bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in specific abdominal fat depots between metabolically healthy and unhealthy children with overweight/obesity: The role of cardiorespiratory fitness
Authors: Cadenas‐Sanchez Cristina , Medrano María , Villanueva Arantxa , Cabeza Rafael , Idoate Fernando , Osés Maddi , Rodríguez‐Vigil Beatriz , Álvarez de Eulate Natalia , Alberdi Aldasoro Nerea , Ortega Francisco B. , Labayen Idoia 
Published: April 2023

ObjectivesFat depots localization has a critical role in the metabolic health status of adults. Nevertheless, whether that is also the case in children remains under‐studied. Therefore, the aims of this study were: (i) to examine the differences between metabolically healthy (MHO) and unhealthy (MUO) overweight/obesity phenotypes on specific abdominal fat depots, and (ii) to further explore whether cardiorespiratory fitness plays a major role in the differences between metabolic phenotypes among children with overweight/obesity.MethodsA total of 114 children with overweight/obesity (10.6 ± 1.1 years, 62 girls) were included. Children were classified as MHO (n = 68) or MUO. visceral (VAT), abdominal subcutaneous (ASAT), intermuscular abdominal (IMAAT), psoas, hepatic, pancreatic, and lumbar bone marrow adipose tissues were measured by magnetic resonance imaging. Cardiorespiratory fitness was assessed using the 20 m shuttle run test.ResultsMHO children had lower VAT and ASAT contents and psoas fat fraction compared to MUO children (difference = 12.4%–25.8%, all p < 0.035). MUO‐unfit had more VAT and ASAT content than those MUO‐fit and MHO‐fit (difference = 34.8%–45.3%, all p < 0.044). MUO‐unfit shows also greater IMAAT fat fraction than those MUO‐fit and MHO‐fit peers (difference = 16.4%–13.9% respectively, all p ≤ 0.001). In addition, MHO‐unfit presented higher IMAAT fat fraction than MHO‐fit (difference = 13.4%, p < 0.001). MUO‐unfit presented higher psoas fat fraction than MHO‐fit (difference = 29.1%, p = 0.008).ConclusionsVAT together with ASAT and psoas fat fraction, were lower in MHO than in MUO children. Further, we also observed that being fit, regardless of metabolic phenotype, has a protective role over the specific abdominal fat depots among children with overweight/obesity.
An Exploration of the Relationships Between Cognitive Style, Psychological Safety, and the Paradigm-Relatedness of Design Solutions in Engineering Design Teams in Education
Authors: Cole Courtney , Marhefka Jacqueline , Jablokow Kathryn , Mohammed Susan , Ritter Sarah , Miller Scarlett 
Published: April 2023

Abstract
Thomas Kuhn revolutionized how we think of scientific discovery and innovation when he identified that scientific change can occur on a continuum from incremental developments to drastic change in the form of a paradigm shift. In engineering design, both types of scientific change are critical when exploring the solution space. This study investigates this gap under a psychological safety lens through an empirical study with 64 engineering design student teams over the course of a 4- and 8-week design project. Specifically, we sought to identify the role of cognitive style using KAI scores, derived from Kirton’s Adaption-Innovation (A-I) theory, on the paradigm-relatedness of ideas generated by individuals and teams. Our results identify that cognitive style may not have a direct relationship to the paradigm of ideas an individual generates, or a team selects and develops. Similarly, both individual perceptions and team psychological safety do not predict the paradigm of ideas generated or selected in a team. The results instead identify that the availability of ideas in each paradigm is the primary driver for teams selecting a higher ratio of these ideas during concept screening. These results highlight that cognitive style at the individual and team levels may not be of paramount importance for developing paradigm-challenging ideas, and that teams should instead turn their focus to developing strategies to generate more ideas within the paradigm that fits best with the desired goals of the design tasks.
Validation of Broadband Noise Prediction Methodology Based on Linearized Navier–Stokes Analyses
Authors: Blázquez-Navarro Ricardo , Corral Roque 
Published: April 2023

Abstract
This article presents an integral validation of a synthetic turbulence broadband noise prediction methodology for fan/outlet-guide-vane (OGV) interaction. The test vehicle is the ACAT1 fan, a modern scaled-down fan, experimentally analyzed in 2018 within the TurboNoiseBB project. Three operating points, namely, Approach, Cutback, and Sideline, and two different rig configurations in terms of the axial gap between the fan and OGV are examined within this work. The methodology consists of using a Reynolds-averaged Navier–Stokes (RANS) solver to model the fan wake and the use of two-dimensional frequency domain linearized Navier–Stokes simulations to resolve the acoustics, including quasi-3D corrections to obtain representative results. The RANS results with no ad hoc tuning are compared in detail against hotwire data to determine the degree of uncertainty incurred by this kind of approach. The predicted broadband noise spectra and noise azimuthal decompositions are compared against the experimental data. The spectral levels are well predicted despite an average underprediction of around 3dB. The noise azimuthal decompositions feature a remarkable agreement with the experiment, denoting accurate modeling of the main physics governing the problem. The impact of increasing the fan/OGV axial gap is quantified numerically for the first time. It is concluded that increasing the gap is detrimental for the broadband noise footprint, unlike intuitively could be expected. Overall, the presented broadband noise methodology yields robust broadband noise predictions at an industrially feasible cost and enables a deeper understanding of the problem.
Combination therapy for painful diabetic neuropathy is safe and effective
Authors: Saul Helen , Deeney Brendan , Imison Candace , Tesfaye Solomon 
Published: April 2023

The studyTesfaye S, Sloan G, Petrie J, et al. Comparison of amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline, and duloxetine supplemented with pregabalin for the treatment of diabetic peripheral neuropathic pain (OPTION-DM): a multicentre, double-blind, randomised crossover trial.Lancet2022;400:680-90.To read the full NIHR Alert, go to:https://evidence.nihr.ac.uk/alert/combination-therapy-for-painful-diabetic-neuropathy-is-safe-and-effective/
Ghrelin attenuates inflammation in diabetic lung disease by TLR4 pathway in vivo and in vitro
Authors: Liu Xiao-Yan , Wei Dong-Guang , Li Rong-Shan 
Published: April 2023

IntroductionDiabetic lung disease is already known as one of the diabetes complications, but report on its therapeutic strategy is rare. The present study aimed to add novel therapeutic strategy for diabetic lung disease, to reveal the protective effect of ghrelin on diabetic lung disease both in vivo and in vitro, and to discuss its probable molecular mechanism.Research design and methodsDiabetic mice and 16HBE cells were our research objects. We surveyed the effect of ghrelin on streptozotocin-induced lung tissue morphology changes by H&E staining. Furthermore, the changes of proinflammatory cytokines (interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α)) were detected by ELISA. To expound the molecular mechanism, we detected critical proteins of TLR4 pathway and observed their changes by immunohistochemistry (IHC), real-time PCR and western blot analysis in vivo and in vitro, respectively.ResultsThe results of H&E staining showed that pathological alterations of the lung induced by hyperglycemia were ameliorated by ghrelin. The results of ELISA demonstrated that the elevated levels of IL-1β and TNF-α induced by hyperglycemia turned to decrease in the lung after ghrelin treatment. In the results of IHC, real-time PCR and western blot analysis, we found that the TLR4 pathway was elevated by hyperglycemia or high glucose and is remarkably inhibited by the treatment of ghrelin both in vivo and in vitro.ConclusionsGhrelin could inhibit inflammation of diabetic lung disease by regulating the TLR4 pathway. This study might affect research on diabetic lung disease, and the therapeutic potential of ghrelin for diabetic lung disease is worth considering.
Development and validation of a multivariable genotype-informed gestational diabetes prediction algorithm for clinical use in the Mexican population: insights into susceptibility mechanisms
Authors: Zulueta Mirella , Gallardo-Rincón Héctor , Martinez-Juarez Luis Alberto , Lomelin-Gascon Julieta , Ortega-Montiel Janinne , Montoya Alejandra , Mendizabal Leire , Arregi Maddi , Martinez-Martinez María de los Angeles , Camarillo Romero Eneida del Socorro , Mendieta Zerón Hugo , Garduño García José de Jesús , Simón Laureano , Tapia-Conyer Roberto 
Published: April 2023

IntroductionGestational diabetes mellitus (GDM) is underdiagnosed in Mexico. Early GDM risk stratification through prediction modeling is expected to improve preventative care. We developed a GDM risk assessment model that integrates both genetic and clinical variables.Research design and methodsData from pregnant Mexican women enrolled in the ‘Cuido mi Embarazo’ (CME) cohort were used for development (107 cases, 469 controls) and data from the ‘Mónica Pretelini Sáenz’ Maternal Perinatal Hospital (HMPMPS) cohort were used for external validation (32 cases, 199 controls). A 2-hour oral glucose tolerance test (OGTT) with 75 g glucose performed at 24–28 gestational weeks was used to diagnose GDM. A total of 114 single-nucleotide polymorphisms (SNPs) with reported predictive power were selected for evaluation. Blood samples collected during the OGTT were used for SNP analysis. The CME cohort was randomly divided into training (70% of the cohort) and testing datasets (30% of the cohort). The training dataset was divided into 10 groups, 9 to build the predictive model and 1 for validation. The model was further validated using the testing dataset and the HMPMPS cohort.ResultsNineteen attributes (14 SNPs and 5 clinical variables) were significantly associated with the outcome; 11 SNPs and 4 clinical variables were included in the GDM prediction regression model and applied to the training dataset. The algorithm was highly predictive, with an area under the curve (AUC) of 0.7507, 79% sensitivity, and 71% specificity and adequately powered to discriminate between cases and controls. On further validation, the training dataset and HMPMPS cohort had AUCs of 0.8256 and 0.8001, respectively.ConclusionsWe developed a predictive model using both genetic and clinical factors to identify Mexican women at risk of developing GDM. These findings may contribute to a greater understanding of metabolic functions that underlie elevated GDM risk and support personalized patient recommendations.
Effect of the interaction between advanced maternal age and pre-pregnancy BMI on pre-eclampsia and GDM in Central China
Authors: Sun Mengting , Luo Manjun , Wang Tingting , Wei Jianhui , Zhang Senmao , Shu Jing , Zhong Taowei , Liu Yiping , Chen Qian , Zhu Ping , Qin Jiabi 
Published: April 2023

IntroductionTo investigate the independent and combined effects of advanced maternal age and pre-pregnancy body mass index (BMI) on the risk of pre-eclampsia and gestational diabetes mellitus (GDM).Research design and methodsLogistic regression models were used to estimate the OR and 95% CIs of pre-eclampsia and GDM with advanced maternal age and pre-pregnancy BMI, respectively, and the interaction between advanced maternal age and pre-pregnancy BMI. We also used causal mediation analysis to assess the mediating role of pre-pregnancy BMI on maternal age–pre-eclampsia/GDM associations.ResultsIn this study, 788 cases (2.31%) were diagnosed with pre-eclampsia and 5430 cases (15.92%) were diagnosed with GDM. We found that advanced maternal age was associated with a higher risk for pre-eclampsia and GDM, with adjusted ORs (aORs) of 1.74 (95% CI 1.49–2.05) and 1.76 (95% CI 1.65–1.89) after adjusting for potential confounders, respectively. In addition, maternal pre-pregnancy overweight/obesity was associated with the risk of pre-eclampsia and GDM, with the corresponding aORs of 3.64 (95% CI 3.12–4.24) and 1.71 (95% CI 1.60–1.85), respectively. We also observed the interaction between maternal age and pre-pregnancy BMI for the risk of pre-eclampsia/GDM (all p for interaction <0.001). In the mediating effect analysis, we found that maternal pre-pregnancy BMI mediated the associations between maternal age and the development of pre-eclampsia and GDM.ConclusionsAdvanced maternal age and pre-pregnancy BMI were respectively associated with the risk of pre-eclampsia/GDM, and there was an interaction between the two risk factors. In addition, we found that pre-pregnancy BMI served as a mediator of the association between advanced maternal age and the risk of pre-eclampsia/GDM, providing an essential target for the prevention of maternal overweight/obesity.
First reports of clinical effects of transjugular intrahepatic portosystemic shunt in four patients with cirrhotic ascites refractory to tolvaptan
Authors: Tsuruya Kota , Koizumi Jun , Sekiguchi Yuka , Ono Shun , Sekiguchi Tatsuya , Hara Takuya , Mishima Yusuke , Arase Yoshitaka , Hirose Shunji , Shiraishi Koichi , Kagawa Tatehiro 
Published: April 2023

ObjectiveAscites in patients with decompensated cirrhosis can lead to abdominal distention and decrease quality of life. Tolvaptan, a vasopressin V2 receptor antagonist, is an effective agent in the treatment of ascites, whereas some patients are refractory to tolvaptan. The efficacy of transjugular intrahepatic portosystemic shunt (TIPS) for these patients is not known. In this study, we performed TIPS for tolvaptan-refractory cirrhotic patients and analysed its efficacy and safety in these patients.DesignThis retrospective analysis included patients with liver cirrhosis who received TIPS for ascites or hydrothorax refractory to tolvaptan therapy along with conventional diuretics between January 2015 and May 2018 at Tokai University Hospital. We evaluated the efficacy and safety of TIPS.ResultsThis study included four patients. All patients presented with Child-Pugh class B liver cirrhosis and model for end-stage liver disease-sodium scores were 10/12/14/16. TIPS was generated successfully without any major complications in all patients. The body weight decreased by a mean of 4.7 (SD=1.0) kg and estimated glomerular filtration rate improved from a mean of 38.2 (SD=10.3) to 59.5 (SD=25.0) mL/min/1.73 m2in a month after TIPS procedure.ConclusionTIPS is an effective potential treatment for ascites in patients with tolvaptan refractory condition. In appropriate patients who can tolerate TIPS, the treatment may lead towards renal function improvement.
Experiences and support needs of informal long-distance caregivers at the end of life: a scoping review
Authors: Ülgüt Rojda , Stiel Stephanie , Herbst Franziska A 
Published: April 2023

ObjectivesThere is a lack of research on the specific experiences and needs of geographically distant kin caregivers in end-of-life situations. Clinicians and researchers would benefit from a systematic overview. The scoping review aimed at examining the international literature on the experiences and needs of informal long-distance (LD) caregivers at the end of life, to address gaps in the evidence base, and to make recommendations for further research.DesignThe scoping review was conducted according to the methodological framework of Arksey and O’Malley. Studies of various designs involving kin caregivers were analysed narratively.Data sourcesA highly sensitive strategy was used to search CINAHL, Google Scholar, PsycInfo, PubMed and Web of Science Core Collection, from inception to 8 November 2021, with searches rerun in CINAHL, PsycInfo and PubMed on 31 January 2023. An additional hand search of the reference lists of the identified articles was performed.ResultsTwo authors independently assessed the titles and abstracts of 3827 scientific papers. As a result, 89 full texts were reviewed and 20 articles plus one review were included in the review. Five major themes were identified: (1) LD as a barrier to caregiving, (2) communication difficulties and the role of video and telephone calls, (3) the burdens and benefits of LD caregiving, (4) interaction and conflict with local caregivers and (5) LD caregivers’ wishes and needs for support.ConclusionsFurther quantitative and mixed-methods studies should be undertaken to improve our understanding of LD caregiving for relatives at the end of life. Studies to explore the feasibility and implementation of communication technologies in end-of-life LD caregiving are also needed.
Effectiveness of interventions designed to mitigate the negative health outcomes of informal caregiving to older adults: an umbrella review of systematic reviews and meta-analyses
Authors: Kirvalidze Mariam , Abbadi Ahmad , Dahlberg Lena , Sacco Lawrence B , Morin Lucas , Calderón-Larrañaga Amaia 
Published: April 2023

ObjectivesThis umbrella review aimed to evaluate whether certain interventions can mitigate the negative health consequences of caregiving, which interventions are more effective than others depending on the circumstances, and how these interventions are experienced by caregivers themselves.DesignAn umbrella review of systematic reviews was conducted.Data sourcesQuantitative (with or without meta-analyses), qualitative and mixed-methods systematic reviews were included.Eligibility criteriaReviews were considered eligible if they met the following criteria: included primary studies targeting informal (ie, unpaid) caregivers of older people or persons presenting with ageing-related diseases; focused on support interventions and assessed their effectiveness (quantitative reviews) or their implementation and/or lived experience of the target population (qualitative reviews); included physical or mental health-related outcomes of informal caregivers.Data extraction and synthesisA total of 47 reviews were included, covering 619 distinct primary studies. Each potentially eligible review underwent critical appraisal and citation overlap assessment. Data were extracted independently by two reviewers and cross-checked. Quantitative review results were synthesised narratively and presented in tabular format, while qualitative findings were compiled using the mega-aggregation framework synthesis method.ResultsThe evidence regarding the effectiveness of interventions on physical and mental health outcomes was inconclusive. Quantitative reviews were highly discordant, whereas qualitative reviews only reported practical, emotional and relational benefits. Multicomponent and person-centred interventions seemed to yield highest effectiveness and acceptability. Heterogeneity among caregivers, care receivers and care contexts was often overlooked. Important issues related to the low quality of evidence and futile overproduction of similar reviews were identified.ConclusionsLack of robust evidence calls for better intervention research and evaluation practices. It may be warranted to avoid one-size-fits-all approaches to intervention design. Primary care and other existing resources should be leveraged to support interventions, possibly with increasing contributions from the non-profit sector.PROSPERO registration numberCRD42021252841; BMJ Open: doi:10.1136/bmjopen-2021-053117.
Effects of a management team training intervention on the compliance with a surgical site infection bundle: a before–after study in operating theatres in the Netherlands
Authors: van Dijk Manon D , van Beeck Ed F , Huis Anita , van der Gun Bernardina TF , Polinder Suzanne , van Eijsden Rianne AM , Burdorf Alex , Vos Margreet C , Erasmus Vicki 
Published: April 2023

ObjectivesTo assess the effects of a quality improvement (QI) team training intervention, by measuring the intervention fidelity and the compliance with a surgical site infection (SSI) bundle in the operating theatre (OT).DesignMulticentre before–after study.SettingThis study was performed in four Dutch hospitals.InterventionThe QI team training intervention consisted of four sessions per hospital and stimulated participants to set culture norms and targets, identify barriers, and formulate management activities to improve compliance with four standard operating procedures (SOPs) of a SSI bundle in the OT. Participants were executive board members, top-level managers, leading clinicians and support staff. The four SOPs were: (1) reducing door movements; (2) preoperative antibiotic prophylaxis prescribing; (3) preoperative shaving; and (4) postoperative normothermia.Poissonand logistic regression analyses were performed to analyse the effect of the intervention on compliance with the individual SOPs (primary outcome measure) and on the influence of medical specialty, time of day the procedure took place and time in the OT (secondary outcome measures).ResultsNot all management layers were successfully involved during all sessions in the hospitals. Top-level managers were best represented in all hospitals, leading clinicians the least. The number of implemented improvement activities was low, ranging between 2 and 14. The team training intervention we developed was not associated with improvements in the compliance with the four SOP of the SSI bundle. Medical specialty, time of day, and time in OT were associated with median number of door movements, and preoperative antibiotic prophylaxis administration.ConclusionThis study showed that after the QI team training intervention the overall compliance with the four SOPs did not improve. Minimal involvement of leading clinicians and a low number of self-initiated activities after the team training were important barriers for compliance.
Colombian Ocular Diseases Epidemiology Study (CODES): incidence and sociodemographic characterisation of keratoconus between 2015 and 2020
Authors: Mejia-Salgado Germán , Cifuentes-González Carlos , Rojas-Carabali William , Zarate-Pinzón Laura , Peña-Pulgar Luisa Fernanda , Polania Diego , Cruz-Reyes Danna Lesley , de-la-Torre Alejandra 
Published: April 2023

ObjectiveTo estimate the incidence and describe the demographic characteristics of keratoconus (KC) in Colombia using national health registry data between January 1st 2015 and December 31th 2020.Methods and analysisWe conducted a nationwide, population-based study using the Integrated Social Protection Information System from the Colombian Ministry of Health, the unique official database in the country. We used the International Classification of Diseases code for KC (H186) to identify the number of new cases of KC and estimate the incidence rates both overall and according to age and sex. We made a standard morbidity ratio map to graph Colombia’s morbidity risk of KC onset.ResultsOf 50 372 424 subjects, 21 710 had KC between 2015 and 2020. However, due to the COVID-19 pandemic, all the incidence rates of this study were based on the 18 419 reported until 2019. The incidence rate in the general population was 10.36 (95% CI 10.08 to 10.64) per 100 000 inhabitants. The incidence peak among males was in their early 20s and females in their late 20s. The overall male to female incidence rate ratio was 1.60. Regarding the distribution of the disease, most cases were reported in Bogotá (48.64%), Antioquia (14.04%) and Cundinamarca (10.38%).ConclusionWe performed the first nationwide, population-based study of KC in Latin America, finding distribution patterns similar to those reported in the literature. This study provides valuable information on the epidemiology of KC in Colombia, which is helpful in the development of policies for the diagnosis, prevention and treatment of the disease.