bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time trends and geographical patterns in suicide among Greenland Inuit
Authors: Seidler Ivalu Katajavaara , Tolstrup Janne Schurmann , Bjerregaard Peter , Crawford Allison , Larsen Christina Viskum Lytken 
Published: March 2023

AbstractBackgroundBetween 1980 and 2018 Greenland has had one of the highest suicide rates in the world with an average rate of 96 suicides per 100,000 people annually. The aim of this study is to investigate suicide rates in Greenland according to age, birth cohort, period, sex, place of residence and suicide method from 1970 until 2018.MethodsSuicide rates were examined using register and census data from 1970–2018 among Greenland Inuit. Rates were calculated by Poisson regression in Stata and by use of Excel. In analyses of the period trends, rates were standardized according to the World Standard Population 2000–2025.ResultsThe suicide rate has been declining since a peak at 120 suicides per 100,000 people annually in the 1980s but remained high at a rate of 81.3 suicides per 100,000 people annually from 2015–2018. Descriptive analyses point to the decrease in male suicides as the primary factor for the overall decreasing rates while the rate among women has been increasing. Simultaneously, the proportion of women who used a violent suicide method increased from 60% in 1970–1979 to 90% in 2010–2018. The highest rates are seen among young people, especially young men aged 20–24 years and youth suicide rates increased with later birth cohorts. When the rates started to increase in the 1980s both the capital Nuuk and East Greenland had the highest rates. Since then, the rate in Nuuk has declined while the rate in East Greenland was three times the national rate from 2015–2018.ConclusionsFrom 1970 to 1989 the suicide rate increased from 28.7 to 120.5 per 100,000 people mirroring a rapid societal transition in the post-colonial period. The rate has slowly declined from the peak in the 1980s but remains at a very high level. Young people in general are at risk, but the steady increase in the rate among women is worrying and there is a need to investigate underlying causes for this development.
The long-term effects of Kerala Diabetes Prevention Program on diabetes incidence and cardiometabolic risk: a study protocol
Authors: Haregu Tilahun , Lekha T. R. , Jasper Smitha , Kapoor Nitin , Sathish Thirunavukkarasu , Panniyammakal Jeemon , Tapp Robyn , Thankappan Kavumpurathu Raman , Mahal Ajay , Absetz Pilvikki , Fisher Edwin B. , Oldenburg Brian 
Published: March 2023

Abstract
Introduction
India currently has more than 74.2 million people with Type 2 Diabetes Mellitus (T2DM). This is predicted to increase to 124.9 million by 2045. In combination with controlling blood glucose levels among those with T2DM, preventing the onset of diabetes among those at high risk of developing it is essential. Although many diabetes prevention interventions have been implemented in resource-limited settings in recent years, there is limited evidence about their long-term effectiveness, cost-effectiveness, and sustainability. Moreover, evidence on the impact of a diabetes prevention program on cardiovascular risk over time is limited.

Objectives
The overall aim of this study is to evaluate the long-term cardiometabolic effects of the Kerala Diabetes Prevention Program (K-DPP). Specific aims are 1) to measure the long-term effectiveness of K-DPP on diabetes incidence and cardiometabolic risk after nine years from participant recruitment; 2) to assess retinal microvasculature, microalbuminuria, and ECG abnormalities and their association with cardiometabolic risk factors over nine years of the intervention; 3) to evaluate the long-term cost-effectiveness and return on investment of the K-DPP; and 4) to assess the sustainability of community engagement, peer-support, and other related community activities after nine years.

Methods
The nine-year follow-up study aims to reach all 1007 study participants (500 intervention and 507 control) from 60 randomized polling areas recruited to the original trial. Data are being collected in two phases. In phase 1 (Survey), we are admintsering a structured questionnaire, undertake physical measurements, and collect blood and urine samples for biochemical analysis. In phase II, we are inviting participants to undergo retinal imaging, body composition measurements, and ECG. All data collection is being conducted by trained Nurses. The primary outcome is the incidence of T2DM. Secondary outcomes include behavioral, psychosocial, clinical, biochemical, and retinal vasculature measures. Data analysis strategies include a comparison of outcome indicators with baseline, and follow-up measurements conducted at 12 and 24 months. Analysis of the long-term cost-effectiveness of the intervention is planned.

Discussion
Findings from this follow-up study will contribute to improved policy and practice regarding the long-term effects of lifestyle interventions for diabetes prevention in India and other resource-limited settings.

Trial registration
Australia and New Zealand Clinical Trials Registry–(updated from the original trial)ACTRN12611000262909; India: CTRI/2021/10/037191.
Association between atherogenic index of plasma and periodontitis among U.S. adults
Authors: Sun Jing , Guo Ge 
Published: March 2023

Abstract
Background
Serum lipids have been proven to influence periodontitis. The atherogenic index of plasma (AIP) is an important marker of lipid levels. The purpose of this study was to investigate the association between periodontitis and AIP in adults.

Methods
The study included participants from the 2009–2014 National Health and Nutrition Examination Survey who received a complete periodontal exam and a complete record of AIP. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Periodontitis can be classified into four categories based on attachment loss and probing depth (no periodontitis, moderate periodontitis, mild periodontitis, and severe periodontitis). Multivariable logistic regression after adjusting and hierarchical analysis were conducted to investigate the relationship between periodontitis and AIP in adults.

Results
The final sample included 4,371 participants, representing approximately 60 million people in the United States. Periodontitis among the AIP groups (quartile, Q1-Q4) was statistically significant (P < 0.05). Univariate analysis showed that AIP was associated with the incidence of periodontitis (P < 0.05), but not with the severity of periodontitis (P > 0.05) in participants. Multifactorial logistic regression analysis showed no correlation between the incidence of periodontitis and AIP among all participants (the trend P-value = 0.341), but a significant association with AIP in the non-smoking participants (the trend P-value = 0.031).

Conclusion
There was a significant correlation between periodontitis and AIP in the non-smoking population.
Construction of an evaluation system for medical staff’s occupational protection ability based on knowledge, attitude, and practice theory, and a cross-sectional survey of current conditions
Authors: Zhao Cunyue , Yu Mingguang , Wang Aijun , Xu Xiaofen , Zheng Xing 
Published: March 2023

Abstract
Introduction
Medical personnel should be in close proximity and high frequency of contact with patients, and be exposed to physical, biological and chemical risk factors for a long time. The incidence of various occupational exposures is high. however, there is still a lack of the medical staff Occupational Protection Core Competence Evaluation Index system with high reliability and validity.

Aim
Based on the theory of knowledge, attitude, and practice, the evaluation system of occupational protection ability of medical personnel was established, and the current situation of occupational protection ability of medical personnel at different levels was investigated, so as to take targeted training and intervention measures to improve the occupational protection ability of medical personnel and reduce the incidence of occupational exposure.

Methods
Based on the knowledge, attitude, and practice theory, the index system of occupational protection core competence of medical personnel was initially constructed by literature retrieval, expert consultation, group discussion, semi-structured interview and other qualitative and quantitative methods, and the reliability and validity of the index system was tested by Delphi expert consultation method. By convenient cluster sampling method, from March to September 2021, the current status of occupational protection core competence of medical personnel was investigated among medical staff from one Class III Grade A hospital and two medical schools in Jinan City, Shandong Province, China.

Results
The evaluation system for medical staff’s occupational protection ability included 3 first-level indexes, 11 second-level indexes, and 109 third-level indexes. A total of 684 valid questionnaires were collected from Grade III, Class A hospital medical staff and two medical school students in clinical practice in Shandong, China. Kruskal Walls test showed that there were significant differences in the overall distribution of occupational protection knowledge, attitude, and practice among registered nurses, nursing students, registered physicians, and physician students (H = 70.252, P < 0.001; H = 76.507, P < 0.001; H = 80.782, P < 0.001); there were statistical significance in the knowledge/ attitude/ practice of nursing and physician students at different levels (H = 33.733, P < 0.001; H = 29.158, P < 0.001; H = 28.740, P < 0.001).

Conclusion
The results of the evaluation system for the medical staff’s occupational protection ability are reliable and can provide a reference for training the medical staff’s occupational protection ability. Managers should strengthen the training of theoretical knowledge of occupational protection ability of medical staff.
Optimizing naloxone distribution to prevent opioid overdose fatalities: results from piloting the Systems Analysis and Improvement Approach within syringe service programs
Authors: Patel Sheila V. , Wenger Lynn D. , Kral Alex H. , Sherr Kenneth , Wagner Anjuli D. , Davidson Peter J. , Lambdin Barrot H. 
Published: March 2023

Abstract
Background
Opioid overdose fatalities are preventable with timely administration of naloxone, an opioid antagonist, during an opioid overdose event. Syringe service programs have pioneered naloxone distribution for potential bystanders of opioid overdose. The objective of this study was to pilot test a multi-component implementation strategy—the systems analysis and improvement approach for naloxone (SAIA-Naloxone)—with the goal of improving naloxone distribution by syringe service programs.

Methods
Two syringe service programs participated in a 6-month pilot of SAIA-Naloxone, which included (1) analyzing program data to identify gaps in the naloxone delivery cascade, (2) flow mapping to identify causes of attrition and brainstorm programmatic changes for improvement, and (3) conducting continuous quality improvement to test and assess whether modifications improve the cascade. We conducted an interrupted time series analysis using 52 weeks of data before and 26 weeks of data after initiating SAIA-Naloxone. Poisson regression was used to evaluate the association between SAIA-Naloxone and the weekly number of participants receiving naloxone and number of naloxone doses distributed.

Results
Over the course of the study, 11,107 doses of naloxone were distributed to 6,071 participants. Through SAIA-Naloxone, syringe service programs prioritized testing programmatic modifications to improve data collection procedures, proactively screen and identify naloxone-naïve participants, streamline naloxone refill systems, and allow for secondary naloxone distribution. SAIA-Naloxone was associated with statistically significant increases in the average number of people receiving naloxone per week (37% more SPP participants; 95% CI, 12% to 67%) and average number of naloxone doses distributed per week (105% more naloxone doses; 95% CI, 79% to 136%) beyond the underlying pre-SAIA-Naloxone levels. These initial increases were extended by ongoing positive changes over time (1.6% more SSP participants received naloxone and 0.3% more naloxone doses were distributed in each subsequent week compared to the weekly trend in the pre-SAIA Naloxone period).

Conclusions
SAIA-Naloxone has strong potential for improving naloxone distribution from syringe service programs. These findings are encouraging in the face of the worsening opioid overdose crisis in the United States and support testing SAIA-Naloxone in a large-scale randomized trial within syringe service programs.
Active targeting schemes for nano-drug delivery systems in osteosarcoma therapeutics
Authors: Shi Pengzhi , Cheng Zhangrong , Zhao Kangcheng , Chen Yuhang , Zhang Anran , Gan Weikang , Zhang Yukun 
Published: March 2023

AbstractOsteosarcoma, the most common malignant tumor of the bone, seriously influences people’s lives and increases their economic burden. Conventional chemotherapy drugs achieve limited therapeutic effects owing to poor targeting and severe systemic toxicity. Nanocarrier-based drug delivery systems can significantly enhance the utilization efficiency of chemotherapeutic drugs through targeting ligand modifications and reduce the occurrence of systemic adverse effects. A variety of ligand-modified nano-drug delivery systems have been developed for different targeting schemes. Here we review the biological characteristics and the main challenges of current drug therapy of OS, and further elaborate on different targeting schemes and ligand selection for nano-drug delivery systems of osteosarcoma, which may provide new horizons for the development of advanced targeted drug delivery systems in the future.
CT-based deep learning model for the prediction of DNA mismatch repair deficient colorectal cancer: a diagnostic study
Authors: Cao Wuteng , Hu Huabin , Guo Jirui , Qin Qiyuan , Lian Yanbang , Li Jiao , Wu Qianyu , Chen Junhong , Wang Xinhua , Deng Yanhong 
Published: March 2023

AbstractBackgroundStratification of DNA mismatch repair (MMR) status in patients with colorectal cancer (CRC) enables individual clinical treatment decision making. The present study aimed to develop and validate a deep learning (DL) model based on the pre-treatment CT images for predicting MMR status in CRC.Methods1812 eligible participants (training cohort: n = 1124; internal validation cohort: n = 482; external validation cohort: n = 206) with CRC were enrolled from two institutions. All pretherapeutic CT images from three dimensions were trained by the ResNet101, then integrated by Gaussian process regression (GPR) to develop a full-automatic DL model for MMR status prediction. The predictive performance of the DL model was evaluated using the area under the receiver operating characteristic curve (AUC) and then tested in the internal and external validation cohorts. Additionally, the participants from institution 1 were sub-grouped by various clinical factors for subgroup analysis, then the predictive performance of the DL model for identifying MMR status between participants in different groups were compared.ResultsThe full-automatic DL model was established in the training cohort to stratify the MMR status, which presented promising discriminative ability with the AUCs of 0.986 (95% CI 0.971–1.000) in the internal validation cohort and 0.915 (95% CI 0.870–0.960) in the external validation cohort. In addition, the subgroup analysis based on the thickness of CT images, clinical T and N stages, gender, the longest diameter, and the location of tumors revealed that the DL model showed similar satisfying prediction performance.ConclusionsThe DL model may potentially serve as a noninvasive tool to facilitate the pre-treatment individualized prediction of MMR status in patients with CRC, which could promote the personalized clinical-making decision.
Anti-human immunodeficiency virus-1 activity of MoMo30 protein isolated from the traditional African medicinal plant Momordica balsamina
Authors: Khan Mahfuz , Diop Amad , Gbodossou Erick , Xiao Peng , Coleman Morgan , De Barros Kenya , Duong Hao , Bond Vincent C. , Floyd Virginia , Kondwani Kofi , Rice Valerie Montgomery , Harris-Hooker Sandra , Villinger Francois , Powell Michael D. 
Published: March 2023

AbstractBackgroundPlants are used in traditional healing practices of many cultures worldwide.Momordica balsaminais a plant commonly used by traditional African healers as a part of a treatment for HIV/AIDS. It is typically given as a tea to patients with HIV/AIDS. Water-soluble extracts of this plant were found to contain anti-HIV activity.MethodsWe employed cell-based infectivity assays, surface plasmon resonance, and a molecular-cell model of the gp120-CD4 interaction to study the mechanism of action of the MoMo30-plant protein. Using Edman degradation results of the 15 N-terminal amino acids, we determined the gene sequence of the MoMo30-plant protein from an RNAseq library from total RNA extracted fromMomordica balsamina.ResultsHere, we identify the active ingredient of water extracts of the leaves ofMomordica balsaminaas a 30 kDa protein we call MoMo30-plant. We have identified the gene for MoMo30 and found it is homologous to a group of plant lectins known as Hevamine A-like proteins. MoMo30-plant is distinct from other proteins previously reported agents from the Momordica species, such as ribosome-inactivating proteins such as MAP30 and Balsamin. MoMo30-plant binds to gp120 through its glycan groups and functions as a lectin or carbohydrate-binding agent (CBA). It inhibits HIV-1 at nanomolar levels and has minimal cellular toxicity at inhibitory levels.ConclusionsCBAs like MoMo30 can bind to glycans on the surface of the enveloped glycoprotein of HIV (gp120) and block entry. Exposure to CBAs has two effects on the virus. First, it blocks infection of susceptible cells. Secondly, MoMo30 drives the selection of viruses with altered glycosylation patterns, potentially altering their immunogenicity. Such an agent could represent a change in the treatment strategy for HIV/AIDS that allows a rapid reduction in viral loads while selecting for an underglycosylated virus, potentially facilitating the host immune response.
The persistence and stabilization of auxiliary genes in the human skin virome
Authors: Graham Ema H. , Tom Wesley A. , Neujahr Alison C. , Adamowicz Michael S. , Clarke Jennifer L. , Herr Joshua R. , Fernando Samodha C. 
Published: March 2023

Abstract
Background
The human skin contains a diverse microbiome that provides protective functions against environmental pathogens. Studies have demonstrated that bacteriophages modulate bacterial community composition and facilitate the transfer of host-specific genes, potentially influencing host cellular functions. However, little is known about the human skin virome and its role in human health. Especially, how viral-host relationships influence skin microbiome structure and function is poorly understood.

Results
Population dynamics and genetic diversity of bacteriophage communities in viral metagenomic data collected from three anatomical skin locations from 60 subjects at five different time points revealed that cutaneous bacteriophage populations are mainly composed of tailed Caudovirales phages that carry auxiliary genes to help improve metabolic remodeling to increase bacterial host fitness through antimicrobial resistance. Sequence variation in the MRSA associated antimicrobial resistance gene, erm(C) was evaluated using targeted sequencing to further confirm the presence of antimicrobial resistance genes in the human virome and to demonstrate how functionality of such genes may influence persistence and in turn stabilization of bacterial host and their functions.

Conclusions
This large temporal study of human skin associated viruses indicates that the human skin virome is associated with auxiliary metabolic genes and antimicrobial resistance genes to help increase bacterial host fitness.
Comparison of clinical outcomes between aggressive and non-aggressive intravenous hydration for acute pancreatitis: a systematic review and meta-analysis
Authors: Li Xiu-Wei , Wang Chien-Ho , Dai Jhih-Wei , Tsao Shu-Han , Wang Po-Hsi , Tai Cheng-Chen , Chien Rong-Nan , Shao Shih-Chieh , Lai Edward Chia-Cheng 
Published: March 2023

AbstractBackgroundCurrent practice guidelines for optimal infusion rates during early intravenous hydration in patients with acute pancreatitis (AP) remain inconsistent. This systematic review and meta-analysis aimed to compare treatment outcomes between aggressive and non-aggressive intravenous hydration in severe and non-severe AP.MethodsThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase and Cochrane Library for randomized controlled trials (RCTs) on November 23, 2022, and hand-searched the reference lists of included RCTs, relevant review articles and clinical guidelines. We included RCTs that compared clinical outcomes from aggressive and non-aggressive intravenous hydration in AP. Meta-analysis was performed using a random-effects model for participants with severe AP and non-severe AP. Our primary outcome was all-cause mortality, and several secondary outcomes included fluid-related complications, clinical improvement and APACHE II scores within 48 h.ResultsWe included a total of 9 RCTs with 953 participants. The meta-analysis indicated that, compared to non-aggressive intravenous hydration, aggressive intravenous hydration significantly increased mortality risk in severe AP (pooled RR: 2.45, 95% CI: 1.37, 4.40), while the result in non-severe AP was inconclusive (pooled RR: 2.26, 95% CI: 0.54, 9.44). However, aggressive intravenous hydration significantly increased fluid-related complication risk in both severe (pooled RR: 2.22, 95% CI 1.36, 3.63) and non-severe AP (pooled RR: 3.25, 95% CI: 1.53, 6.93). The meta-analysis indicated worse APACHE II scores (pooled mean difference: 3.31, 95% CI: 1.79, 4.84) in severe AP, and no increased likelihood of clinical improvement (pooled RR:1.20, 95% CI: 0.63, 2.29) in non-severe AP. Sensitivity analyses including only RCTs with goal-directed fluid therapy after initial fluid resuscitation therapy yielded consistent results.ConclusionsAggressive intravenous hydration increased the mortality risk in severe AP, and fluid-related complication risk in both severe and non-severe AP. More conservative intravenous fluid resuscitation protocols for AP are suggested.Graphical Abstract
Service composition considering energy consumption of users and transferring files in a multicloud environment
Authors: Li Jianmin , Zhu Shunzhi 
Published: March 2023

AbstractIn the internet and cloud environment, service composition is always used to enhance the function and processing ability of clouds. Those clouds work together for a user and provide different functions. A service request may involve multiple clouds. The past work focuses on the method of service composition and ignores the energy composition when files are transferred between clouds, including the energy consumption for transferring files (sending files from the user to the cloud and receiving files from the cloud to the user) of the user. The paper models the service composition in a multicloud environment. Based on those models, we use the GA (genetic algorithm) algorithm (GA-C) to solve the service composition problem with multiple targets in a multicloud environment. Simulation results show that the GA-C can: (1) reduce the average number of involved clouds and the energy consumption between clouds, and (2) reduce the energy consumption of the user and the failure rate of service composition.