and its complications. Weight loss was initially attributed to decreased energy absorption from the gut but has since been linked to reduced appetitive behavior and potentially increased energy expenditure. Implicated mechanisms associating rearrangement of the gastrointestinal tract with these metabolic outcomes include central appetite control, release of gut peptides, change in microbiota, and bile acids. However, the exact combination and timing of signals remain largely unknown. In this review, we survey recent research investigating these mechanisms, and seek to provide insights on unanswered questions over how weight loss is achieved following bariatric surgery which may eventually lead to safer, nonsurgical weight-loss interventions or combinations of medications with surgery.
Synergism of Checkpoint Inhibitors and Peptide Receptor Radionuclide Therapy in the Treatment of Pituitary Carcinoma
Authors: Lin Andrew L , Tabar Viviane , Young Robert J , Cohen Marc , Cuaron John , Yang T Jonathan , Rosenblum Marc , Rudneva Vasilisa A , Geer Eliza B , Bodei Lisa 
Published: August 2021

Abstract

Context
Aggressive pituitary tumors that have progressed following temozolomide have limited treatment options. Peptide receptor radionuclide therapy and immunotherapy may have a complementary role in the management of these tumors.

Methods
We provide follow-up data on a previously reported patient with a hypermutated recurrent tumor. The patient in this report provided written informed consent for tumor sequencing and review of medical records on an institutional review board–approved research protocol (NCT01775072).

Results
This patient with a corticotroph pituitary carcinoma with alkylator-induced somatic hypermutation has remained on treatment with ipilimumab and nivolumab for 3.5 years and remains clinically well. After an initial partial response to checkpoint inhibitors, she has had several recurrences that have undergone immunoediting of subclonal mutations, which have been effectively treated with continuation of immunotherapy, surgery, external beam radiation, and 177Lu-DOTATATE. Following external beam radiotherapy (RT), she had radiographic evidence of an abscopal response at a distant site of disease suggesting a synergism between checkpoint inhibitors and RT. Following treatment with 177Lu-DOTATATE, the patient had a partial response with a 61% reduction in volume of the target lesion.

Conclusion
In patients with aggressive pituitary tumors, treatment with checkpoint inhibitors may trigger an abscopal response from RT. With appropriate selection, an additional efficacious treatment, 177Lu-DOTATATE, may be available for a limited number of patients with aggressive pituitary tumors, including patients who have progressed on temozolomide and exhibit increased somatostatin receptor expression on 68Ga-DOTATATE positron emission tomography.
Beyond Ethnicity: New Politics of Race in Hawai‘i, Camilla Fojas, Rudy P. Guevarra Jr. and Nitasha Tamar Sharma (eds) (2018)
Authors: da Rocha Ana Cristina Gomes 
Published: August 2021

Review of: Beyond Ethnicity: New Politics of Race in Hawai‘i, Camilla Fojas, Rudy P. Guevarra Jr. and Nitasha Tamar Sharma (eds) (2018)
Honolulu, HI: University of Hawai‘i Press, 232 pp.,
ISBN 978 0 82486 988 5 (hbk), US$72
Anglicization of Written Igbo Personal and Place Names: A Sociolinguistic Study
Authors: Nnamdi-Eruchalu Geraldine Ifesinachi 
Published: August 2021

The Igbo people are at the verge of losing their language, culture and identity to the English Language [Azuonye 2002, Asonye 2013, Emeka-Nwobia 2020]. This work aims at investigating into the Anglicization of written Igbo personal and place names with a view to highlighting the extent of spellings and pronunciation inconsistencies, discover what impact it has on the learning and development of the language, and discover ways the attitude of the people can be changed towards the language to forestall its death. It argues that the spelling inconsistencies it introduced to the language is a source of challenge to learners, the majority of whom already have negative attitude towards the language. Ogbalu [1974], Oruchalu [1979] and Okodo [2008] made lists of anglicized names with their correct Igbo spellings, and decried the practice. The data for this research were collected from personal experiences, class lists, radio and television programmes, the internet, social and print media, and interviews. It concludes that a change in the attitude of the people towards their language, culture and identity as well as total implementation of the Onwu Orthography with regards to the spelling of personal and place names will complement the efforts being made to sustain the language.
New and interesting seaweed records from the Hakai area of the central coast of British Columbia, Canada: Chlorophyta
Authors: Lindstrom Sandra C. , Lemay Matthew A. , Starko Samuel , Hind Katharine R. , Martone Patrick T. 
Published: August 2021

Abstract
Since 2011 we have been documenting seaweed diversity and abundance along a poorly studied area of the central coast of British Columbia, Canada. This first installment focuses on the Chlorophyta. To date, 42 species have been recorded, and we have obtained DNA sequences for most. Although most of these species reportedly have wide distributions along the west coast of North America, others appear to represent new northern or southern records or possible introductions, and a number have yet to be described. New southern limits are recorded for Acrosiphonia sonderi, Acrosiphonia sp., Protomonostroma undulatum, and Ulva pouliotii sp. nov., and new northern records are documented for Ulva expansa, U. stenophylla, and another undescribed species of Ulva. Among species of Cladophoraceae, we obtained a sequence only for Cladophora opaca, a Japanese species not previously recorded from North America, and an undetermined species of Rhizoclonium. We sequenced three species of Derbesia, none of which is D. marina, the currently recognized species for this area; all three require taxonomic treatment. A sequence for a shell-boring species, which is tentatively identified as Eugomontia sacculata, was also obtained. These findings extend our understanding of the diversity and biogeography of green macroalgae in the northeast Pacific.
Optical elements from 3D printed polymers
Authors: Blachowicz Tomasz , Ehrmann Guido , Ehrmann Andrea 
Published: August 2021

Abstract
3D printing belongs to the emerging technologies of our time. Describing diverse specific techniques, 3D printing enables rapid production of individual objects and creating shapes that would not be produced with other techniques. One of the drawbacks of typical 3D printing processes, however, is the layered structure of the created parts. This is especially problematic in the production of optical elements, which in most cases necessitate highly even surfaces. To meet this challenge, advanced 3D printing techniques as well as other sophisticated solutions can be applied. Here, we give an overview of 3D printed optical elements, such as lenses, mirrors, and waveguides, with a focus on freeform optics and other elements for which 3D printing is especially well suited.
Global continuity of variational solutions weakening the one-sided bounded slope condition
Authors: Stanin Thomas 
Published: August 2021

Abstract
We study regularity properties of variational solutions to a class of Cauchy–Dirichlet problems of the form

{

∂
t

⁡
u

-

div
x

⁡

(

D
ξ

⁢
f
⁢

(

D
⁢
u

)

)

=
0

in
⁢

Ω
T

,

u

=

u
0

on
⁢

∂
𝒫

⁡

Ω
T

.

\left\{\begin{aligned} \displaystyle\partial_{t}u-\operatorname{div}_{x}(D_{%
\xi}f(Du))&\displaystyle=0&&\displaystyle\phantom{}\text{in }\Omega_{T},\\
\displaystyle u&\displaystyle=u_{0}&&\displaystyle\phantom{}\text{on }\partial%
_{\mathcal{P}}\Omega_{T}.\end{aligned}\right.

We do not impose any growth conditions from above on

f
:

ℝ
n

→
ℝ

{f\colon\mathbb{R}^{n}\to\mathbb{R}}

, but only require it to be convex and coercive. The domain

Ω
⊂

ℝ
n

{\Omega\subset\mathbb{R}^{n}}

is mainly supposed to be bounded and convex, and for the time-independent boundary datum

u
0

:

Ω
¯

→
ℝ

{u_{0}\colon\overline{\Omega}\to\mathbb{R}}

we only require continuity. These requirements are weaker than a one-sided bounded slope condition. We prove global continuity of the unique variational solution

u
:

Ω
T

→
ℝ

{u\colon\Omega_{T}\to\mathbb{R}}

. If the boundary datum is Lipschitz continuous, we obtain global Hölder continuity of the solution.