bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supplemental Nutrition Assistance Program participation and health care expenditures in children
Authors: Rogers Stephen , Garg Arvin , Tripodis Yorghos , Brochier Annelise , Messmer Emily , Gordon Wexler Mikayla , Peltz Alon 
Published: March 2022

Abstract
Background
The Supplemental Nutrition Assistance Program (SNAP) has well-established positive impacts on child health outcomes, including increased birth weight and decreased likelihood of underweight status. Studies in adult populations suggest that SNAP is associated with lower health care costs, although less is known in children.

Methods
Retrospective analysis of U.S. children (age <18 years) living in low-income households (< 200% of the federal poverty level) in the 2013-2017 Medical Expenditure Panel Survey. We used multivariable regression, adjusting for sociodemographic and clinical covariates, to model the effect of continuous SNAP enrollment on health expenditures as compared to non-enrollees at 12 and 24 months.

Results
The sample included 5,626 children, of whom 49.2% consistently received SNAP for the entire two-year survey period. Compared with SNAP non-recipients, SNAP-recipient households more often had incomes below 100% FPL (78.3% vs 37.9%), and children in SNAP-recipient households were more often publicly insured (94.9% vs 64.5%). Unadjusted expenditures were lower for children in SNAP-recipient households at 12 ($1222 vs $1603) and 24 months ($2447 vs $3009). However, when adjusting for sociodemographic and clinical differences, no statistically significant differences in health care expenditures, including emergency department, inpatient, outpatient, and prescription costs, were identified.

Conclusion
SNAP participant children experience heightened social hardships across multiple domains. There were no differences in short term health care costs based on SNAP enrollment when accounting for differences in sociodemographic and clinical factors. Despite demonstrated child health benefits, we found that sustained enrollment in SNAP over a two-year period did not generate significant short- term health care cost reductions. Our findings suggest that although SNAP is intended to act as a benefit towards the health and well-being of its recipients, unlike among adults, it may not reduce health care costs among children.
Evaluation of prestyloid recess morphology and ulnar-sided contrast leakage in CT arthrography of the wrist
Authors: Gietzen Carsten Herbert , Kunz Andreas Steven , Luetkens Karsten Sebastian , Huflage Henner , Christopoulos Georgios , van Schoonhoven Jörg , Bley Thorsten Alexander , Schmitt Rainer , Grunz Jan-Peter 
Published: March 2022

Abstract
Background
In wrist arthrograms, aberrant contrast material is frequently seen extending into the soft tissue adjacent to the ulnar styloid process. Since the prestyloid recess can mimic contrast leakage in CT arthrography, this study aims to provide a detailed analysis of its morphologic variability, while investigating whether actual ulnar-sided leakage is associated with injuries of the triangular fibrocartilage complex (TFCC).

Methods
Eighty-six patients with positive wrist trauma history underwent multi-compartment CT arthrography (40 women, median age 44.5 years). Studies were reviewed by two board-certified radiologists, who documented the morphology of the prestyloid recess regarding size, opening type, shape and position, as well as the presence or absence of ulnar-sided contrast leakage. Correlations between leakage and the presence of TFCC injuries were assessed using the mean square contingency coefficient (rɸ).

Results
The most common configuration of the prestyloid recess included a narrow opening (73.26%; width 2.26 ± 1.43 mm), saccular shape (66.28%), and palmar position compared to the styloid process (55.81%). Its mean length and anterior–posterior diameter were 6.89 ± 2.36 and 5.05 ± 1.97 mm, respectively. Ulnar-sided contrast leakage was reported in 29 patients (33.72%) with a mean extent of 12.30 ± 5.31 mm. Leakage occurred more often in patients with ulnar-sided TFCC injuries (rɸ = 0.480; p < 0.001), whereas no association was found for lesions of the central articular disc (rɸ = 0.172; p = 0.111).

Conclusions
Since ulnar-sided contrast leakage is more common in patients with peripheral TFCC injuries, distinction between an atypical configuration of the prestyloid recess and actual leakage is important in CT arthrography of the wrist.
Evaluation of efficacy and safety of subcutaneous acetaminophen in geriatrics and palliative care (APAPSUBQ)
Authors: El Khoury Joe , Hlais Sani , Helou Mariana , Mouhawej Marie-Claire , Barmo Serge , Fadel Patricia , Tohme Aline 
Published: March 2022

Abstract
Introduction
Subcutaneous infusion (SC) or hypodermoclysis is an old perfusion technique that is often used off-label although it has been shown to be effective. Acetaminophen (paracetamol) subcutaneous injection is performed in some centers despite the lack of conclusive evidence on its effectiveness. This study aims to evaluate the efficacy of subcutaneous infusion of Acetaminophen in the treatment of pain and fever in geriatrics and in palliative care and to determine its safety profile and possible side effects.

Material and methods
This experimental study was conducted between 2018 and 2019 on adult patients in palliative care or in geriatrics in several hospitals and nursing homes in Lebanon. Primary outcomes were change in temperature; change in pain score on the numerical rating scale (NS) or on the Algoplus scale after 60 min from the start of the infusion; and the appearance of local side effects at the infusion site. Changes in the various parameters at 30 min and 180 min were also evaluated as secondary outcomes.

Results
Thirty-one patients were included in the study, with a total of 120 doses of acetaminophen. At 60 min, the mean decrease in pain on the NS was 5.35 points, while the mean decrease in temperature was 0.79 degrees Celsius. At 60 min, 75%, CI = [47.62-92.73] of the patients who received acetaminophen for pain and 66.67%, CI = [38.38-88.17] of those who received it for fever had clinically significant improvement. The overall effect of subcutaneous acetaminophen, defined as any clinically significant effect on pain or fever, was 70.97%, CI = [51.96-85.78]. The overall effect at 30 min and at 180 min was 23.33%, CI = [9.93-42.28] and 87.10%, CI = [70.17-96.37], respectively. The side effects reported 30 min after the injection and observed after at least one of the doses were: local edema in 16 patients (51.61%), induration in one patient (3.23%), local pain in one patient (3.23%) and local heat in one patient (3.23%). At 180 min, only 2 patients (6.45%) still had edema at the infusion site.

Conclusion
Subcutaneous administration of acetaminophen is effective and well tolerated in geriatric and palliative care patients. It is appropriate when no other route is available, especially for home-based care. Comparative studies are needed to allow the expansion of this practice.
Path analysis of the association between self-compassion and depressive symptoms among nursing and medical students: a cross-sectional survey
Authors: Zhao Fang-Fang , Yang Li , Ma Jiang-Ping , Qin Zheng-Ji 
Published: March 2022

Abstract
Background
Nursing and medical students are suffering from high rates of depressive symptoms. Mental health benefits students’ learning, growth and professional development. Exploring psychological resources to prevent depression is emphasized recently, and self-compassion is shown to be inversely associated with depressive symptoms. However, the mechanism through which self-compassion contributes to decreased depressive symptoms is limited. Therefore, this study aimed to explore and examine a model detailing the potential paths between self-compassion and depressive symptoms.

Methods
A cross-sectional study was conducted and convenient sampling was used. Among the 1800 nursing and medical students targeted from two universities in East and North China, 1341 completed the questionnaires, and 1127 valid questionnaires were analyzed comprising 566 and 561 from medical and nursing students, respectively. Data in May 2020 and July 2020 were collected through Patient Health Questionnaire, self-compassion scale, resilience scale, Life Orientation Test and Perceived Stress Scale. Then, path model analysis was conducted to analyze the data.

Results
Finally, this study included 1125 valid questionnaires after excluding two extremes of study variables. Participants consisted of 50.2% medical students and 49.8% nursing students. The model showed an acceptable fit to the data. After controlling for the demographics, self-compassion was directly and indirectly associated with decreased depressive symptoms by increasing resilience and optimism and reducing perceived stress among nursing and medical students. Resilience and optimism were directly and indirectly associated with decreased depressive symptoms by reducing perceived stress among nursing students and indirectly associated with decreased depressive symptoms among medical students.

Conclusions
The study provides evidence that self-compassion significantly influences the decrease in depressive symptoms by increasing resilience and optimism and reducing perceived stress. These findings suggested that programs enhancing students’ self-compassion, resilience, and optimism simultaneously can help decrease depressive symptoms and improve mental health in education and healthcare institutes. These findings may facilitate the designing of educational programs for preventing depressive symptoms and promoting mental health among nursing and medical students.
Assess the diversity of gut microbiota among healthy adults for forensic application
Authors: Wang Shuangshuang , Song Feng , Gu Haoyu , Shu Zhilong , Wei Xiaowen , Zhang Ke , Zhou Yuxiang , Jiang Lanrui , Wang Zefei , Li Jienan , Luo Haibo , Liang Weibo 
Published: March 2022

Abstract
Background
Human gut microbiota is individually unique that hints the microbiota in fecal traces left in the crime scene could act as a potential biomarker for forensic personal identification. Next-generation DNA sequencing and bioinformatic analysis of fecal samples are revolutionizing our insights into gut microbial communities. While the formation of the gut microbiota is known to be multifactorial, it is unclear whether these characteristics can be applied to forensic applications. Therefore, the gut microbiota of healthy adults with different traits was investigated in this study.

Results
Based on the STAMP analysis of each study group, the difference in gut microbiota composition of male and female subjects was observed. The male group was characterized by taxa in the phylum Proteobacteria, while the female group was described by Synergistetes phylum. The gut bacterial community assembly mechanism was mainly affected by the deterministic process. In addition, gut microbiota composition showed meaningful discrimination in each of the BMI groups. At the phylum level, in male subjects, increased representative phyla were Patescibacteria (p < 0.05) in the underweight group and Bacteroidetes (p < 0.05) in the normal-weight group, while in the female group, the significantly different phyla were Bacteroidetes, Firmicutes, and Actinobacteria. At the genus level, 44 unique genera were found to be significantly distinct across BMI study groups. By Fisher’s Linear Discriminant Analysis, ninety-four point four percent (94.4%) of original BMI grouped subjects were correctly classified. The linear regression analysis model showed an accuracy of seventy-four percent (74%) in predicting body type.

Conclusion
In conclusion, subjects with different individual characters have specific gut microbiota, and can be discriminated by bioinformatics methods, suggesting it is promising to apply gut microbiota to forensic personal identification.
Production of indole by Corynebacterium glutamicum microbial cell factories for flavor and fragrance applications
Authors: Mindt Melanie , Beyraghdar Kashkooli Arman , Suarez-Diez Maria , Ferrer Lenny , Jilg Tatjana , Bosch Dirk , Martins dos Santos Vitor , Wendisch Volker F. , Cankar Katarina 
Published: March 2022

Abstract
Background
The nitrogen containing aromatic compound indole is known for its floral odor typical of jasmine blossoms. Due to its characteristic scent, it is frequently used in dairy products, tea drinks and fine fragrances. The demand for natural indole by the flavor and fragrance industry is high, yet, its abundance in essential oils isolated from plants such as jasmine and narcissus is low. Thus, there is a strong demand for a sustainable method to produce food-grade indole.

Results
Here, we established the biotechnological production of indole upon l-tryptophan supplementation in the bacterial host Corynebacterium glutamicum. Heterologous expression of the tryptophanase gene from E. coli enabled the conversion of supplemented l-tryptophan to indole. Engineering of the substrate import by co-expression of the native aromatic amino acid permease gene aroP increased whole-cell biotransformation of l-tryptophan to indole by two-fold. Indole production to 0.2 g L−1 was achieved upon feeding of 1 g L−1l-tryptophan in a bioreactor cultivation, while neither accumulation of side-products nor loss of indole were observed. To establish an efficient and robust production process, new tryptophanases were recruited by mining of bacterial sequence databases. This search retrieved more than 400 candidates and, upon screening of tryptophanase activity, nine new enzymes were identified as most promising. The highest production of indole in vivo in C. glutamicum was achieved based on the tryptophanase from Providencia rettgeri. Evaluation of several biological aspects identified the product toxicity as major bottleneck of this conversion. In situ product recovery was applied to sequester indole in a food-grade organic phase during the fermentation to avoid inhibition due to product accumulation. This process enabled complete conversion of l-tryptophan and an indole product titer of 5.7 g L−1 was reached. Indole partitioned to the organic phase which contained 28 g L−1 indole while no other products were observed indicating high indole purity.

Conclusions
The bioconversion production process established in this study provides an attractive route for sustainable indole production from tryptophan in C. glutamicum. Industrially relevant indole titers were achieved within 24 h and indole was concentrated in the organic layer as a pure product after the fermentation.
Modelling new insecticide-treated bed nets for malaria-vector control: how to strategically manage resistance?
Authors: Madgwick Philip G. , Kanitz Ricardo 
Published: March 2022

Abstract
Background
The program to eradicate malaria is at a critical juncture as a new wave of insecticides for mosquito control enter their final stages of development. Previous insecticides have been deployed one-at-a-time until their utility was compromised, without the strategic management of resistance. Recent investment has led to the near-synchronous development of new insecticides, and with it the current opportunity to build resistance management into mosquito-control methods to maximize the chance of eradicating malaria.

Methods
Here, building on the parameter framework of an existing mathematical model, resistance-management strategies using multiple insecticides are compared to suggest how to deploy combinations of available and new insecticides on bed nets to achieve maximum impact.

Results
Although results support the use of different strategies in different settings, deploying new insecticides ideally together in (or at least as a part of) a mixture is shown to be a robust strategy across most settings.

Conclusions
Substantially building on previous works, alternative solutions for the resistance management of new insecticides to be used in bed nets for malaria vector control are found. The results support a mixture product concept as the most robust way to deploy new insecticides, even if they are mixed with a pyrethroid that has lower effectiveness due to pre-existing resistance. This can help deciding on deployment strategies and policies around the sustainable use of these new anti-malaria tools.
Delivery of seasonal malaria chemoprevention with enhanced infection prevention and control measures during the COVID-19 pandemic in Nigeria, Burkina Faso and Chad: a cross-sectional study
Authors: Ward Charlotte , Phillips Abimbola , Oresanya Olusola , Olisenekwu Gloria , Arogunade Ekundayo , Moukénet Azoukalné , Beakgoubé Honoré , De Paul Allambademel Vincent , Compaoré Cheick Saïd , Traoré Adama , Ouedraogo Jean-Bosco , Compaoré Yves Daniel , Zongo Issaka , Donovan Laura , Decola Monica Anna , Smith Helen , Baker Kevin 
Published: March 2022

Abstract
Background
Seasonal malaria chemoprevention (SMC) is a WHO-recommended intervention for children aged 3–59 months living in areas of high malaria transmission to provide protection against malaria during the rainy season. Operational guidelines were developed, based on WHO guidance, to support countries to mitigate the risk of coronavirus disease 2019 (COVID-19) transmission within communities and among community distributors when delivering SMC.

Methods
A cross-sectional study to determine adherence to infection prevention and control (IPC) measures during two distribution cycles of SMC in Nigeria, Chad and Burkina Faso. Community distributors were observed receiving equipment and delivering SMC. Adherence across six domains was calculated as the proportion of indications in which the community distributor performed the correct action. Focus group discussions were conducted with community distributors to understand their perceptions of the IPC measures and barriers and facilitators to adherence.

Results
Data collectors observed community distributors in Nigeria (n = 259), Burkina Faso (n = 252) and Chad (n = 266) receiving IPC equipment and delivering SMC. Adherence to IPC indications varied. In all three countries, adherence to mask use was the highest (ranging from 73.3% in Nigeria to 86.9% in Burkina Faso). Adherence to hand hygiene for at least 30 s was low (ranging from 3.6% in Nigeria to 10.3% in Burkina Faso) but increased substantially when excluding the length of time spent hand washing (ranging from 36.7% in Nigeria to 61.4% in Burkina Faso). Adherence to safe distancing in the compound ranged from 5.4% in Chad to 16.4% in Nigeria. In Burkina Faso and Chad, where disinfection wipes widely available compliance with disinfection of blister packs for SMC was low (17.4% in Burkina Faso and 16.9% in Chad). Community distributors generally found the IPC measures acceptable, however there were barriers to optimal hand hygiene practices, cultural norms made social distancing difficult to adhere to and caregivers needed assistance to administer the first dose of SMC.

Conclusion
Adherence to IPC measures for SMC delivery during the COVID-19 pandemic varied across domains of IPC, but was largely insufficient, particularly for hand hygiene and safe distancing. Improvements in provision of protective equipment, early community engagement and adaptations to make IPC measures more feasible to implement could increase adherence.
CRISPR/Cas9 and next generation sequencing in the personalized treatment of Cancer
Authors: Selvakumar Sushmaa Chandralekha , Preethi K. Auxzilia , Ross Kehinde , Tusubira Deusdedit , Khan Mohd Wajid Ali , Mani Panagal , Rao Tentu Nageswara , Sekar Durairaj 
Published: March 2022

Abstract
Background
Cancer is caused by a combination of genetic and epigenetic abnormalities. Current cancer therapies are limited due to the complexity of their mechanism, underlining the need for alternative therapeutic approaches. Interestingly, combining the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR/Cas9) system with next-generation sequencing (NGS) has the potential to speed up the identification, validation, and targeting of high-value targets.

Main text
Personalized or precision medicine combines genetic information with phenotypic and environmental characteristics to produce healthcare tailored to the individual and eliminates the constraints of “one-size-fits-all” therapy. Precision medicine is now possible thanks to cancer genome sequencing. Having advantages over limited sample requirements and the recent development of biomarkers have made the use of NGS a major leap in personalized medicine. Tumor and cell-free DNA profiling using NGS, proteome and RNA analyses, and a better understanding of immunological systems, are all helping to improve cancer treatment choices. Finally, direct targeting of tumor genes in cancer cells with CRISPR/Cas9 may be achievable, allowing for eliminating genetic changes that lead to tumor growth and metastatic capability.

Conclusion
With NGS and CRISPR/Cas9, the goal is no longer to match the treatment for the diagnosed tumor but rather to build a treatment method that fits the tumor exactly. Hence, in this review, we have discussed the potential role of CRISPR/Cas9 and NGS in advancing personalized medicine.
Giving meaning to the scores of the Amsterdam instrumental activities of daily living questionnaire: a qualitative study
Authors: Dubbelman Mark A. , Terwee Caroline B. , Verrijp Merike , Visser Leonie N. C. , Scheltens Philip , Sikkes Sietske A. M. 
Published: March 2022

AbstractBackgroundEveryday functioning is a clinically relevant concept in dementia, yet little is known about the clinical meaningfulness of scores on functional outcome measures. We aimed to establish clinically meaningful scoring categories for the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q), representing no, mild, moderate and severe problems in daily functioning.MethodsInformal caregivers (n = 6) of memory-clinic patients and clinicians (n = 13), including neurologists and nurse specialists, working at various memory clinics in The Netherlands. In focus groups, participants individually ranked nine summaries of fictional patients from least to most impairment in daily functioning. Then, they placed bookmarks to demarcate the thresholds for mild, moderate and severe problems. Individual bookmark placements were then discussed to reach consensus. Clinicians completed a survey in which they placed bookmarks, individually.ResultsWhile individual categorizations varied somewhat, caregivers and clinicians generally agreed on the thresholds, particularly about the distinction between ‘no’ and ‘mild’ problems. Score categories were no problems (T-score ≥ 60), mild problems (T-score 50–59), moderate problems (T-score 40–49), and severe problems in daily functioning (T-score < 40), on a scale ranging 20–80.ConclusionsOur findings provide categories for determining the level of functional impairment, which can facilitate interpretation of A-IADL-Q scores. These categories can subsequently be used by clinicians to improve communication with patients and caregivers.