bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regression of Pressure Overload‐Induced Cardiac Hypertrophy by Trientine‐Induced Copper Redistribution to the Heart in Rats
Authors: Liu Jiaming , Liu Yinjie , Fu Chunyan , Xiao Ying , Feng Qipu , Fan Suzhen , Ding Xueqin , Qiu Liying , Han Pengfei , Kang Y. James 
Published: November 2023

Sustained pressure overload leads to pathological cardiac hypertrophy and copper efflux from the heart with a simultaneous increase in plasma copper concentrations. We have observed that copper‐trientine complex increased copper uptake by primary cultures of neonatal rat cardiomyocytes. The present study was undertaken to test the hypothesis that trientine can redistribute copper from plasma to the copper‐depleted heart tissue. Adult male Sprague‐Dawley rats were subjected to ascending aortic constriction (AAC). Sixteen weeks after the operation, cardiac hypertrophy was observed by echocardiography. Trientine at a dose of 4.38 mg/kg, twice a day, was administered orally for 6 weeks. At the end of the treatment, copper concentrations were significantly increased in the heart along with a reduction of plasma copper concentrations. This copper repletion in the heart led to regression of cardiac hypertrophy as judged by IVSD and LVPWD, and recovery of cardiac contractile function as measured by EF and FS. In addition, cardiac fibrosis was also reduced as reflected by the decrease in the content of collagens type I and III and the reduced cross linking of the collagens. This study demonstrates that trientine, although traditionally considered as a copper chelator, is capable of redistributing copper from plasma to the heart, leading to regression of pathological cardiac hypertrophy.Support or Funding InformationSupported by National Science Foundation of China (81230004 and 81300109).
Zinc and Copper in Oral Submucous Fibrosis
Authors: Sachdev Prageet K , Freeland‐Graves Jeanne , Beretvas Natasha S , Sanjeevi Namrata 
Published: November 2023

Oral Submucous Fibrosis (OSMF) is a precancerous condition of the oral cavity that is characterized by inflammation and progressive fibrosis of the submucosal tissues. This chronic condition is more prevalent among South Asian population, but cases have also been identified in Europe and North America. The trace elements zinc (Zn) and copper (Cu), act as cofactors of antioxidant enzymes that are protective against free radicals. Studies have reported altered Zn and Cu in the body fluids of OSMF subjects; but findings are inconsistent. The objective of this research is to perform a meta‐analysis to summarize studies that report Zn and Cu status in subjects with and without OSMF. A literature search of Embase, PubMed, Cochrane library and Web of Science electronic databases was conducted for cross sectional, case‐controlled and prospective studies investigating the trace element concentrations in OSMF subjects up to November 2016. Values for these trace elements for control and patient groups were extracted. A total of 22 reports met the inclusion criteria, amounting to 44 effect sizes. Standardized mean difference, the bias corrected Hedges' g, was utilized as the effect size for the meta‐analysis. Robust Variance Estimation (RVE) method was chosen to handle dependency of multiple related outcomes in meta‐analysis. No publication bias was found from the funnel plot. Results suggested a significant increase in the levels of Cu (effect size= 2.70, p‐value <0.05, 95% Confidence Interval (CI): 0.371 — 5.032) and a significant decrease in levels of Zn (effect size= −1.57, p‐value <0.01, 95% CI: −2.676 — −0.459) in OSMF patients as compared to controls. The estimation of zinc and copper status may serve as an additional tool to understand OSMF along with the clinical features.Support or Funding InformationThe Bess Heflin Centennial Professorship
Multiple Low‐Level Metal Exposure and Indicators of Weight and Height in Uruguayan Urban School Children
Authors: Donangelo Carmen Marino , Queirolo Elena I , Mañay Nelly , Peregalli Fabiana , Kordas Katarzyna 
Published: November 2023

The contribution of chronic environmental lead and other toxic metal exposure to anthropometric status of children is unclear. Effects of multiple metal interactions at low levels of exposure are unknown. In this study, associations between concentrations of lead in blood, and of arsenic, cadmium, and manganese in hair, and indicators of weight and height status were examined in Uruguayan urban school children (n=290). Study recruitment, procedures and informed consent were approved by Institutional Ethical Committees. Fasting blood samples were collected, and lead in blood (BLL) was analyzed by GFAAS. Hair was cut close to the scalp with stainless steel scissors, from back of the head. Metals in hair were analyzed by ICPMS. Associations were examined by multifactor ANOVA and multiple regression analyses, with gender and tertiles of metal concentrations entered as factors into a single model, adjusted for serum ferritin corrected for C‐reactive protein. HAZ (height for age Z score), WAZ (weight for age Z score) and BAZ (body mass index for age Z score), were modeled separately. Children were 6–9 years old, 45% girls, non‐anemic, and with low iron reserves (median serum ferritin: 17.9 μg/L). Median Z scores of anthropometric measures were adequate (0.41, 0.70, 0.60, for HAZ, WAZ, BAZ, respectively), but with wide ranges between extreme values. Median (range) for BLL was 4.0 (0.8–13.2) μg/dL, and for hair metals: Mn 0.81 (0.06–25.7), As 0.052 (0.002–1.332), Cd 0.095 (0.005–0.8), μg/g. BLL was negatively associated with all 3 anthropometric Z scores (P≤0.003). Children at the lowest BLL tertile had higher mean Z scores than in each of the other tertiles (0.48 and 0.59 higher for HAZ; 0.77 and 0.60 for WAZ; 0.78 and 0.40 for BAZ). Hair Mn was positively associated with BAZ (P=0.017). Hair As tended to have a positive association with WAZ (P=0.0502). Exposure to low levels of lead may impair measures of anthropometric growth in children of school age. Interactions between low levels of combined metals exposure and anthropometric indices in children appear to be complex, and possibly related to nutritional status and other unknown factors.Support or Funding InformationNIEHS R21ES16523, R21ES019949
Nutritional Resilience Following the 2015 Earthquake in Nepal
Authors: Thorne‐Lyman Andrew L , Manohar Swetha , Shrestha Binod , Neupane Sumanta , Nonyane Bareng , Shrestha Sudeep , Webb Patrick , Klemm Rolf DW , West Keith P 
Published: November 2023

BACKGROUNDThe earthquake that hit Nepal in April, 2015, caused considerable structural damage and loss of life but little is known about the longer term impacts of the earthquake on nutritional status of preschool children and related risk factors. This analysis provides the first systematic national estimate of the nutritional situation in Nepal following the earthquake.OBJECTIVEIdentify individual, household and community level factors associated with stunting in Nepali children 6–59 months of age.METHODSThe Policy and Science for Health, Agriculture, and Nutrition (PoSHAN) study under the Nutrition Innovation Lab operating in Nepal has established a national agriculture‐to‐nutrition surveillance system comprising a representative sample of ~5500 households in 63 wards across 21 districts, 7 in each of the 3 agro‐ecological zones of the country. Within each ward, all households with a child under 5 years of age or a newly married woman were eligible for inclusion. We present data from three annual rounds of data collection conducted at the same sites in the same season each year (2013, 2014, and 2016), with <50% of 2016 data yet available at submission. Household agricultural, SES, dietary, anthropometric, program and other risk factor and resource data were collected each year. Child anthropometry included height and weight, with status expressed as height‐for‐age (HAZ) and weight‐for‐height or length (WHZ or WLZ) z‐scores against the WHO growth reference.RESULTSData is available for 5401 children surveyed in 2013, 5474 in 2014 and, to date, 2188 in 2016. Over the 3‐year period the national prevalence of stunting (<‐2HAZ) remained stable at 35.5%, 37.4%, and 34.6%, respectively. Wasting (<‐2 WHZ or WLZ) decreased from 17.7% to 16.3% to 12.9% in 2013, 2014 and 2016, respectively. The final analysis will isolate trends in agricultural productivity, household food security, dietary diversity and nutritional status by quake affected areas within zones.CONCLUSIONAvailable data from one year after the earthquake suggests that the earthquake was not associated with an increase in national rates of malnutrition, and are consistent with a reduction in wasting malnutrition over the three period.Support or Funding InformationSupported by USAID Feed the Future Innovation Lab for Nutrition
A Grandmother‐Inclusive Approach to Community Nutrition Education Improves Infant and Young Child Feeding Outcomes in Southern Sierra Leone
Authors: Wee Rebecca , Simba Joseph , Aidam Bridget , Gruenewald Christina , Aubel Judi , MacDonald Carolyn , Bangura Allieu S , Girard Amy Webb 
Published: November 2023

Suboptimal infant and young child feeding (IYCF) practices contribute to child undernutrition in Sierra Leone. We examined whether a grandmother‐inclusive approach to nutrition‐related social and behavior change could improve maternal diet and IYCF outcomes in southern Sierra Leone. The GM‐inclusive approach is grounded in formative ethnographic research and builds on GMs' culturally‐designated role as advisors and caregivers and aims to strengthen their knowledge and confidence to promote positive change for maternal and child health. Following mixed methods formative research, World Vision implemented a quasi‐experimental proof of concept study in two sections in the Bum Chiefdom, Bonthe Sierra Leone. The villages of one section received the grandmother‐inclusive approach consisting of monthly participatory nutrition education sessions with GM, quarterly community praise sessions focused on the attributes of and supportive roles of GM, the identification and support of GM leaders as change agents for maternal and child health and intergenerational forums. Villages in the control section received the standard of care for nutrition education provided by the Ministry of Health. The endline survey utilized a census based sampling strategy and surveyed all women in the study communities who were pregnant or had a child less than 2 years of age. Data were collected on household sociodemographics, maternal diet and IYCF knowledge, attitudes, and intentions/practices. Preliminary analyses examined differences in proportions between intervention and comparison participants with chi‐square. At endline, infants (n=291) were on average 11.8± 6.9 months of age and 52.2% were female. The proportion of 0–23 month olds exclusively breastfed during the first week of life was significantly higher in the intervention group (90.2% vs 79.4%, P=0.01) but there were no statistically significant differences in other breastfeeding practices. Among infants 6–23 months, the proportion achieving minimum dietary diversity (77.2% vs 51.8%, P<0.001) and minimum acceptable diet (53.8% vs 22.6%, P<0.001) was significantly higher in the intervention group. Differences in the proportions achieving minimum meal frequency were only significant for infants 9–23 months of age with a greater proportion of infants in the intervention group achieving minimum meal frequency (54.6% vs 36.9%, P=0.02). Preliminary analyses suggest that a grandmother‐inclusive approach that recognizes GMs' role in child nutrition and health and strengthens their knowledge can contribute to improved IYCF practices.Support or Funding InformationSupport provided by World Vision Canada, Nutrition Centre of Expertise, World Vision Germany, World Vision Sierra Leone and the Emory University Global Field Experiences Program.
Ethnicity and Socioeconomic Factors Are Associated with Poor Nutritional Status in Female Tea Plantation Workers from Rural India
Authors: Venkatramanan Sudha , Marquis Grace S , Haas Jere D 
Published: November 2023

Poor nutritional status is a major challenge for rural Indian women. The objective of the present study was to determine the association between the socioeconomic and nutritional status of female tea plantation workers from West Bengal, India.MethodsThis cross‐sectional survey collected data on the nutritional and socioeconomic status of 246 female tea plantation workers from Panighata tea garden, West Bengal. The participants were non‐pregnant female estate workers of Adivasi and Nepali ethnic groups who were full‐time, experienced, permanently employed tea pickers. Poor nutritional status or underweight was defined as BMI <18.5 wt/ht2 (kg/m2).ResultsThe prevalence of underweight was 57% and 17% in Adivasi and Nepali, respectively. The estimated odds (OR [95% CI]) of being underweight was 6.5 times greater in Adivasi compared to Nepali women (OR=6.5 [3.6, 11.7]; p=<0.0001). The odds of being underweight when toilet facilities were present were 70 percent lower than when the toilet facilities were not available (OR = 0.3 [0.1, 0.6]; p=0.002). Similarly, being underweight was negatively associated with the literacy of the spouse (OR = 0.3 [0.1, 0.7]; p=0.004). The effect of ethnicity on nutritional status was still significant after controlling for socioeconomic variables (OR=2.7 [1.1, 6.9]; p=0.03).ConclusionsPoor socioeconomic status and exposure to poor sanitation challenge the health of rural Indian women. Ethnicity is an additional barrier affecting the nutritional status of these tea plantation workers with the Adivasi tribal population at the greatest risk for underweight. To improve women's nutritional situation in rural India, it is important to implement comprehensive nutritional, educational, and health programmes considering the ethnic diversity along with the existing rural development policies and programmes.Support or Funding InformationSupported by the Mathile Institute for the Advancement of Human Nutrition and the Micronutrient Initiative
Cross Sectional Survey of Pregnant Adolescent Malnutrition in Rural Malawi
Authors: Patella Christine , Thakwalakwa Chrissie , Stoecker Barbara J 
Published: November 2023

The high rates of adolescent pregnancies in Malawi challenge the health and nutritional status for both the mother and infant. If an adolescent is unable to meet her own nutritional needs and becomes malnourished, this may lead to a continued cycle of complications. Research involving the nutritional status of pregnant adolescents in Malawi is lacking. The purpose of this study was to assess diet diversity and nutritional status in pregnant adolescents in rural Malawi. The study included sixty‐two pregnant adolescents. The mean age of the subjects was 17.7 years (SD 1.2). Of the sixty‐two subjects, 84% were married, 98% were not enrolled in school, and 92% were not working outside of the home. For 89% of the subjects, this was their first pregnancy. Data were collected using a pre‐tested questionnaire and a standardized dietary diversity survey. Mid‐upper arm circumference (MUAC), height, weight, and hemoglobin (Hgb) were measured. The mean (SD) MUAC was 25.9 (2.0) cm. The mean Hgb was 10.4 (1.9) g/dL and 66% had a Hgb lower than 11 g/dL. In this season of relatively available fruits and vegetables, the mean diet diversity score was 3.8 (3.2). Dietary intake results included 98% eating starchy staples, 62% eating dark leafy green vegetables, 56% eating Vitamin A rich fruits and vegetables, 89% eating other fruits and vegetables, 39% eating meat or fish, 31% eating legumes, nuts, or seeds, 6% eating eggs, and 0% eating milk or milk products. Of the sixty‐two subjects, 63% were not taking any vitamin/mineral supplements while 37% were taking ferrous sulfate. 35% restricted some foods during pregnancy, 52% received no advice regarding foods to eat during pregnancy, and 92% received no advice regarding infant and young child feeding (IYCF) practices. Interventions for pregnant adolescents should include nutrition education on dietary diversity, healthy nutrition during pregnancy, and IYCF guidelines.Support or Funding InformationSupported by Child Legacy International (CLI) and CLI Scholarship, Humphrey's Travel Grant, and Watkins' Matthew 25:40 Scholarship.
Utilizing a processing‐based diet index to measure change in BMI in a population undergoing a nutrition transition
Authors: Cooper Erica L , Baylin Ana , Jones Andrew 
Published: November 2023

Low‐ and middle‐income countries (LMICs) experiencing rapid shifts in dietary and physical activity patterns that characterize the nutrition transition are correspondingly contributing to an increase in obesity at a greater rate than high‐income countries. One of the principal defining characteristics of dietary change in LMICs has been an increase in the consumption of highly processed foods, which in turn has been implicated in the rising prevalence of obesity observed in these countries. However, identifying the relationship between food processing and obesity has proven difficult because current approaches for measuring the degree of processing in diets have been inadequate.This study used cross‐sectional primary data collection from participants enrolled in an ongoing three‐year longitudinal cohort study. Implementing the use of food frequency questionnaires, 24‐hour dietary recalls, and a novel processing‐based diet index (i.e., the Processed Food Dietary Index (PFDI)) to characterize the level of processing of diets among women of reproductive age (18–49 years) living in Montero, Bolivia, measurements to assess body mass index (BMI) and waist‐to‐hip ratio (WHR) were also collected to examine the association of the extent of processing of diets with prevalent obesity among these women.Participants were women that consumed a highly processed diet (n=80, mean ± standard deviation age 32.65 ± 8.68 years) or a minimally processed diet (n=80, mean ± standard deviation age 32.13 ± 9.28 years) as determined by baseline FFQs from their participation in the longitudinal cohort study. Upon enrollment in the cross‐sectional sub‐study, participants completed three non‐sequential 24‐hour dietary recalls and had their height, weight, waist and hip circumference measured by trained research assistants over the course of three in‐home visits during September‐October 2016. Mean BMI [calculated as kg/m2] and WHR [calculated as waist [cm]/hip [cm]] of participants that consumed a highly processed diet was 30.21 ± 5.42 and 0.84 ± 0.08, whereas mean BMI and WHR of participants that consumed a minimally processed diet was 28.91± 5.76 and 0.83 ± 0.08, respectively.This research is significant in that it utilizes a new paradigm of dietary pattern analysis to investigate the extent to which the processing level of diets may be associated with obesity. Intrinsically linked with the nutrition transition, food processing has provided freedom from the daily need to process raw commodities, contributing to societal growth and development. The knowledge attained through this study will inform public health efforts to mitigate the effects of dietary transitions on the increasing prevalence and persistence of obesity by motivating future behavioral change.
Economic development and associations with growth of preschool children in the Middle East and North African Region
Authors: Jones Rebecca Evelyn , Cunningham Solveig 
Published: November 2023

ObjectivesGlobally, populations are experiencing major economic and social changes, which are coinciding with increasing prevalence of obesity, even as under‐nutrition has not been fully eliminated. In this study, we investigate the associations between growth patterns among young children and economic development in the Middle East and North African(MENA) Region, a region demonstrating these rapid changes and experiencing high levels of obesity in adult populations.MethodsWe used nationally representative data from the most recent Demographic and Health Survey (2001–2014) in the seven countries of the MENA region (n=47,998) with available data (Azerbaijan, Egypt, Jordan, Mauritania, Morocco, Turkey, and Yemen). Survey‐adjusted multinomial logistic regression was used to quantify predictors of child growth measured in terms of stunting, thinness, and overweight. Measures of economic development were quantified Gross Domestic Product and Human Development Index and change therein during the previous 5‐years.ResultsAdjusting for child and household characteristics, children in countries categorized as low HDI were more likely to be stunted (1.80[1.54,2.03]). Children in countries categorized as high HDI were less likely to be stunted (0.37[0.34,0.40]) or thin (0.18[0.15,0.21]) but were not more likely to be overweight (0.27[0.23,0.30]). A 1000 USD change in GDP in the past 5 years was associated with a higher prevalence of overweight (15.6%) compared to no change (5%) and a 2000 USD change (4.8%).ConclusionsAs HDI increases, children are less likely to be stunted. Rapid economic change is associated with child over‐nutrition. National economic indicators are associated with child growth patterns even after accounting for household and individual characteristics.
A Reliable Instrument of Health Literacy in Hospitalized Patients: 3‐Question Brief Health Literacy Screen (BHLS)
Authors: Dikmen Derya , Madalı Berna , Özdemir Aslıhan , İnan‐Eroğlu Elif 
Published: November 2023

IntroductionHealth literacy is generally defined as the ability and motivation of individuals to access, understand and use basic health knowledge. Some studies showed that low health literacy is associated with longer average length of stay in hospital and less effective utilization of health care.AimThe purpose of this was to compare the health literacy levels of patients with Short Test of Functional Health Literacy in Adults (S‐TOFHLA), Rapid Estimate of Adult Literacy in Medicine (REALM) and 3‐Question Brief Health Literacy Screen (BHLS).MethodIn this study, individuals who were hospitalized comprised of 103 (42.9%) men and 137 (57.1%) women patients, ranged from 18 to 64 years (44.9±13.75 years). In this study, S‐TOFHLA, REALM and BHLS were used to determine patients' health literacy. Questions on socio‐demographic characteristics were also included.ResultsA total of 240 patients were recruited for the study. On the S‐TOFHLA, 65% of the patients had adequate health literacy. On the REALM, 50.4% of patients were able to read most of the patient education materials. According to BHLS 57.9 % of the patients were categorized as adequate health literacy. It was found that having lower education levels was more common among patients with lower health literacy compared with higher health literacy levels measured with BHLS (p<0.05), REALM (p<0.05) and S‐TOFHLA (p<0.05). There was a correlation between BHLS, REALM and S‐TOFHLA results (p=0.00).ConclusionThis is the first study that measures the health literacy levels of hospitalized patients with different health literacy tools. There was a linear relationship between the number of hospitalizations and the health literacy levels. According to our results BHLS provide consistent health literacy levels of hospitalized patients when we compare with S‐TOFHLA and REALM. It can be concluded BHLS is a reliable health literacy instrument.