bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivating non-physician health workers to reduce the behavioral risk factors of non-communicable diseases in the community: a field trial study
Authors: Asadi-Aliabadi Mehran , Karimi Seyed M. , Mirbaha-Hashemi Fariba , Tehrani-Banihashemi Arash , Janani Leila , Babaee Ebrahim , Nojomi Marzieh , Moradi-Lakeh Maziar 
Published: March 2023

Abstract
Background
Non-communicable diseases behavioral risk factors can be improved if effective interventions are designed considering the health system’s capabilities and local resources. This study evaluated the effectiveness of interventions that aimed at increasing non-physician community health workers’ motivation in reducing non-communicable diseases behavioral risk factors in the community.

Methods
A randomized field trial study was conducted in 32 community health centers in 4 Iranian districts after a baseline population survey on the status of NCDs of 30–70-year-old individuals (n = 1225). The interventions were performed to improve insufficient physical activity, insufficient fruit consumption, insufficient vegetable consumption, high salt intake, and tobacco use. Four intervention packages were implemented in 24 community health centers; the other 8 centers were used as control groups. The non-physician community health workers performed the interventions. The packages additively included goal-setting, evidence-based education, operational planning, and incentive payments. A second survey was conducted 1 year after the start of the interventions to identify the effects on an independent random sample of 30–70-year-old individuals (n = 1221). Difference-in-difference method was used to quantify the interventions’ effects.

Results
The average age of participants in both surveys was about 49 years. Also, about half of the participants were female, and about 43% were illiterate or had a primary school education. The interventions had statistically significant effects only on decreasing the prevalence of insufficient physical activity. The package with all the intervention components decreased the odds of insufficient physical activity to 0.24 (95% CI, 0.08, 0.72). The package with operational planning but no performance-based financing did not change the odds of insufficient physical activity.

Conclusions
This study highlighted the importance of components, design, and implementation details of interventions intended to reduce NCDs behavioral risk factors. Some risk factors, such as insufficient physical activity, seem more easily modifiable with limited low-cost interventions in a one-year horizon. However, risk factors related to healthy food consumption and tobacco use need more extensive interventions.

Trial registration
This trial was registered on the Iranian Registry of Clinical Trials (IRCT20081205001488N2) on 3 June 2018 (https://en.irct.ir/trial/774).
Relationship between species richness, taxonomic distinctness, functional diversity, and local contribution to β diversity and effects of habitat disturbance in the riparian spider community of the Ganga River, India
Authors: De Kritish , Singh Amar Paul , Sarkar Arkojyoti , Singh Kritika , Siliwal Manju , Uniyal Virendra Prasad , Hussain Syed Ainul 
Published: March 2023

AbstractBackgroundIn the riverine riparian ecosystem, particularly in India, the knowledge of the effects of habitat disturbance on taxonomic distinctness, functional diversity, and local contribution to β diversity (LCBD) of spider community is elusive. The present study examined the relationships between the index of taxonomic distinctness (Δ+), index of variation in taxonomic distinctness (λ+), functional evenness (FEve), functional divergence (FDiv), functional dispersion (FDis), and LCBD of spider community of the Ganga River and the effects of habitat disturbance on these indices. A total of 27 sampling sites were selected along the bank of the Ganga River. Based on the rating of the disturbance scores, the sites were classified into lowly, moderately, and highly disturbed sites. To understand the relationships between species richness, Δ+, λ+, FDis, FDiv, FEve, LCBD, and habitat disturbance score, Pearson’s correlation was calculated, followed by the linear regression model. The one-way multivariate analysis of variance was used to find differences in taxonomic distinctness and functional diversity in the different disturbed sites.ResultsSignificant relationships were found between λ+and Δ+, FDis and Δ+, FDis and λ+, FDiv and species richness, FEve and species richness, FEve and λ+, FEve and habitat disturbance, LCBD and FEve, and LCBD and habitat disturbance. A significant difference was present in the indices of functional diversity between the lowly, moderately, and highly disturbed sites. Agriculture, garbage dump, human settlement, and created embankment influenced the spider community's λ+, FEve, and LCBD.ConclusionUnrestrained anthropogenic activities exacerbate habitat disturbance by affecting ecological processes. Thus, understanding linkages between ecosystem disturbance, taxonomic, functional, and β diversity can be fundamental to managing and conserving natural resources. This work highlights the importance of including taxonomic and functional diversity to comprehend the impact of habitat disturbance on riverine riparian spiders beyond just the number of species. An integrated taxonomic and functional diversity approach coupled with β diversity can be used to support environmental assessment, restoration, and conservation planning of the biological resources of the Ganges River.
The oncogenic circular RNA circ_63706 is a potential therapeutic target in sonic hedgehog-subtype childhood medulloblastomas
Authors: Katsushima Keisuke , Pokhrel Rudramani , Mahmud Iqbal , Yuan Menglang , Murad Rabi , Baral Prabin , Zhou Rui , Chapagain Prem , Garrett Timothy , Stapleton Stacie , Jallo George , Bettegowda Chetan , Raabe Eric , Wechsler-Reya Robert J. , Eberhart Charles G. , Perera Ranjan J. 
Published: March 2023

AbstractMedulloblastoma (MB) develops through various genetic, epigenetic, and non-coding (nc) RNA-related mechanisms, but the roles played by ncRNAs, particularly circular RNAs (circRNAs), remain poorly defined. CircRNAs are increasingly recognized as stable non-coding RNA therapeutic targets in many cancers, but little is known about their function in MBs. To determine medulloblastoma subgroup-specific circRNAs, publicly available RNA sequencing (RNA-seq) data from 175 MB patients were interrogated to identify circRNAs that differentiate between MB subgroups. circ_63706 was identified as sonic hedgehog (SHH) group-specific, with its expression confirmed by RNA-FISH analysis in clinical tissue samples. The oncogenic function of circ_63706 was characterized in vitro and in vivo. Further, circ_63706-depleted cells were subjected to RNA-seq and lipid profiling to identify its molecular function. Finally, we mapped the circ_63706 secondary structure using an advanced random forest classification model and modeled a 3D structure to identify its interacting miRNA partner molecules. Circ_63706 regulates independently of the host coding gene pericentrin (PCNT), and its expression is specific to the SHH subgroup. circ_63706-deleted cells implanted into mice produced smaller tumors, and mice lived longer than parental cell implants. At the molecular level, circ_63706-deleted cells elevated total ceramide and oxidized lipids and reduced total triglyceride. Our study implicates a novel oncogenic circular RNA in the SHH medulloblastoma subgroup and establishes its molecular function and potential as a future therapeutic target.
A comparison of pin site complications between large and small pin diameters in robotic‐assisted total knee arthroplasty
Authors: Desai Sohil S. , Kunes Jennifer A. , Held Michael B. , Ren Mark , deMeireles Alirio J. , Geller Jeffrey A. , Shah Roshan P. , Cooper H. John 
Published: March 2023

AbstractPurposeRobotic‐assisted total knee arthroplasty typically necessitates use of tracking pins, which can vary in diameter. Complications such as infections and fractures at the pin‐site have been observed, but clarification of the effect of pin diameter on complication is needed. The aim of this study is to compare the pin‐related complication rates following robotic‐assisted total knee arthroplasty between 4.5 mm and 3.2 mm diameter pins.MethodsIn this retrospective cohort study, 90‐day pin‐site complication rates after robotic‐assisted total knee arthroplasty were compared between 4.5 mm diameter and 3.2 mm diameter groups. In total, 367 patients were included: 177 with large pin diameter and 190 with small pin diameter. All four pin sites were evaluated using postoperative radiographs. Cases without orthogonal views or visualization of all four pin tracts were noted. Multivariate logistic regression was used to control for age, which differed between the two cohorts.ResultsThe rate of pin‐site complications was 5.6% in the large pin diameter cohort and 2.6% in the small pin diameter cohort, with no statistically significant difference between the groups. The adjusted odds ratio for complications in small compared to large diameter group was 0.48, with a p‐value of 0.18. The most common pin‐site complication was infection/persistent drainage, found in 1.9% of patients, followed by intraoperative fracture of the second cortex in 1.4%. Intraoperative fracture could not be ruled out in 96 cases due to inadequate radiographic visualization of all pin sites. There was one postoperative pin‐site fracture in the large diameter cohort, which required operative fixation.ConclusionThis study demonstrates no statistically significant difference in pin‐site complication rates after robotic‐assisted total knee arthroplasty between 4.5 mm and 3.2 mm pin diameter cohorts, although there was a trend towards increased intraoperative and postoperative pin‐site fractures in the 4.5 mm group.
Prevalence of undernutrition among pregnant women and its differences across relevant subgroups in rural Ethiopia: a community-based cross-sectional study
Authors: Chea Nana , Tegene Yadessa , Astatkie Ayalew , Spigt Mark 
Published: March 2023

AbstractBackgroundMaternal undernutrition is one of the commonest public health problems in many low- and middle-income countries where generally more than 20% of women are undernourished. It is more common in rural areas due to unclear factors. Therefore, the aim of this study was to investigate the prevalence of undernutrition in general and in subgroups and determine risk factors among pregnant women in rural Ethiopia.MethodsA community-based cross-sectional survey was conducted from April 30 to May 30, 2019 on 550 pregnant women who were randomly selected from six districts in southern Ethiopia. Trained and experienced nurses measured undernutrition using mid-upper arm circumference and collected other data. We used multilevel mixed-effect logistic regression to identify factors associated with undernutrition among pregnant women.ResultsThe prevalence of undernutrition among pregnant women was 38% (95% CI: (34.2–42.3). The odds of undernutrition was higher among women who got pregnant previously (adjusted odds ratio [AOR]: 1.66; 95% CI: 1.02–2.71), who had a history of miscarriage (AOR: 3.18; 95% CI: 1.77–5.70), who practiced food taboos (AOR: 2.23; 95% CI: 1.47–3.39), and who did not get any nutritional counseling during pregnancy (AOR: 2.97; 95% CI: 1.79- 4.95). The prevalence of undernutrition was higher among pregnant women who had multiple risk factors and the difference was statistically significant (p < 0.001).ConclusionUndernutrition is a highly prevalent problem among rural Ethiopian pregnant women, especially with those who avoid food, do not get counseled, and had two or more pregnancies and a history of miscarriage. Improving the integration of nutrition programs with routine healthcare services and encouraging a multi-sectorial intervention strategy would help to reduce maternal undernutrition in the country.
Immunoexpression of CDX2 in metastatic nonintestinal adenocarcinomas: an immunohistochemical pitfall and its pathological implications
Authors: Agarwal Krachi , Agarwal Preeti , Singh Shipra , Jain Mili , Qayoom Sumaira 
Published: March 2023

Abstract
Background
CDX2, a homeobox gene is the marker of intestinal differentiation. Its expression may lead to misdiagnosis while evaluating metastasis from unknown primary. In the present narrative, we discuss the clinical, morphological, and immunohistochemical (IHC) findings of metastatic adenocarcinoma of the lymph node that displayed nuclear immunoexpression of CDX2. However, the clinical and radiological picture supported the non-intestinal primary; prostate in one and lung in the other.

Case presentation
A 68-year-old man presented cervical lymph node enlargement. An epithelial tumor with acinar and cribriform pattern was seen that showed expression of CK, CDX2, and PSA in IHC. The patients complained of nonspecific symptoms related to both the gastrointestinal system and the prostate. Serum PSA was diagnostic (> 500 ng/ml). Similarly, core biopsy from mediastinal lymph node from a 51-year-male was received with possible differential of cancer and tuberculosis. Moderately differentiated adenocarcinoma was observed with the expression of EMA, CK 7, CDX2, and TTF1. The expression of both CDX2 and TTF1 was patchy. When the patient was called and all the details were sought the computed tomography (CT) thorax showed a lower chest wall lesion and multiple metastasis. The case was hence signed off as primary from lung on basis of clinical picture.

Conclusion
Such deviants must be reported and recorded. The knowledge of these will make a pathologist cautious and thus avoid misdiagnosis.
Comparing five equations to calculate estimated glomerular filtration rate to predict acute kidney injury following total joint arthroplasty
Authors: Mekkawy Kevin L. , Chaudhry Yash P. , Rao Sandesh S. , Raad Micheal , Amin Raj M. , Khanuja Harpal S. 
Published: March 2023

Abstract
Background
Acute kidney injury (AKI) following total joint arthroplasty (TJA) is associated with increased morbidity and mortality. Estimated glomerular filtration rate (eGFR) is used as an indicator of renal function. The purpose of this study was (1) to assess each of the five equations that are used in calculating eGFR, and (2) to evaluate which equation may best predict AKI in patients following TJA.

Methods
The National Surgical Quality Improvement Program (NSQIP) was queried for all 497,261 cases of TJA performed from 2012 to 2019 with complete data. The Modification of Diet in Renal Disease (MDRD) II, re-expressed MDRD II, Cockcroft-Gault, Mayo quadratic, and Chronic Kidney Disease Epidemiology Collaboration equations were used to calculate preoperative eGFR. Two cohorts were created based on the development of postoperative AKI and were compared based on demographic and preoperative factors. Multivariate regression analysis was used to assess for independent associations between preoperative eGFR and postoperative renal failure for each equation. The Akaike information criterion (AIC) was used to evaluate predictive ability of the five equations.

Results
Seven hundred seventy-seven (0.16%) patients experienced AKI after TJA. The Cockcroft-Gault equation yielded the highest mean eGFR (98.6 ± 32.7), while the Re-expressed MDRD II equation yielded the lowest mean eGFR (75.1 ± 28.8). Multivariate regression analysis demonstrated that a decrease in preoperative eGFR was independently associated with an increased risk of developing postoperative AKI in all five equations. The AIC was the lowest in the Mayo equation.

Conclusions
Preoperative decrease in eGFR was independently associated with increased risk of postoperative AKI in all five equations. The Mayo equation was most predictive of the development of postoperative AKI following TJA. The mayo equation best identified patients with the highest risk of postoperative AKI, which may help providers make decisions on perioperative management in these patients.
Semen human papillomavirus (HPV) shedding in males: frequency, clinical significance, and reproductive outcomes—literature review
Authors: Zhaffal Mokhamad , Salame Anastasia 
Published: March 2023

Abstract
Background
The interest in the HPV status of the male has risen after the discovery of HPV shedding in the semen. To date, there is no consensus on the true prevalence of male HPV infection, yet there is a rising body of evidence suggesting that male HPV infection might negatively affect the sperm parameters.

Main body
The concern that HPV can lead to a couple’s infertility and affect reproductive outcomes had increased after the multiple publications of semen criteria perturbations specifically the asthenospermia associated with HPV infection. An extensive literature review was performed to define the actual frequency of male HPV infection as well as the true extent of sperm analysis perturbations related to the HPV illness. We also intended to define the impact of these infections on reproductive outcomes and to highlight any treatment plans for affected couples.

Conclusion
HPV is a prevalent disease with a rising concern among the male populations given the suggested impact on sperm motility as well as the pregnancy and miscarriage rates post-ART treatment. Vaccines are being studied now as a possible infertility adjunct treatment for males who are already infected.
Trimeric protein vaccine based on Beta variant elicits robust immune response against BA.4/5-included SARS-CoV-2 Omicron variants
Authors: He Cai , Chen Li , Yang Jingyun , Chen Zimin , Lei Hong , Hong Weiqi , Song Xiangrong , Yang Li , Li Jiong , Wang Wei , Shen Guobo , Lu Guangwen , Wei Xiawei 
Published: March 2023

AbstractThe current Coronavirus Disease 2019 (COVID-19) pandemic, induced by newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variants, posed great threats to global public health security. There is an urgent need to design effective next‑generation vaccines against Omicron lineages. Here, we investigated the immunogenic capacity of the vaccine candidate based on the receptor binding domain (RBD). An RBDβ-HR self-assembled trimer vaccine including RBD of Beta variant (containing K417, E484 and N501) and heptad repeat (HR) subunits was developed using an insect cell expression platform. Sera obtained from immunized mice effectively blocked RBD-human angiotensin-converting enzyme 2 (hACE2) binding for different viral variants, showing robust inhibitory activity. In addition, RBDβ-HR/trimer vaccine durably exhibited high titers of specific binding antibodies and high levels of cross-protective neutralizing antibodies against newly emerging Omicron lineages, as well as other major variants including Alpha, Beta, and Delta. Consistently, the vaccine also promoted a broad and potent cellular immune response involving the participation of T follicular helper (Tfh) cells, germinal center (GC) B cells, activated T cells, effector memory T cells, and central memory T cells, which are critical facets of protective immunity. These results demonstrated that RBDβ-HR/trimer vaccine candidates provided an attractive next-generation vaccine strategy against Omicron variants in the global effort to halt the spread of SARS-CoV-2.
Phase II Clinical Trial of Axitinib and Avelumab in Patients With Recurrent/Metastatic Adenoid Cystic Carcinoma
Authors: Ferrarotto Renata , Sousa Luana G. , Feng Lei , Mott Frank , Blumenschein George , Altan Mehmet , Bell Diana , Bonini Flavia , Li Kaiyi , Marques-Piubelli Mario L. , Dal Lago Eduardo A. , Johnson Jason J. , Mitani Yoshitsugu , Godoy Myrna , Lee Anna , Kupferman Michael , Hanna Ehab , Glisson Bonnie S. , Elamin Yasir , El-Naggar Adel 
Published: March 2023

PURPOSE We conducted a phase II trial evaluating the efficacy of VEGFR inhibitor axitinib and PD-L1 inhibitor avelumab in patients with recurrent/metastatic adenoid cystic carcinoma (R/M ACC). PATIENTS AND METHODS Eligible patients had R/M ACC with progression within 6 months before enrollment. Treatment consisted of axitinib and avelumab. The primary end point was objective response rate (ORR) per RECIST 1.1; secondary end points included progression-free survival (PFS), overall survival (OS), and toxicity. Simon's optimal two-stage design tested the null hypothesis of ORR ≤5% versus ORR ≥20% at 6 months; ≥4 responses in 29 patients would reject the null hypothesis. RESULTS Forty patients enrolled from July 2019 to June 2021; 28 were evaluable for efficacy (six screen failures; six evaluable for safety only). The confirmed ORR was 18% (95% CI, 6.1 to 36.9); there was one unconfirmed partial response (PR). Two patients achieved PR after 6 months; thus, the ORR at 6 months was 14%. The median follow-up time for surviving patients was 22 months (95% CI, 16.6 to 39.1 months). The median PFS was 7.3 months (95% CI, 3.7 to 11.2 months), 6-month PFS rate was 57% (95% CI, 41 to 78), and median OS was 16.6 months (95% CI, 12.4 to not reached months). Most common treatment-related adverse events (TRAEs) included fatigue (62%), hypertension (32%), and diarrhea (32%). Ten (29%) patients had serious TRAEs, all grade 3; four patients (12%) discontinued avelumab, and nine patients (26%) underwent axitinib dose reduction. CONCLUSION The study reached its primary end point with ≥4 PRs in 28 evaluable patients (confirmed ORR of 18%). The potential added benefit of avelumab to axitinib in ACC requires further investigation.
Unsettling Participation by Foregrounding More-than-Human Relations in Digital Forests
Authors: Westerlaken Michelle , Gabrys Jennifer , Urzedo Danilo , Ritts Max 
Published: March 2023

AbstractThe question of who participates in making forest environments usually refers to human stakeholders. Yet forests are constituted through the participation of many other entities. At the same time, digital technologies are increasingly used in participatory projects to measure and monitor forest environments globally. However, such participatory initiatives are often limited to human involvement and overlook how more-than-human entities and relations shape digital and forest processes. To disrupt conventional anthropocentric understandings of participation, this text travels through three different processes of “unsettling” to show how more-than-human entities and relations disrupt, rework, and transform digital participation in and with forests. First, forest organisms as bioindicators signal environmental changes and contribute to the formation and operation of digital sensing technologies. Second, speculative blockchain infrastructures and decision-making algorithms raise questions about whether and how forests can own themselves. Third, Amerindian cosmologies redistribute subjectivities to change how digital technologies identify and monitor forests within Indigenous territories. Each of these examples shows how more-than-human participation can rework participatory processes and digital practices in forests. In a time when forests are rapidly disappearing, an unsettled and transformed understanding of participation that involves the world-making practices of more-than-human entities and relations can offer more pluralistic and expansive forest inhabitations and futures.