bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moving beyond individual barriers and identifying multi-level strategies to reduce anemia in Odisha India
Authors: Sedlander Erica , Long Michael , Mohanty Satyanarayan , Munjral Ashita , Bingenheimer Jeffrey B. , Yilma Hagere , Rimal Rajiv N. 
Published: July 2019

Abstract
Background: To reduce the prevalence of anemia, the Indian government recommends daily iron and folic acid supplements (iron supplements) for pregnant women and weekly iron supplements for adolescents and all women of reproductive age. The government has distributed free iron supplements to adolescents and pregnant women for over four decades. However, initial uptake and adherence remain inadequate and non-pregnant women of reproductive age are largely ignored. The aim of this study is to examine the multilevel barriers to iron supplement use and to subsequently identify promising areas to intervene.

Methods: We conducted a qualitative study in the state of Odisha, India. Data collection included key informant interviews, focus group discussions with women, husbands, and mothers-in-law, and direct observations in health centers, pharmacies and village health and nutrition days.

Results: We found that at the individual level, participants knew that iron supplements prevent anemia but underestimated anemia prevalence and risk in their community. Participants also believed that taking too many iron supplements during pregnancy would “make your baby big” causing a painful birth and a costly cesarean section. At the interpersonal level, mothers-in-law were not supportive of their daughters-in-law taking regular iron supplements during pregnancy but husbands were more supportive. At the community level, participants reported that only pregnant women and adolescents are taking iron supplements, ignoring non-pregnant women altogether. Unequal gender norms are also an upstream barrier for non-pregnant women to prioritize their health to obtain iron supplements. At the policy level, frontline health workers distribute iron supplements to pregnant women only and do not follow up on adherence.

Conclusions: Interventions should address multiple barriers to iron supplements use along the socio-ecological model. They should also be tailored to a woman’s reproductive life course stage: adolescents, pregnancy, and non-pregnant women of reproductive age because social norms and available services differ between the subpopulations.
Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017
Authors: Zhong Xuan , Wang Hui , Chen Chun , Zou Xiaoni , Li Tiegang 
Published: July 2019

Abstract
Background: Hand, foot and mouth disease (HFMD) is a common infectious disease that occurs mostly in infants and children. Reinfection is not uncommon because of the limited cross-protection from infections of different enterovirus. This study was to investigate the epidemiological characteristics and its influential factors of HFMD reinfection in Guangzhou.
Methods: Data on HFMD patients aged ≤5 years from 2012 to 2017 were extracted from surveillance system. Descriptive epidemiology method was adopted to analyze the characteristics of populations and time. Influential factors of reinfection were assessed using the logistic regression model.
Results: Of 369,054 HFMD patients, 11,321 patients were classified as reinfection, corresponding to a rate of 3.07%. The reinfection rate in male was higher than in female (χ2=60.11, P<0.001). The reinfection rate in patients ≤1 year was 3.86%, which showed a downward trend with age (Z=37.37, Ptrend<0.001). The highest reinfection rate was observed in the scattered children (3.38%), followed by nursery care children and others (χ2=514.75, P<0.001). Besides, higher risk of reinfection was detected among those who were male, lower age group and other enteroviruses infection compared with their respective counterparts. Seasonality was illustrated according to the number of reinfections peaked from April to July. Time intervals curves revealed the number of reinfections gradually increased after 13 months from the initial infection.
Conclusions: These results indicated that male ≤4 years, especially those lived scattered and infected with other enteroviruses were more likely to be reinfection. Administrations need to be alert to signs of HFMD reinfection. Effective interventions should be imposed on these high-risk children in time.
Making Progress: Introducing progress testing approaches to a single semester paramedic subject
Authors: Thompson James , Houston Don 
Published: July 2019

Abstract
Abstract
Background. Paramedicine is a rapidly evolving profession with continually increasing demands placed upon educating its future workforce. Ensuring graduates are adequately prepared places many expectations on the suitability and effectiveness of university assessment practices, in a discipline where summative credentialing has established traditions of use. Progress tests and programmatic assessment have growingly become common fixtures of medical education, offering longitudinal information about student knowledge, ability and progress, usually across an entire program of study. Methods. Our project explored the development, implementation and evaluation of progress testing in a single semester capstone undergraduate paramedic topic. We examined the changes in student performance between two MCQ tests spaced ten weeks apart, and performance in a final oral assessment based on the same test content. Student perceptions and experiences of these events were also evaluated. Results. 55% of students indicated it was common practice to guess answers in exams. After introducing of negative marking students achieved 40% mean correct answers on previously satisfied curriculum content in our test 1. Scores increased by 65% by test 2, with substantial declines in numbers of incorrect and don’t know responses. Conclusion. Our results demonstrate a substantial increase in correct responses between the two tests, a high mean score in the viva, and broad agreement about the significant impact the approaches have had on learning growth.
Transcriptome analysis for Fraxinus mandshurica seedlings from different carbon fixation and growth provenances in response to nitrogen deficiency
Authors: zhao xingtang , Zhang Tongwei , Liu Hualing , Wang Xiaoming , Xiao Ying , Yu Lei , Zhang Xu , Liu Zhang , Zeng Fansuo , Zhan Yaguang 
Published: July 2019

Abstract
Background

The carbon fixation characteristic of F. mandshurica seedlings from 20 provenances has been evaluated by our research group. In order to explore whether growth and carbon sequestration are related to nutritional adaptability, the foliage and roots of the annual Wuchang (WC) seedlings with high carbon content and Hailin (HL) seedlings with low carbon content which were grown in nitrogen-deficient nutrition and total nutrition were used for RNA-seq determination.

Results

Eight transcriptome libraries by high-throughput sequence were analysis. 1,235,174,984 clean reads and 88,655 unigenes with N50 length of 1,259 bp were obtained. Under normal nitrogen condition, 783 differentially expressed genes (DEGs) between WC and HL were identified, the number in foliage (669) of DEGs between HL and WC was more than that in roots (149). The number of transcription factors (TFs), hormone, and Protein kinase (PK) genes was significantly more in WC than that in HL. Compared to the normal nitrogen, 8173 DEGs related to nitrogen deficiency were identified and the number of DEGs in roots (6999) was more than that in foliage (1616). Several nitrogen deficiency-related metabolic pathways and many DEGs involved in nitrogen absorption and assimilation, carbon metabolism, hormones, transcription factors and kinases were identified. The numbers of DEGs encoding nitrate transporters, PK, TFs and hormone in WC were less than that in HL, which indicated the response of HL provenance seedlings to nitrogen deficiency was stronger than that of WC provenance seedlings. However, under nitrogen deficiency, the number of up-regulated DEGs in the WC provenance seedlings is more than that in the HL, which indicated that the WC provenance seedlings were more tolerant to nitrogen deficiency than HL.

Conclusions

The data showed that high carbon content and high growth rate of WC provenance seedlings are mainly attributed to the high transcriptional expression of many metabolic genes in foliage. The response of HL provenance seedlings to nitrogen deficiency is significantly greater than that of WC provenances seedlings, but WC provenance seedlings were more tolerant to nitrogen deficiency than HL. Many genes related to nitrogen deficiency were identified, which will expand our current understanding of nitrogen responses.
Simultaneous cardio-cerebral embolization associated with atrial fibrillation: a case report
Authors: Abe Soichiro , Tanaka Kanta , Yamagami Hiroshi , Sonoda Kazutaka , Hayashi Hiroya , Yoneda Shuichi , Toyoda Kazunori , Koga Masatoshi 
Published: July 2019

Abstract
Background: Simultaneous cerebral and myocardial infarction is called cardiocerebral infarction (CCI), and is rarely encountered. Because of the narrow time window and complex pathophysiology, CCI is challenging to immediately diagnose and treat.

Case presentation: A 73-year-old woman suddenly developed right hemiplegia and severe aphasia. Twelve-lead electrocardiography showed tachycardic atrial fibrillation without any significant ST-T change. Magnetic resonance imaging revealed a proximal middle cerebral artery occlusion. She was immediately treated with alteplase at the dosage approved for ischemic stroke followed by mechanical thrombectomy as bridging therapy, and complete recanalization was achieved. Aphasia improved and she began to complain of chest pain, and reported that she had experienced chest discomfort just prior to right limb weakness. Coronary angiography showed a partial filling defect in the right coronary artery with rapid and adequate distal flow, for which percutaneous coronary intervention was not required. Alteplase was suggested to have effectively resolved the coronary emboli. The occlusions of the cerebral and coronary arteries were assumed to have occurred nearly simultaneously and cardiogenic embolism due to atrial fibrillation was considered as the most likely etiology.

Conclusions: As seen in the present case, CCI may benefit from immediate treatment with intravenous tissue plasminogen activator (IV-tPA). Although which of percutaneous coronary intervention or cerebral thrombectomy should be performed first remains unclear, we must decide whether to rescue the brain or heart first in each patient within a limited window of time. This dilemma has recently become evident in this era with mechanical thrombectomy strongly established as an effective intervention for acute ischemic stroke. Close cooperation between stroke physicians and cardiologists is becoming more important.
Randomised controlled trial of the short-term effects of OROS-methylphenidate on ADHD symptoms and behavioural outcomes in young male prisoners with attention-deficit/hyperactivity disorder (CIAO-II)
Authors: Asherson Philip , Johansson Lena , Holland Rachel , Fahy Thomas , Forester Andrew , Howitt Sheila , Lawrie Stephen , Strang John , Young Susan , Landau Sabine , Thomson Lindsay 
Published: July 2019

Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalence disorder, seen in 20-30% of young adult prisoners. Pharmacoepidemiological studies, a small randomised controlled, and open trial data suggest clinically significant reductions in ADHD symptoms, emotional dysregulation, disruptive behaviour and engagement with educational activities. Yet, routine treatment of ADHD in offenders with ADHD is not yet established clinical practice. There is continued uncertainty about the clinical response to methylphenidate, a first line treatment for ADHD, in offenders who often present with an array of complex mental health problems that may better explain states of inattentive, overactive restless and impulsive behaviours. To address this problem we conduct an efficacy trial to establish the short term effects of OROS-methylphenidate (Concerta XL), an extended release formulation of MPH, on ADHD symptoms, emotional dysregulation and behaviour.
Methods: Parallel arm randomised placebo-controlled trial of OROS-MPH on ADHD symptoms, behaviour and functional outcomes in young male prisoners aged 16-25, meeting DSM-5 criteria for ADHD. Participants are randomised to 8-weeks treatment with OROS-MPH or placebo, titrated over 5 weeks to balance ADHD symptom improvement against side effects. 200 participants will be recruited with 1:1 ratio of drug to placebo. The primary outcome is change in level of ADHD symptoms after 8-weeks of trial medication.
Discussion: Potential benefits include improvement in ADHD symptoms, emotional dysregulation, attitudes towards violence, critical incidents and engagement with educational and rehabilitation programs. Demonstrating efficacy and safety of MPH on ADHD symptoms and associated impairments may provide the data needed to develop effective healthcare pathways for a significant group of young offenders. Establishing efficacy of MPH in this population will provide the foundation needed to establish long term effectiveness studies with the potential for demonstrating significant reductions in criminal behaviour and improved health-economic outcomes.
Trial Registration: ISRCTN16827947l; EudraCT Number: 2015-004271-78.
Protocol version: v2.0 30.08.2018
The effect of Spinal Manipulative Therapy on Heart Rate Variability and pain in patients with chronic neck pain: A Randomized Controlled trial
Authors: Bakken Anders Galaasen , Eklund Andreas , O'neill Sören , Axén Iben 
Published: July 2019

Abstract
Background

Recent experimental research has suggested that Spinal Manipulative Therapy (SMT) may reduce pain through modulation of the ascending pain signals and/or the central pain regulating mechanisms. People with persistent neck pain (NP) have also been found to have disturbances in Autonomic Nervous System (ANS) regulation. A common way to study ANS is to measure heart rate variability (HRV). It is not known if deviations in HRV are related to changes in pain perception or to the treatment response to SMT.

Commonly, an individual in pain will experience pain reduction when exposed to a second pain stimulus, a mechanism known as Conditioning Pain Modulation (CPM). Patients with persistent pain have been found to have a reduced CPM reaction. It is not known if this is predictive of treatment response to SMT.

The aim of the study is to examine the effects of SMT on HRV and pain and to test if a CPM test can be used to predict treatment response, in a population of patients with recurrent and persistent NP.

Method/Design

A multicentre randomized controlled clinical trial will be carried out in multidisciplinary primary care clinics. This setting is chosen to minimize bias resulting from patient preference to treatment modality and provider.

The subjects are either self-referred or referred from other health care practitioners locally. The treatment modalities are two well-known interventions for NP; SMT and stretching exercises compared to stretching exercises alone.

The subjective pain experience will be investigated by assessing pain intensity and the affective quality of pain. HRV will be measured using a portable heart monitor and CPM will be measured with a standardized cold-pressor-test. Measurements will be performed at baseline, prior to the third treatment and after the fourth treatment.

Discussion

The study will utilize normal clinical procedures, which should aid transferability and external validity of the results. The study will provide knowledge regarding the underlying mechanisms of the effects of SMT. Furthermore, the study will examine if a CPM test is predictive of treatment outcome in a population of patients with recurrent and persistent NP.
Genotype × Environment Interactions of Industrial Hemp Cultivars Highlight Diverse Responses to Environmental Factors
Authors: Campbell Brian J. , Berrada Abdel F. , Hudalla Chris , Amaducci Stefano , McKay John K. 
Published: July 2019

Core Ideas
Some hemp traits are more strongly affected by environmental factors than others.
Multi‐environment testing is an integral part of hemp cultivar development.
Water availability can have a significant impact on yield and other traits.
Starting with the 2014 Farm Bill, hemp (Cannabis sativa L.) is being re‐introduced as an industrial crop in the United States. Since the crop has been absent for over 70 yr, little is known regarding the genetic mechanisms controlling economically relevant traits. Particularly, with federal legality of the crop hinging on a stringent tetrahydrocannabinol (THC) content of 0.3% or less, it is necessary to assess variance in this trait due to environmental effects and genotype × environment interactions (GEI) to avoid running afoul of federal law. Understanding how physical and biochemical traits respond to the environment also plays a strong role in selecting and developing appropriate cultivars for production in diverse growing regions. In 2016 we performed cultivar trials in multiple environments in Colorado to assess performance characteristics of a diverse set of germplasm from breeding programs across Europe and Asia. From these data, we were able to identify traits nearly entirely controlled by genetic factors, like days to maturity and THC and cannabidiol (CBD) production. We also identified traits strongly influenced by the environment and GEI, like grain yield, plant height, and water use. Individual cultivars also exhibited widely varying degrees of sensitivity to the environment. This underscores the importance of continued work to characterize genetic control of hemp traits to expedite breeding of cultivars that are well‐adapted to target growing regions.
Combination of Novel Mutation in FAD3C and FAD3A for Low Linolenic Acid Soybean
Authors: Held James P. , Carrero‐Colón Militza , Hudson Karen A. 
Published: July 2019

Core Ideas
New low linolenic soybean with novel alleles of FAD3A and FAD3C.
Mutation in GmFAD3C reduces linolenic acid levels.
Soybean FAD3C controls linolenic acid levels.
Conventional commodity soybean oil can typically have levels of linolenic acid up to 8% of the total oil fraction. As linolenic acid is unsaturated, unstable, and contributes to off‐flavors, and the hydrogenation process can produce harmful trans fats, genetic alternatives for soybean [Glycine max (L.) Merr.] low in linolenic acid are desirable. We identified a novel mutant allele of the gene encoding the omega‐3 desaturase FAD3C in a screen of a N‐nitroso‐N‐methylurea (NMU)‐mutagenized population. This allele resulted in a 2 to 3% reduction in linolenic acid levels as a fraction of the total fatty acids. We measured the effect of combining this mutation with mutations in the homeologous FAD3A desaturase gene on the soybean fatty acid profile. This FAD3C polymorphism may be useful to breeders seeking conventional approaches to reduce linolenic acid levels. In particular, combinations of mutant alleles of FAD3A and FAD3C result in soybean with linolenic acid comprising only 2 to 3% of the total fatty acids.
Fecal Indicator Bacteria and Antibiotic Resistance Genes in Storm Runoff from Dairy Manure and Compost‐Amended Vegetable Plots
Authors: Jacobs Kyle , Wind Lauren , Krometis Leigh‐Anne , Hession W. Cully , Pruden Amy 
Published: July 2019

Given the presence of antibiotics and resistant bacteria in livestock manures, it is important to identify the key pathways by which land‐applied manure‐derived soil amendments potentially spread resistance. The goal of this field‐scale study was to identify the effects of different types of soil amendments (raw manure from cows treated with cephapirin and pirlimycin, compost from antibiotic‐treated or antibiotic‐free cows, or chemical fertilizer only) and crop type (lettuce [Lactuca sativa L.] or radish [Raphanus sativus L.]) on the transport of two antibiotic resistance genes (ARGs; sul1 and ermB) via storm runoff from six naturally occurring storms. Concurrent quantification of sediment and fecal indicator bacteria (FIB; Escherichia coli and enterococci) in runoff permitted comparison to traditional agricultural water quality targets that may be driving factors of ARG presence. Storm characteristics (total rainfall volume, storm duration, etc.) significantly influenced FIB concentration (two‐way ANOVA, p < 0.05), although both effects from individual storm events (Kruskal–Wallis, p < 0.05) and vegetative cover influenced sediment levels. Composted and raw manure‐amended plots both yielded significantly higher sul1 and ermB levels in runoff for early storms, at least 8 wk following initial planting, relative to fertilizer‐only or unamended barren plots. There was no significant difference between sul1 or ermB levels in runoff from plots treated with compost derived from antibiotic‐treated versus antibiotic‐free dairy cattle. Our findings indicate that agricultural fields receiving manure‐derived amendments release higher quantities of these two “indicator” ARGs in runoff, particularly during the early stages of the growing season, and that composting did not reduce effects of ARG loading in runoff.Core Ideas
Compost and manure soil amendments elevated FIB and ARGs in storm runoff.
Composting manure prior to soil amendment did not reduce ARGs in runoff.
Antibiotic and antibiotic‐free composts had similar quantities of ARGs and FIB.
Vegetable type influenced sediment concentrations, but not FIB or ARGs, in runoff.
Storm characteristics affected both FIB and ARG levels.
The Effectiveness of Riparian Hedgerows at Intercepting Drift from Aerial Pesticide Application
Authors: Hancock Jaclyn , Bischof Matthew , Coffey Todd , Drennan Margaret 
Published: July 2019

The primary tool used currently for preventing pesticide drift from entering streams is a no‐spray buffer zone. Riparian hedgerows may provide an additional option; however, quantitative information on their effectiveness is limited. To quantify the potential benefit of riparian hedgerows for drift reduction, aerial malathion {diethyl 2‐[(dimethoxyphosphorothioyl)sulfanyl]butanedioate} applications on blueberry (Vaccinium corymbosum L.) farms with fields adjacent to streams or ditches were monitored. Drift from fields with extensive dense woody riparian vegetation was compared with drift from fields with no dense woody riparian vegetation. Overall, total instream malathion deposition was 96.1% lower at vegetated sites compared with nonvegetated sites. Univariable models identified six variables that were significantly related to decreasing instream total malathion deposition: increasing bank canopy cover, increasing average site canopy cover, increasing canopy angle, increasing the distance between the field edge and vegetation edge, increasing the distance between the field edge and center of stream, and decreasing bank slope. For the variables most feasible for landowners to alter, the following increases could result, on average, in a 26% decrease in the total instream malathion deposition: bank canopy cover (7%), distance between field and vegetation (0.3 m), and distance between field and center of stream (0.9 m). No‐spray buffer sizes needed for significant deposition reductions may be large, but for nonvegetated or minimally vegetated streams similar to those studied here, increasing bank canopy cover may give comparable advantages while allowing the use of the entire field area and conferring additional ecosystem benefits such as shading streams and improving habitat.Core Ideas
Instream pesticide deposition was significantly higher at nonvegetated sites.
Riparian vegetation can be used as a tool to mitigate pesticide loading to streams.
Increasing riparian canopy cover and angle may reduce pesticide drift into streams.
Future studies on drift reduction should reduce collinearity of variables.