bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary polycyclic aromatic hydrocarbon excretion and regional body fat distribution: evidence from the U.S. National Health and Nutrition Examination Survey 2001–2016
Authors: Wang Yeli , Zhu Lu , James-Todd Tamarra , Sun Qi 
Published: August 2022

Abstract
Background
Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants that may contribute to the etiology of obesity. However, it is unclear whether PAHs from environmental sources are associated with regional body fat distribution, and whether the association varies across racial/ethnic groups who may have differential PAH exposure patterns.

Objectives
To examine correlations between PAHs and body fat distribution, and potential racial/ethnic differences among U.S. adults.

Methods
Ten PAHs were measured in spot urine samples from 2691 non-smoking adults (age ≥ 20 years) in the NHANES 2001–2016. Dual-energy X-ray absorptiometry was used to measure fat mass percent (FM%). Partial Pearson correlation coefficients (r) with multivariable adjustment were used to assess PAH-FM% associations.

Results
In the total population, 1-naphthalene, 3-fluorene, and 1-pyrene were inversely correlated with total FM% or trunk FM% (adjusted r ranged: − 0.06 to − 0.08), while 2-naphthalene, 9-fluorene, and 4-phenanthrene were positively correlated with the FM% measurements (r: 0.07–0.11). PAH levels are highest among non-Hispanic Blacks, followed by Hispanics and Whites and some of the correlations were different by these races/ethnicities. Among non-Hispanic Whites, no PAH was correlated with FM%. In contrast, 9-fluorene was positively correlated with total FM% (r = 0.20) and trunk FM% (r = 0.22) among Blacks, and 4-phenanthrene was positively correlated with total FM% (r = 0.23) and trunk FM% (r = 0.24) among Hispanics (P-interaction: 0.010–0.025).

Discussion
In this US adult population, certain PAHs are significantly associated with higher body fat contents among non-Hispanic Blacks and Hispanics but not non-Hispanic Whites, suggesting that minority groups might be particularly susceptible to PAH’s obesogenic effects or the effects of other factors that determine the PAH exposure levels. Alternatively, differences in body composition may contribute to differential PAH metabolism in minority groups. Future studies are warranted to explore the racial/ethnic disparity in PAH exposures, drivers of these exposure differences, and mechanisms through which PAHs may influence body composition by races/ethnicities.
Current treatment strategies for seasonal allergic rhinitis: where are we heading?
Authors: Ridolo Erminia , Incorvaia Cristoforo , Pucciarini Francesco , Makri Elena , Paoletti Giovanni , Canonica Giorgio Walter 
Published: August 2022

Abstract
Introduction
Allergic rhinitis (AR) is very commonly caused by pollens. The symptoms of AR consist of sneezing, nasal congestion, rhinorrhea, nasal itching and airflow obstruction. The diagnosis has long been based on clinical history, skin prick tests and in vitro measurement of specific IgE, but the innovative approach of precision medicine has made diagnostic tools of much greater accuracy available.

Areas covered
This review covers the advances in the treatment of seasonal AR concerning the drugs to be used according to the grade of disease and the characteristics of the patients, and the role of allergen immunotherapy (AIT), which is the only treatment capable of acting, in addition to the symptoms, on the cause of AR and therefore to modify its natural history.

Expert opinion
Drug treatment of AR include a large number of agents, the choice of which depends on the severity of the disease. AIT has high evidence of efficacy demonstrated by meta-analyses, and further improvement is currently apparent, as for diagnosis, applying the means of precision medicine. However, when AIT is performed in current practice, without the strict rules of controlled trials, long-term low adherence is a major problem to be solved.
Opioid agonist treatment take-home doses (‘carries’): Are current guidelines resulting in low treatment coverage among high-risk populations in Canada and the USA?
Authors: Russell Cayley , Lange Shannon , Kouyoumdjian Fiona , Butler Amanda , Ali Farihah 
Published: August 2022

AbstractOpioid agonist treatment (OAT) is the primary intervention for opioid use disorder (OUD) in Canada and the USA. Yet, a number of barriers contribute to sub-optimal treatment uptake and retention, including daily-supervised medication administration. Thus, clients are eventually granted access to take-home OAT doses (i.e., ‘carries’) to reduce this burden. However, this decision is based on physician discretion and whether patients can demonstrate stability in various life domains, many of which are inextricably linked to the social determinants of health (SDOH). Current Canadian and USA OAT carry guidance documents are not standardized and do not take the SDOH into consideration, resulting in the potential for inequitable access to OAT carries, which may be the case particularly among marginalized populations such as individuals with OUD who have been released from custody. This perspective article posits that current OAT guidelines contribute to inequities in access to OAT carries, and that these inequities likely result in disproportionately low coverage for OUD treatment among some high-risk groups, including individuals on release from incarceration in particular. Relevant impacts of COVID-19 and related policy changes are considered, and suggestions and recommendations to amend current OAT guidance documents are provided.
An affordable approach to classifying type 2 diabetes based on fasting plasma glucose, TyG index and BMI: a retrospective cohort study of NHANES Data from 1988 to 2014
Authors: Xie Jing , Zhang Xin , Shao Hua , Jing Shenqi , Shan Tao , Shi Yaxiang , Li Yong , Liu Yun , Liu Naifeng 
Published: August 2022

Abstract
Background
The β-cell function and insulin resistance required by existing methods of classifying type 2 diabetes are not routinely adopted in most medical institutions of developing countries and regions. This study aims to propose a novel, affordable classification approach and evaluate its predictive ability for several health and mortality outcomes, including cardiovascular health (CVH), retinopathy, chronic kidney disease (CKD), nonalcoholic fatty liver disease (NAFLD), advanced liver fibrosis, and mortality caused by all-cause, cardiovascular disease (CVD), cancer.

Methods
Based on 4060 participants with diabetes (aged ≥ 30 at the time of diagnosis) selected from the National Health and Nutrition Examination Survey III & 1999–2014, we proposed a novel, but simple classification approach based on the threshold of fasting plasma glucose (FPG), triglyceride-glucose (TyG) index and body mass index (BMI). We used logistic regression model to assess its predictability for diabetes complications, and Cox regression model to estimate the mortality risks.

Results
By utilizing this approach, we characterized the subjects into four subgroups: subgroup A (obesity-related), which accounts for 37% of the total, subgroup B (age-related), 38%, subgroup C (insulin resistance), 20%, and subgroup D (severe insulin deficiency), 5%. Subjects in subgroup D had a higher risk of retinopathy, in subgroup B had a lower risk of poor cardiovascular health, nonalcoholic fatty liver disease, and advanced liver fibrosis, in subgroup C had a higher risk of all-cause mortality.

Conclusions
This study proposes an affordable and practical method for classifying patients with type 2 diabetes into different subgroups, with a view to yield a high predictability of patient outcomes and to assist clinicians in providing better treatment.
Public sector implementation strategies to approach the judicialization of health care: a systematic review protocol
Authors: Yamauti Sueli Miyuki , Barreto Jorge Otávio Maia , Barberato-Filho Silvio , Machado Fernanda Lacerda da Silva , Lopes Luciane Cruz 
Published: August 2022

Abstract
Background
The judicialization of health care can be understood as a societal response to pressing healthcare needs, which probably are not being adequately addressed by the current healthcare system. This phenomenon increases the strain on service resources, both in the health sector and in the judiciary system as well, demanding an institutional reorganization to manage judicial actions. It is believed that each institution has developed strategies for coping with the problem in isolation and with little public disclosure. The purpose of this review will be to identify institutional strategies implemented and to investigate their effects in approaching the judicialization of health care.

Methods
Electronic searches will be conducted up to December 2021 on 11 databases, supplemented with gray literature and references lists of secondary studies. The descriptor “judicialization of health” will be the basis for conducting the main research. Studies describing any strategy implemented by public institutions to approach the judicialization of health care will be included. Results related to the quality of services provided by the implemented strategy reported in the studies and those that report accessibility, usability, and potential adverse effects or harms caused by the implemented strategy will be investigated. In addition, it will be explored if there have been changes related to the value or characteristics of health litigation. Two reviewers will independently screen all citations, abstract data, and full-text papers. The risk of bias in each study will be appraised using a tool suggested by Cochrane Effective Practice and Care Organization Group (EPOC). Subsequently, the reviewers will also extract the data of interest and classify the findings of these studies according to their performance at the institutional level. The results obtained will be described as a narrative synthesis.

Discussion
This review may provide evidence on the effects of the strategies implemented to approach the judicialization of health care. It will potentially benefit health care and legal professionals, decision-makers, and researchers by identifying the types and characteristics of strategies that have the potential to improve service delivery in the future.

Systematic review registration
PROSPERO CRD42020160608
Analysis of international public funding flows for the environment, climate change, and sustainability: the case of Bosnia and Herzegovina
Authors: Causevic Amar , Avdic Sanjin , Padegimas Bernardas , Macura Biljana 
Published: August 2022

Abstract
Background
Securing adequate financing for the environment, climate change, and sustainable development has been challenging, especially in low- and middle-income economies. Bosnia and Herzegovina is a country aspiring to become a member state of the European Union. Despite undergoing a socio-economic transition, the country is more than four times as energy-intensive as the average European Union member state. Since the end of the war in the 1990s, the country has received significant amounts of bilateral and multilateral development aid, including environmental finance (e.g., climate finance, funding for biodiversity conservation, impact funding). To facilitate future sustainable finance prioritization, this study analyzes Bosnia and Herzegovina’s environmental finance.

Results
The study conducted a scoping literature review and detailed analysis of the environmental finance flows for Bosnia and Herzegovina in the period from 2015 to 2020. The results show that the scientific knowledge on the (effectiveness of) environmental finance for Bosnia and Herzegovina is almost non-existent. The country received US$545.6 million in environmental finance in the studied period and more than 99% of this funding was spent on water, energy, waste, and environmental management. In contrast, biodiversity, resource management, chemical safety and environmental noise received less than 1% of total funding. Bosnia and Herzegovina received 58% of the financing in grants, while 38% was provided in various types of loans.

Conclusions
There is a considerable difference in the received funding among different sectors. Funders prioritized a few sectors (e.g., water), whereas others (i.e., biodiversity and nature conservation, chemical safety and noise, and resource management) were neglected. Bosnia and Herzegovina can argue for more equitable funding distribution based on its minor contribution to global greenhouse gas emissions. Providing almost 40% of environmental finance to Bosnia and Herzegovina in loans increases the country’s level of indebtedness. It distorts the principle of climate justice since the country has been an irrelevant greenhouse gas emitter.
Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for single-arm feasibility trial
Authors: Reardon Tessa , Ball Susan , Breen Maria , Brown Paul , Day Emily , Ford Tamsin , Gray Alastair , Green Iheoma , Hill Claire , Jasper Bec , King Thomas , Larkin Michael , Macdonald Ian , Morgan Fran , Pollard Jack , Sancho Michelle , Sniehotta Falko F. , Spence Susan H. , Stallard Paul , Stainer Jason , Ukoumunne Obioha C. , Violato Mara , Williams Chloe , Williamson Victoria , Creswell Cathy 
Published: August 2022

Abstract
Background
Anxiety disorders are common among primary-school aged children, but few affected children receive evidence-based treatment. Identifying and supporting children who experience anxiety problems through schools would address substantial treatment access barriers that families and school staff often face. We have worked with families and school staff to co-design procedures that incorporate screening, feedback for parents, and the offer of a brief intervention in primary schools. This study sets out to assess the feasibility of a subsequent school-based cluster randomised controlled trial to evaluate these procedures. Our objectives are to ensure our procedures for identifying and supporting children with anxiety difficulties through primary schools are acceptable and there are no negative impacts, to estimate recruitment and retention rates, and to identify any changes needed to study procedures or measures.

Methods
We will recruit six primary/junior schools in England (2 classes per school), and invite all children (aged 8–9) (n = 360) and their parent/carer and class teacher in participating classes to take part. Children, parents and class teachers will complete questionnaires at baseline and 12-week follow-up. Children who ‘screen positive’ on a 2-item parent-report child anxiety screen at baseline will be the target population (expected n = 43). Parents receive feedback on screening questionnaire responses, and where the child screens positive the family is offered support (OSI: Online Support and Intervention for child anxiety). OSI is a brief, parent-led online intervention, supported by short telephone sessions with a Children’s Wellbeing Practitioner. Participants’ experiences of study procedures will be assessed through qualitative interviews/discussion groups.

Discussion
Evidence-based procedures for identifying and supporting children with anxiety difficulties through primary schools would improve children’s access to timely, effective intervention for anxiety difficulties.

Trial registration
ISRCTN registry: ISRCTN30032471. Retrospectively registered on 18 May 2021.
A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population
Authors: El-Ghitany Engy Mohamed , Farag Shehata , Farghaly Azza Galal , Hashish Mona H. , Hassaan Mahmoud A. , Omran Eman A. 
Published: August 2022

Abstract
Background
Population-based studies on COVID-19 have important implications for modeling the pandemic and determining vaccination policies. Limited data are available from such surveys in Egypt.

Methods
This cross-sectional was conducted throughout the period between January and June 2021, which coincided with the second and third waves of the COVID-19 pandemic in Egypt. At that time, vaccines against COVID-19 were not available to the general population. The study was carried out in eight Egyptian governorates and included 2360 participants, who were recruited through a multistage stratified cluster sample technique, based on gender, age, and district followed by a random sample within each district. Socio-demographic data were recorded and serum samples were collected and tested for SARS-Co-V2 spike (S) antibodies.

Results
The overall adjusted prevalence of anti-S was 46.3% (95% CI 44.2–48.3%), with significant differences between governorates. Factors associated with anti-S seropositivity were: being female (p = 0.001), living in a rural area (p = 0.008), and reporting a history of COVID-19 infection (p = 0.001). Higher medians of anti-S titers were significantly associated with: extremes of age (p < 0.001), living in urban areas, having primary education (p = 0.009), and reporting a history of COVID-19 infection, especially if based on chest CT or PCR (p < 0.001).

Conclusions
High seroprevalence rates indicate increased COVID-19 infection and immune response among a considerable percentage of the community. Age, gender, residence, educational level, and previous PCR-confirmed COVID-19 infections were all determinants of the immune response.
Differential requirement for DICER1 activity during the development of mitral and tricuspid valves
Authors: Yan Shun , Peng Yin , Lu Jin , Shakil Saima , Shi Yang , Crossman David K. , Johnson Walter H. , Liu Shanrun , Rokosh Donald G. , Lincoln Joy , Wang Qin , Jiao Kai 
Published: August 2022

ABSTRACT
Mitral and tricuspid valves are essential for unidirectional blood flow in the heart. They are derived from similar cell sources, and yet congenital dysplasia affecting both valves is clinically rare, suggesting the presence of differential regulatory mechanisms underlying their development. Here, we specifically inactivated Dicer1 in the endocardium during cardiogenesis and found that Dicer1 deletion caused congenital mitral valve stenosis and regurgitation, whereas it had no impact on other valves. We showed that hyperplastic mitral valves were caused by abnormal condensation and extracellular matrix (ECM) remodeling. Our single-cell RNA sequencing analysis revealed impaired maturation of mesenchymal cells and abnormal expression of ECM genes in mutant mitral valves. Furthermore, expression of a set of miRNAs that target ECM genes was significantly lower in tricuspid valves compared to mitral valves, consistent with the idea that the miRNAs are differentially required for mitral and tricuspid valve development. We thus reveal miRNA-mediated gene regulation as a novel molecular mechanism that differentially regulates mitral and tricuspid valve development, thereby enhancing our understanding of the non-association of inborn mitral and tricuspid dysplasia observed clinically.
Gender Diversity in Primary Care Sports Medicine Leadership
Authors: Mattson Laura M. , Rosario-Concepcion Raul A. , Hurdle Mark Friedrich B. , Pagan-Rosado Robert D. , Clapp Adrianna D. , Maynard Jennifer R. 
Published: August 2022

Abstract
Diversity, equity, and inclusion have been recognized as important drivers of excellence and innovation in the physician workforce. Given the historical underrepresentation of women in medicine, gender diversity is of interest. In this cross-sectional study, we sought to quantify leadership representation of female physicians in primary care sports medicine settings, including primary care sports medicine fellowship programs, select sports medicine societies, and select sports medicine-related scientific journals. Data were collected by querying the corresponding web site for each fellowship program, society, and journal and analyzed in a descriptive manner. Results showed that fewer female physicians hold primary care sports medicine leadership roles than men do. This work establishes a baseline for female representation in primary care sports medicine leadership; efforts should continue to increase the presence of women in leadership positions.
The Role of Exercise in Treating Low Back Pain
Authors: Essman Matthew , Lin Cindy Y. 
Published: August 2022

Abstract
The purpose of this review is to highlight the role of exercise in preventing and managing acute and chronic axial low back pain (LBP). LBP is one of the leading contributors to years lived with disability as well as health care expenditures in the United States. With an expected increase in prevalence due to an aging population, sports medicine providers have a unique opportunity to provide effective treatment strategies incorporating exercise advice and prescription. Although the majority of individuals with acute LBP will have their symptoms resolve spontaneously, almost 40% will have recurrence or develop chronic LBP within 1 year. No single exercise method has been shown to be more effective than another. The evidence for walking programs, aerobic exercise, yoga, Pilates, and tai chi for LBP is discussed. Our review summarizes the beneficial role of a personalized exercise program and related counseling strategies in the prevention and management of LBP.
Case Report: A rare case of choledochal cyst
Authors: Tariq Wasiq Bin , Twayana Anu Radha , Sunuwar Neela , Anjum Azwar , Deo Sulav , Rayamajhi Sushil , Singh Amit 
Published: August 2022

Background: Choledochal cysts are dilated portions of the biliary tract that account for 1% of all benign biliary diseases. It is prevalent among Asian and female populations and the incidence is 1:100,000–150,000. Among the different types, only 15–35% of all choledochal cysts are type IV cysts, with type I being the most common representing 50–80%. Clinical presentation and therapy of biliary cysts (BC) differ depending on the type. Case: We present a case of a 2-year-old male who presented with non-specific symptoms of multiple episodes of vomiting. Laboratory investigations revealed raised alkaline phosphatase and gamma-glutamyl transpeptidase. His symptoms of acute pancreatitis were resolved with conventional therapy. Ultrasonography of the abdomen showed intra and extra-hepatic cystic biliary tree dilatation suggestive of choledochal cyst Type IV A. Conclusions: Choledochal cysts present with clinical features varying with age and anatomical variants and can pose challenges in management that can be addressed by surgery to avoid further complications.
Language Means of Expressing Emotional and Rational Evaluativity in Online Comments
Authors: Van Yue 
Published: August 2022

The paper goes on emotional and rational evaluativity in the Internet on the material of Russian-language online comments. Examples of online comments are given, which explore the relationship of emotion and evaluation, objective and subjective evaluation, rational and emotional evaluation.
The aim of this study is to analyze the online comments from the point of view of identifying the language means of expressing emotional and rational evaluativity. The language means of implementation of rational and emotional evaluativity in online comments are analyzed on different linguistic levels: lexical, morphological, syntactic, stylistic and phonetic.
The research material was 289 online comments from VK, YouTube, and various forums, published in 2020-2022. The selection principle was texts, in which emotional and rational evaluativity were verbalized.
In online comments, rational evaluativity is often combined with emotional evaluativity, which makes it difficult to distinguish them.