bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary diversity in primary schoolchildren of south-central Côte d’Ivoire and risk factors for non-communicable diseases
Authors: Traoré Sylvain G. , Kouassi Kouadio B. , Coulibaly Jean T. , Beckmann Johanna , Gba Bomey C. , Lang Christin , Long Kurt Z. , Dao Daouda , Gerber Markus , Probst-Hensch Nicole , Pühse Uwe , Utzinger Jürg , Bonfoh Bassirou 
Published: November 2022

Abstract
Background
A balanced nutrition is important for children’s physical and cognitive development; yet, remains a challenge in many parts of low- and middle-income countries (LMICs). Early detection of nutritional deficiency and metabolic syndrome in school-aged children is necessary to prevent non-communicable diseases (NCDs) in later life. This study aimed at obtaining baseline data on health, nutritional status, and metabolic markers of NCDs among primary schoolchildren in Côte d’Ivoire.

Methods
A cross-sectional survey was conducted among 620 children from 8 public primary schools located in the south-central part of Côte d’Ivoire. Underweight and overweight were defined as a body mass index (BMI; kg/m2) < 5th and 85th up to 95th percentile for sex and age, respectively. Dietary diversity of children was calculated based on a 24-hour recall conducted with the primary caretaker according to the guideline of Food and Agriculture Organization. Anaemia, malaria, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood glucose levels (HbA1c) were assessed, using capillary blood samples. Logistic models were performed to identify risk factors associated with overweight, HDL-C, LDL-C, and HbA1c.

Results
Among the 620 children (330 girls, 290 boys; Mage 8.0 (± 1.7) years), 530 children attended school in a semi-urban and 90 in a rural area. Around 60% of children had a medium dietary diversity score (DDS). Children in peri-urban areas consumed more cereals (80.2% vs. 63.3%, p < 0.05). Most children were normal weight (n = 496), whereas 3.9% of children classified as prediabetic, 5% were underweight, and 15% overweight. LDL-C and HDL-C levels of children were associated with age, high DDS, and moderate anaemia. A significant association was found between prediabetes and malaria infection, as well as medium and high DDS. Overweight was associated with malaria infection and moderate anaemia.

Conclusion
Overweight, prediabetes, low HDL-C, malaria, and anaemia are the main concerns of children’s health in Taabo. Our findings highlight interactions between infectious diseases, particularly malaria, and NCD risk factors. Monitoring NCD risk and infectious disease comorbidity in LMIC paediatric populations simultaneously is essential to better understand the dual diseases burden and apply early prevention measures.
Time change in the distribution of physical activity and its correlates among retired older Swedish adults: a repeated cross-sectional study from a national survey
Authors: Vilhelmson Bertil , Thulin Eva , Elldér Erik 
Published: November 2022

Abstract
Background
Understanding how older adults spend time in moderate- to vigorous-intensity physical activity (MVPA) is crucial to understanding healthy ageing. This study connects 24-h time-use diary records of the daily activities of a sample of Swedish older adults to energy intensities. The aim was to: i) estimate the prevalence of Swedish older adults (aged 65–84 years) who achieved recommended daily levels of physical activity; ii) identify what domains of everyday life contribute to MVPA; and iii) explore socio-demographic factors affecting rates of active living.

Methods
We draw on two Swedish nationally representative samples of time-use diary data from 2000/2001 and 2010/2011. Data covering the duration of all activities performed over two days were combined with activity-intensity information (metabolic equivalent of task [MET] values) to estimate the energy expenditure (MET min) originating from MVPA.

Results
Results indicate that 94.1% of Swedish older adults achieved the WHO-recommended minimum level of daily MVPA in 2010/2011; the share remained unchanged over the period. MVPA performed in natural environments (24.2%), during housework (22.8%), and on everyday walks in one’s local area (18.1%) were dominant domains contributing to energy expenditure. Home maintenance and repairs (8.8%), active transport (9.9%), and physical exercise (8.2%) contributed to a lesser extent. In 2000/2001, total MVPA energy expenditure was associated with gender, housing, living region, and disability; in 2010/2011, except for disability, these associations were no longer significant.

Conclusions
The high proportion of older adults who achieved the recommended level of MVPA, their allocation of MVPA time to diverse domains, and the reduced social distribution over time suggest that elderly people increasingly find their own paths to everyday physical activity. This indicates a need to promote MVPA not only in established ways, such as prescribed training programmes. The importance of active physical activities in natural environments, and of regular walks in the vicinity of home, indicates a need to incorporate healthy ageing considerations in wider urban and regional planning, for example, to increase access to natural environments and urban walkability. Also, older adults’ involvement in household chores, maintenance and repairs, and active transport extends responsibility to new policy areas.
Chronic rhinosinusitis associated with chronic bronchitis in a five-year follow-up: the Telemark study
Authors: Bergqvist Joel , Bove Mogens , Andersson Anders , Schiöler Linus , Klepaker Geir , Abrahamsen Regine , Fell Anne Kristin M. , Hellgren Johan 
Published: November 2022

Abstract
Background
Chronic rhinosinusitis (CRS) is associated with generalised airway inflammation. Few studies have addressed the relationship between CRS and chronic bronchitis (CB).

Methods
This prospective study over a five-year period aims to investigate the risk of developing CB in subjects reporting CRS at the beginning of the study. A random sample of 7393 adult subjects from Telemark County, Norway, answered a comprehensive respiratory questionnaire in 2013 and then 5 years later in 2018. Subjects reporting CB in 2013 were excluded from the analyses. New cases of CB in 2018 were analysed in relation to having CRS in 2013 or not.

Results
The prevalence of new-onset CB in 2018 in the group that reported CRS in 2013 was 11.8%. There was a significant increase in the odds of having CB in 2018 in subjects who reported CRS in 2013 (OR 3.8, 95% CI 2.65–5.40), adjusted for age, sex, BMI, smoking and asthma.

Conclusion
In this large population sample, CRS was associated with increased odds of developing CB during a five-year follow-up. Physicians should be aware of chronic bronchitis in patients with CRS.
Comparison between magnetic resonance imaging and electrical impedance myography for evaluating lumbar skeletal muscle composition
Authors: Albano Domenico , Gitto Salvatore , Vitale Jacopo , Bernareggi Susan , Aliprandi Alberto , Sconfienza Luca Maria , Messina Carmelo 
Published: November 2022

Abstract
Background
To compare electrical impedance myography (EIM) and MRI in assessing lumbar skeletal muscle composition.

Methods
One hundred forty-one patients (78 females, mean age 57 ± 19 years) were prospectively enrolled and underwent lumbar spine MRI, EIM with Skulpt®, and clinical evaluation including the questionnaire SARC-F. MRIs were reviewed to assess the Goutallier score of paravertebral muscles at L3 level and to calculate the cross sectional area (CSA) of both psoas, quadratus lumborum, erector spinae, and multifidus muscles on a single axial slice at L3 level, in order to calculate the skeletal muscle index (SMI=CSA/height2). We tested the correlation between EIM-derived parameters [body fat percentage (BF%) and muscle quality] and body mass index (BMI), Goutallier score (1–4), SMI, and SARC-F scores (0–10) using the Pearson correlation coefficient. The strength of association was considered large (0.5 to 1.0), medium (0.3 to 0.5), small (0.1 to 0.3).

Results
Pearson’s correlation coefficient showed small (0.26) but significant (p < 0.01) positive correlation between BF% obtained with EIM and Goutallier score. Small negative correlation (− 0.22, p < 0.01) was found between EIM muscle quality and Goutallier Score. Large negative correlation (− 0.56, p < 0.01) was found between SMI and Goutallier Score, while SMI showed small negative correlation with SARC-F (− 0.29, p < 0.01). Medium positive correlation was found between Goutallier Score and SARC-F (0.41, p < 0.01). BMI showed medium positive correlation with SMI (r = 0.369, p < 0.01) and small correlation with EIM muscle quality (r = − 0.291, p < 0.05) and BF% (r = 0.227, p < 0.05). We found a substantial increase of the strength of associations of BF% and muscle quality with Goutallier in the 18–40 years (r = 0.485 and r = − 0.401, respectively) and in the 41–70 years group (r = 0.448 and r = − 0.365, respectively).

Conclusions
Muscle quality and BF% measured by EIM device showed only small strength of correlation with other quantitative parameters for assessing muscle mass and fat infiltration. Interesting results have been found in younger patients, but Skulpt Chisel™ should be applied cautiously to assess lumbar skeletal muscle composition. This point deserves further investigation and other studies are warranted.

Trial registration
The registration number of this study is 107/INT/2019.
Development of an assessment technique for basic science retention using the NBME subject exam data
Authors: Matus Alexandra R. , Matus Lyndsey N. , Hiltz Adam , Chen Tian , Kaur Bhavneep , Brewster Pamela , Sun Zhen , Mukundan Deepa , DeShetler Lori M. , Laukka Jeremy J. , Menon Bindu 
Published: November 2022

Abstract
Introduction
One of the challenges in medical education is effectively assessing basic science knowledge retention. National Board of Medical Examiners (NBME) clerkship subject exam performance is reflective of the basic science knowledge accrued during preclinical education. The aim of this study was to determine if students’ retention of basic science knowledge during the clerkship years can be analyzed using a cognitive diagnostic assessment (CDA) of the NBME subject exam data.

Methods
We acquired a customized NBME item analysis report of our institution’s pediatric clerkship subject exams for the period of 2017–2020 and developed a question-by-content Q-matrix by identifying skills necessary to master content. As a pilot study, students’ content mastery in 12 major basic science content areas was analyzed using a CDA model called DINA (deterministic input, noisy “and” gate).

Results
The results allowed us to identify strong and weak basic science content areas for students in the pediatric clerkship. For example: “Reproductive systems” and “Skin and subcutaneous tissue” showed a student mastery of 83.8 ± 2.2% and 60.7 ± 3.2%, respectively.

Conclusions
Our pilot study demonstrates how this new technique can be applicable in quantitatively measuring students’ basic science knowledge retention during any clerkship. Combined data from all the clerkships will allow comparisons of specific content areas and identification of individual variations between different clerkships. In addition, the same technique can be used to analyze internal assessments thereby creating an opportunity for the longitudinal tracking of student performances. Detailed analyses like this can guide specific curricular changes and drive continuous quality improvement in the undergraduate medical school curriculum.
Sequential gene expression analysis of cervical malignant transformation identifies RFC4 as a novel diagnostic and prognostic biomarker
Authors: Zhang Jianwei , Meng Silu , Wang Xiaoyan , Wang Jun , Fan Xinran , Sun Haiying , Ning Ruoqi , Xiao Bing , Li Xiangqin , Jia Yao , Kong Dongli , Chen Ruqi , Wang Changyu , Ma Ding , Li Shuang 
Published: November 2022

Abstract
Background
Cervical squamous cell carcinoma (SCC) is known to arise through increasingly higher-grade squamous intraepithelial lesions (SILs) or cervical intraepithelial neoplasias (CINs). This study aimed to describe sequential molecular changes and identify biomarkers in cervical malignant transformation.

Methods
Multidimensional data from five publicly available microarray and TCGA-CESC datasets were analyzed. Immunohistochemistry was carried out on 354 cervical tissues (42 normal, 62 CIN1, 26 CIN2, 47 CIN3, and 177 SCC) to determine the potential diagnostic and prognostic value of identified biomarkers.

Results
We demonstrated that normal epithelium and SILs presented higher molecular homogeneity than SCC. Genes in the region (e.g., 3q, 12q13) with copy number alteration or HPV integration were more likely to lose or gain expression. The IL-17 signaling pathway was enriched throughout disease progression with downregulation of IL17C and decreased Th17 cells at late stage. Furthermore, we identified AURKA, TOP2A, RFC4, and CEP55 as potential causative genes gradually upregulated during the normal-SILs-SCC transition. For detecting high-grade SIL (HSIL), TOP2A and RFC4 showed balanced sensitivity (both 88.2%) and specificity (87.1 and 90.1%), with high AUC (0.88 and 0.89). They had equivalent diagnostic performance alone to the combination of p16INK4a and Ki-67. Meanwhile, increased expression of RFC4 significantly and independently predicted favorable outcomes in multi-institutional cohorts of SCC patients.

Conclusions
Our comprehensive study of gene expression profiling has identified dysregulated genes and biological processes during cervical carcinogenesis. RFC4 is proposed as a novel surrogate biomarker for determining HSIL and HSIL+, and an independent prognostic biomarker for SCC.
Rapid elimination of cervical cancer while maintaining the harms and benefits ratio of cervical cancer screening: a modelling study
Authors: Jansen Erik E. L. , de Kok Inge M. C. M. , Kaljouw Sylvia , Demirel Erhan , de Koning Harry J. , Hontelez Jan. A. C. 
Published: November 2022

Abstract

Background
Human papillomavirus (HPV) vaccination and intensifying screening expedite cervical cancer (CC) elimination, yet also deteriorate the balance between harms and benefits of screening. We aimed to find screening strategies that eliminate CC rapidly but maintain an acceptable harms-benefits ratio of screening.

Methods
Two microsimulation models (STDSIM and MISCAN) were applied to simulate HPV transmission and CC screening for the Dutch female population between 2022 and 2100. We estimated the CC elimination year and harms-benefits ratios of screening for 228 unique scenarios varying in vaccination (coverage and vaccine type) and screening (coverage and number of lifetime invitations in vaccinated cohorts). The acceptable harms-benefits ratio was defined as the number of women needed to refer (NNR) to prevent one CC death under the current programme for unvaccinated cohorts (82.17).

Results
Under current vaccination conditions (bivalent vaccine, 55% coverage in girls, 27.5% coverage in boys), maintaining current screening conditions is projected to eliminate CC by 2042, but increases the present NNR with 41%. Reducing the number of lifetime screens from presently five to three and increasing screening coverage (61% to 70%) would prevent an increase in harms and only delay elimination by 1 year. Scaling vaccination coverage to 90% in boys and girls with the nonavalent vaccine is estimated to eliminate CC by 2040 under current screening conditions, but exceeds the acceptable NNR with 23%. Here, changing from five to two lifetime screens would keep the NNR acceptable without delaying CC elimination.

Conclusions
De-intensifying CC screening in vaccinated cohorts leads to little or no delay in CC elimination while it substantially reduces the harms of screening. Therefore, de-intensifying CC screening in vaccinated cohorts should be considered to ensure acceptable harms-benefits ratios on the road to CC elimination.
Evaluation of internal farm biosecurity measures combined with sow vaccination to prevent influenza A virus infection in groups of due-to-wean pigs
Authors: Lopez-Moreno Gustavo , Schmitt Cameron , Spronk Taylor , Culhane Marie , Torremorell Montserrat 
Published: November 2022

Abstract
Background
Influenza A virus (IAV) is an important respiratory pathogen of pigs that affects pig health, well-being and productivity, has zoonotic potential, and has significant economic impact for producers. The ultimate goal is to maintain herds free from IAV. Due to the probability of IAV introduction into the herds, it is also desirable for herds to have some immunity to the virus. In this study, we evaluated a protocol that combined sow vaccination with the implementation of internal biosecurity practices during the pre-weaning period with the goal to wean IAV negative pigs.
Five IAV positive breeding herds were vaccinated twice, 3 weeks apart with a herd-specific autogenous vaccine. For the subsequent 8 weeks, a biosecurity protocol was maintained, consisting of no pig movements after 3 days of age, no use of nurse sows, workers changing disposable gloves between litters, workers not stepping into farrowing crates, and daily disinfection of tools and materials used to handle pigs.

Results
Following these interventions, four of the five treatment farms had significant reductions in IAV detection (p value < 0.05). Three of the farms tested negative at all sampling points post-intervention and one farm had a 21% reduction in IAV positivity.

Conclusions
This study indicates that a protocol that combines sow vaccination and enhanced biosecurity practices may limit IAV transmission among piglets and enable the weaning of groups of pigs free from the virus.
Laparoscopic versus open distal gastrectomy for elderly patients with advanced gastric cancer: a retrospective comparative study
Authors: Yen Hung-Hsuan , Yeh Chi-Chuan , Lai I-Rue 
Published: November 2022

Abstract
Background
Laparoscopic radical distal gastrectomy (LDG) has been more frequently performed for locally advanced distal gastric cancer (AGC) than open distal gastrectomy (ODG). However, the benefits of LDG for elderly AGC patients (AGC-lap) remain unclear.

Methods
Patients aged ≥ 70 years who underwent D2 distal gastrectomy from July 2014 to July 2021 were enrolled consecutively. Perioperative parameters, pathological features, and oncological outcomes of AGC-lap patients (n = 39) were compared with those of elderly AGC patients receiving ODG (AGC-open; n = 37) and elderly early gastric cancer patients receiving LDG (EGC-lap; n = 41) respectively.

Results
The median age of all AGC patients was 77 years, and 28% of them had an Eastern Cooperative Oncology Group score ≥ 2. Most of the perioperative and pathological features (including the number of lymph nodes harvested) were similar between the AGC-lap and AGC-open groups. AGC-lap patients had longer median operative times (215 min versus 192 min) but significantly less surgical complications (10.3% versus 37.8%) and shorter median hospital stays (11 days versus 13 days) than did AGC-open patients (all p < 0.05). The 3-year recurrence-free and overall survival was 66.2% and 88.8% in the AGC-lap group and 51% and 66.3% in the AGC-open group (both p = 0.1). The perioperative features, including operative time, number of lymph nodes harvested, hospital stay, and complication rates, were similar between the AGC- and EGC-lap groups.

Conclusions
LDG was safely and effectively performed in elderly AGC patients, resulting in faster recovery and a lower complication rate than ODG, without compromising oncological outcomes.
Application of near-infrared fluorescence imaging in the accurate assessment of surgical margins during breast-conserving surgery
Authors: Wang Yabing , Jiao Wei , Yin Zhaocai , Zhao Wanjun , Zhao Kai , Zhou Yong , Fang Rui , Dong Bingbin , Chen Bin , Wang Zheng 
Published: November 2022

Abstract
Objective
To evaluate the feasibility and accuracy of near-infrared fluorescence imaging technology for assessing margins during breast-conserving surgery for breast cancer.

Methods
Forty-three breast cancer patients who received surgical treatment at Yijishan Hospital of Wannan Medical College were selected. Before the operation, the patients were administered with an indocyanine green injection of 0.5 mg/kg intravenously 2 h before operation. During and after the operation, all patients underwent surgical margin monitoring with the near-infrared fluorescence imaging system for fluorescence imaging and acquisition of images and quantitative fluorescence intensity. During the operation, the patients’ tissue specimens were collected on the upper, lower, inner, outer, apical, and basal sides of the fluorescence boundary of the isolated lesions for pathological examination.

Results
Fluorescence was detected in the primary tumor in all patients. The average fluorescence intensities of tumor tissue, peritumoral tissue, and normal tissue were 219.41 ± 32.81, 143.35 ± 17.37, and 105.77 ± 17.79 arbitrary units, respectively (P < 0.05, t test). The signal-to-background ratio of tumor to peritumor tissue and normal tissue was 1.54 ± 0.20 and 2.14 ± 0.60, respectively (P < 0.05, t test). Abnormal indocyanine green fluorescence was detected in 11.6% patients (5/43), including 3 patients with residual infiltrating carcinoma and 2 patients with adenosis with ductal dilatation.

Conclusion
This study confirms the high sensitivity and specificity of near-infrared fluorescence imaging technology for breast-conserving surgery margin assessment. Near-infrared fluorescence imaging technology can be used as an intraoperative diagnosis and treatment tool to accurately determine the surgical margin and is of important guiding value in breast-conserving surgery for breast cancer.
The effectiveness of a tablet-based video game that stimulates cognitive, emotional, and social skills in developing academic skills among preschoolers: study protocol for a randomized controlled trial
Authors: Rojas-Barahona Cristian A. , Gaete Jorge , Véliz Mauricio , Castillo Ramón D. , Ramírez Saray , Araya Ricardo 
Published: November 2022

Abstract
Background
Evidence suggests that children from low-income families begin the preschool stage with less academic and non-academic skills development compared to higher-income families. There are several successful experiences of early stimulation of cognitive and social-emotional skills; however, there is scarce evidence of the effectiveness of a video game that incorporates the stimulation of these skills simultaneously. This study aims to evaluate the effectiveness of a video game in stimulating cognitive, emotional, and social competence skills in developing academic skills in socioeconomically disadvantaged preschool children.

Methods
A cluster-randomized controlled trial design will be used. A tablet-based video game that stimulates cognitive and socio-emotional skills to improve the development of academic skills is compared with a tablet-based game where students draw and paint with no explicit stimulation of cognitive and socio-emotional skills. Eighteen schools and 750 Chilean preschool students will be recruited. The effectiveness of the intervention will be assessed using a direct evaluation of children on literacy learning and pre-calculation skills at baseline, immediately after stimulation, and at 6, 12, 18, and 24 months post-intervention. The mediating effect of working memory, inhibitory control, emotion recognition, and prosocial behaviours will be assessed on the effectiveness of the intervention.

Discussion
The proposed study will be the first to test the effectiveness of a tablet-based video game stimulating cognitive and social-emotional skills to improve academic skills in socioeconomically disadvantaged preschool children in Chile, controlling for gender, age (in months), mental health, and baseline conditions of stimulated skills.

Trial registration
ClinicalTrials.gov NCT05224700. Registered on February 2022