bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mid-upper arm circumference in pregnant women and birth weight in newborns as substitute for skinfold thickness: findings from the MAASTHI cohort study, India
Authors: Babu Giridhara R. , Das Aritra , Lobo Eunice , R Deepa , John Daisy A. , Thankachan Prashanth , Khetrapal Sonalini , Benjamin-Neelon Sara E. , Murthy GVS 
Published: July 2021

AbstractBackgroundEstimating total body fat in public hospitals using gold-standard measurements such as air displacement plethysmography (ADP), deuterium oxide dilution, or dual-energy X-ray absorptiometry (DXA) is unaffordable, and it is challenging to use skinfold thickness. We aimed to identify the appropriate substitute marker for skinfold thickness to estimate total body fat in pregnant women and infants.MethodsThe study is part of a prospective cohort study titled MAASTHI in Bengaluru, from 2016 to 19. Anthropometric measurements such as body weight, head circumference, mid-upper arm circumference (MUAC), and skinfold thickness were measured in pregnant women between 14 and 36 weeks of gestational age; while measurements such as birth weight, head, chest, waist, hip, mid-upper arm circumference, and skinfold thickness were recorded for newborns. We calculatedKappastatistics to assess agreement between these anthropometric markers with skinfold thickness.ResultsWe found the highest amount of agreement between total skinfold thickness and MUAC (Kappastatistic, 0.42; 95 % CI 0.38–0.46) in pregnant women. For newborns, the highest agreement with total skinfold thickness was with birth weight (0.57; 95 % CI 0.52–0.60). Our results indicate that MUAC higher than 29.2 cm can serve as a suitable alternative to total skinfolds-based assessments for obesity screening in pregnancy in public facilities. Similarly, a birth weight cut-off of 3.45 kg can be considered for classifying obesity among newborns.ConclusionMid-upper arm circumference and birth weight can be used as markers of skinfold thickness, reflecting total body fat in pregnant women and the infant, respectively. These two anthropometric measurements could substitute for skinfold thickness in low- and middle-income urban India settings.
Factors associated with unintended pregnancy in Ethiopia; further analysis of the 2016 Ethiopian demographic health survey data
Authors: Bekele Yibeltal Alemu , Fekadu Gedefaw Abeje 
Published: July 2021

Abstract
Background
Unintended pregnancy an important public health problem in Ethiopia. It is associated with adverse physical, mental, social and economic outcomes. Identifying factors associated with unintended pregnancy may help to reduce unintended pregnancy and hence adverse outcomes. There are few studies about the prevalence and associated factors of unintended pregnancy in Ethiopia. But these studies were based on small sample size and fragmented. Therefore, this analysis was done to identify factors associated with unintended pregnancy in Ethiopia based on nationally representative data.

Methods
The study used the 2016 Ethiopian demographic and health survey data. The data was downloaded from The DHS program with permission. A total of 1135 women were included in the final model. Data was weighted to consider disproportionate sampling and non-response. Multivariable logistic regression was used to identify factors associated with unintended pregnancy among women.

Result
About 30% (95% CI: 25.33–34.39) pregnancies were unintended. Married women (Adjusted odds ratio (AOR); 0.34; 95% CI: (0.01–0.14), woman living in developing regions AOR; 0.14; 95% CI: (0.07–0.27) and women who reported distance was not a big problem to get medical care AOR; 0.59; 95% CI: (0.36–0.99) had lower odds of unintended pregnancy. On the other hand, multiparous AOR; 3.77; 95% CI: (1.71–8.33), grand multiparous AOR; 6.72; 95% CI: (2.74–16.49) women and women who ever used contraceptives AOR; 1.86 95% CI: (1.06–3.26) had higher odds of unintended pregnancy.

Conclusion
Although high, the magnitude of unintended pregnancy in Ethiopia was lower compared to the global level. Marital status, region, perceived distance to seek medical care, parity and history of contraceptive use were found significant predictors of unintended pregnancy in Ethiopia.
Maternal–fetal attachment in pregnant Italian women: multidimensional influences and the association with maternal caregiving in the infant’s first year of life
Authors: Sacchi Chiara , Miscioscia Marina , Visentin Silvia , Simonelli Alessandra 
Published: July 2021

AbstractBackgroundMaternal–Fetal Attachment (MFA) describes the cognitive-representational, emotional, and behavioral aspects of the mother–fetus relationship that develops during pregnancy.We present two studies conducted on pregnant Italian women. In Study I, we aimed to explore multifaceted associations of MFA with variables important for a healthy pregnancy (e.g., maternal mental health, the couple’s relationship). In Study II, we investigated the predictive role of MFA on observed maternal caregiving during the first months of the infant’s life.MethodsIn Study I, 113 pregnant Italian women were assessed on MFA (Maternal Antenatal Attachment Scale, MAAS), maternal depression (Beck Depression Inventory-II, BDI-II), maternal anxiety (State Trait Anxiety Inventory – State version,STAI), adjustment of the couple (Dyadic Adjustment Scale,DAS), and perceived parental care (The Parental Bonding Instrument,PBI). In Study II, 29 mother–infant pairs were followed up at 4 months to assess observational variables of maternal caregiving through theEmotional Availability Scale(EAS) and to test for an association with MFA in pregnancy.ResultsStudy I showed a significant association between MFA and the quality of the couple relationship (β = .49,P < .001) and between MFA and the recall of memories of care received in childhood (β = .22,P = .025). Study II showed a predictive effect of MFA on maternal structuring observed during mother–infant interactions at 4 months of age (β = 0.36,P = .046).ConclusionThe study points out relevant relationship contexts that might receive care and support throughout pregnancy to protect MFA. The findings also provide thoughtful insights on the role of MFA in early maternal caregiving, suggesting that MFA might be a candidate as one putative antecedent of mother–infant interaction processes.
A circular RNAs dataset landscape reveals potential signatures for the detection and prognosis of early-stage lung adenocarcinoma
Authors: Chen Zhiying , Wei Jiahui , Li Min , Zhao Yongjuan 
Published: July 2021

Abstract
Background
This study aimed to identify potential circular ribonucleic acid (circRNA) signatures involved in the pathogenesis of early-stage lung adenocarcinoma (LAC).

Methods
The circRNA sequencing dataset of early-stage LAC was downloaded from the Gene Expression Omnibus database. First, the differentially expressed circRNAs (DEcircRNAs) between tumour and non-tumour tissues were screened. Then, the corresponding miRNAs and their target genes were predicted. In addition, prognosis-related genes were identified using survival analysis and further used to build a network of competitive endogenous RNAs (ceRNAs; DEcircRNA–miRNA–mRNA). Finally, the functional analysis and drug–gene interaction analysis of mRNAs in the ceRNA network was performed.

Results
A total of 35 DEcircRNAs (30 up-regulated and 5 down-regulated circRNAs) were identified. Moreover, 135 DEcircRNA–miRNA and 674 miRNA–mRNA pairs were predicted. The survival analysis of these target mRNAs revealed that 60 genes were significantly associated with survival outcomes in early-stage LAC. Of these, high levels of PSMA 5 and low levels of NAMPT, CPT 2 and TNFSF11 exhibited favourable prognoses. In addition, the DEcircRNA–miRNA–mRNA network was constructed, containing 5 miRNA–circRNA (hsa_circ_0092283/hsa-miR-762/hsa-miR-4685-5p; hsa_circ_0070610/hsa-let-7a-2-3p/hsa-miR-3622a-3p; hsa_circ_0062682/hsa-miR-4268) and 60 miRNA–mRNA pairs. Functional analysis of the genes in the ceRNA network showed that they were primarily enriched in the Wnt signalling pathway. Moreover, PSMA 5, NAMPT, CPT 2 and TNFSF11 had strong correlations with different drugs.

Conclusion
Three circRNAs (hsa_circ_0062682, hsa_circ_0092283 and hsa_circ_0070610) might be potential novel targets for the diagnosis of early-stage LAC.
53 years old is a reasonable cut-off value to define young and old patients in clear cell renal cell carcinoma: a study based on TCGA and SEER database
Authors: Tang Fucai , Lu Zechao , He Chengwu , Zhang Hanbin , Wu Weijia , He Zhaohui 
Published: July 2021

Abstract
Background
The objectives of this study were to screen out cut-off age value and age-related differentially expressed genes (DEGs) in clear cell renal cell carcinoma (CCRCC) from Surveillance Epidemiology and End Results (SEER) database and The Cancer Genome Atlas (TCGA) database.

Methods
We selected 45,974 CCRCC patients from SEER and 530 RNA-seq data from TCGA database. The age cut-off value was defined using the X-tile program. Propensity score matching (PSM) was used to balance the differences between young and old groups. Hazard ratio (HR) was applied to evaluate prognostic risk of age in different subgroups. Age-related DEGs were identified via RNA-seq data. Survival analysis was used to assess the relationship between DEGs and prognosis.

Results
In this study, we divided the patients into young (n = 14,276) and old (n = 31,698) subgroups according to cut-off value (age = 53). Age > 53 years was indicated as independent risk factor for overall survival (OS) and cancer specific survival (CSS) of CCRCC before and after PSM. The prognosis of old group was worse than that in young group. Eleven gene were differential expression between the younger and older groups in CCRCC. The expression levels of PLA2G2A and SIX2 were related to prognosis of the elderly.

Conclusion
Fifty-three years old was cut-off value in CCRCC. The prognosis of the elderly was worse than young people. It remind clinicians that more attention and better treatment should be given to CCRCC patients who are over 53 years old. PLA2G2A and SIX2 were age-related differential genes which might play an important role in the poor prognosis of elderly CCRCC patients.
Survival benefit of induction chemotherapy for locally advanced nasopharyngeal carcinoma: prognosis based on a new risk estimation model
Authors: Liu Wei , Yu Bolong , Luo Yunfan , Li Junzheng , Yuan Xiaofei , Wu Shuting , Liang Bijun , Lv Zehong , Li Yanfei , Peng Xinyu , Lu Juan , Peng Xiaohong , Liu Xiong 
Published: July 2021

Abstract
Background
Although the National Comprehensive Cancer Network (NCCN) Guidelines recommend CCRT+AC and IC + CCRT as level 2A evidence for treatment of the locoregionally advanced NPC (II-IVa), IC + CCRT+AC could also be an alternative but it is seldom used because of the low completion rates. This article aimed to compare the effectiveness of the three radiotherapy regimens using a large-scale retrospective study.

Methods
This retrospective single center analysis enrolled 1812 diagnosed NPC patients at Nanfang Hospital from January 2005 to December 2015 and only 729 patients met the inclusion criteria and were analyzed. Patients without distant metastasis, age of 18–70 years, Karnofsky scores of at least 70,stage III-IVb, and adequate adequate bone marrow, liver and renal function. Were enrolled. Adverse events and other categorical variables were compared by Pearson chi-square test or Fishier exact test. Time-to-event data were described with the Kaplan-Meier curves, time-to-event intervals compared with the log-rank test. We did multivariable analyses with the Cox proportional hazards model to test the independent signifi cance of diff erent factors. Cox proportional hazards model was used to estimate the β regression coeffi cient, p value, and hazard ratio and its 95% CI for each of the selected risk predictors.

Results
The median follow-up time was 47 months. Kaplan-Meier analyses revealed no significant differences among three groups in 3-year failure-free survival (FFS, P = 0.225), 3-year overall survival (OS, P = 0.992), 3-year locoregional failure-free survival (LFFS, P = 0.549), and 3-year distant failure-free survival (DFFS, P = 0.174). Stratified survival analysis based on the risk scoring model revealed no differences in FFS, OS, LFFS, and DFFS between IC + CCRT and CCRT+AC groups for low-risk patients, however, the 3-year OS (88.3% vs. 77.6%, P = 0.049) and 3-year DFFS (84.0% vs.66.8%, P = 0.032) were respectively significantly better in IC + CCRT group compared with CCRT+AC group for high-risk patients.

Conclusions
Compared with CCRT+AC, IC + CCRT lowers distant metastasis rate and improves OS among patients with locally advanced NPC in high risk group.
The role of FoxP3+ regulatory T cells and IDO+ immune and tumor cells in malignant melanoma – an immunohistochemical study
Authors: Salmi Satu , Lin Anton , Hirschovits-Gerz Benjamin , Valkonen Mari , Aaltonen Niina , Sironen Reijo , Siiskonen Hanna , Pasonen-Seppänen Sanna 
Published: July 2021

Abstract
Background
FoxP3+ Regulatory T cells (Tregs) and indoleamine-2,3-dioxygenase (IDO) participate in the formation of an immunosuppressive tumor microenvironment (TME) in malignant cutaneous melanoma (CM). Recent studies have reported that IDO expression correlates with poor prognosis and greater Breslow’s depth, but results concerning the role of FoxP3+ Tregs in CM have been controversial. Furthermore, the correlation between IDO and Tregs has not been substantially studied in CM, although IDO is known to be an important regulator of Tregs activity.

Methods
We investigated the associations of FoxP3+ Tregs, IDO+ tumor cells and IDO+ stromal immune cells with tumor stage, prognostic factors and survival in CM. FoxP3 and IDO were immunohistochemically stained from 29 benign and 29 dysplastic nevi, 18 in situ -melanomas, 48 superficial and 62 deep melanomas and 67 lymph node metastases (LNMs) of CM. The number of FoxP3+ Tregs and IDO+ stromal immune cells, and the coverage and intensity of IDO+ tumor cells were analysed.

Results
The number of FoxP3+ Tregs and IDO+ stromal immune cells were significantly higher in malignant melanomas compared with benign lesions. The increased expression of IDO in melanoma cells was associated with poor prognostic factors, such as recurrence, nodular growth pattern and increased mitotic count. Furthermore, the expression of IDO in melanoma cells was associated with reduced recurrence˗free survival. We further showed that there was a positive correlation between IDO+ tumor cells and FoxP3+ Tregs.

Conclusions
These results indicate that IDO is strongly involved in melanoma progression. FoxP3+ Tregs also seems to contribute to the immunosuppressive TME in CM, but their significance in melanoma progression remains unclear. The positive association of FoxP3+ Tregs with IDO+ melanoma cells, but not with IDO+ stromal immune cells, indicates a complex interaction between IDO and Tregs in CM, which demands further studies.
Non-invasive duo positive airway pressure ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: a randomized controlled trial
Authors: Malakian Arash , Aramesh Mohammad Reza , Agahin Mina , Dehdashtian Masoud 
Published: July 2021

Abstract
Background
The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications.

Methods
148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications.

Results
there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002).

Conclusions
In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group.

Trial registration
IRCT20180821040847N1, Approved on 2018-09-10.
Military and demographic predictors of mental ill-health and socioeconomic hardship among UK veterans
Authors: Burdett H. , Fear N. T. , Wessely S. , Rona R. J. 
Published: July 2021

Abstract
Background
Around 8% of the UK Armed Forces leave in any given year, and must navigate unfamiliar civilian systems to acquire employment, healthcare, and other necessities. This paper determines longer-term prevalences of mental ill health and socioeconomic outcomes in UK Service leavers, and how they are related to demographic factors, military history, and pre-enlistment adversity.

Methods
This study utilised data from a longitudinal sample of a cohort study UK Armed Forces personnel since 2003. A range of self-reported military and sociodemographic factors were analysed as predictors of probable Post-Traumatic Stress Disorder, common mental disorders, alcohol misuse, unemployment and financial hardship. Prevalences and odds ratios of associations between predictors and outcomes were estimated for regular veterans in this cohort.

Results
Veteran hardship was mostly associated with factors linked to socio-economic status: age, education, and childhood adversity. Few military-specific factors predicted mental health or socio-economic hardship, except method of leaving (where those leaving due to medical or unplanned discharge were more likely to encounter most forms of hardship as veterans), and rank which is itself related to socioeconomic status.

Conclusion
Transition and resettlement provisions become increasingly generous with longer service, yet this paper shows the need for those services becomes progressively less necessary as personnel acquire seniority and skills, and instead could be best targeted at unplanned leavers, taking socioeconomic status into consideration. Many will agree that longer service should be more rewarded, but the opposite is true if provision instead reflects need rather than length of service. This is a social, political and ethical dilemma.
Potential health impact of increasing adoption of sustainable dietary practices in Sweden
Authors: Patterson Emma , Eustachio Colombo Patricia , Milner James , Green Rosemary , Elinder Liselotte Schäfer 
Published: July 2021

Abstract
Background
An urgent transition to more sustainable diets is necessary for the improvement of human and planetary health. One way to achieve this is for sustainable practices to become mainstream. We estimated the potential health impact of wider adoption of dietary practices deemed by consumers, researchers and stakeholders in Sweden to be niche, sustainable and with the potential to be scaled up.

Methods
A life table method was used to estimate the impact - changes in years of life lost (YLL) - over periods of 20 and 30 years in the Swedish population had the practices been adopted in 2010–11, when the last national adult dietary survey was conducted. The practices modelled were reducing red and processed meat (by 25, 50 and 100%), and assuming, for each stage, replacement by an equal weight of poultry/fish and vegetables +/− legumes; reducing milk intake (by 25, 50 and 100%); and reducing sugar-sweetened beverage intake (by 25, 50 and 100%). Using population data together with data on cause-specific mortality and relative risks for diet-disease outcomes, impacts were estimated for each scenario separately and in combination, for the outcomes ischaemic heart disease (IHD), ischaemic stroke, diabetes type 2 and colorectal cancer.

Results
For a “moderate” combination of scenarios (changes at the 50% level), reductions of 513,200 YLL (lower-upper uncertainty estimate 59,400-797,900) could have been achieved over 20 years and 1,148,500 YLL (135,900-1,786,600) over 30 years. The majority (over 90%) of YLLs prevented were related to IHD, and the majority were in men. The singular practice that had the most impact was reducing the intake of red and processed meat and replacing it with a mixture of vegetables and legumes. Reducing milk intake resulted in an increase in YLL, but this was compensated for by other scenarios.

Conclusion
If these practices were more widely adopted, they would be expected to lead to improvements in public health in Sweden. Over the long term, this would translate to many premature deaths postponed or prevented from a number of chronic diseases, to the benefit of individuals, society, the climate and the economy.