bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of vitamin D status and cathelicidin antimicrobial peptide on adults with active pulmonary TB globally: A systematic review and meta-analysis
Authors: Acen Ester Lilian , Biraro Irene Andia , Worodria William , Joloba Moses L. , Nkeeto Bill , Musaazi Joseph , Kateete David Patrick 
Published: June 2021

Background
Tuberculosis remains a global threat and a public health problem that has eluded attempts to eradicate it. Low vitamin D levels have been identified as a risk factor for tuberculosis infection and disease. The human cathelicidin LL-37 has both antimicrobial and immunomodulatory properties and is dependent on vitamin D status. This systematic review attempts to compare vitamin D andLL-37 levels among adult pulmonary tuberculosis patients to non-pulmonary TB individuals between 16–75 years globally and to determine the association between vitamin D and cathelicidin and any contributing factor among the two study groups.

Methods/Design
We performed a search, through PubMed, HINARI, Google Scholar, EBSCOhost, and databases. A narrative synthesis through evaluation of vitamin D and LL-37 levels, the association of vitamin D and LL-37, and other variables in individual primary studies were performed. A random-effect model was performed and weighted means were pooled at a 95% confidence interval. This protocol is registered under the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42019127232.

Results
Of the 2507 articles selected12 studies were eligible for the systematic review and of these only nine were included in the meta-analysis for vitamin D levels and six for LL-37 levels. Eight studies were performed in Asia, three in Europe, and only one study in Africa. The mean age of the participants was 37.3±9.9 yrs. We found low vitamin D and high cathelicidin levels among the tuberculosis patients compared to non-tuberculosis individuals to non-tuberculosis. A significant difference was observed in both vitamin D and LL-37 levels among tuberculosis patients and non-tuberculosis individuals (p = < 0.001).

Conclusion
This study demonstrated that active pulmonary tuberculosis disease is associated with hypovitaminosis D and elevated circulatory cathelicidin levels with low local LL-37 expression. This confirms that vitamin D status has a protective role against tuberculosis disease.
Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study
Authors: van der Zee Esther N. , Noordhuis Lianne M. , Epker Jelle L. , van Leeuwen Nikki , Wijnhoven Bas P. L. , Benoit Dominique D. , Bakker Jan , Kompanje Erwin J. O. 
Published: June 2021

Introduction
Given clinicians’ frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and performance status of cancer patients 2 years following an unplanned ICU admission.

Materials and methods
This was a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned ICU admission in 2017 into two groups: patients with or without an active malignancy. Descriptive statistics, Pearson’s Chi-square tests and the Mann-Whitney U tests were used to evaluate the primary objective 2-year mortality and performance status. A good performance status was defined as ECOG performance status 0 (fully active) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out light work). A multivariable binary logistic regression analysis was used to identify factors associated with 2-year mortality within cancer patients.

Results
Of the 1046 unplanned ICU admissions, 125 (12%) patients had cancer. The 2-year mortality in patients with cancer was significantly higher than in patients without cancer (72% and 42.5%, P <0.001). The median performance status at 2 years in cancer patients was 1 (IQR 0–2). Only an ECOG performance status of 2 (OR 8.94; 95% CI 1.21–65.89) was independently associated with 2-year mortality.

Conclusions
In our study, the majority of the survivors have a good performance status 2 years after ICU admission. However, at that point, three-quarter of these cancer patients had died, and mortality in cancer patients was significantly higher than in patients without cancer. ICU admission decisions in acutely ill cancer patients should be based on performance status, severity of illness and long-term prognosis, and this should be communicated in the shared decision making. An ICU admission decision should not solely be based on the presence of a malignancy.
Knowledge about mother to child transmission of HIV/AIDS, its prevention and associated factors among reproductive-age women in sub-Saharan Africa: Evidence from 33 countries recent Demographic and Health Surveys
Authors: Teshale Achamyeleh Birhanu , Tessema Zemenu Tadesse , Alem Adugnaw Zeleke , Yeshaw Yigizie , Liyew Alemneh Mekuriaw , Alamneh Tesfa Sewunet , Tesema Getayeneh Antehunegn , Worku Misganaw Gebrie 
Published: June 2021

Background
In sub-Saharan Africa (SSA) 90 percent of babies acquired HIV/AIDS from infected mothers. Maternal knowledge about mother to child transmission (MTCT) of HIV/AIDS and its prevention is a cornerstone for elimination of MTCT of HIV/AIDS. Despite this, there is limited evidence about knowledge about MTCT of HIV/AIDS and its prevention and associated factors in SSA. Therefore, this study aimed to assess knowledge of MTCT of HIV/AIDS, its prevention (PMTCT) and, associated factors among reproductive-age women in sub-Saharan Africa.

Objective
To assess Knowledge about mother to child transmission of HIV/AIDS and its prevention and associated factors among reproductive-age women in Sub-Saharan Africa.

Methods
The recent SSA countries’ Demographic and Health Surveys (DHS), which were conducted from 2008/09 to 2018/19, was our data source. We appended 33 countries’ DHS data for our analysis. For our study, a total weighted sample of 350,888 reproductive-age women was used. Due to the hierarchical nature of the DHS data, we conducted a multilevel analysis. Finally, the adjusted odds ratio with its 95% confidence interval was reported, and variables with p-value≤0.05 were considered as significant predictors of knowledge of MTCT of HIV/AIDS and its prevention.

Results
In this study, 56.21% (95% CI: 56.05–56.38) of respondents had correct knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA. In the multilevel logistic regression analysis: being in the older age group, better education level, being from a rich household, having mass media exposure, having parity of one and above were associated with higher odds of knowledge about MTCT of HIV/AIDS and its prevention. However, being perceiving distance from the health facility as a big problem was associated with lower odds of knowledge about MTCT of HIV/AIDS and its prevention.

Conclusion
Knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA was low. Therefore, it is better to consider the high-risk groups during the intervention to increase awareness about this essential public health issue and to tackle its devastating outcome.
Prevalence of active tuberculosis disease among healthcare workers and support staff in healthcare settings of the Amhara region, Ethiopia
Authors: Shiferaw Melashu Balew , Sinishaw Mulusew Alemneh , Amare Desalegne , Alem Genetu , Asefa Dawit , Klinkenberg Eveline 
Published: June 2021

BackgroundHealth care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia.MethodsA cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology.ResultsA total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18–24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals).ConclusionsThe magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.
Understanding dogwhistles politics
Authors: Torices José Ramón 
Published: June 2021

This paper aims to deepen our understanding of so-called covert dogwhistles. I discuss whether a covert dogwhistle is a specific sort of mechanism of manipulation or whether, on the contrary, it draws on other already familiar linguistic mechanisms such as implicatures or presuppositions. I put forward a series of arguments aimed at illustrating that implicatures and presuppositions, on the one hand, and covert dogwhistles, on the other, differ in their linguistic behaviour concerning plausible deniability, cancellability, calculability and mutual acceptance. I concluded this paper by outlining a simple theory for covert dogwhistles according to which they are attitude-foregrounders.
Fasting Ketonuria and the Risk of Incident Nonalcoholic Fatty Liver Disease With and Without Liver Fibrosis in Nondiabetic Adults
Authors: Kim Yejin , Chang Yoosoo , Kwon Min-Jung , Hong Yun Soo , Kim Mi Kyung , Sohn Won , Cho Yong Kyun , Shin Hocheol , Wild Sarah H. , Byrne Christopher D. , Ryu Seungho 
Published: June 2021

INTRODUCTION:
Dietary carbohydrate restriction or ketogenic diets are known to be beneficial in preventing liver fat accumulation. However, the effect of ketonemia on the risk of nonalcoholic fatty liver disease (NAFLD) in nondiabetic population is largely unknown. We investigated the association between fasting ketonuria and the risk of incident NAFLD in healthy adults.

METHODS:
A cohort of 153,076 nondiabetic Koreans with no hepatic steatosis and low probability of fibrosis at baseline was followed for a median of 4.1 years. The outcome was incident hepatic steatosis with or without liver fibrosis, and it was assessed by liver ultrasound and noninvasive fibrosis indices, including fibrosis-4 and the NAFLD fibrosis score (NFS). Parametric proportional hazard models were used to estimate hazard ratios (HRs) for outcome according to ketonuria status.

RESULTS:
Within 677,702.1 person-years of follow-up, 31,079 subjects developed hepatic steatosis. Compared with no ketonuria (reference), fasting ketonuria was significantly associated with a decreased risk of incident hepatic steatosis, with multivariable-adjusted HRs (95% confidence interval) of 0.81 (0.78–0.84). The corresponding HRs for incident hepatic steatosis with intermediate-to-high NFS were 0.79 (0.69–0.90). Similar associations were observed replacing NFS with fibrosis-4. In addition, the presence of persistent ketonuria at both baseline and subsequent visit was associated with the greatest decrease in the adjusted HR for incident NAFLD.

DISCUSSION:
Ketonuria was associated with a reduced risk of developing incident hepatic steatosis with and without intermediate-to-high probability of advanced fibrosis in a large cohort of nondiabetic healthy individuals. The role of hyperketonemia in the prevention of NAFLD requires further exploration.
“We learn from each other”: peer review writing practices in English for Academic Purposes
Authors: Kostopoulou Stergiani , O’Dwyer Fergus 
Published: June 2021

Abstract
This evidence-based, procedural paper outlines academic writing peer review practices conducted by Pre-Master’s Pathway and pre-undergraduate Foundation programme students at two Irish universities. The theoretical framework section presents the view that formative teacher feedback on student writing alone is insufficient, suggesting sustainable feedback through transmission of knowledge via student-generated feedback. We outline the peer review process, providing learners’ reactions focusing on what went well and what can be improved. This provides an outline of possible processes for others to use in their context, with a discussion of relevant considerations. Issues discussed include how to enhance the quality of peer feedback and maximize its impact on student learning. The ultimate aim of the practices is to improve the experience of the learners, and better facilitate their readiness for forthcoming modules in Irish universities. Overall peer review practices develop emerging academic writers, and should be considered in foundational, pre-sessional and beginning stages of learning in undergraduate, and those returning to Masters programmes. Peer review practices require active involvement and collaboration, and can improve self-regulation capabilities of emerging academic writers. The practices effectively encourage the transmission of socially constructed knowledge regarding their capabilities, and ultimately lead to improved self-efficacy and general writing abilities of learners.
Introducing integrated language skills assessment at the language department of a Czech university
Authors: Haug Laura 
Published: June 2021

Abstract
Integrated assessment evaluates language proficiency through tasks that require the test-taker to produce a written or spoken output based on listening or reading comprehension (reading or listening-into-writing or speaking). Since integrated assessment aims at reflecting the communicative and cognitive requirements of academic life and other professions, it is considered a means of assessment that is both authentic and valid. Examples of integrated tests can be found in high-stakes examinations at universities with English as the medium of instruction, and in the standardised high-stakes examinations offered by ETS, Pearson Education and Trinity College London. This report provides an example of integrated assessment in action by describing a currently used integrated test developed at the Language Department of the Faculty of Science, University of South Bohemia in the Czech Republic. Since 2018, this particular integrated test has served as the entrance examination for Biological Chemistry (EEBC), a bachelor’s degree course delivered entirely in English. By detailing the rationale behind the examination and the design process, this report aims to show that integrated assessment can provide a valid alternative to independent assessment at the tertiary level.
‚Influenc­­­ing‘ – ein Modell religionspädagogisch reflektierten Handelns?
Authors: Pirker Viera 
Published: June 2021

Abstract
With the changes in the world we live in, the conditions for learning change. Children and adolescents have access to orientation opportunities in the media, which they can approach independently. Digital environments call for a rethinking of educational theory and teaching practice in terms of content and didactics.
In the contexts of YouTube and Instagram, Influencing has developed as a new factor in market, opinion and personality formation. In order to understand peer learning on social media, two classical learning theories can be applied. In the context of communication science and media pedagogy, influencing is based on an update of the conception of parasocial relationship. Technological aspects have to be taken into account. The article concludes with a media pedagogical assessment and religious pedagogical perspectives for educational practice and research.
Potent kings and antisocial heroes: lion symbolism and elite masculinity in ancient Mesopotamia and Greece
Authors: Geoghegan Micheál 
Published: June 2021

AbstractIn the great kingdoms of ancient Mesopotamia, the king’s power was often evoked by means of lion symbolism. This has led scholars to conclude that lion motifs, and especially that of the lion-slaying hero, in early Greek art and literature were cultural borrowings from the more populous and urbanised civilisations to the east. Yet it is also notable that the Greek tradition, at least from the time of the Homeric poems, tended to problematise the ethics of the leonine man. This article explores the function of lion imagery in narratives of elite masculinity in western Asia and early Greece respectively. It will argue that Greek myth and epic reflect on and problematise any potential equation between lions and kingly prestige, power and masculinity, instead drawing attention to the savagery and social isolation of the lion-like man-of-power, and his difficulty in conforming to the expectations of civilised society.
Ethical challenges in management of critically ill pregnant patients with coronavirus disease 2019 (COVID-19)
Authors: Gulersen Moti , Rochelson Burton , Bornstein Eran , McCullough Laurence B. , Chervenak Frank A. 
Published: June 2021

Abstract
Despite the overwhelming number of coronavirus disease 2019 (COVID-19) cases worldwide, data regarding the optimal clinical guidance in pregnant patients is not uniform or well established. As a result, clinical decisions to optimize maternal and fetal benefit, particularly in patients with critical COVID-19 in the early preterm period, continue to be a challenge for obstetricians. There is often uncertainty in clinical judgment about fetal monitoring, timing of delivery, and mode of delivery because of the challenge in balancing maternal and fetal interests in reducing morbidity and mortality. The obstetrician and critical care team should empower pregnant patients or their surrogate decision maker to make informed decisions in response to the team’s clinical evaluation. A clinically grounded ethical framework, based on the concepts of the moral management of medical uncertainty, beneficence-based obligations, and preventive ethics, should guide the decision-making process.
Lie symmetry analysis, optimal system, and new exact solutions of a (3 + 1) dimensional nonlinear evolution equation
Authors: Tiwari Ashish , Sharma Kajal , Arora Rajan 
Published: June 2021

Abstract
Studies on Non-linear evolutionary equations have become more critical as time evolves. Such equations are not far-fetched in fluid mechanics, plasma physics, optical fibers, and other scientific applications. It should be an essential aim to find exact solutions of these equations. In this work, the Lie group theory is used to apply the similarity reduction and to find some exact solutions of a (3+1) dimensional nonlinear evolution equation. In this report, the groups of symmetries, Tables for commutation, and adjoints with infinitesimal generators were established. The subalgebra and its optimal system is obtained with the aid of the adjoint Table. Moreover, the equation has been reduced into a new PDE having less number of independent variables and at last into an ODE, using subalgebras and their optimal system, which gives similarity solutions that can represent the dynamics of nonlinear waves.
Language ecology, language endangerment, and relict languages: Case studies from Adamawa (Cameroon-Nigeria)
Authors: Connell Bruce , Zeitlyn David , Griffiths Sascha , Hayward Laura , Martin Marieke 
Published: June 2021

AbstractAs a contribution to the more general discussion on causes of language endangerment and death, we describe the language ecologies of four related languages (Bà Mambila [mzk]/[mcu], Sombә (Somyev or Kila) [kgt], Oumyari Wawa [www], Njanga (Kwanja) [knp]) of the Cameroon-Nigeria borderland to reach an understanding of the factors and circumstances that have brought two of these languages, Sombә and Njanga, to the brink of extinction; a third, Oumyari, is unstable/eroded, while Bà Mambila is stable. Other related languages of the area, also endangered and in one case extinct, fit into our discussion, though with less focus. We argue that an understanding of the language ecology of a region (or of a given language) leads to an understanding of the vitality of a language. Language ecology seen as a multilayered phenomenon can help explain why the four languages of our case studies have different degrees of vitality. This has implications for how language change is conceptualised: we see multilingualism and change (sometimes including extinction) as normative.
Synergistic effect of oxidized low-dimensional carbon nanomaterials on the properties of polysulfone composite membrane
Authors: Xu Jin , Wang Fei , Wang Chunting , Zhang Qi , He Yan 
Published: June 2021

Abstract
Using the immersion phase inversion process, polysulfone (PSF), grapheme oxide (GO) and modified carbon nanotubes (MCNTs) were dissolved in 1-methyl-2-pyrrolidone (NMP) to prepare nanocomposite membranes. The GO-MCNTs blended PSF membranes were characterized by several analytical methods, such as morphology analysis, group characteristic peak test, hydrophilic measurement and permeation tests, and the synergistic effect of GO and MCNTs on the membrane performance was investigated. Microscope images depict two-layer structure of the composite membrane, in which, the lower layer is finger like porous layer, and the upper layer is a thinner separation layer. M-CNTs have great influence on formation of the upper separation layer, while the hydrophilic nature of GO results in the formation of the lower supporting layer, which changes from finger shaped hole to honeycomb pore. The change of membrane structure not only improves the surface hydrophilicity, but also promotes the membrane performance. In particular, the composite membrane (m
GO:MCNTs = 2:1) exhibits a much smaller contact angle (48.01°), a high permeation flux (33.25 L/m2·h) and superior rejection rate (95.2%). Furthermore, the fine compaction performance of composite membrane also provides great potential application prospects in water treatment.