bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitigating Weight Bias in the Clinical Setting: A New Approach to Care
Authors: Olson Signey M. , Muñoz Elizabeth G. , Solis Ellen C. , Bradford Heather M. 
Published: December 2023

AbstractWeight bias toward patients in larger bodies is pervasive among health care providers and can negatively influence provider‐patient communication, as well as patients’ behavior and health outcomes. Weight bias has historical roots that perpetuate thinness and Whiteness as the cultural norm. Although weight bias remains socially acceptable in US culture, contributing factors to an individual's body size are complex and multifactorial. Providers and health care systems also consistently use body mass index (BMI) as an indicator of health status, despite its limitations and harmful effects in the clinical setting. This state of the science review presents 8 evidence‐based strategies that demonstrate how to mitigate harm from weight bias and improve quality of care and health outcomes for patients living in larger bodies. Person‐centered approaches to care include (1) eliminating clinical recommendations to lose weight; (2) shifting from a focus on weight to health; (3) implementing a size and weight‐inclusive approach; (4) engaging in weight bias self‐evaluation; (5) creating a welcoming environment for patients of all sizes; (6) seeking permission and learning the patient's story; (7) using weight‐inclusive language; and (8) re‐evaluating clinical guidelines and policies based on BMI. Midwives and other health care providers may benefit from training that re‐imagines the delivery of health care to patients in larger bodies.
Clinical impact of unsuccessful subcutaneous administration of octreotide LAR instead of intramuscular administration in patients with metastatic gastroenteropancreatic neuroendocrine tumors
Authors: Krishnan Tharani , Safro Maria , Furlanetto Daniel Moreira , Gill Sharlene , Solar Vasconcelos Joao Paulo , Stuart Heather C. , Martineau Patrick , Loree Jonathan M. 
Published: December 2023

AbstractOctreotide LAR is a long‐acting somatostatin analogue (SSA) used in the management of metastatic gastroenteropancreatic neuroendocrine tumors (GEP NETs). It requires intramuscular (IM) injection. Missed IM injections cause subcutaneous nodules (SCNs) on radiologic images. We reviewed the rates of SCNs in a real‐world cohort of GEP NETs receiving octreotide LAR and explored treatment outcomes. Patients commencing octreotide LAR between August 5, 2010 and March 8, 2018 at a single cancer center in Canada were identified from pharmacy records. Patients were included if they had a computed tomography (CT) scan performed at the time of progression and a preceding CT with pelvis included to enable assessment for the presence of nodules. Fisher's exact test was used to examine predictors of SCNs, and Kaplan–Meier curves summarized differences in progression free (PFS) and overall survival (OS) that were compared with log‐rank tests. Of 243 patients receiving octreotide LAR, 45 had all required CT images available for central review. SCNs were found in 20/45 (44%) of patients on the last scan showing stable disease before progression and were numerically but not statistically more likely in females (OR: 2.36, 95% CI: 0.66–8.29, p = .23). There was an increased risk of SCNs in patients with a skin‐to‐muscle distance >38 mm (the length of an octreotide LAR needle) on CT (OR: 5.09, 95% CI: 1.39–16.6, p = .018) and a trend toward increased risk in obese patients (OR: 5.71, 95% CI: 1.26–23.4, p = .061). PFS (HR: 1.01, 95% CI: 0.56–1.78, p = .98) and OS (HR: 0.86, 95% CI: 0.41–1.8, p = .70) was similar between those with/without SCNs. In conclusion, almost half of patients receiving octreotide LAR had SCNs; however, missed administration of SSA did not appear to result in worse survival in this small study. Factors such as sex, younger age skin‐to‐muscle distance, and obesity may affect SCN development and should be considered when choosing an SSA.
School‐Based Services May Eliminate Substance Treatment Disparities: Results From a Nonrandomized Program Evaluation
Authors: Thurstone Christian , Loh Ryan , O'Leary Sonja , Bruce Sophia , Ladegard Kristie 
Published: December 2023

ABSTRACTBackgroundThere are known health disparities in adolescent substance treatment access and engagement. The purpose of this project is to compare outcomes from school‐ and clinic‐based substance treatment and to evaluate if providing school‐based substance treatment reduces disparities in treatment access and engagement.MethodThis quality improvement retrospective chart review compares baseline and outcome data for adolescents accessing school‐based (n = 531) and clinic‐based (n = 523) substance treatment in a natural quasi‐experimental study with nonequivalent control group design. Baseline demographic and clinical measures include age, sex, ethnicity, race, and clinical diagnoses. Outcome measures include the number of sessions completed, proportion reaching a week of self‐reported abstinence, and proportion providing a negative urine drug screen.ResultsCompared to the clinic‐based sample, the school‐based sample includes more female (47.65% vs 26.77%) and Hispanic/Latinx (59.89% vs 46.46%) adolescents. The school‐based group has a similar proportion reaching a negative urine drug screen (31.84% vs 28.83%, p = .5259) or a week of abstinence (43.15% vs 41.03%, p = .6718) as the clinic‐based sample. There are significant differences in total session completion over a period of 16 weeks between school‐based and clinic‐based adolescents. In multivariable analyses, there was a significant interaction effect of race/ethnicity by location on the number of sessions completed.ConclusionProviding school‐based substance treatment increases access to care and treatment engagement for female, African American, and Hispanic/Latinx adolescents without diminishing outcomes.
Engagement, Mental Health, and Substance Use Under In‐Person or Remote School Instruction During the COVID‐19 Pandemic
Authors: Chaffee Benjamin W. , Cheng Jing , Couch Elizabeth T. , Halpern‐Felsher Bonnie 
Published: December 2023

ABSTRACTBACKGROUNDAdolescents' school engagement, mental health, and substance use have been major concerns during the COVID‐19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health‐related outcomes within an adolescent cohort followed during the pandemic.METHODSDuring 3 semi‐annual follow‐up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self‐efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting.RESULTSRelative to in‐person instruction, students in remote instruction reported lower academic self‐efficacy (Beta: −0.11; 95% confidence interval [CI]: −0.22, −0.01) and school connectedness (Beta: −0.37; 95% CI: −0.48, −0.25), greater odds of past 30‐day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30‐day e‐cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86).CONCLUSIONSMultiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources.
Effect of 5′‐adenosine monophosphate‐activated protein kinase agonists on insulin and glucose dynamics in experimentally induced insulin dysregulation in horses
Authors: Pinnell Erin F. , Hostnik Laura D. , Watts Mauria R. , Timko Kathryn J. , Thriffiley Allison A. , Stover Mercedes R. , Koenig Lauren E. , Gorman Olivia M. , Toribio Ramiro E. , Burns Teresa A. 
Published: December 2023

AbstractBackground5′‐adenosine monophosphate‐activated protein kinase (AMPK) agonists, particularly resveratrol (RES), have not been extensively evaluated for their effect on insulin dysregulation (ID) in horses.ObjectivesEvaluate the effects of treatment with RES (10 mg/kg PO q12h), metformin (MET; 30 mg/kg PO q12h), and aspirin (ASP; 20 mg/kg PO q24h) on experimentally induced ID.AnimalsThirty‐three healthy, adult, light‐breed horses.MethodsUnblinded, placebo‐controlled, experimental trial evaluating effects of AMPK agonists (RES, MET, and ASP) on experimentally induced ID. Horses were randomly assigned to a treatment group (RES, MET/ASP, RES/ASP, RES/MET/ASP, or placebo [CON]) after induction of ID with dexamethasone (0.08 mg/kg PO q24h for 7 days). Frequently sampled insulin‐modified IV glucose tolerance tests (FSIGTT) and oral sugar tests (OST) were performed at baseline, 7 days after ID, and ID plus 7 days of treatment. Minimal model and OST variables were compared between (1‐way ANOVA) and within (1‐way ANOVA for repeated measures) groups over time to determine effects of treatment on ID.ResultsAdministration of dexamethasone for 14 days resulted in significantly altered insulin and glucose dynamics (SI, DI, basal [glucose], and [insulin]) and produced clinical signs of laminitis in 5 out of 33 (15%) of horses included in the study. Combination therapy with RES, MET, and ASP did not significantly improve insulin and glucose dynamics in horses with experimentally induced ID.Conclusions and Clinical ImportanceMetabolic testing before glucocorticoid administration should be considered in horses with clinical signs of metabolic syndrome.
Impact of Phytophthora cinnamomi on the taxonomic and functional diversity of forest plants in a mediterranean‐type biodiversity hotspot
Authors: Harshani Himbutugoda S. , Tsakalos James L. , Mansfield Thomas M. , McComb Jen , Burgess Treena I. , St. J. Hardy Giles E. 
Published: December 2023

AbstractAimDiversity‐rich mediterranean‐type sclerophyllous forests are home to 20% of described species on Earth. In the Eucalyptus marginata (jarrah) forest of southwest of Western Australia diversity is being reduced by extensive human use and the introduction of the plant pathogen Phytophthora cinnamomi. This study investigated the influence of P. cinnamomi infestation on the structure, taxonomic and functional diversity, and species composition of the forest.LocationJarrah forest of southwestern Australia.MethodsSpecies abundance, understorey cover and canopy cover were assessed along 22, 30 m long transects which crossed infested and non‐infested zones in five reserves in the jarrah forest. A trait database was assembled for 137 plants using 13 traits related to nutrient and carbon acquisition, disturbance tolerance and reproduction. The responses of canopy cover, understorey cover, species richness, Shannon diversity, evenness, abundance, and functional diversity for trait groups, and all groups combined were modelled against reserve and zone as fixed effects and transect and transect section as random effects. To assess the species composition, non‐metric multidimensional scaling (NMDS) ordination based on Jaccard resemblance and indicator species analyses were used.ResultsSignificantly higher understorey cover, species richness, Shannon diversity and evenness were recorded in non‐infested compared to infested zones, but there were no changes in the canopy cover and overall abundance. In non‐infested zones, the functional diversity of nutrient acquisition and reproductive traits was higher, but the functional diversity of carbon acquisition traits was lower. No difference in functional diversity was recorded in disturbance tolerance and overall traits between the two zones. NMDS ordination and analysis of similarities (ANOSIM) revealed a significant difference in the species composition between the two zones, and 11 indicator species significantly associated with infested and non‐infested zones were identified.ConclusionPhytophthora cinnamomi has significantly affected the forest structure, taxonomic and functional diversity, and species composition. Contrasting responses of functional trait groups obscured overall trait responses to P. cinnamomi.
Northwest Africa 13669, a reequilibrated nakhlite from a previously unsampled portion of the nakhlite igneous complex
Authors: Ramsey Sierra R. , Ostwald Amanda M. , Udry Arya , O'Neal Evan , Day James M. D. , Wilbur Zoë , Barnes Jessica J. , Griffin Sammy 
Published: December 2023

AbstractNorthwest Africa (NWA) 13669 is a recently found nakhlite and here, we use 2‐D and 3‐D mineralogy and texture, quantitative textural analysis of pyroxene, bulk rock and mineral major and trace element compositions, and melt inclusion analyses to assess its formation and emplacement. Using these combined results, we determine that NWA 13669 is derived from a depleted mantle source common to nakhlites and modeled parental melt compositions from olivine‐ and pyroxene‐hosted melt inclusions record similar major element trends to other nakhlites, including an alkali enrichment. Homogeneous pyroxene and olivine and diffusive reequilibration of trace elements in melt inclusions provide evidence for magma storage in a crystal mush within the nakhlite plumbing system and suggest NWA 13669 has undergone extensive reequilibration. Quantitative textural analysis of NWA 13669, including crystal size distribution (CSD) profiles, CSD slope and intercepts, and residence times, are similar to the Yamato nakhlite group, and indicate that NWA 13669 likely experienced similar emplacement conditions. However, differences in bulk rock and mineral compositions suggest NWA 13669 represents a new flow or sill from a previously unsampled portion of the nakhlite igneous complex, further increasing the diversity of the nakhlite suite.
Assessing implementation outcomes for launching balanced energy protein supplementation: A formative study in rural Bangladesh
Authors: Kalbarczyk Anna , de Boer Mary , Khaled Nazrana , Chakraborty Barnali , Rahman Atiya , Zavala Eleonor , Rahman Hafizur , Ali Hasmot , Haque Rezwanul , Ayesha Kaniz , Siddiqua Towfida J. , Afsana Kaosar , Christian Parul , Thorne‐Lyman Andrew 
Published: December 2023

AbstractBalanced energy protein (BEP) supplementation is an efficacious intervention in pregnancy for improving birthweight and is recommended by World Health Organization (WHO) in countries with high maternal undernutrition. Few countries have implemented BEP programmes due in part to high cost, lack of data on acceptability and feasibility, and complexity of delivery. We sought to address implementation gaps in BEP interventions through a formative study designed to understand implementation outcomes. We conducted 52 in‐depth interviews and 8 focus‐group discussions with married women of reproductive age, family members, health care providers and pharmacists in three unions of the Gaibandha district in rural Bangladesh. Interviews were translated and transcribed in English and analysed using an analytic framework for implementation science in nutrition. BEP was viewed as an acceptable and appropriate intervention to combat undernutrition in this setting. There was a lack of clarity on who should or could be responsible for providing/distributing BEP in a way convenient to mothers. Many participants preferred door‐to‐door delivery and thought this approach could address social and gender inequities, but providers mentioned already being overworked and worried about adding new tasks. Participants were concerned about the affordability of BEP and opportunity costs associated with travel to proposed distribution sites such as ANC or pharmacies. Women in these communities do not always have the agency to travel without supervision or make purchasing decisions. BEP supplementation is a complex intervention; future trials seek to assess ways to overcome these implementation challenges and inform a long‐term systems‐owned BEP intervention.
A Radiographic Analysis of Coronal Morphological Parameters of Lower Limbs in Chinese Non‐knee Osteoarthritis Populations
Authors: Jiang Xu , Xie Kai , Chen Hongyu , Zhang Kai , Hu Yuqi , Kan Tianyou , Sun Lin , Ai Songtao , Zhu Xianping , Zhang Lichi , Yan Mengning , Wang Liao 
Published: December 2023

ObjectivesAnalyzing the lower limb coronal morphological parameters in populations without knee osteoarthritis (KOA) holds significant value in predicting, diagnosing, and formulating surgical strategies for KOA. This study aimed to comprehensively analyze the variability in these parameters among Chinese non‐KOA populations, employing a substantial sample size.MethodsA cross‐sectional retrospective analysis was performed on the Chinese non‐KOA populations (n = 407; 49.9% females). The study employed an in‐house developed artificial intelligence software to meticulously assess the coronal morphological parameters of all 814 lower limbs. The parameters evaluated included the hip‐knee‐ankle angle (HKAA), weight‐bearing line ratio (WBLR), joint line convergence angle (JLCA), mechanical lateral‐proximal‐femoral angle (mLPFA), mechanical lateral‐distal‐femoral angle (mLDFA), mechanical medial‐proximal‐tibial angle (mMPTA), and mechanical lateral‐distal‐tibial angle (mLDTA). Differences in these parameters were compared between left and right limbs, different genders, and different age groups (with 50 years as the cut‐off point).ResultsHKAA and JLCA exhibited left–right differences (left vs. right: 178.2° ± 3.0° vs. 178.6° ± 2.9° for HKAA, p = 0.001; and 1.8° ± 1.5° vs. 1.4° ± 1.6° for JLCA, p < 0.001); except for the mLPFA, all other parameters show gender‐related differences (male vs. female: 177.9° ± 2.8° vs. 179.0° ± 3.0° for HKAA, p < 0.001; 1.5° ± 1.5° vs. 1.8° ± 1.7° for JLCA, p = 0.003; 87.1° ± 2.1° vs. 88.1° ± 2.1° for mMPTA, p < 0.001; 90.2° ± 4.0° vs. 91.1° ± 3.2° for mLDTA, p < 0.001; 38.7% ± 12.9% vs. 43.6% ± 14.1% for WBLR, p < 0.001; and 87.7° ± 2.3° vs. 87.4° ± 2.7° for mLDTA, p = 0.045); mLPFA increase with age (younger vs. older: 90.1° ± 7.2° vs. 93.4° ± 4.9° for mLPFA, p < 0.001), while no statistical difference exists for other parameters.ConclusionsThere were differences in lower limb coronal morphological parameters among Chinese non‐KOA populations between left and right sides, different genders, and age.
Antimicrobial to anti‐herbivore: Sakuranetin in rice efficiently inhibits brown planthopper by targeting their beneficial endosymbionts
Authors: Kundu Anish 
Published: December 2023

AbstractIn rice, biosynthesis of specialized metabolites active against insect herbivores is elusive. The major known defense metabolites in rice against the destructive phloem‐sucking herbivore brown planthoppers (BPH) (Nilaparvata lugens) are proteinase inhibitors, phenolamides and some terpenes (Xiao et al., 2012), which are induced during the invasion. Specifically, phenolamides were found to be induced upon herbivory with different feeding guild, including chewing and phloem‐sucking, but could only provide defense against phloem‐sucking BPH, though the clear mode of action of phenolamides has not been explored yet. Moreover, the jasmonic acid‐mediated modulation of biosynthesis of these specialized metabolites in rice is not elucidated yet. However, a recent study by Liu et al. (2023) demonstrated that sakuranetin, a phytoalexin in rice, was induced upon BPH invasion and showed significant detrimental effect on herbivore's performance by targeting their beneficial endosymbionts. This is the first report on a strong bioactive anti‐herbivore molecule observed in rice with an unusual mode of action. In this article, a view has been presented on this work, its impact and exceptionality.
A paper tiger in the fog of governance: Norway's riddle in biodiversity matters
Authors: Colombo Esmeralda 
Published: December 2023

AbstractEffective biodiversity protection is generally associated with a strict rule of law and democratic participation in environmental decision making. Norway's exceptional ranking in terms of governance, however, has failed to be a predictor of effective biodiversity protection. Through a systematic review of the main regulatory frameworks relevant to protecting biodiversity in Norway, this article analyses the misconceptions, perverse incentives and institutional bottlenecks that lie at the centre of the problem. The analysis finds three overarching barriers that regulatory frameworks have created to the effective protection and promotion of biodiversity in Norway, namely, a governance system based on diffuse legal obligations and responsibilities, excessive trust in private operators and considerable discretion to local entities. Accordingly, this article proposes three enabling factors, and related reform suggestions, for mitigating such barriers and domesticating earth system governance in biodiversity matters.
South African student retention during 2020: Evidence from system‐wide higher education institutional data
Authors: Branson Nicola , Whitelaw Emma 
Published: December 2023

AbstractUsing longitudinal, institutional data, we document the impact of COVID‐19 on undergraduate student retention at public universities in South Africa in 2020. We find that student dropout increased in 2020 for students in years 3–5, with little evidence of a change for those entering their second year of study. These aggregate findings mask significant differences across institutions. Students enrolled in most historically advantaged, traditional institutions, and some comprehensive institutions, were not significantly affected, whereas dropout increased significantly at the University of Fort Hare, Walter Sisulu University and the University of Venda, three historically disadvantaged institutions located in rural areas. No difference in retention is found, however, for students enrolled at the University of Zululand (UZ) or the University of Limpopo (UL), equally resource‐disadvantaged institutions where a majority (over 90%) of students are funded via the National Student Financial Aid Scheme (NSFAS). Furthermore, at institutions where dropout increased, NSFAS‐funded students were typically less impacted than their unfunded peers. Our overall findings accord with growing evidence that COVID‐19‐related changes in the sector differentially impacted students from lower socioeconomic backgrounds. However, they also illustrate that the NSFAS bursary appears to have provided a social safety net during this time. Finally, the example of UZ and the UL provide suggestive evidence that institutional relational aspects not observed in our data are important too. Together, results foreground the complex interplay of factors impacting a student's decision to drop out of or remain in university, highlighting that institutional responses and/or relational context during a crisis like COVID‐19 can positively impact student retention.