bluuebunny/crossref_metadata_2025_split huggingface dataset:
Policymakers’ and healthcare providers’ perspectives on the introduction of oral pre-exposure prophylaxis for key populations in Ghana
Authors: Nagai Henry , Adiibokah Edward , Tagoe Henry , Tun Waimar , Pilgrim Nanlesta A. , Ankomah Augustine , Rahman Yussif Ahmed Abdul , Addo Stephen Ayisi , Atuahene Stephen Kyeremeh , Essandoh Emmanuel , Maher Sean , Kowalski Mark 
Published: March 2022

Abstract
BackgroundKey populations (KPs) such as female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and their partners contribute more than a quarter (27.5%) of new HIV infection in Ghana. Oral pre-exposure prophylaxis (PrEP) can substantially reduce HIV acquisition among this group. While the available research indicates KPs willingness to take PrEP in Ghana, little is known about the position of policymakers and healthcare providers on the introduction of PrEP for KPs. MethodsQualitative and quantitative data were collected through a cross-sectional study from September to October 2017 in the Greater Accra (GA) and Brong-Ahafo (BA) regions of Ghana. In-depth interviews (IDIs) were conducted with 20 regional and national policymakers and 23 healthcare providers to explore their level of support for PrEP and their perspectives on challenges and issues to consider for oral PrEP implementation. The quantitative survey involved interviews with 409 healthcare providers to examine willingness to provide PrEP, challenges to PrEP roll-out and how it should be implemented. Thematic content analysis was used for the qualitative interviews descriptive analysis was conducted using frequencies of variables of interest for the quantitative analysis. ResultsPolicymakers and providers (95%) in both regions expressed strong support for introducing PrEP for KPs. Key concerns regarding oral PrEP introduction included potential for behavioral disinhibition, non-adherence and side effects of medication, cost and long-term financial implications, and stigma related to HIV and key populations. Participants stressed the need to integrate PrEP into existing services. While over three-fourths of providers indicated they would personally provide PrEP to HIV negative partners of HIV positive clients (87%), people who have multiple sex partners (83%), and FSWs (78%), a smaller percentage indicated they would provide PrEP to MSM (66%) and PWID (58%). ConclusionsPolicymakers and providers recognize the value of PrEP but have concerns about disinhibition, non-adherence, and cost. Therefore, a range of strategies are needed to address their concerns including: sensitization with providers to mitigate underlying stigma towards KPs, particularly MSM, integration of PrEP into existing services, and innovative strategies to improve continued use of PrEP.
Biosensor-integrated transposon mutagenesis reveals rv0158 as a coordinator of metabolism-linked redox homeostasis in Mycobacterium tuberculosis
Authors: Singh Amit , SHEE SOMNATH , TV Reshma , Mohanraj Karthikeyan , Nagarajan Sathyanarayanan , Das Mayashree , Malhotra Nitish , Sinha Vikrant , Thakur Chandrani , Rajmani Raju , Chandra Nagasuma , Singh Mahavir , Samal Areejit , Seshasayee Aswin Sai Narain 
Published: March 2022

Abstract
Mycobacterium tuberculosis (Mtb) is evolutionarily equipped to resist exogenous reactive oxygen species but shows vulnerability to an increase in endogenous ROS (eROS). Since eROS is an unavoidable consequence of aerobic metabolism, understanding how eROS levels are controlled is essential yet remains uncharacterized. By combining the Mrx1-roGFP2 redox biosensor with transposon mutagenesis, we identified 368 genes (redoxosome) responsible for maintaining non-toxic levels of eROS in Mtb. Integrating redoxosome with a global network of protein-protein interactions and transcriptional regulators revealed a hypothetical protein (rv0158) as a top node managing eROS and redox homeostasis in Mtb. RNA sequencing, seahorse XF flux measurements, and lipid analysis indicate that rv0158 is required to balance the deployment of fatty acid substrates between lipid anabolism and oxidation. Disruption of rv0158 perturbed redox balance in a carbon-source-specific manner, promoted killing in response to anti-TB drugs, reduced survival in macrophages, and lowered persistence in mice.
Transferrin Predicts Trimethylamine-N-Oxide Levels and is a Potential Biomarker of Cardiovascular Disease
Authors: Bean Lamuel D. , Wing Jeffrey J. , Harris Randall E. , Smart Suzanne M. , Raman Subha V. , Milks M. Wesley 
Published: March 2022

Abstract
Introduction: Trimethylamine-N-oxide (TMAO) is a circulating biomarker associated with cardiovascular disease (CVD). Production of TMAO is facilitated by gut microbiota and dependent on micronutrients such as choline, betaine, and L-carnitine, present in foods such as red meat and eggs.Hypothesis: We sought to predict serum TMAO quartile levels among healthy individuals at increased risk of CVD using clinical data via an ordinal logistic model.Methods: Data from participants (n=127) enrolled in a longitudinal observational study on CVD were used to build a predictive model for TMAO using ordinal logistic regression with demographic variables and 40 other variables considered related to CVD risk. First, univariate models for each covariate were tested (with serum TMAO quartiles as the dependent variable), and only variables with P < 0.30 were evaluated further. Second, demographic variables (age, gender, white vs. non-white race) were included in a multivariable model with each previously identified independent variable controlling for potential confounding. Last, the final model included fixed demographics and candidates from the confounder-adjusted model with P < 0.10.Results: Eight candidate variables were included in the final model, with only transferrin, high-density lipoprotein cholesterol (HDL-C) and race (White vs non-white) showing significant associations with TMAO. Participants had 0.16 (Q2), 0.31 (Q3), and 0.20 (Q4) odds of being in a higher TMAO quartile compared with participants in the lowest transferrin quartile. Non-white participants had 2.92 times higher odds of being in the highest TMAO quartile compared to white individuals. Participants in the second quartile of HDL-C had 2.68 times higher odds of being in a higher TMAO quartile compared with participants in the lowest HDL-C quartile.Conclusions: Transferrin demonstrated a significant predictive association with TMAO and may represent a novel potential biomarker of increased CVD risk worthy of further study. These results warrant further examination of iron, metabolism, homeostasis, and gut microbiome to better understand and mitigate known increased CVD risk.
Relationship Between Oral Function Measurement and Malnutrition Following Oral Cancer Treatment: A Single-Center Cross-Sectional Study
Authors: Morioka Reon , Matsuda Yuhei , Kato Akira , Okui Tatsuo , Okuma Satoe , Tatsumi Hiroto , Kanno Takahiro 
Published: March 2022

Abstract
Objectives
Oral dysfunction and dysphagia after oral cancer treatment have been linked to a decrease in nutritional status. This study aimed to identify specific oral functions related to nutritional status.
Patients and Methods
: We conducted a cross-sectional study from September 2019 to December 2021. We recruited 75 participants (median age: 72.0 years), including 52 (69.3%) males and 23 (30.7%) females, collected background data, and evaluated oral function. The Mini Nutritional Assessment-Short Form (MNA-SF) scores were divided into three groups (normal nutritional status, at risk of malnutrition, and malnourished), and a multi-group comparison was conducted for each oral function measurement (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function, and Eating Assessment Tool [EAT-10]).
Results
The primary tumor site was the tongue in 31 patients (41.3%), gingiva in 30 (40.0%), and others in 14 (18.7%). Multiple comparisons revealed significant differences in occlusal force, tongue pressure, masticatory function, and EAT-10 level between each MNA-SF group (P < 0.05). Multiple regression analysis showed a statistically significant association with MNA-SF in terms of masticatory function and EAT-10 levels.
Conclusion
Decreased masticatory function and EAT-10 levels are risk factors for malnutrition. Nutritional instructions and oral-maxillofacial prosthetic treatment should be adapted to changes in oral function.
Identifying major yield limiting nutrients on sorghum (Girana one) for developing site-specific nutrient management practices in low lands of Eastern Amhara
Authors: Teshome Habtemariam , Gedam Samuel , Sisay Kassa , Hailu Tadesse 
Published: March 2022

Abstract
Background: Omission trial is a passionate way of identifying yield limiting nutrients. A field experiment was conducted for identification of yield limiting nutrients through crop response in Kobo with test crop sorghum (Girana one variety) for two years in three kebeles. The design for experiment was a randomized completely block (RCBD) using farmer field as replication. Biological yield data were collected and subjected to analysis of variance (ANOVA). Whenever there was significant difference between treatments, the means were separated using LSD test at P≤0.05. Results: The results showed that the omission of nutrients from inorganic fertilizer alone or in combination resulted in significance grain yield reduction. The highest grain yield was observed with the treatment receiving NPS+FYM whereas the lowest was omission of all nutrients (control). There was no significant difference in biomass yield between treatments for both years. Omission of all nutrients from inorganic fertilizer alone or in combination significantly reduced grain yield of sorghum. Application of FYM in combination with inorganic fertilizer (NPS) and NP contained treatments (NPS, NPSK and NPSKZN) can meet nutrient requirement for sorghum. Conclusions: This experiment shows a significant yield advantage of all applied nutrients compared to omitting nutrients. Application of farm yard manure was also significantly affected grain yield compared to the control. Based on this result, nitrogen and phosphorous fertilizers with farm yard manure rather than secondary and micro nutrients can be recommended in the study area for increasing production and productivity of the sorghum.
Surgical Treatment for Pediatric Hydrocephalus: a Report of 163 Clinical Cases in a Single Center
Authors: Yan Lin , Zhang Chengyue , Ding Shikuan , Cheng Quan , He Jian , Zhang Zhiping , Liu Jingping , Wang Yuchang , Xiao Gelei 
Published: March 2022

Abstract
Objectives: Surgical treatment is the preferred treatment for pediatric hydrocephalus. The analysis of the outcome of pediatric hydrocephalus surgery and its complications is limited by the lack of available data. Our goal was to better understand the effectiveness of surgery and to explore better surgical treatment methods and management of complications.Methods: 163 patients with pediatric hydrocephalus were included. A retrospective chart review was performed on all patients. Data collected included surgical techniques, number of surgical treatments, complications, and basic demographics.Results: There were 163 patients in this group including 103 males and 60 females. Among the patients, 106 (106/163, 65.0%) patients received ventricular peritoneal shunt (VP), 7 (7/163, 4.3%) patients received ventricle-right atrium shunt (VA) and 50 (50/163, 30.7%) patients received endoscopic third ventriculostomy (ETV). Among the patients who received VP, 74 (74/163, 45.4%) patients were cured and 32 (32/163, 19.6%) patients underwent surgery again. Among the patients who received VA, 38 (38/163, 23.3%) patients were cured and 12 (12/163, 7.4%) patients underwent surgery again. Among the patients who received ETV, 3 (3/163, 1.8%) patients were cured and 4 (4/163, 2.5%) patients underwent surgery again. The most common complication is shunt-related peritonitis or abdominal abscess, abdominal end obstruction (17/163，10.4%).Conclusion: A single surgery can cure most patients, and sometimes more than one surgery is required. For pediatric hydrocephalus, ETV is more efficient and has fewer surgical complications. However, the management of unrelieved symptoms and related complications after ETV surgery and bypass surgery should still be taken seriously.
Communication barriers to education to referrals from the perspective of referrals to health centers and health care providers attendants in Kerman
Authors: Alizadeh Somayeh , Iranpour Abedin , Mirafzali Sedigheh 
Published: March 2022

Abstract
Introduction: One of the most important factors affecting the increase of clients' satisfaction is how health care providers (HCP) communicate with clients. On the other hand, different factors can hinder proper communication and thus education, which is one of the main tasks of HCP. Therefore, the purpose of this study was to investigate Communication barriers to education to referrals from the perspective of referrals to health centers (RHC) and HCP attendants in Kerman.Method: This descriptive-analytical study was conducted on RHC and HCP in 2021. Using a multi-stage sampling method, 162 HCP and 414 RHC were included in the study. Data collection tool was 2 researcher-made questionnaires. Data were analyzed using SPSS 16.findings: From the perspective of RHC and HCP, the most communication barriers were related to environmental and then socio-cultural factors. Among the demographic variables of HCP, level of education showed a significant relationship with the physical-psychological, verbal-non-verbal and informational domains. And in relation to RHC, a significant relationship was found between education and job in the socio-cultural field and environmental barriers(p <0.05).Conclusion: HCP faces a variety of barriers in educating people, most of which are related to environmental factors. Given the cost-effectiveness of education to the public, it is essential that planners and policymakers use strategies to eliminate environmental factors as well as the placement of indigenous HCP in health facilities to reduce communication barriers.
Healthcare utilization and financial protection among those with mental disorders in India: Insights from the 75th round of the National Sample Survey
Authors: Ranjan Alok , Crasta Jewel 
Published: March 2022

Abstract
Background: Mental disorders pose a significant public health issue in India, with a prevalence rate of one in seven individuals diagnosed with varying severities of mental disorders in 2017. This study examined the patterns of socio-demographic factors associated with diseases burden, healthcare utilization, and financial protection among individuals reported to have a mental disorder across India.Methods: Data from the recently released (November 2019) 75th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used. Data collected from 555,115 individuals (rural: 325,232; urban: 229,232) included 283 outpatient and 374 hospitalization cases due to mental disorders in India. Logistic regression models were used for analyses.Results: Self-reporting of mental health disorders was significantly higher in the general category compared to scheduled tribe, and among the richest income quintile compared to the poorest income quintile in India. The private sector was a major service provider for mental health services with a larger share for outpatient (66.1%) than inpatient care (59.2%). Over 63.5% of individuals with a mental disorder and who went to the private sector for hospitalization reported unavailability or poor service quality at public facilities. Out of total hospitalization cases, 23.5% had insurance coverage. Average out of pocket expenditure during hospitalization [public: Rs.7947 (107 USD); private: Rs. 37152 (502 USD)] and outpatient care [ public: Rs.544 (7 USD); private: Rs. 2358 (32 USD)] was higher under the private sector than the public sector. This led to high catastrophic health expenditure (CHE-10: public- 30.8%; private- 82.5%).Conclusions: Stigma associated with mental disorders may have decreased the self-reporting of mental disorders in this survey. India urgently needs greater investment in mental health resources to improve access and financial protection. To achieve universal health coverage under sustainable development goals, the country needs to strengthen its healthcare system, providing comprehensive primary care, along with robust tertiary and rehabilitative care referral linkages.Trial Registration: Not applicable
Oxidoreduction potential controlling for increasing the fermentability of enzymatically hydrolyzed steam-exploded corn stover for butanol production
Authors: Wang Min , Xia Menglei , Wang Di , Xia Yiming , Shi Haijiao , Tian Zhongyu , Zheng Yu 
Published: March 2022

Abstract
Background: Lignocellulosic biomass is recognized as an effective potential substrate for biobutanol production. Though many pretreatment and detoxification methods have been set up, the fermentability of detoxicated lignocellulosic substrate is still far lower than that of starchy feedstocks. On the other hand, the number of recent efforts on rational metabolic engineering approaches to increase butanol production in Clostridium strains are also quite limited, demonstrating the physiological complexity of solventogenic clostridia. In fact, the strain performance is greatly impacted by process controlling. developing efficient process control strategies could be a feasible solution to this problem.Result: In this study, oxidoreduction potential (ORP) controlling was applied to increase the fermentability of enzymatically hydrolyzed steam-exploded corn stover (SECS) for butanol production. When ORP of detoxicated SECS was controlled at -350mV, the period of fermentation was shortened by 6 h with an increase of 27.5% in the total solvent (to 18.1 g/L) and 34.2% in butanol (to 10.2 g/L) respectively. Silico modeling revealed that the fluxes of NADPH, NADH and ATP strongly differed between the different scenarios. Quantitative analysis showed that intracellular concentrations of ATP, NADPH/NADP+ and NADH/NAD+ were increased by 25.1%，81.8% and 62.5%. ORP controlling also resulted in a 2.1-fold increase in butyraldehyde dehydrogenase, a 1.2-fold increase in butanol dehydrogenase and 29% increase in the cell integrity.Conclusion: ORP control strategy is effective for altering intracellular metabolic profiles and can significantly improve Clostridium cell growth and butanol production. The working mechanism can be summarized into three aspects: First, Glycolysis and TCA circulation pathway are strengthened through key nodes such as pyruvate carboxylase [EC: 6.4.1.1], which provides sufficient NADH and NADPH for the cell. Second, sufficient ATP is provided to avoid “acid crash”. Third, the key enzymes activities regulating butanol biosynthesis and cell membrane integrity was improved.
Individual characteristics associated with utilization of nursing care in very old population: cross-sectional study
Authors: Zimmermann Jaroslava 
Published: March 2022

Abstract
Background: Older adults aged 80 or older belong to the most frequent recipient of nursing care. Since this age group remains often underrepresented in previous research, little is known about the characteristics associated with utilization of nursing care services. Therefore, the aim of this study was to examine individual (predisposing, enabling, and need) predictors of nursing care utilization in very old population of North Rhine-Westphalia (NRW). Methods: Using data from a representative cross-sectional study, 1,531 community-dwelling and institutionalized individuals aged ≥80 years were included. The use of outpatient care services, day care, private and inpatient nursing care was considered. Multinomial regression was applied to investigate the factors explaining nursing care use in very old adults. Results: Overall, 69.9% of participants used no nursing care services, 21.9% were using outpatient/day and/or private care, and 8.2% were institutionalized. Compared to very old adults who did not use any nursing care services, users of outpatient/day and/or private care had higher likelihood of being older, having no partner, and experiencing higher functional and cognitive disability. Comparing non-users with those using inpatient nursing care, institutionalized individuals were more likely older, had lower socioeconomic status, were childless and not in partnership, socially isolated, felt more likely lonely, were more functional and cognitive impaired, but they experienced less likely five or more chronic conditions, and were less likely physically pre-frail and frail. Conclusions: Individual need factors (referring to health status) dominated in explaining utilization of outpatient/day and/or private care, suggesting that very old population in NRW may have equitable access to these services. Since social structure, region, and social resources explained who have received inpatient nursing care, this kind of care might be inequitable accessible to very old adults in NRW. Nevertheless, the results indicate that nursing homes could substitute the role of missing closest relatives as potential caregivers, prevent frailty and multimorbidity, but fail to ensure social inclusion of the oldest-old within facilities.
SEVA-Cpf1, a CRISPR-Cas12a vector for Genome Editing in Cyanobacteria
Authors: Baldanta Sara , Guevara Govinda , Navarro-Llorens Juana María 
Published: March 2022

Abstract
Background: Cyanobacteria are photosynthetic autotrophs that have tremendous potential for fundamental research and industrial applications due to their high metabolic plasticity and ability to grow using CO2 and sunlight. CRISPR technology using Cas9 and Cpf1 has been applied to different cyanobacteria for genome manipulations and metabolic engineering. Despite significant advances with genome editing in several cyanobacteria strains, the lack of proper genetic toolboxes is still a limiting factor compared to other model laboratory species. Among the limitations, it is essential to have versatile plasmids that could ease the benchwork when using CRISPR technology. Results: In the present study, several CRISPR-Cpf1 vectors were developed for genetic manipulations in cyanobacteria using SEVA plasmids. SEVA collection is based on modular vectors that enable the exchangeability of diverse elements (e.g. origins of replication and antibiotic selection markers) and the combination with many cargo sequences for varied end-applications. Firstly, using SEVA vectors containing the broad host range RSF1010 origin we demonstrated that these vectors are replicative not only in model cyanobacteria but also in a new cyanobacterium specie, Chroococcidiopsis sp., which is different from those previously published. Then, we constructed SEVA vectors by harbouring CRISPR elements and showed that they can be easily assimilated not only by conjugation, but also by natural transformation. Finally, we used our SEVA-Cpf1 tools to delete the nblA gene in Synechocystis sp. PCC 6803, demonstrating that our plasmids can be applied for CRISPR-based genome editing technology. Conclusions: The results of this study provide new CRISPR-based vectors based on the SEVA (Standard European Vector Architecture) collection that can improve editing processes using the Cpf1 nuclease in cyanobacteria.