bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
Authors: Dong Hong , Chi Jinghan , Wang Wei , Liu Lei 
Published: April 2023

Abstract
Background
Interpregnancy interval (IPI) has been linked with several maternal and neonatal adverse events in the general population. However, the association between IPI and maternal and neonatal outcomes in women whose first delivery was by cesarean delivery is unclear. We aimed to investigate the association between IPI after cesarean delivery and the risk of maternal and neonatal adverse events.

Methods
Women (aged ≥ 18 years) whose first delivery was cesarean delivery with 2 consecutive singleton pregnancies from the National Vital Statistics System (NVSS) database between 2017 and 2019 were included in this retrospective cohort study. In this post-hoc analysis, logistic regression analyses were used to examine IPI (≤ 11, 12–17, 18–23 [reference], 24–35, 36–59, and ≥ 60 months) in relation to the risk of repeat cesarean delivery, maternal adverse events (maternal transfusion, ruptured uterus, unplanned hysterectomy, and admission to an intensive care unit), and neonatal adverse events (low birthweight, premature birth, Apgar score at 5 min < 7, and abnormal conditions of the newborn). Stratified analysis based on age (< 35 and ≥ 35 years) and previous preterm birth.

Results
We included 792,094 maternities, 704,244 (88.91%) of which underwent a repeat cesarean delivery, 5,246 (0.66%) women had adverse events, and 144,423 (18.23%) neonates had adverse events. After adjusting for confounders, compared to an IPI of 18–23 months, the IPI of ≤ 11 months [odds ratio (OR) = 1.55, 95% confidence interval (CI): 1.44–1.66], 12–17 months (OR = 1.38, 95%CI: 1.33–1.43), 36–59 months (OR = 1.12, 95%CI: 1.10–1.15), and ≥ 60 months (OR = 1.19, 95%CI: 1.16–1.22) were associated with an increased risk of repeat cesarean delivery. In terms of maternal adverse events, only IPI of ≥ 60 months (OR = 0.85, 95%CI: 0.76–0.95) was observed to be associated with decreased risk of maternal adverse events in women aged < 35 years. In analysis of neonatal adverse events, IPI of ≤ 11 months (OR = 1.14, 95%CI: 1.07–1.21), 12–17 months (OR = 1.07, 95%CI: 1.03–1.10), and ≥ 60 months (OR = 1.05, 95%CI: 1.02–1.08) were related to an increased risk of neonatal adverse events.

Conclusion
Both short and long IPI were associated with an increased risk of repeat cesarean delivery and neonatal adverse events, and women < 35 years may benefit from a longer IPI.
Location, age, and race matter: a path model of emotional distress in the U.S. during COVID-19
Authors: Clark Viktor , Ming Hannah , Kim Sunny Jung 
Published: April 2023

Abstract
Background
We aim to identify factors that explain emotional distress among underserved populations during the COVID-19 pandemic.

Methods
Starting in August 2020, we conducted an online epidemiological survey among 947 U.S. adults. The survey asked a wide array of constructs, including demographics, past-month substance use, and psychological distress. We developed a path model to understand how financial strain, age, and substance use are associated with emotional distress among People of Color (POC) and those living in rural areas.

Results
22.6% (n = 214) of participants were POC; 114 (12%) resided in rural areas; 17.2% (n = 163) made between $50,000 and $74,999 annually; and the emotional distress average was 1.41 (SD = 0.78). POC, especially those younger, experienced higher rates of emotional distress (p < .05). People living in rural contexts reported lower rates of emotional distress through low alcohol intoxication and less financial strain (p < .05).

Conclusions
We found mediating factors related to emotional distress among vulnerable populations during the COVID-19 pandemic. Younger POC experienced higher rates of emotional distress. People in rural communities had less emotional distress when they had fewer days spent intoxicated by alcohol, which was associated with lower financial strain. We conclude with a discussion of important unmet needs and future research directions.
A novel thermostable TP-84 capsule depolymerase: a method for rapid polyethyleneimine processing of a bacteriophage-expressed proteins
Authors: Łubkowska Beata , Czajkowska Edyta , Stodolna Aleksandra , Sroczyński Michał , Zylicz-Stachula Agnieszka , Sobolewski Ireneusz , Skowron Piotr M. 
Published: April 2023

Abstract
Background
In spite of the fact that recombinant enzymes are preferably biotechnologically obtained using recombinant clones, the purification of proteins from native microorganisms, including those encoded by bacteriophages, continues. The native bacteriophage protein isolation is often troubled by large volumes of the infected bacterial cell lysates needed to be processed, which is highly undesired in scaled-up industrial processing. A well-known ammonium sulphate fractionation is often a method of choice during purification of the native bacteriophage protein. However, this method is time-consuming and cumbersome, and requires large amounts of the relatively expensive reagent. Thus, other effective and inexpensive methods of reversible protein precipitation are highly desirable. We have previously characterized thermophilic TP-84 bacteriophage, defined a new genus TP84virus within Siphoviridae family, conducted the TP-84 genome annotation and proteomic analysis. The longest Open Reading Frame (ORF) identified in the genome is TP84_26. We have previously annotated this ORF as a hydrolytic enzyme depolymerizing the thick polysaccharides host’s capsule.

Results
The TP84_26 ‘capsule depolymerase’ (depolymerase) is a large, 112 kDa protein, biosynthesized by the infected Geobacillus stearothermophilus 10 (G. stearothermophilus 10) cells. The TP84_26 protein biosynthesis was confirmed by three approaches: (i) purification of the protein of the expected size; (ii) mass spectrometry (LC–MS) analysis and (iii) detection of the enzymatic activity toward G. stearothermophilus polysaccharide capsules. Streptomycin-resistant mutant of the host was generated and microbiological aspects of both the TP-84 and G. stearothermophilus 10 were determined. A new variant of polyethyleneimine (PEI)-mediated purification method was developed, using the novel TP-84 depolymerase as a model. The enzyme was characterized. Three depolymerase forms were detected: soluble, unbound proteins in the bacteriophage/cells lysate and another integrated into the TP-84 virion.

Conclusions
The novel TP-84 depolymerase was purified and characterized. The enzyme exists in three forms. The soluble, unbound forms are probably responsible for the weakening of the capsules of the uninfected bacterial cells. The form integrated into virion particles may generate a local passage for the invading TP-84. The developed PEI purification method appears well suited for the scaled-up or industrial production of bacteriophage proteins.
Differential transmissibility to Anopheles arabiensis of Plasmodium vivax gametocytes in patients with diverse Duffy blood group genotypes
Authors: Abate Andargie , Hassen Jifar , Dembele Laurent , Menard Didier , Golassa Lemu 
Published: April 2023

Abstract
Background
Measuring risk of malaria transmission is complex, especially in case of Plasmodium vivax. This may be overcome using membrane feeding assays in the field where P. vivax is endemic. However, mosquito-feeding assays are affected by a number of human, parasite and mosquito factors. Here, this study identified the contributions of Duffy blood group status of P. vivax-infected patients as a risk of parasite transmission to mosquitoes.

Methods
A membrane feeding assay was conducted on a total of 44 conveniently recruited P. vivax infected patients in Adama city and its surroundings in East Shewa Zone, Oromia region, Ethiopia from October, 2019 to January, 2021. The assay was performed in Adama City administration. Mosquito infection rates were determined by midgut dissections at seven to 8 days post-infection. Duffy genotyping was defined for each of the 44 P. vivax infected patients.

Results
The infection rate of Anopheles mosquitoes was 32.6% (296/907) with 77.3% proportion of infectious participants (34/44). Infectiousness of participants to Anopheles mosquitoes appeared to be higher among individuals with homozygous Duffy positive blood group (TCT/TCT) than heterozygous (TCT/CCT), but the difference was not statistically significant. The mean oocyst density was significantly higher among mosquitoes fed on blood of participants with FY*B/FY*BES than other genotypes (P = 0.001).

Conclusion
Duffy antigen polymorphisms appears to contribute to transmissibility difference of P. vivax gametocytes to Anopheles mosquitoes, but further studies are required.
Protective and risk factors of impaired awareness of hypoglycemia in patients with type 1 diabetes: a cross-sectional analysis of baseline data from the PR-IAH study
Authors: Sakane Naoki , Kato Ken , Hata Sonyun , Nishimura Erika , Araki Rika , kouyama Kunichi , Hatao Masako , Matoba Yuka , Matsushita Yuichi , Domichi Masayuki , Suganuma Akiko , Sakane Seiko , Murata Takashi , Wu Fei Ling 
Published: April 2023

Abstract
Background
Hypoglycemia in type 1 diabetes (T1D) is associated with mortality and morbidity, especially when awareness of hypoglycemia is impaired. This study aimed to investigate the protective and risk factors for impaired awareness of hypoglycemia (IAH) in adults with T1D.

Methods
This cross-sectional study enrolled 288 adults with T1D (mean age, 50.4 ± 14.6 years; male, 36.5%; diabetes duration, 17.6 ± 11.2 years; mean HbA1c level, 7.7 ± 0.9%), who were divided into IAH and non-IAH (control) groups. A survey was conducted to assess hypoglycemia awareness using the Clarke questionnaire. Diabetes histories, complications, fear of hypoglycemia, diabetes distress, hypoglycemia problem-solving abilities, and treatment data were collected.

Results
The prevalence of IAH was 19.1%. Diabetic peripheral neuropathy was associated with an increased risk of IAH (odds ratio [OR] 2.63; 95% confidence interval [CI] 1.13–5.91; P = 0.014), while treatment with continuous subcutaneous insulin infusion and hypoglycemia problem-solving perception scores were associated with a decreased risk of IAH (OR, 0.48; 95% CI, 0.22–0.96; P = 0.030; and OR, 0.54; 95% CI, 0.37–0.78; P = 0.001, respectively). There was no difference in continuous glucose monitoring use between the groups.

Conclusion
We identified protective factors in addition to risk factors for IAH in adults with T1D. This information may help manage problematic hypoglycemia.

Trial registration
University hospital Medical Information Network (UMIN) Center: UMIN000039475). Approval date 13 February 2020.
A study of glycemic perturbations following two doses of COVID-19 vaccination for patients with diabetes: the impacts of vaccine type and anti-diabetes drugs
Authors: Lin Cheng-Wei , Hung Shih-Yuan , Chen I-Wen 
Published: April 2023

Abstract
Background
Glycemic monitoring has become critical during the COVID-19 pandemic because of poor prognosis in diabetes. Vaccines were key in reducing the spread of infection and disease severity but data were lacking on effects on blood sugar levels. The aim of the current study was to investigate the impact of COVID-19 vaccination on glycemic control.

Methods
We performed a retrospective study of 455 consecutive patients with diabetes who completed two doses of COVID-19 vaccination and attended a single medical center. Laboratory measurements of metabolic values were assessed before and after vaccination, while the type of vaccine and administrated anti-diabetes drugs were analyzed to find independent risks associated with elevated glycemic levels.

Results
One hundred and fifty-nine subjects received ChAdOx1 (ChAd) vaccines, 229 received Moderna vaccines, and 67 received Pfizer–BioNtech (BNT) vaccines. The average HbA1c was raised in the BNT group from 7.09 to 7.34% (P = 0.012) and non-significantly raised in ChAd (7.13 to 7.18%, P = 0.279) and Moderna (7.19 to 7.27%, P = 0.196) groups. Both Moderna and BNT groups had around 60% of patients with elevated HbA1c following two doses of COVID-19 vaccination, and the ChAd group had only 49%. Under logistic regression modeling, the Moderna vaccine was found to independently predict the elevation of HbA1c (Odds ratio 1.737, 95% Confidence interval 1.12–2.693, P = 0.014), and sodium-glucose co-transporter 2 inhibitor (SGLT2i) was negatively associated with elevated HbA1c (OR 0.535, 95% CI 0.309–0.927, P = 0.026).

Conclusions
Patients with diabetes might have mild glycemic perturbations following two doses of COVID-19 vaccines, particularly with mRNA vaccines. SGLT2i showed some protective effect on glycemic stability. Hesitancy in having vaccinations should not be indicated for diabetic patients with respect to manageable glycemic change.

Trial registration
Not applicable.
Extracellular enzymes secreted in the mycelial block of Lentinula edodes during hyphal growth
Authors: Kobayashi Nanae , Wada Nagisa , Yokoyama Haruna , Tanaka Yuki , Suzuki Tomohiro , Habu Naoto , Konno Naotake 
Published: April 2023

AbstractLentinula edodes (shiitake mushroom) is one of the most widely cultivated edible mushrooms and is primarily cultivated using sawdust medium. While there have been improvements in the cultivation technology, the mechanism of mycelial block cultivation, such as mycelial growth and enzymatic sawdust degradation, has not been clarified. In this study, the mycelium was elongated longitudinally in the bottle sawdust culture for 27 days, and the cultivated sawdust medium was divided into three sections (top, middle, and bottom parts). To determine spatial heterogeneity in the enzyme secretion, the enzymatic activities of each part were analyzed. Lignocellulose degradation enzymes, such as endoglucanase, xylanase, and manganese peroxidase were highly secreted in the top part of the medium. On the other hand, amylase, pectinase, fungal cell wall degradation enzyme (β-1,3-glucanase, β-1,6-glucanase, and chitinase), and laccase activities were higher in the bottom part. The results indicate that the principal sawdust degradation occurs after mycelial colonization. Proteins with the laccase activity were purified from the bottom part of the medium, and three laccases, Lcc5, Lcc6 and Lcc13, were identified. In particular, the expression of Lcc13 gene was higher in the bottom part compared with the level in the top part, suggesting Lcc13 is mainly produced from the tip region and have important roles for mycelial spread and nutrient uptake during early stage of cultivation.
The COVID-19 Israeli tapestry: the intersectionality health equity challenge
Authors: Shadmi Efrat , Khatib Mohammad , Spitzer Sivan 
Published: April 2023

Abstract
Background
COVID-19 is disproportionately affecting disadvantaged populations, with greater representation and worse outcomes in low socioeconomic and minority populations, and in persons from marginalized groups. General health care system approaches to inequity reduction (i.e., the minimization of differences in health and health care which are considered unfair or unjust), address the major social determinants of health, such as low income, ethnic affiliation or remote place of residents. Yet, to effectively reduce inequity there is a need for a multifactorial consideration of the aspects that intersect and generate significant barriers to effective care that can address the unique situations that people face due to their gender, ethnicity and socioeconomic situation.

Main body
To address the health equity challenges of diverse population groups in Israel, we propose to adopt an intersectional approach, allowing to better identify the needs and then better tailor the infection prevention and control modalities to those who need them the most. We focus on the two main ethnic – cultural—religious minority groups, that of Arab Palestinian citizens of Israel and Jewish ultra-orthodox (Haredi) communities. Additionally, we address the unique needs of persons with severe mental illness who often experience an intersection of clinical and sociodemographic risks.

Conclusions
This perspective highlights the need for responses to COVID-19, and future pandemic or global disasters, that adopt the unique lens of intersectionality and equity. This requires that the government and health system create multiple messages, interventions and policies which ensure a person and community tailored approach to meet the needs of persons from diverse linguistic, ethnic, religious, socioeconomic and cultural backgrounds. Under-investment in intersectional responses will lead to widening of gaps and a disproportionate disease and mortality burden on societies’ most vulnerable groups.
The danger of the toxicity and inefficacy of alcohol-based hand rubs in Iran during COVID-19: a cross-sectional study
Authors: Rafizadeh Ali , Kolahi Ali-Asghar , Shariati Shahab , Zamani Nasim , Roberts Darren M , Hassanian-Moghaddam Hossein 
Published: April 2023

Abstract
Background
The use of disinfectants and alcohol-based hand rubs (ABHR) to prevent COVID-19 transmission increased in the first wave of the infection. To meet the increased demand, the Iranian Ministry of Health issued an emergency use authorization allowing new manufacturers to enter the market, despite the limited capacity for surveillance of these products during COVID-19. Methanol poisoning outbreaks spread rapidly, and more people died from methanol poisoning than COVID-19 in some cities. The aim of this study was to analyze some ABHRs in the Iranian market to see if (a) ABHRs are standard and suitable for hand antisepsis and (b) contained potentially dangerous toxic alcohols.

Method
Between February and March 2020, 64 brands of ABHR were conveniently collected from pharmacies, supermarkets, and shops selling hygienic products and analyzed using Gas Chromatography. World Health Organization and Food and Drug Administration guidelines were used to define minimum requirements for ABHR. For estimating the risk for acute methanol poisoning, we assumed a serum methanol concentration of 200 mg/L following ABHR ingestion was sufficient to cause intoxication. This threshold concentration would be achieved in an average 75-kg adult after consuming 8000 mg (or eight grams) methanol in 1–2 h.

Results
The median [IQR] (range) concentration of ethanol, isopropanol, and methanol were 59% v/v [32.2, 68] (0, 99), 0 mg/L [0, 0] (0, 197,961), and 0 mg/L [0, 0] (0, 680,100), respectively. There was a strong negative correlation between methanol and ethanol contents of hand rubbers (r= -0.617, p < 0.001). Almost 47% of ABHRs complied with minimum standards. In 12.5% of ABHRs, high concentrations of methanol were observed, which have no antiseptic properties but could cause acute methanol poisoning if ingested.

Conclusion
COVID-19 initiated a policy for distribution and use of ABHR with little control. As ABHR and masks are still accepted preventive measures of the disease, non-standard ABHR compositions may increase the population’s risk to both COVID-19 infection and methanol poisoning.
The spectrum of phenylalanine hydroxylase variants and genotype–phenotype correlation in phenylketonuria patients in Gansu, China
Authors: Zhang Chuan , Zhang Pei , Yan Yousheng , Zhou Bingbo , Wang Yupei , Tian Xinyuan , Hao Shengju , Ma Panpan , Zheng Lei , Zhang Qinghua , Hui Ling , Wang Yan , Cao Zongfu , Ma Xu 
Published: April 2023

Abstract
Background
Phenylketonuria (PKU) is a common, congenital, autosomal recessive, metabolic disorder caused by Phenylalanine hydroxylase (PAH) variants.

Methods
967 PKU patients from Gansu, China were genotyped by Sanger sequencing, multiplex ligation-dependent probe amplification, and whole exome sequencing. We analyzed the variants of PAH exons, their flanking sequences, and introns.

Results
The detection of deep intronic variants in PAH gene can significantly improve the genetic diagnostic rate of PKU. The distribution of PAH variants among PKU subtypes may be related to the unique genetic background in Gansu, China.

Conclusion
The identification of PAH hotspot variants will aid the development of large-scale neonatal genetic screening for PKU. The five new PAH variants found in this study further expand the spectrum of PAH variants. Genotype–phenotype correlation analysis may help predict the prognosis of PKU patients and enable precise treatment regimens to be developed.
Risk factors of cognitive impairment post-ischemic stroke
Authors: Utomo Nunki Puspita , Pinzon Rizaldy Taslim 
Published: April 2023

Abstract
Background
Stroke is still remarked as one of the major ailments in Indonesia. Cognitive impairment occurs frequently after stroke events and its predictors are needed to identify patients with a high risk of cognitive impairment. However, the researches done in Indonesia still vary in results. This retrospective cohort study evaluated 236 ischemic stroke patients in Bethesda Hospital Yogyakarta from January–November 2020 through medical records. Cognitive impairment was measured by MMSE and CDT, defined as MMSE score $$\le$$
≤
20 for patients with the educational attainment of 1–6 years; $$\le$$
≤
24 for the educational attainment of > 6 years and/ or CDT < 4. All data were analyzed with univariate test and Chi-square test, followed by logistic regression.

Results
Of 236 subjects, the frequency of cognitive impairment was 67.4% and the risk factors are age > 80 years old (RR: 1,545; CI 0.136–17.542; p: 0.026), educational attainment ≤ 6 years (RR: 20.016; CI 1.951–222.120; p: 0.012), temporal (RR: 4.238; CI 2.266–7.926; p: 0.007) or multiple site lesion location (RR: 7.522; CI: 3.522–17.532; p: 0.047) and multiple (> 1) lesions (RR: 1,819; CI 0.822–4.022; p: 0.040).

Conclusions
The prevalence of post-stroke cognitive impairment is high, affecting up to 2 out of 3 people in this study. The risk factors of post-stroke cognitive impairment are age > 80 years, educational attainment $$\le$$
≤
6 years, temporal or multiple site lesion, and > 1 lesion. Strict stroke prevention strategies are needed to halt the development of post-stroke cognitive impairment.
Development of a machine learning-based method for the analysis of microplastics in environmental samples using µ-Raman spectroscopy
Authors: Weber Felix , Zinnen Andreas , Kerpen Jutta 
Published: April 2023

AbstractThis research project investigates the potential of machine learning for the analysis of microplastic Raman spectra in environmental samples. Based on a data set of > 64,000 Raman spectra (10.7% polymer spectra) from 47 environmental or waste water samples, two methods of deep learning (one single model and one model per class) with the Rectified Linear Unit function (ReLU) (hidden layer) as the activation function and the sigmoid function as the output layer were evaluated and compared to human-only annotation. Based on the one-model-per-class algorithm, an approach for human–machine teaming was developed. This method makes it possible to analyze microplastic (polyethylene, polypropylene, polystyrene, polyvinyl chloride, and polyethylene terephthalate) spectra with high recall (≥ 99.4%) and precision (≥ 97.1%). Compared to human-only spectra annotation, the human–machine teaming reduces the researchers’ time required per sample from several hours to less than one hour.
Medication choice in post-traumatic stress disorder
Authors: Cooper Heidi 
Published: April 2023

SUMMARYPost-traumatic stress disorder is a disabling condition resulting from a range of traumas and affecting many people worldwide. This month's Cochrane Corner review systematically searched and reported findings from 66 randomised controlled trials of pharmacotherapy for PTSD, 54 of which were included in a meta-analysis. Evidence was shown for the benefit of selective serotonin reuptake inhibitors, mirtazapine and amitriptyline in treatment response. This Round the Corner commentary critically appraises the review's findings, concluding that the summative evidence was of poor quality owing to the low number of studies, the high risk of bias and significant heterogeneity.