bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional Quality and In vitro Protein Digestibility of Complementary Foods Formulated from Maize, Cowpea and Orange-Fleshed Sweet Potato Flours: A Preliminary Study
Authors: Adigwe N. E. , Kiin-Kabari D. B. , Emelike N. J. T. 
Published: March 2023

Complementary foods were formulated from blends of maize, cowpea and orange fleshed sweet potatoes (OFSP). Five different blends of flour were formulated with the substitution with cowpea flour at 5-30%, and OFSP substitution at 5-20% while 100% maize flour was used as the control. The flour blends were heated and extruded using a cold extruder. The samples were thereafter analyzed for their proximate, mineral, and vitamin compositions, and % In vitro Protein Digestibility. The moisture, ash, fat, crude protein, crude fibre, carbohydrate and energy of the complementary fruits samples varied from 8.11-11.39%, 2.27-3.66%, 2.20-3.10%, 8.87-13.07%, 2.39-4.07%, 68.90-73.43% and 357.08-367.68 Kcal/100g, respectively. All the samples were within the standard RDA for infants and young children, except for fat which was less than 10% recommendation. The mineral contents of the complementary food samples ranged from 44.20 – 80.67mg/100g for calcium, 8.86 – 24.50 mg/100g iron, 127.23- 167.72 mg/100 g magnesium, 1.53 -3.17 mg/100g zinc, 31.75 – 63.75 mg/100g phosphorus and 26.86 – 39.98 mg/100g sodium. There were significantly increase (p < 0.05) in these minerals as the substitution with cowpea and OFSP flours increased. β -carotene and vitamin C content of the complementary food samples ranged from 10.90 – 31.00 mg/100g and 1.80 – 12.01 mg/100 g, respectively. Increase in substitution with cowpea and OFSP led to an increase in β -carotene values. Vitamin content also increase significantly (P<0.05) with increase in proportion of cowpea and OFSP flours. % in vitro protein digestibility of the samples varied between 30.29 in MCOA (100% maize complementary food) to 48.77% in sample MCOF (50% maize: 30% cowpea: 20% OFSP). Protein digestibility of the complementary food samples also increased significantly with increase in substitution. Most of the nutrients were highest in the samples containing 20% an 10% OFSP and 30% cowpea and 20% OFSP, making these samples suitable for use as of complementary foods.
Assessment of the Risk of Venous Thromboembolism in Nonhospitalized Patients With COVID-19
Authors: Fang Margaret C. , Reynolds Kristi , Tabada Grace H. , Prasad Priya A. , Sung Sue Hee , Parks Anna L. , Garcia Elisha , Portugal Cecilia , Fan Dongjie , Pai Ashok P. , Go Alan S. 
Published: March 2023

ImportancePatients hospitalized with COVID-19 have higher rates of venous thromboembolism (VTE), but the risk and predictors of VTE among individuals with less severe COVID-19 managed in outpatient settings are less well understood.ObjectivesTo assess the risk of VTE among outpatients with COVID-19 and identify independent predictors of VTE.Design, Setting, and ParticipantsA retrospective cohort study was conducted at 2 integrated health care delivery systems in Northern and Southern California. Data for this study were obtained from the Kaiser Permanente Virtual Data Warehouse and electronic health records. Participants included nonhospitalized adults aged 18 years or older with COVID-19 diagnosed between January 1, 2020, and January 31, 2021, with follow-up through February 28, 2021.ExposuresPatient demographic and clinical characteristics identified from integrated electronic health records.Main Outcomes and MeasuresThe primary outcome was the rate per 100 person-years of diagnosed VTE, which was identified using an algorithm based on encounter diagnosis codes and natural language processing. Multivariable regression using a Fine-Gray subdistribution hazard model was used to identify variables independently associated with VTE risk. Multiple imputation was used to address missing data.ResultsA total of 398 530 outpatients with COVID-19 were identified. The mean (SD) age was 43.8 (15.8) years, 53.7% were women, and 54.3% were of self-reported Hispanic ethnicity. There were 292 (0.1%) VTE events identified over the follow-up period, for an overall rate of 0.26 (95% CI, 0.24-0.30) per 100 person-years. The sharpest increase in VTE risk was observed during the first 30 days after COVID-19 diagnosis (unadjusted rate, 0.58; 95% CI, 0.51-0.67 per 100 person-years vs 0.09; 95% CI, 0.08-0.11 per 100 person-years after 30 days). In multivariable models, the following variables were associated with a higher risk for VTE in the setting of nonhospitalized COVID-19: age 55 to 64 years (HR 1.85 [95% CI, 1.26-2.72]), 65 to 74 years (3.43 [95% CI, 2.18-5.39]), 75 to 84 years (5.46 [95% CI, 3.20-9.34]), greater than or equal to 85 years (6.51 [95% CI, 3.05-13.86]), male gender (1.49 [95% CI, 1.15-1.96]), prior VTE (7.49 [95% CI, 4.29-13.07]), thrombophilia (2.52 [95% CI, 1.04-6.14]), inflammatory bowel disease (2.43 [95% CI, 1.02-5.80]), body mass index 30.0-39.9 (1.57 [95% CI, 1.06-2.34]), and body mass index greater than or equal to 40.0 (3.07 [1.95-4.83]).Conclusions and RelevanceIn this cohort study of outpatients with COVID-19, the absolute risk of VTE was low. Several patient-level factors were associated with higher VTE risk; these findings may help identify subsets of patients with COVID-19 who may benefit from more intensive surveillance or VTE preventive strategies.
Association of Participation in a Value-Based Insurance Design Program With Health Care Spending and Utilization
Authors: Zhang Hui , Cowling David W. 
Published: March 2023

ImportanceValue-based insurance design (VBID) has mostly been used in improving medication use and adherence for certain conditions or patients, but its outcomes remain uncertain when applied to other services and to all health plan enrollees.ObjectiveTo determine the association of participation in a California Public Employees’ Retirement System (CalPERS) VBID program with its enrollees’ health care spending and utilization.Design, Setting, and ParticipantsA retrospective cohort study with difference-in-differences propensity-weighted 2-part regression models was performed in 2021 to 2022. A VBID cohort was compared with a non-VBID cohort both before and after VBID implementation in California in 2019 with 2 years’ follow-up. The study sample included CalPERS preferred provider organization continuous enrollees from 2017 through 2020. Data were analyzed from September 2021 to August 2022.ExposuresThe key VBID interventions include (1) if selecting and using a primary care physician (PCP) for routine care, PCP office visit copayment is $10 (otherwise, PCP office visit copayment is $35 as for specialist visit); and (2) annual deductibles reduced by a half through completion of the following 5 activities: annual biometric screening, influenza vaccine, nonsmoking certification, second opinion for elective surgical procedures, and disease management participation.Main Outcomes and MeasuresThe primary outcome measures included annual per member total approved payments for multiple inpatient and outpatient services.ResultsThe 2 compared cohorts of 94 127 participants (48 770 were female [52%]; 47 390 were younger than 45 years old [50%]) had insignificant baseline differences after propensity-weighting adjustment. The VBID cohort had significantly lower probabilities of inpatient admissions (adjusted relative odds ratio [OR], 0.82; 95% CI, 0.71-0.95), and higher probabilities of receiving immunizations (adjusted relative OR, 1.07; 95% CI, 1.01-1.21) in 2019. Among those with positive payments, VBID was associated with higher mean total allowed amounts for PCP visits in 2019 and 2020 (adjusted relative payments ratio, 1.05; 95% CI, 1.02-1.08). There were no significant differences for inpatient and outpatient combined totals in 2019 and 2020.Conclusions and RelevanceThe CalPERS VBID program achieved desired goals for some interventions with no added total costs in its first 2 years of operation. VBID may be used to promote valued services while containing costs for all enrollees.
COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States
Authors: Xiao Yunyu , Brown Timothy T. , Snowden Lonnie R. , Chow Julian Chun-Chung , Mann J. John 
Published: March 2023

ImportanceThe adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects.ObjectivesTo determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19–related worry, and sleep.Design, Setting, and ParticipantsThis cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023.ExposuresPolicy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling).Main Outcomes and MeasuresPerceived stress scale, National Institutes of Health (NIH)–Toolbox sadness, NIH-Toolbox positive affect, COVID-19–related worry, and sleep (latency, inertia, duration).ResultsIn this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19–related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep.Conclusions and RelevanceTo our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children’s mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.
Comparison of Perinatal Outcomes for Women With and Without Epilepsy
Authors: Mazzone Paolo Pierino , Hogg Kirsty Mhairi , Weir Christopher J. , Stephen Jacqueline , Bhattacharya Sohinee , Chin Richard F. M. 
Published: March 2023

ImportancePregnant women who have epilepsy need adequate engagement, information, and pregnancy planning and management to improve pregnancy outcomes.ObjectiveTo investigate perinatal outcomes in women with epilepsy compared with women without epilepsy.Data SourcesOvid MEDLINE, Embase, CINAHL, and PsycINFO were searched with no language or date restrictions (database inception through December 6, 2022). Searches also included OpenGrey and Google Scholar and manual searching in journals and reference lists of included studies.Study SelectionAll observational studies comparing women with and without epilepsy were included.Data Extraction and SynthesisThe PRISMA checklist was used for abstracting data and the Newcastle-Ottawa Scale for risk-of-bias assessment. Data extraction and risk-of-bias assessment were done independently by 2 authors with mediation conducted independently by a third author. Pooled unadjusted odds ratios (OR) or mean differences were reported with 95% CI from random-effects (I2 heterogeneity statistic &amp;gt;50%) or fixed-effects (I2 &amp;lt; 50%) meta-analyses.Main Outcomes and MeasuresMaternal, fetal, and neonatal complications.ResultsOf 8313 articles identified, 76 were included in the meta-analyses. Women with epilepsy had increased odds of miscarriage (12 articles, 25 478 pregnancies; OR, 1.62; 95% CI, 1.15-2.29), stillbirth (20 articles, 28 134 229 pregnancies; OR, 1.37; 95% CI, 1.29-1.47), preterm birth (37 articles, 29 268 866 pregnancies; OR, 1.41; 95% CI, 1.32-1.51) and maternal death (4 articles, 23 288 083 pregnancies; OR, 5.00; 95% CI, 1.38-18.04). Neonates born to women with epilepsy had increased odds of congenital conditions (29 articles, 24 238 334 pregnancies; OR, 1.88; 95% CI, 1.66-2.12), neonatal intensive care unit admission (8 articles, 1 204 428 pregnancies; OR, 1.99; 95% CI, 1.58-2.51), and neonatal or infant death (13 articles, 1 426 692 pregnancies; OR, 1.87; 95% CI, 1.56-2.24). The increased odds of poor outcomes was increased with greater use of antiseizure medication.Conclusions and RelevanceThis systematic review and meta-analysis found that women with epilepsy have worse perinatal outcomes compared with women without epilepsy. Women with epilepsy should receive pregnancy counseling from an epilepsy specialist who can also optimize their antiseizure medication regimen before and during pregnancy.
Intensity modulated proton arc therapy via geometry‐based energy selection for ependymoma
Authors: Cao Wenhua , Li Yupeng , Zhang Xiaodong , Poenisch Falk , Yepes Pablo , Sahoo Narayan , Grosshans David , McGovern Susan , Gunn G. Brandon , Frank Steven J. , Zhu Xiaorong R. 
Published: March 2023

AbstractPurposeWe developed and tested a novel method of creating intensity modulated proton arc therapy (IMPAT) plans that uses computing resources similar to those for regular intensity‐modulated proton therapy (IMPT) plans and may offer a dosimetric benefit for patients with ependymoma or similar tumor geometries.MethodsOur IMPAT planning method consists of a geometry‐based energy selection step with major scanning spot contributions as inputs computed using ray‐tracing and single‐Gaussian approximation of lateral spot profiles. Based on the geometric relation of scanning spots and dose voxels, our energy selection module selects a minimum set of energy layers at each gantry angle such that each target voxel is covered by sufficient scanning spots as specified by the planner, with dose contributions above the specified threshold. Finally, IMPAT plans are generated by robustly optimizing scanning spots of the selected energy layers using a commercial proton treatment planning system (TPS). The IMPAT plan quality was assessed for four ependymoma patients. Reference three‐field IMPT plans were created with similar planning objective functions and compared with the IMPAT plans.ResultsIn all plans, the prescribed dose covered 95% of the clinical target volume (CTV) while maintaining similar maximum doses for the brainstem. While IMPAT and IMPT achieved comparable plan robustness, the IMPAT plans achieved better homogeneity and conformity than the IMPT plans. The IMPAT plans also exhibited higher relative biological effectiveness (RBE) enhancement than did the corresponding reference IMPT plans for the CTV in all four patients and brainstem in three of them.ConclusionsThe proposed method demonstrated potential as an efficient technique for IMPAT planning and may offer a dosimetric benefit for patients with ependymoma or tumors in close proximity to critical organs. IMPAT plans created using this method had elevated RBE enhancement associated with increased linear energy transfer (LET) in both targets and abutting critical organs.
Responsiveness and Minimum Clinically Important Difference in Patient‐Reported Outcome Measures Among Patients With Psoriatic Arthritis: A Prospective Cohort Study
Authors: Karmacharya Paras , Stull Courtney , Stephens‐Shields Alisa , Husni M. Elaine , Scher Jose U. , Craig Ethan , Fitzsimmons Robert , Reddy Soumya M. , Magrey Marina N. , Ogdie Alexis , Walsh Jessica A. 
Published: March 2023

ObjectiveTo determine the responsiveness to therapy and minimum clinically important improvement (MCII) for patient‐reported outcome measures in psoriatic arthritis (PsA) and to examine the impact of baseline disease activity on the ability to demonstrate change.MethodsA longitudinal cohort study was performed within the PsA Research Consortium. Patients completed several patient‐reported outcomes, including the Routine Assessment of Patient Index Data, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Psoriatic Arthritis Impact of Disease 12‐item (PsAID12) questionnaire, and others. The mean change in the scores between visits and standardized response means (SRMs) were calculated. The MCII was calculated as the mean change in score among patients who reported minimal improvement. SRMs and MCIIs were compared among subgroups with moderate to highly active PsA and those with lower disease activity.ResultsAmong 171 patients, 266 therapy courses were included. The mean ± SD age was 51 ± 13.8 years, 53% were female, and the mean swollen and tender joint counts were 3 and 6, respectively, at baseline. SRMs and MCII for all measures were small to moderate, although greater among those with higher baseline disease activity. BASDAI had the best SRM overall and for less active PsA, and the clinical Disease Activity of PsA (cDAPSA) and PsAID12 were best for those with higher disease activity.ConclusionSRMs and MCII were relatively small in this real‐world population, particularly among those with lower disease activity at baseline. BASDAI, cDAPSA, and PsAID12 had good sensitivity to change, but selection for use in trials should consider the baseline disease activity of patients to be enrolled.
Flexible MXene‐Based Composite Films for Multi‐Spectra Defense in Radar, Infrared and Visible Light Bands
Authors: Wen Caiyue , Zhao Biao , Liu Yihao , Xu Chunyang , Wu Yuyang , Cheng Yifeng , Liu Jiwei , Liu Yanxia , Yang Yaxiong , Pan Hongge , Zhang Jincang , Wu Limin , Che Renchao 
Published: March 2023

AbstractSimultaneously developing protective electronics film for multi‐spectra, including the radar, infrared (IR), and visible ranges, for both the military and civilian sectors is extremely challenging. The existing multi‐spectra‐compatible materials mainly concentrate on either the radar/IR or IR/visible bands, trailing the rapid evolution of advanced devices for monitoring electromagnetic signals. Here, it is designed and fabricated an ultra‐thin MXene‐based composite film (20 µm) containing black phosphorus (BP) and Ni chains (M‐B‐M(Ni)) with integrated highly efficient thermal IR stealth, visible light absorption, and electromagnetic wave shielding. M‐B‐M(Ni) exhibits an extremely low IR emissivity of 0.1, decreasing the radiation temperature difference between the surrounding environment and target device. BP offers a high solar absorptance of 80%, which guarantees energy conversion from visible light to heat. Moreover, the absorption proportion of the electromagnetic shielding effectiveness for M‐B‐M(Ni) is 16% higher than that of pure MXene films (68.7%), owing to the improved magnetic loss by decoration with magnetic Ni chains. Due to the combined merits of MXene, BP, and Ni chains, M‐B‐M(Ni) opens an avenue for the construction of advanced multi‐spectra compatible materials for versatile applications in thermal IR stealth, electromagnetic wave shielding, and energy transformation.
Doped Mn Enhanced NiS Electrooxidation Performance of HMF into FDCA at Industrial‐Level Current Density
Authors: Li Suiqin , Wang Shibin , Wang Yuhang , He Jiahui , Li Kai , Xu Yinjie , Wang Mengxin , Zhao Shuying , Li Xiaonian , Zhong Xing , Wang Jianguo 
Published: March 2023

AbstractElectrooxidation of 5‐hydroxymethylfurfural (HMF) into 2,5‐furandicarboxylic acid (FDCA) is a highly promising approach for producing value‐added chemicals from biomass. However, developing highly efficient electrocatalysts for HMF oxidation (HMFOR) with high current density in large‐scale productions remains a challenge. Herein, it is demonstrated that the Mn‐doped NiS nanosheet electrocatalysts grown directly on 3D graphite felt (GF) substrates can efficiently perform electrooxidation of HMF into FDCA at industrial‐level current density (500 mA cm−2) in the H‐cell. The Mn0.2NiS/GF exhibits excellent HMFOR performance with high selectivity (98.3%), yield (97.6%), faradaic efficiency (94.2%), and robust stability (10 cycles). Especially, FDCA production rate up to 4.56 g h−1 can be achieved, superior to those reported in HMFOR literatures. Furthermore, by scaling up the Mn0.2NiS/GF electrode area and assembling it in a continuous‐flow electrolyzer, high FDCA production rate of 44.32 g h−1 is achieved. The high activity of Mn0.2NiS/GF for HMFOR can be attributed to incorporation of Mn into NiS material, theoretical calculation results indicate that the Mn and Ni as both the adsorption sites for HMF oxidation, thereby effectively facilitate the HMF electro‐oxidation performance. This work provides a strategy for developing potential industrial‐grade electrocatalysts at a large current density.
Reaction Mechanisms in Platinum‐Mediated Electrodynamic Therapy
Authors: Lu Zijie , Zhou Linming , Yao Yingpei , Li Feiyu , Hong Zijian , Wu Yongjun , Li Xiang 
Published: March 2023

AbstractElectrodynamic therapy (EDT) has emerged as an alternative stimuli‐responsive approach for tumor treatment. The current understanding of its mechanism is that an electric field activates water dissociation on platinum nanoparticles (PtNPs) to produce toxic hydroxyl radicals. Nevertheless, the argument here remains that, if without direct contact with electrodes, the equipotential surfaces of PtNPs may hardly trigger electrocatalytic reactions and thus the induction of any radicals. Clearly, the limited understanding of EDT has considerably hindered its current and further explorations. Herein, the fundamental mechanism of EDT is revealed from the view of heterogeneous catalysis. First and foremost, the free chlorine generated during electrolysis is identified as the crucial reactant, which is not observed previously. Through experimental examinations and density functional theory (DFT) calculations, the fundamental reaction is confirmed to be the catalytic activation of HOCl by PtNPs, resulting in the production of oxygen anion radicals and the corrosion of PtNPs. Moreover, the cytotoxicity and intracellular abnormalities further verify the findings and provide new insight into its in vitro anti‐cancer mechanism. This study not only assists in re‐recognizing the nature of EDT, but also provides core knowledge in guiding its future investigations in catalytic medicine and medical technologies.
Dimensional Regulation of Titanosilicate by Kinetically Controlled Intergrowth Crystals
Authors: Lin Dong , Feng Xiang , Zheng Xiuhui , Xu Yang , Zhao Hui , Song Zhaoning , Wang Liang , Shan Honghong , Xiao Feng‐Shou , Chen De , Yang Chaohe 
Published: March 2023

AbstractDimensional regulation of titanosilicates from conventional 3D to revolutionary 2D without extra additives is limited by the Ostwald ripening process together with the mismatch of hydrolysis rate between Ti and Si species. Herein, the kinetically controlled and additive‐free strategy is devised to continuously regulate the dimensionality of intergrowth titanosilicate from 3D bulk to 2D nanosheets. The kinetic relative growth rate of orthorhombic MFI to tetragonal MEL (rMFI/rMEL) dominated by temperature control can determine the morphology of intermediates. Crisscross intermediates assembled by MFI branches along a direction and MEL connectors along a/b directions restrain the Ostwald ripening of titanosilicate and further transform into 2D nanosheets (≈2 nm), which show enhanced olefin epoxidation performance due to boosted diffusion ability. This kinetically controlled strategy unlocks green and efficient regulation of titanosilicate dimension.