bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying and Linking Patients At Risk for MASLD with Advanced Fibrosis to Care in Primary Care
Authors: Xiao Ted G. , Witek Lauren , Bundy Richa A. , Moses Adam , Obermiller Corey S. , Schreiner Andrew D. , Dharod Ajay , Russo Mark W. , Rudnick Sean R. 
Published: July 2024

Abstract

Background and Aims
Severity of fibrosis is the driver of liver-related outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD), and non-invasive testing such as fibrosis-4 (FIB-4) score is utilized for risk stratification. We aimed to determine if primary care patients at risk for MASLD and advanced fibrosis were evaluated with subsequent testing. A secondary aim was to determine if at-risk patients with normal aminotransferases had advanced fibrosis.

Methods
Primary care patients at increased risk for MASLD with advanced fibrosis (n = 91,914) were identified using previously established criteria. Patients with known alternative/concomitant etiology of liver disease or cirrhosis were excluded. The study cohort included patients with calculated FIB-4 score in 2020 (n = 52,006), and stratified into low, indeterminate, and high likelihood of advanced fibrosis. Among those at indeterminate/high risk, rates of subsequent testing were measured.

Results
Risk stratification with FIB-4 characterized 77% (n = 40,026) as low risk, 17% (n = 8847) as indeterminate, and 6% (n = 3133) as high risk. Among indeterminate/high-risk patients (n = 11,980), 78.7% (n = 9433) had aminotransferases within normal limits, 0.95% (n = 114) had elastography, and 8.2% (n = 984) were referred for subspecialty evaluation.

Conclusion
In this cohort of primary care patients at risk for MASLD with fibrosis, the FIB-4 score identified a substantial proportion of indeterminate/high-risk patients, the majority of which had normal aminotransferase levels. Low rates of subsequent testing were observed. These data suggest that a majority of patients at increased risk for liver-related outcomes remain unrecognized and highlight opportunities to facilitate their identification.
Disparities in Use of Novel Diabetes Medications by Insurance: A Nationally Representative Cohort Study
Authors: Bepo Lurit , Nguyen Oanh K. , Makam Anil N. 
Published: July 2024

Abstract
Background
Minority racial and ethnic populations have the highest prevalence of type 2 diabetes mellitus but lower use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1ra), novel medications that reduce morbidity and mortality. Observed disparities may be due to differences in insurance coverage, which have variable cost-sharing, prior authorization, and formulary restrictions that influence medication access.

Objective
To assess whether racial/ethnic differences in SGLT2i and GLP1ra use differ by payer.

Design
Cross-sectional analysis of 2018 and 2019 Medical Expenditure Panel Survey data.

Participants
Adults ≥ 18 years old with diabetes.

Main Measures
We defined insurance as private, Medicare, or Medicaid using ≥ 7 months of coverage in the calendar year. We defined race/ethnicity as White (non-Hispanic) vs non-White (including Hispanic). The primary outcome was use of ≥ 1 SGLT2i or GLP1ra medication. We used multivariable logistic regression to assess the interaction between payer and race/ethnicity adjusted for cardiovascular, socioeconomic, and healthcare access factors.

Key Results
We included 4997 adults, representing 24.8 million US adults annually with diabetes (mean age 63.6 years, 48.8% female, 38.8% non-White; 33.5% private insurance, 56.8% Medicare, 9.8% Medicaid). In our fully adjusted model, White individuals with private insurance had significantly more medication use versus non-White individuals (16.1% vs 8.3%, p < 0.001), which was similar for Medicare beneficiaries but more attenuated (14.7% vs 11.0%, p = 0.04). Medication rates were similar among Medicaid beneficiaries (10.0% vs 9.0%, p = 0.74).

Conclusions
Racial/ethnic disparities in novel diabetes medications were the largest among those with private insurance. There was no disparity among Medicaid enrollees, but overall prescription rates were the lowest. Given that disparities vary considerably by payer, differences in insurance coverage may account for the observed disparities in SGLT2i and GLP1ra use. Future studies are needed to assess racial/ethnic differences in novel diabetes use by insurance formulary restrictions and out-of-pocket cost-sharing.
Mountain research for sustainability: where are we and where to go?
Authors: Palau Anna Zango , Claramunt-López Bernat 
Published: July 2024

AbstractMountains have socio-economic and environmental importance for the entire world, and they are also one of the regions most threatened by global change. As mountains are systems in which the human and nature dimensions are tightly interconnected, studying them as social–ecological systems (SES) is increasingly common. To date, a variety of approaches and frameworks have been used to study mountain SES, making comparisons across mountain areas challenging. In this paper, we use Ostrom’s SES framework to review the mountain SES peer-reviewed literature under a common scope, aiming at unraveling which frameworks, approaches, domains, sectors, and elements are studied by researchers. Among the 169 reviewed manuscripts, only 28% of them employed a framework to study their system, and custom-made frameworks were preferred over existing ones. Although most research articles were in the domain of environmental sciences, socio-economic attributes were included more often than ecological ones, and more than 30% did not combine social and ecological information. Moreover, albeit most manuscripts had an empirical approach, field data were seldomly used. Future works should focus on collecting social and ecological data at comparable scales, as well as on developing tools to effectively integrate both dimensions in mountain SES studies. Finally, we examine components of mountain socio-ecological systems commonly addressed in literature, highlighting important elements for overall and sector-specific sustainability. Regarding social aspects, understanding local inhabitants’ diverse perspectives and socioeconomic context is crucial. In terms of ecological elements, describing climatic patterns and ecosystem history is key.
Regional agroecological stewardship: a framework to analyze the (re)territorialization of sustainable food systems
Authors: Ying William , Egermann Markus 
Published: July 2024

AbstractThe negative effects of climate change as well as the COVID-19 pandemic have underscored the fragility of the current global food system. To respond to such crises, the European Union’s (EU) “Farm to Fork” strategy strives to reshape the region’s food system to be more resilient and calls for new approaches to do so. The practices connected to the concepts of both agroecology and environmental stewardship are referenced for their potential to foster a transformation toward a more sustainable food system. However, these practices have been conducted on a small scale and independent from each other. A combined and holistic view of food systems based on the practices of both concepts remains missing. To close this gap, we developed a regional agroecological stewardship framework using the current literature to explore how these concepts can be combined to generate new insights for (re)territorialization by expanding agroecological practices beyond individual initiatives. To validate and refine the key components of the framework, we used an illustrative case study (Free State of Saxony, Germany) and interviewed relevant stakeholders including an agroecology expert, farm workers, network actors, and public officials from different governance levels. We identified actors and their motivations and capacity, a stewardship network, the outcomes of agroecological activities and the amplification of (re)territorialization as key components for regional agroecological stewardship. The framework can be used as an evaluation tool to assess the status of agroecological stewardship in a region and to determine regional challenges that need to be addressed.
On some properties of Cronbach’s α coefficient for interval-valued data in questionnaires
Authors: García-García José , Gil María Ángeles , Lubiano María Asunción 
Published: July 2024

AbstractAlong recent years, interval-valued rating scales have been considered as an alternative to traditional single-point psychometric tools for human evaluations, such as Likert-type or visual analogue scales. More concretely, in answering to intrinsically imprecise items in a questionnaire, interval-valued scales seem to allow capturing a richer information than conventional ones. When analyzing data from given performances of questionnaires, one of the main targets is that of ensuring the internal consistency of the items in a construct or latent variable. The most popular indicator of internal consistency, whenever answers to items are given in accordance with a numerically based/encoded scale, is the well-known Cronbach α coefficient. This paper aims to extend such a coefficient to the case of interval-valued answers and to analyze some of its main statistical properties. For this purpose, after presenting some formal preliminaries for interval-valued data, firstly Cronbach’s α coefficient is extended to the case in which the constructs of a questionnaire allow interval-valued answers to their items. The range of the potential values of the extended coefficient is then discussed. Furthermore, the asymptotic distribution of the sample Cronbach α coefficient along with its bias and consistency properties, are examined from a theoretical perspective. Finally, the preceding asymptotic distribution of the sample coefficient as well as the influence of the number of respondents to the questionnaire and the number of items in the constructs are empirically illustrated through simulation-based studies.
Quantitative evaluation of nicotine and particulate matter exposure for passive- and non-smokers via a nicotine passive sampler and a particulate matter sensor
Authors: Hoshino Saria , Noro Kazushi , Moriya Miyu , Komatsu Ayana , Wang Qi , Miyake Yuichi , Amagai Takashi 
Published: July 2024

AbstractPassive smoking poses a major hazard to the health of non-smokers. Cigarette combustion emits environmental tobacco smoke (ETS) that contains various pollutants, including volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons, and particulate matter with particles < 2.5 μm in aerodynamic diameter (PM2.5). Therefore, to assess the risk of passive smoking, it is necessary to determine the exposure levels to ETS compounds caused by passive smoking. However, it is difficult to assess exposure to ETS compounds by excluding the effects of other sources of pollution. In this study, we assessed the individual exposure levels to ETS compounds using a nicotine passive sampler and PM2.5 sensor in 258 non-smokers. Median nicotine and PM2.5 concentrations were 0.065 and 7.5 µg m− 3, respectively. The median nicotine concentration was nearly identical to that found in non-smoking areas (0.05 µg m− 3). The median PM2.5 concentrations were below the standard value for indoor PM2.5 concentrations (12 µg m− 3). These results indicated that the effect of passive smoking was rather modest. Nicotine concentrations in individuals exposed to passive smoking indoors were significantly higher than in those not exposed to passive smoking. Nicotine exposure from domestic passive smoking was twice that from non-domestic passive smoking. There was no significant difference in PM2.5 exposure between passive smoking in domestic and non-domestic settings. Moreover, it was suggested that passive smoking was equivalent to the act of smoking 2.4 × 10− 3 cigarettes per day.
Dairy and Headaches: What is the Connection?
Authors: Ceren Akgör Merve , Ekizoğlu Esme , Özge Aynur 
Published: July 2024

Abstract
Purpose of Reviews
Headaches represent a prevalent and burdensome health condition, affecting individuals of all ages worldwide. While dietary factors have been implicated in headache pathophysiology, the association between dairy consumption and headaches remains controversial and inadequately understood. This comprehensive review systematically examines the existing literature to elucidate the relationship between dairy intake and headaches, addressing methodological challenges, potential biases, and gaps in the current knowledge.

Recent Findings
A thorough search of electronic databases identified relevant observational studies, clinical trials, and mechanistic investigations exploring the impact of dairy consumption on headache incidence, frequency, severity, and duration. Methodological considerations, including study design, measurement of exposure and outcome variables, confounding factors, and sources of bias, were critically evaluated to assess the strength of evidence and validity of findings. Despite heterogeneity across studies, emerging evidence suggests a complex and multifaceted relationship between dairy intake and headaches, influenced by individual characteristics, dietary patterns, headache subtype, and study context. While some studies report a positive association between dairy consumption and headaches, others indicate no significant effect or potential therapeutic benefits of dairy restriction. Mechanistic insights suggest plausible biological mechanisms, including neuroinflammatory pathways, neurotransmitter modulation, vascular effects, and gut-brain interactions, which may mediate the observed associations.

Summary
Future research directions encompass longitudinal studies, mechanistic investigations, stratified analyses, randomized controlled trials, and exploration of the gut microbiota to further elucidate the underlying mechanisms and inform evidence-based dietary recommendations for headache management. This integrative review underscores the importance of interdisciplinary collaboration and personalized approaches to address the complex interplay between diet, headaches, and overall health.
Electrical vagus nerve stimulation is a promising approach to reducing pulmonary complications after an esophagectomy: an experimental rodent model
Authors: Janssen Henricus J. B. , Geraedts Tessa C. M. , Fransen Laura F. C. , van Ark Ingrid , Leusink-Muis Thea , Folkerts Gert , Garssen Johan , Ruurda Jelle P. , Nieuwenhuijzen Grard A. P. , van Hillegersberg Richard , Luyer Misha D. P. 
Published: July 2024

AbstractAfter esophagectomy, an imbalanced inflammatory response increases the risk of postoperative morbidity. The vagus nerve modulates local and systemic inflammatory responses, but its pulmonary branches are transected during esophagectomy as part of the oncological resection, which may account for the high incidence of postoperative (pulmonary) complications. This study investigated the effect of electrical vagus nerve stimulation (VNS) on lipopolysaccharide (LPS)-induced lung injury in rats. Rats (n = 60) were randomly assigned to a non-vagotomy or cervical vagotomy group, with VNS or without (NOSTIM). There were four non-vagotomy groups: NOSTIM and bilateral VNS with 100, 50, or 10 µA. The four vagotomy groups were NOSTIM and VNS with fixed amplitude (50 µA) bilaterally before (VNS-50-before) or after bilateral vagotomy (VNS-50-after), or unilaterally (left) before ipsilateral vagotomy (VNS-50-unilaterally). LPS was administered intratracheally after surgery. Pulmonary function, pro-inflammatory cytokines in serum, broncho-alveolar lavage fluid (BALF), and histopathological lung injury (LIS) were assessed 180 min post-procedure. In non-vagotomized rats, neutrophil influx in BALF following intra-tracheal LPS (mean 30 [± 23]; P = 0.075) and LIS (mean 0.342 [± 0.067]; P = 0.142) were similar after VNS-100, compared with NOSTIM. VNS-50 reduced neutrophil influx (23 [± 19]; P = 0.024) and LIS (0.316 [± 0.093]; P = 0.043). VNS-10 reduced neutrophil influx (15 [± 6]; P = 0.009), while LIS (0.331 [± 0.053]; P = 0.088) was similar. In vagotomized rats, neutrophil influx (52 [± 37]; P = 0.818) and LIS (0.407 [SD ± 0.037]; P = 0.895) in VNS-50-before were similar compared with NOSTIM, as well as in VNS-50-after (neutrophils 30 [± 26]; P = 0.090 and LIS 0.344 [± 0.053]; P = 0.073). In contrast, VNS-50-unilaterally reduced neutrophil influx (26 [± 10]; P = 0.050) and LIS (0.296 [± 0.065]; P = 0.005). Systemic levels of cytokines TNF-α and IL-6 were undetectable in all groups. Pulmonary function was not statistically significantly affected. In conclusion, VNS limited influx of neutrophils in lungs in non-vagotomized rats and may attenuate LIS. Unilateral VNS attenuated lung injury even after ipsilateral vagotomy. This effect was absent for bilateral VNS before and after bilateral vagotomy. It is suggested that the effect of VNS is dependent on (partially) intact vagus nerves and that the level of the vagotomy during esophagectomy may influence postoperative pulmonary outcomes.
Regulating to Exclude or to Enable: Institution Building and Transnational Standard Adoption in Mexican Food Safety
Authors: McDermott Gerald A. , Ruiz Belem Avendaño 
Published: July 2024

Abstract
A key challenge for integrating new transnational regulations into a semi-periphery country is creating institutional capacities for effective dissemination and monitoring of the standards and for upgrading a broad base of firms to implement and benefit from them. Instilled by NAFTA, Mexico embraced transnational food value chains, yet the results were rather mixed, as the vast majority of producers cannot implement new standards and participate. New rules and practices are not adopted on a tabula rasa but layered on prior socio-political institutions that are raw materials for new collaboration and blockage. We argue that improvements in both regulatory institutions and firm capabilities are driven by the creation of public–private learning communities, which in turn are shaped by prior institutional legacies at the public–private divide. The ability of producers to undertake organizational experiments with one another and key public actors is greatly constrained by the legacies of corporatism. Refashioned producer associations could initiate with certain local public institutions regulatory and technological upgrading for a limited number of firms, which became gatekeepers for certification.
Structure and Properties of Thermally Stabilized and Ecologically Friendly Organic Cotton Fibers as a New Activated Carbon Fiber Precursor
Authors: Hariri Hiba , Tunçel Kemal Şahin , Karacan Ismail 
Published: July 2024

AbstractOrganic cotton precursor yarn was impregnated in an aqueous solution consisting of diammonium hydrogen phosphate (DAP), boric acid (BA), and urea (U) mixtures before the thermal stabilization stage and then subjected to heat treatments in an air environment at 245 °C. The effect of chemical pretreatment on organic cotton yarn was examined using methods such as X-ray diffraction (XRD), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and infrared (IR) spectroscopy. The XRD analysis revealed a gradual decrease in the crystalline structure, attributed to the disruption of intermolecular hydrogen bonds. DSC and TGA measurements showed an improved thermal stability due to the formation of pre-graphitic structures with aromatic entities at higher temperatures. For samples chemically impregnated and then stabilized, the char yield values increased from 25% to 68% at 500 °C and 23% to 53% at 1000 °C. Analysis of IR spectra indicated a gradual reduction in both intermolecular and intramolecular hydrogen bonds associated with dehydration and dehydrogenation reactions. The IR spectra also confirmed a decrease in crystallinity with increasing oxidation time, which is consistent with the findings from X-ray diffraction. In addition, the IR spectra showed the presence of C = C bonds, indicating the formation of a crosslinked ladder-like structure. The results showed that DAP-BA-U integration increased the thermal stability of organic cotton fibers and the obtained samples were ready for the next stage, carbonization.
Graphical Abstract
Pottery use across the Neolithic transition in northern Belgium: evidence from isotopic, molecular and microscopic analysis
Authors: Teetaert Dimitri , Vannoorenberghe Marieke , Van de Velde Thomas , Boudin Mathieu , Bodé Samuel , Kubiak-Martens Lucy , Baert Mathijs , Lynen Frederic , Crombé Philippe , Boeckx Pascal 
Published: July 2024

AbstractThis study represents the first extensive residue analysis of prehistoric pottery from northern Belgium. It examines pottery use and culinary practices across the Mesolithic-Neolithic transition, from the late 6th to the early 4th millennium cal BC. Residue analyses were performed on more than 200 samples from nine archaeological sites, representing different cultural groups from this transitional phase. This includes the analysis of charred food residues encrusted on the vessel surfaces by elemental analysis-isotope ratio mass spectrometry (EA-IRMS), gas chromatography-mass spectrometry (GC-MS), stereomicroscopic analysis and Scanning Electron Microscopy (SEM), as well as the analysis of absorbed lipids by gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS). This study provides the first evidence of ruminant dairy fats in Early Neolithic Limburg pottery, supporting the hypothesis that this pottery was produced and used by LBK farmers rather than hunter-gatherer populations. The first indigenous pottery of the Swifterbant culture was frequently used to process freshwater fish (often together with plant foods) and ruminant meat, although several of the studied vessels likely contained mixtures of resources which could also include porcine products. Ruminant dairy is nearly absent from this pottery. Similar results were obtained for pottery of the subsequent Michelsberg culture/Group of Spiere of the late 5th and early 4th millennium cal BC. The limited presence of ruminant dairy fats in this pottery contrasts with the findings for Middle Neolithic pottery from neighbouring regions, providing further evidence for the existence of regional variations in pottery use or culinary practices throughout prehistoric NW Europe. However, our current view of pottery use during the Mesolithic-Neolithic transition in northern Belgium might be biased by the difficulties in distinguishing between wild and domesticated ruminant adipose fats as well as in detecting plant foods through lipid residue analysis.
Qualification of the attitude control system of the E-band CubeSat EIVE
Authors: Eggert M. , Bötsch-Zavřel L. , Fugmann M. , Holeczek C. , Koller M. T. , Kranz M. , Lengowski M. , Löffler T. , Loidold L.-M. , Maier P. , Meier J. , Mohr U. , Müller R. , Schweigert R. , Starzmann D. , Steinert M. , Zietz M. , Schoch B. , Haußmann S. , Tessmann A. , Freese J. , Klinkner S. 
Published: July 2024

AbstractThe 6U CubeSat EIVE was developed for the verification of an E-band link from space to ground. Establishing such a link presents challenging requirements for the development of an attitude control system of a CubeSat. To verify the functionality of its components, both the sensors and actuators, a number of tests were conducted prior to launch. These ranged from simple functionality tests to performance tests and were accompanied by calibration campaigns. Qualification of the attitude control algorithms proved to be a challenge, as a fitting simulator setup was not available. Therefore, limited tests comparing the onboard software code to MatLab algorithms were used. This paper presents the types of tests conducted during the qualification campaign and their significance. On-ground behavior is compared to in-orbit telemetry. The issues detected during ground tests as well as the issues achieving significant results from the tests are discussed and compared to the problems detected during launch and early orbit phase. These comparisons illustrate the shortcomings of some of the tests executed and improvements for the validity of some tests are presented.