bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated health benefits, costs and cost-effectiveness of eliminating dietary industrial trans fatty acids in Kenya: cost-effectiveness analysis
Authors: Marklund Matti , Aminde Leopold N , Wanjau Mary Njeri , Huang Liping , Awuor Celine , Steele Lindsay , Cobb Laura K , Veerman J Lennert , Wu Jason HY 
Published: October 2023

ObjectivesTo model the potential health gains and cost-effectiveness of a mandatory limit of industrial trans fatty acids (iTFA) in Kenyan foods.DesignMultiple cohort proportional multistate life table model, incorporating existing data from the Global Burden of Disease study, pooled analyses of observational studies and peer-reviewed evidence of healthcare and policy implementation costs.SettingKenya.ParticipantsAdults aged ≥20 years at baseline (n=50 million).InterventionA mandatory iTFA limit (≤2% of all fats) in the Kenyan food supply compared with a base case scenario of maintaining current trans fat intake.Main outcome measuresAverted ischaemic heart disease (IHD) events and deaths, health-adjusted life years; healthcare costs; policy implementation costs; net costs; and incremental cost-effectiveness ratio.ResultsOver the first 10 years, the intervention was estimated to prevent ~1900 (95% uncertainty interval (UI): 1714; 2148) IHD deaths and ~17 000 (95% UI: 15 475; 19 551) IHD events, and to save ~US$50 million (95% UI: 44; 56). The corresponding estimates over the lifespan of the model population were ~49 000 (95% UI: 43 775; 55 326) IHD deaths prevented, ~113 000 (95% UI: 100 104; 127 969) IHD events prevented and some ~US$300 million (256; 331) saved. Policy implementation costs were estimated as ~US$9 million over the first 10 years and ~US$20 million over the population lifetime. The intervention was estimated to be cost saving regardless of the time horizon. Findings were robust across multiple sensitivity analyses.ConclusionsFindings support policy action for a mandatory iTFA limit as a cost-saving strategy to avert IHD events and deaths in Kenya.
Spatial multilevel analysis of age at death of under-5 children and associated determinants: EDHS 2000–2016
Authors: Agidew Bezawit Tarekegn , Belay Denekew Bitew , Tesfaw Lijalem Melie 
Published: October 2023

ObjectiveThis study examines trends, spatial distribution and determinants of age at death of under-5 children in Ethiopia.DesignThis study used secondary data from the 2000, 2005, 2011 and 2016 Ethiopian Demographic and Health Surveys. A multilevel partial ordinal logistic regression model was used to assess the effects of variables on the age at death of children under 5 years.SettingEthiopia.ParticipantsThe final analysis included a sample of 3997 deaths of newborns, infants and toddlers.ResultsA total of 1508, 1054, 830 and 605 deaths of under-5 children were recorded in the 2000, 2005, 2011 and 2016 survey years, respectively. The death of newborns, infants and toddlers showed a significant decrease from 2000 to 2016, with reductions of 33.3% to 17.4%, 42.4% to 12.6% and 45.2% to 11.6%, respectively. The analysis using Global Moran’s Index revealed significant spatial autocorrelation in mortality for each survey year (p<0.05). The intraclass correlation of age at death of under-5 children within regions was substantial. Furthermore, the odds of newborn deaths among under-5 children (OR: 0.638, 95% CI: 0.535, 0.759) were lower for those delivered in health institutions compared with those delivered at home.ConclusionsThroughout the survey years from 2000 to 2016, newborn children had higher mortality rates compared with infants and toddlers, and significant spatial variations were observed across different zones in Ethiopia. Factors such as child’s sex, age of mother, religion, birth size, sex of household head, place of delivery, birth type, antenatal care, wealth index, spatial autocovariate, Demographic and Health Survey year, place of residence and region were found to be significant in influencing the death of under-5 children in Ethiopia. Overall, there has been a decreasing trend in the proportion of under-5 child mortality over the four survey years in Ethiopia.
Work characteristics and emotional exhaustion among young workers: a latent class analysis
Authors: van Veen Malte , Schelvis Roosmarijn MC , Hoekstra Trynke , Bongers Paulien M , Boot Cécile RL , Oude Hengel Karen M 
Published: October 2023

ObjectivesThis study aims to assess the heterogeneity of psychosocial working conditions of young workers by identifying subgroups of work characteristic configurations within young workers and to assess these subgroups’ associations with emotional exhaustion.DesignLatent class analysis. Groups were formed based on 12 work characteristics (8 job demands and 4 job resources), educational level and sex. Differences in emotional exhaustion between subgroups were analysed using analysis of variance and post hoc comparisons.SettingData from the 2019 wave of the Netherlands Working Conditions Survey.Participants7301 individuals between the age of 18 and 30 years, who worked more than 16 hours per week.Main outcome measureEmotional exhaustion.ResultsFive subgroups of work characteristics could be identified and were labelled as: (1) ‘low-complexity work’ (24.4%), (2) ‘office work’ (32.3%), (3) ‘manual and non-interpersonal work’ (12.4%), (4) ‘non-manual and interpersonal work’ (21.0%), and (5) ‘manual and interpersonal work’ (9.9%). Mean scores for emotional exhaustion in the two interpersonal work groups (M=3.11, SD=1.4; M=3.45, SD=1.6) were significantly higher than in the first three groups (M=2.05, SD=1.1; M=1.98, SD=1.0; M=2.05, SD=1.1) (all 95% CIs excluding 0). Further, mean scores for emotional exhaustion were significantly higher in the ‘manual and interpersonal work’ group than in the ‘non-manual and interpersonal work’ group (95% CI 0.24, 0.45). All results could be replicated in the 2017 and 2021 waves of the Netherlands Working Conditions Survey.ConclusionsYoung workers reported heterogeneous work characteristic configurations with substantial differences in degrees of emotional exhaustion between the identified subgroups. Preventing emotional exhaustion should focus on the two interpersonal work subgroups, which showed a high degree of emotional exhaustion. In prevention efforts, these groups’ configurations of work characteristics should be taken into account.
Associations Between Albuminuria and Mortality Among US Adults by Demographic and Comorbidity Factors
Authors: Drexler Yelena , Tremblay Julien , Mesa Robert A. , Parsons Bailey , Chavez Efren , Contreras Gabriel , Fornoni Alessia , Raij Leopoldo , Swift Samuel , Elfassy Tali 
Published: October 2023

Background
Albuminuria is a known marker of mortality risk. Whether the association between albuminuria and mortality differs by demographic and comorbidity factors remains unclear. Therefore, we sought to determine whether albuminuria is differentially associated with mortality.

Methods and Results
This study included 49 640 participants from the National Health and Nutrition Examination Survey (1999–2018). All‐cause mortality through 2019 was linked from the National Death Index. Multivariable‐adjusted Poisson regression models were used to determine whether levels of urine albumin‐to‐creatinine ratio (ACR) were associated with mortality. Models were adjusted for demographic, socioeconomic, behavioral, and clinical factors. Mean age in the population was 46 years, with 51.3% female, and 30.3% with an ACR ≥10 mg/g. Over a median follow‐up of 9.5 years, 6813 deaths occurred. Compared with ACR <10, ACR ≥300 was associated with increased risk of mortality by 132% overall (95% CI, 2.01–2.68), 124% among men (95% CI, 1.84–2.73), 158% among women (95% CI, 2.14–3.11), 130% among non‐Hispanic White adults (95% CI: 1.89–2.79), 135% among non‐Hispanic Black adults (95% CI, 1.82–3.04), and 114% among Hispanic adults (95% CI, 1.55–2.94). Compared with ACR <10, ACR ≥300 was associated with increased risk of mortality by 148% among individuals with neither hypertension nor hypercholesterolemia (95% CI, 1.69–3.64), 128% among individuals with hypertension alone (95% CI, 1.86–2.79), and 166% among individuals with both hypertension and hypercholesterolemia (95% CI, 2.18–3.26).

Conclusions
We found strong associations between albuminuria and mortality risk, even at mildly increased levels of albuminuria. Associations persisted across categories of sex, race or ethnicity, and comorbid conditions, with subtle differences.
Age‐Stratified Prevalence and Relative Prognostic Significance of Traditional Atherosclerotic Risk Factors: A Report from the Nationwide Registry of Percutaneous Coronary Interventions in Japan
Authors: Kanenawa Kenji , Yamaji Kyohei , Kohsaka Shun , Ishii Hideki , Amano Tetsuya , Ando Kenji , Kozuma Ken 
Published: October 2023

Background
The prevalence of traditional atherosclerotic risk factors (TARFs) and their association with clinical profiles or mortality in percutaneous coronary intervention remain unclear.

Methods and Results

The study analyzed 559 452 patients who underwent initial percutaneous coronary intervention between 2012 and 2019 in Japan. TARFs were defined as male sex, hypertension, dyslipidemia, diabetes, smoking, and chronic kidney disease. We calculated the relative importance according to
R
2
and machine learning models to assess the impact of TARFs on clinical profile and in‐hospital mortality. The relative contribution (RC) of each TARF was defined as the average percentage of the relative importance calculated from these models. The age‐specific prevalence of TARFs, except for chronic kidney disease, formed an inverted U‐shape with significantly different peaks and percentages. In the logistic regression model and relative risk model, smoking was most strongly associated with acute myocardial infarction (adjusted odds ratio [OR], 1.62 [95% CI, 1.60–1.64]; RC, 47.1%) and premature coronary artery disease (adjusted unstandardized beta coefficient, 2.68 [95% CI, 2.65–2.71], RC, 42.2%). Diabetes was most strongly associated with multivessel disease (adjusted unstandardized beta coefficient, 0.068 [95% CI, 0.066–0.070], RC, 59.4%). The absence of dyslipidemia was most strongly associated with presentation of cardiogenic shock (adjusted OR, 0.62 [95% CI, 0.61–0.64], RC, 34.2%) and in‐hospital mortality (adjusted OR, 0.44 [95% CI, 0.41–0.46], RC, 39.8%). These specific associations were consistently observed regardless of adjustment or stratification by age.

Conclusions
Our analysis showed a significant variation in the age‐specific prevalence of TARFs. Further, their contribution to clinical profiles and mortality also varied widely.
Previous Ischemic Stroke Significantly Alters Stroke Risk in Newly Diagnosed Cancer Patients
Authors: Lun Ronda , Cerasuolo Joshua O. , Carrier Marc , Gross Peter L. , Kapral Moira K. , Shamy Michel , Dowlatshahi Dar , Sutradhar Rinku , Siegal Deborah M. 
Published: October 2023

BACKGROUND:
Previous ischemic stroke (IS) is a risk factor for subsequent IS in the general population; it is unclear if this relationship remains true in patients with cancer. Our objective was to examine the association between previous IS and risk for future IS in individuals newly diagnosed with cancer.

METHODS:
We conducted a retrospective population-based matched cohort study of newly diagnosed adult cancer patients (excluding nonmelanoma skin cancers and primary central nervous system tumors) in Ontario, Canada from 2010 to 2020; those with prior IS were matched (1:4) by age, sex, year of cancer diagnosis, cancer stage, and cancer site to those without a history of stroke. Cumulative incidence function curves were created to estimate the incidence of IS. Subdistribution adjusted hazard ratios (aHRs) and 95% CIs were calculated, where death was treated as a competing event. Multivariable analysis was adjusted for imbalanced baseline characteristics.

RESULTS:
We examined 65 525 individuals with cancer, including 13 070 with a history of IS. The median follow-up duration was 743 days (interquartile range, 177–1729 days). The incidence of IS following cancer diagnosis was 261.3/10 000 person-years in the cohort with prior IS and 75.3/10 000 person-years in those without prior IS. Individuals with prior IS had an increased risk for IS after cancer diagnosis compared with those without a history (aHR, 2.68 [95% CI, 2.41–2.98]); they also had more prevalent cardiovascular risk factors. The highest risk for stroke compared with those without a history of IS was observed in the gynecologic cancer (aHR, 3.84 [95% CI, 2.15–6.85]) and lung cancer (aHR, 3.18 [95% CI, 2.52–4.02]) subgroups. The risk of IS was inversely correlated with lag time of previous stroke; those with IS 1 year before their cancer diagnosis had the highest risk (aHR, 3.68 [95% CI, 3.22–4.22]).

CONCLUSIONS:
Among individuals with newly diagnosed cancer, those with IS history were almost 3× more likely to experience a stroke after cancer diagnosis, especially if the prediagnosis stroke occurred within 1 year preceding cancer diagnosis.
The Canadian ‘War of the Two Sugars’: Homegrown Sugar Beets and the Racial Stratification of Labour
Authors: Komori Jane 
Published: October 2023

Abstract
This paper provides a history of more than a century of efforts to establish and maintain a homegrown Canadian sugar supply – a twentieth-century version of what Eric Williams called the ‘war of the two sugars’, or the global competition between sugar beet and cane. To resolve beet sugar’s so-called ‘labour problem’, the industry has collaborated with the Canadian state to produce new classes of temporary workers, mobilising incarcerated Japanese Canadians, migrant Indigenous families, and Mexican and Caribbean workers employed through the Seasonal Agricultural Worker Program. At the same time, the sugar industry has sought to refine itself of the racialised workers upon whom it relies by promoting the figure of the white Canadian worker. The Canadian ‘war of the two sugars’ has been fought through the stratification of the labour force along the lines of citizenship, resulting in the production of unique racial forms.
The Practice of Pluralism: How Ritual Strengthens Democratic Politics
Authors: Gillin Joel 
Published: October 2023

Abstract
This article argues that ritual can play a positive role in democratic politics in conditions of pluralism. It situates discussions of ritual and pluralism in the context of anthropological and social theory. It examines two insights scholars have made with regards to ritual that make it both compatible with and enabling of pluralism: ritual creates cohesion without agreement and a ‘subjunctive’ space for managing ambiguity. Finally, it develops an account of how these important social benefits of ritual are connected to a democratic pluralist politics, especially its formal, institutional dimensions. Drawing on the work of Luke Bretherton and Chantal Mouffe, it argues that ritual can strengthen the informal dimensions of citizenship and thus affective bonds toward the political community. The claim is also made that ritual constructs shared discourse by creating forms of life from which agreement can emerge in discursive political contexts.
Post-Apartheid South Africa and its Contribution to African Peace and Security
Authors: Biao Opeoluwa 
Published: October 2023

Abstract
This study has two main research questions. (i) Which factors have led to post-apartheid South Africa developing the Developmental Peacekeeping (DP) and Post-conflict reconstruction and development (PCRD) peace and security strategies? (ii) Has post-apartheid South Africa’s peace and security innovations led to the resolution of African conflicts? These two questions were answered. First, using a thematic qualitative method approach, we found out that post-apartheid South Africa has, since 1994, been innovative to find permanent solutions to African crises. The second research question unravels that what is observable and discernable from the literature is that there is a sort of dependence on the Republic of South Africa because of its power capabilities. The theory that guides this study is the International Relations Structural Realism as advanced by Kenneth Waltz. The theory was tested for its efficacy in an African peace and security context. Although the paper does not perform a confirmation of the theory, it suggests that the Rational Persuasion theory (KP = W) be considered as a route that can be taken by African states in their quest for Continental peace.
Phylogenetic relationships and historical biogeography of Otus species based on mitochondrial cytochrome b gene sequence
Authors: Daipan Bernard Peter O. , Lambio Ivy Amor F. , Gonzales Juan Carlos T. , Pampolina Nelson M. 
Published: October 2023

Abstract
This study analyzed mitochondrial cytochrome b gene sequences to infer Otus species’ phylogenetic relationships and historical biogeography. The researchers used Maximum Parsimony and Maximum Likelihood methods to generate the phylogenetic trees. They constructed a Bayesian MCC Chronogram Tree to determine the Otus species’ age and speciation events. Paleoclimate and paleogeology maps were also used to correlate the branching out of Otus species with geological time periods and climatic conditions. The results showed five major clusters or clades for the core taxon group (Otus) and one for the sister group (Tyto). The Bayesian tree showed seven major clades for Otus, with the first speciation occurrence dating back to 21.54 mya during the Early Miocene epoch. Most of the core taxon species speciated during the Pliocene Period, with some exceptions. The paleoclimate data indicated that Otus clades branched out during the Icehouse climate state, with the first branching out occurring during the Coolhouse climatic state. The paleogeologic data revealed that the African and American (North and South) continents were already distinct and divided by the Atlantic Ocean during the first branching out of the Otus clade. The distribution areas of Otus species were also mapped using updated Wallace’s zoogeographic realms. Overall, this study provides a better understanding of the phylogenetic history of Otus species and their diversification in relation to geological and climatic events. However, the authors caution that all phylogenetic trees, evolutionary studies, and divergence time estimates should be considered hypotheses with significant uncertainty.
Bioaccumulation of heavy metals in water and organs of Tilapia brevimanus and Euthynnus alletteratus from a coaster water in southwestern Nigeria
Authors: Njinga Raymond L. , Adebayo Adebiyi S. , Olufemi Ayodele P. 
Published: October 2023

AbstractThe bioaccumulation of some heavy metals in coaster waters directly affects the ecosystem and human beings. Thus, the objectives of this study are to evaluate the interaction between fish and coastal water and assess the long-term implications of human consumption of some major organs obtained from Tilapia brevimanus and Euthynnus alletteratus. The study determined the concentrations of arsenic (As), cadmium (Cd), chromium (Cr), and lead (Pb) in twenty coaster water samples collected from two points and in the muscle, gills, and intestine of ten pieces of Tilapia brevimanus and ten pieces of Euthynnus alletteratus using a Perkin Elmer Model 306 Atomic Absorption Spectrometer. Furthermore, the accumulation of these metals and the assessment of the long-term implications of human consumption of the designated organs of the two species types were performed. The statistical significance level of the obtained results was determined using the T-test analysis tool, which revealed that the distribution of the metals varies in different organs of the fish species. The levels of pollutants were higher in Tilapia brevimanus organs than in Euthynnus alletteratus. The contents of As, Cd, Cr, and Pb in the gills were higher than those in the muscle. Also, the metal pollution index in the organs followed the order of intestine > gills > muscle for both Tilapia brevimanus and Euthynnus alletteratus, posing serious health risks.
Relation between red blood cell distribution width and 30-day in-hospital mortality of patients with ventilator-associated pneumonia
Authors: Li Zhonghua , Yang Liping , Xu Qin , Wu Feifei 
Published: October 2023

Abstract
Background
Epidemiological studies have demonstrated an association between red blood cell distribution width (RDW) and the prognosis of pneumonia-associated diseases. However, prognostic value of RDW in patients with ventilator-associated pneumonia (VAP) has yet to be investigated. This study aimed to explore the association between RDW and in-hospital mortality in VAP patients and explore predictive value of RDW for VAP patients.

Methods
This retrospective cohort study included 1,543 VAP patients from the Medical Information Mart for Intensive Care IV database 2008-2019. The primary outcome was considered to 30-day in-hospital mortality of VAP patients in this study. Non-high RDW level group was defined as <15 %, and high RDW level group as ≥15%. The possible confounding factors were screened by least absolute shrinkage and selection operator regression. Univariate and multivariate COX regression analyses were used for the assessment on the association of RDW and 30-day in-hospital mortality in VAP patients. We also performed subgroup analyses. Furthermore, a comparative analysis of RDW and sequential organ failure assessment (SOFA) score and simplified acute physiology score II (SAPS II) were performed by receiver operating characteristic (ROC) curves.

Results
The 30-day in-hospital mortality of VAP patients was approximately 19.05%. After adjusting all confounding factors, high RDW was associated with 30-day in-hospital mortality among VAP patients by using non-high RDW as the reference [hazard ratio (HR) =1.29, 95% confidence interval (CI): 1.01-1.63]. Additionally, the relationship was also robust in several populations, such as patients were younger than 60 years, or had not a history of congestive heart failure, or had a history of sepsis, or had not received renal replacement therapy, or had a duration of mechanical ventilation for more than 7 days. The result of ROC indicated that RDW had a better prognostic value in predicting 30-day in-hospital mortality for VAP patients than SOFA score and SAPS II score.

Conclusion
High RDW level is associated with an increased 30-day in-hospital mortality. The RDW is a promising biomarker in predicting 30-day in-hospital mortality for patients admitted to the ICU, regardless of VAP.