bluuebunny/crossref_metadata_2025_split huggingface dataset:
Four-way decomposition of effect of cigarette smoking and body mass index on serum lipid profiles
Authors: Yu Wenhao , Gao Chaonan , Zhao Xiangjuan , Li Chunxia , Fan Bingbing , Lv Jiali , Wei Mengke , He Li , Su Chang , Zhang Tao 
Published: August 2022

Objective
Smoking and obesity are established risk factors of dyslipidemia, however, the interplay between them has not been well studied. This study aims to explore the joint effect of smoking and body mass index (BMI) on serum lipid profiles.

Methods
The study consisted of 9846 Chinese adults (mean age = 49.9 years, 47.6% males, 31.2% ever smokers), based on the China Health and Nutrition Survey. Serum lipid profiles included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A (APO-A), and apolipoprotein B (Apo-B). The joint effect of smoking and BMI on serum lipids were examined by the four-way decomposition analysis and multivariate linear regression models.

Results
The four-way decomposition showed that the interplay between smoking and BMI was complicated. There was only indirect effect (the mediated effect) between smoking and BMI on TC, LDL-C and APO-B. The pure indirect effect was -0.023 for TC, -0.018 for LDL-C, and -0.009 for APO-B. For TG, HDL-C and APO-A, the interaction effect was dominant. The reference interaction (the interactive effect when the mediator is left to what it would be in the absence of exposure) was 0.474 (P < 0.001) for TG, -0.245 (P = 0.002) for HDL-C, and -0.222 (P < 0.001) for APO-A, respectively. The effect of BMI on TG, HDL-C and APO-A were significantly higher in smokers than in nonsmokers (TG: 0.151 in smokers versus 0.097 in nonsmokers, HDL-C: -0.037 versus -0.027, APO-A: -0.019 versus -0.009, P for difference < 0.001 for all).

Conclusion
These findings illustrate the joint effects of smoking and BMI on serum lipid profiles. There were significant interaction effects of smoking and BMI on TG, HDL-C and APO-A, while BMI maybe a mediator for the association of smoking with TC, LDL-C and APO-B. The effects between them were rather complex. Smoking cessation is necessary, especially for those overweight.
Medication regimen complexity and its association with adherence and blood pressure control among hypertensive patients at selected hospitals of South Gondar Zone: A hospital based cross sectional study
Authors: Yazie Taklo Simeneh , Mengistu Workneh Ebabu , Asmare Zemen , Belete Abebe Muche , Teshome Assefa Agegnehu , Yimer Yohannes Shumet 
Published: August 2022

Introduction
Despite the availability of effective antihypertensive medications, blood pressure (BP) control is suboptimal. High medication regimen complexity index (MRCI) is known to reduce adherence and may be the reason for poor BP control. However, there is no data in the present study areas. Hence, the aim of this study was to assess MRCI and its association with adherence and BP control among hypertensive patients at selected hospitals of South Gondar Zone.

Methods
A hospital based cross sectional study was conducted from December 1, 2020 to February 30, 2021 at selected hospitals of South Gondar Zone. Medication regimen complexity and adherence was evaluated using 65-item validated tool called MRCI and eight items Morisky Medication Adherence, respectively. Multivariable logistic regression analysis was done to determine the association between predictive and outcome variables.

Results
About 3.3% of participants were classified as having high HTN specific MRCI whereas 34.75% of participants were classified as having high patient level MRCI. Among participants, 37.8% were adherent to their medications, and 52.2% of respondents were categorized as having controlled BP. Multivariate logistic regression showed being married, and having lower education level was more likely and less likely to be adherent, respectively. Being illiterate, and having low HTN MRCI were more likely to have controlled BP in adjusted analyses. On the contrary, being non-adherent, not having health insurance, and having lower monthly income were less likely to have controlled BP.

Conclusion
A considerable proportion of patients had high MRCI. Having low HTN MRCI was more likely to have controlled BP. Simplification of a complex medication regimen for patients with HTN should be sought by physicians and pharmacists to improve BP control.
Timely initiation of antenatal care and associated factors among pregnant women attending antenatal care in Southwest Ethiopia
Authors: Redi Toffik , Seid Oumer , Bazie Getaw Walle , Amsalu Erkihun Tadesse , Cherie Niguss , Yalew Melaku 
Published: August 2022

BackgroundThe timing of initiation of first antenatal care visit is paramount for ensuring optimal care and health outcomes for women and children. However, the existing evidence from developing countries, including Ethiopia, indicates that most pregnant women are attending antenatal care in late pregnancy. Thus, this study was aimed to assess timely initiation of antenatal care and associated factors among pregnant women attending antenatal care services in Southwest Ethiopia.MethodsInstitutional based cross-sectional study was conducted among 375 pregnant women from April 15 to June 15, 2019 in Southwest Ethiopia. A structured and pre-tested face-to-face interviewer-administered questionnaire technique was used to collect data. Systematic random sampling technique was employed to recruit pregnant women. The data were entered into Epi data version 4.4.2 and analyzed using SPSS version 25. Frequency tables, charts and measures of central tendency were used to describe the data. The effect of each variable on timely initiation of antenatal care was assessed using bi-variable logistic regression. A multivariable logistic regression model was used to identify factors associated with timely initiation of antenatal care. The adjusted odds ratio with 95% confidence interval and p<0.05 was used to identify factors associated with timely initiation of antenatal care.ResultsThe study revealed that 41.9% of pregnant women started antenatal care timely. Pregnant women who had good knowledge of timely initiation of antenatal care (AOR = 3.8, 95% CI: 2.2–6.5), planned to be pregnant (AOR = 5.1, 95% CI: 2.9–8.9), being primigravida (AOR = 2.6, 95% CI: 1.4–4.7) and confirmed their pregnancy by urine test (AOR = 4.1, 95% CI: 2.4–6.9) were found to be significant predictors for timely initiation of antenatal care.ConclusionsDespite the efforts made to make ANC visit services freely available, timely initiation of antenatal care among pregnant women in the study area was low. Pregnant women who had good knowledge of timely initiation of antenatal care, planned to be pregnant, being primigravida and confirmed pregnancy by urine test were found to be significant predictors for timely initiation of antenatal care. Therefore, efforts that strengthen awareness on antenatal care and its right time of commencement, increase pregnant women’s knowledge of timing of antenatal care services and reducing unplanned pregnancies should be organized.
Multi-center matched cohort study of convalescent plasma for hospitalized patients with COVID-19
Authors: Zhou Cindy Ke , Bennett Monica M. , Villa Carlos H. , Hammonds Kendall P. , Lu Yun , Ettlinger Jason , Priest Elisa L. , Gottlieb Robert L. , Davis Steven , Mays Edward , Clarke Tainya C. , Shoaibi Azadeh , Wong Hui-Lee , Anderson Steven A. , Kelly Ronan J. 
Published: August 2022

Background
Although frequently used in the early pandemic, data on the effectiveness of COVID-19 convalescent plasma (CCP) remain mixed. We investigated the effectiveness and safety of CCP in hospitalized COVID-19 patients in real-world practices during the first two waves of the pandemic in a multi-hospital healthcare system in Texas.

Methods and findings
Among 11,322 hospitalized patients with confirmed COVID-19 infection from July 1, 2020 to April 15, 2021, we included patients who received CCP and matched them with those who did not receive CCP within ±2 days of the transfusion date across sites within strata of sex, age groups, days and use of dexamethasone from hospital admission to the match date, and oxygen requirements 4–12 hours prior to the match date. Cox proportional hazards model estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for effectiveness outcomes in a propensity score 1:1 matched cohort. Pre-defined safety outcomes were described. We included 1,245 patients each in the CCP treated and untreated groups. Oxygen support was required by 93% of patients at the baseline. The pre-defined primary effectiveness outcome of 28-day in-hospital all-cause mortality (HR = 0.85; 95%CI: 0.66,1.10) were similar between treatment groups. Sensitivity and stratified analyses found similar null results. CCP-treated patients were less likely to be discharged alive (HR = 0.82; 95%CI: 0.74, 0.91), and more likely to receive mechanical ventilation (HR = 1.48; 95%CI: 1.12, 1.96). Safety outcomes were rare and similar between treatment groups.

Conclusion
The findings in this large, matched cohort of patients hospitalized with COVID-19 and mostly requiring oxygen support at the time of treatment, do not support a clinical benefit in 28-day in-hospital all-cause mortality for CCP. Future studies should assess the potential benefits with specifically high-titer units in perhaps certain subgroups of patients (e.g. those with early disease or immunocompromised).
Effectiveness of web-based intervention for life-change adaptation in family caregivers of community-dwelling individuals with acquired brain injury: A cluster-randomized controlled trial
Authors: Iwata (Shindo) Yuka , Tadaka Etsuko 
Published: August 2022

Objective
To test the effectiveness of the web-based intervention “Koji-family.net 3-day program” (KF3 PGM) for life-change adaptation in family caregivers of community-dwelling individuals with acquired brain injury (ABI).

Design
A cluster-randomized trial.

Settings
All 82 institutions for families of individuals with ABI in Japan.

Participants
Participants were 240 families at 16 different institutions for families of individuals with ABI. Inclusion criteria for participants were (1) families caring for an individual with ABI, (2) family members aged 20 years and over, and (3) the individual with ABI developed ABI when aged more than 16 years and less than 65 years.

Methods
Clusters were randomly assigned to the intervention (8 clusters, n = 120) or the control (8 clusters, n = 120) group. For the intervention group, the KF3 PGM was assigned, in addition to routine family group activities to enhance the life-change adaptation. The control group followed their daily routine and received usual services. The primary outcome was the life-change adaptation scale (LCAS); secondary outcomes were the multidimensional scale of perceived social support (MSPSS) and the positive appraisal of care (PAC) scale at the baseline, after 3 days (short-term follow-up), and after 1 month (long-term follow-up). A mixed model for repeated measures (MMRM) was applied.

Results
A total of 91 participants were enrolled. The mean age (SE) of the participants was 64.0 (9.2) years; 87.8% of them were female. The intervention group showed better improvement in the LCAS than the control group in the whole study period (F = 6.5, p = 0.002). The mean observed change in LCAS from baseline was +8.0 (SE = 2.0) at 3 days and +11.6 (SE = 2.0) at 1 month in the intervention group (F = 18.7, p < 0.001). No significant differences in MSPSS and PAC were observed among the intervention and control groups in the whole study.

Conclusions
The KF3 PGM can be an effective method of enhancing the adaptation to daily life in family caregivers of community-dwelling individuals with ABI. The results show that a potential web-based intervention in institutions for families of individuals with ABI plays a substantial, longer-term role in their support in Japan. Future studies could address the same research questions in different settings and cultures for family caregivers for even longer time periods.
Effectiveness of Core Exercise Training Programs Designed to Enhance Ball-Throwing Velocity in Overhead Athletes: A Systematic Review
Authors: Oyama Sakiko , Palmer Thomas G. 
Published: August 2022

ABSTRACT
In overhead throwing, core muscles play a role in transferring momentum from the trunk to the arm. Yet, studies evaluating various core exercise programs on core muscle function and ball-throwing velocity yield varying results. The objective of this systematic review was to synthesize the effects of these programs on ball-throwing velocity and trunk muscle function based on the focus of the training program. Searches were conducted using MEDLINE on November 24, 2020, and updated on April 27, 2022. Articles were included if the training was administered to overhead-throwing athletes, targeted the core musculature, and had at least 1 comparison group. Of a total of 875 articles retrieved, 11 were selected for analysis. The synthesis of evidence suggests that (a) commonly used spinal stabilization exercises may improve trunk muscle endurance and isometric strength, but not ball-throwing velocity; (b) advanced spinal stabilization exercises performed on a sling suspension system can improve ball-throwing velocity; and (c) trunk plyometrics using medicine balls can improve trunk rotational strength, power, and ball-throwing velocity. More challenging core exercises that incorporate unstable surfaces, higher resistance, and dynamic trunk movement seem necessary to promote improvement in ball-throwing velocity.
A case of early-onset diabetes with impaired insulin secretion carrying a PAX6 gene Gln135* mutation
Authors: Sekiya Motohiro , Yuhara Mikiko , Murayama Yuki , Ohyama Osawa Mariko , Nakajima Rikako , Ohuchi Nami , Matsumoto Nako , Yamazaki Daichi , Mori Sayuri , Matsuda Takaaki , Sugano Yoko , Osaki Yoshinori , Iwasaki Hitoshi , Suzuki Hiroaki , Shimano Hitoshi 
Published: August 2022

Summary
A paired homeodomain transcription factor, PAX6 (paired-box 6), is essential for the development and differentiation of pancreatic endocrine cells as well as ocular cells. Despite the impairment of insulin secretion observed in PAX6-deficient mice, evidence implicating causal association between PAX6 gene mutations and monogenic forms of human diabetes is limited. We herein describe a 33-year-old Japanese woman with congenital aniridia who was referred to our hospital because of her uncontrolled diabetes with elevated hemoglobin A1c (13.1%) and blood glucose (32.5 mmol/L) levels. Our biochemical analysis revealed that her insulin secretory capacity was modestly impaired as represented by decreased 24-h urinary C-peptide levels (38.0 μg/day), primarily explaining her diabetes. Intriguingly, there was a trend toward a reduction in her serum glucagon levels as well. Based on the well-recognized association of PAX6 gene mutations with congenital aniridia, we screened the whole PAX6 coding sequence, leading to an identification of a heterozygous Gln135* mutation. We tested our idea that this mutation may at least in part explain the impaired insulin secretion observed in this patient. In cultured pancreatic β-cells, exogenous expression of the PAX6 Gln135* mutant produced a truncated protein that lacked the transcriptional activity to induce insulin gene expression. Our observation together with preceding reports support the recent attempt to include PAX6 in the growing list of genes causally responsible for monogenic diabetes. In addition, since most cases of congenital aniridia carry PAX6 mutations, we may need to pay more attention to blood glucose levels in these patients.

Learning points

PAX6 Gln135* mutation may be causally associated not only with congenital aniridia but also with diabetes.

Blood glucose levels may deserve more attention in cases of congenital aniridia with PAX6 mutations.

Our case supports the recent attempt to include PAX6 in the list of MODY genes, and Gln135* may be pathogenic.
Scattered QL Surface Waves Reveal Edge-Driven Convection Mantle Flow beneath the Magma-Poor Malawi Rift Zone, East Africa
Authors: Cheng Wei , Wang Guocheng , Liang Xinghui , Liu Lintao 
Published: August 2022

Abstract
How the initial rupturing of the magma-poor rifts started remains a controversial scientific issue due to the lack of definitive studies on the lithospheric structure and mantle flow beneath the lithosphere from these rift systems. We constrain the anisotropic structure of the mantle in the magma-poor Malawi rift zone (MRZ) by observing quasi-Love (QL) waves, which are abnormal waveforms with Rayleigh wave polarization characteristics formed by the scattering of Love waves through lateral gradients in anisotropic structures. Here, we observed clear QL waves at stations in the western MRZ, indicating that there are significant lateral gradients in anisotropy beneath the western MRZ. The stations that recorded QL waves are close to the eastern edge of an unexposed Niassa craton revealed by the latest high-resolution tomographic model AF2019. Comparing the observations of QL waves with recently published shear-wave splitting measurements in the MRZ, we infer that the cratonic lithosphere of the Niassa induced edge-driven convection (EDC) of the asthenospheric mantle on its eastern boundary, resulting in lateral gradients in seismic anisotropy beneath the western MRZ. As the EDC is a small-scale, relatively weak form of mantle convection that is easily overwhelmed by strong active upwelled asthenosphere, its presence indicates the lack of large-scale mantle convection associated with asthenospheric upwelling beneath the MRZ. The magma-poor MRZ could be an example of passive rifting due to the local asthenospheric mantle flow.
La Dismorfología como Herramienta para un Diagnóstico Temprano de la Anemia de Fanconi; Dysmorphology as a Tool for Earlier Diagnosis of Fanconi Anemia
Authors: Fiesco-Roa Moisés Ó , Gómez-Moreno Paulina G , Espinosa-Curiel Rubí M , Rodríguez Alfredo , Frías Vázquez Sara 
Published: August 2022

La anemia de Fanconi es un síndrome de inestabilidad cromosómica que cursa con falla medular, alteraciones dismorfológicas y predisposición a cáncer. Las manifestaciones de esta enfermedad incluyen anomalías del desarrollo que son parte de los acrónimos VACTERL-H y PHENOS. Estas alteraciones pueden detectarse a edades tempranas, incluso antes del inicio de las manifestaciones hemato-oncológicas. Aquí describimos cómo la búsqueda y evaluación de estas manifestaciones puede conducir a un diagnóstico temprano de la anemia de Fanconi. Fanconi anemia is a chromosome instability syndrome associated with bone marrow failure, physical abnormalities, and cancer predisposition. The Fanconi anemia phenotype includes several morphological anomalies that are part of the VACTERL-H and PHENOS acronyms. These physical alterations can be detected at an early age, even before the onset of hemato-oncological manifestations. Here we describe how to look for and evaluate these manifestations, leading to an early diagnosis of Fanconi anemia.
Directive Speech Acts and Wisdom Values in Q.S. Al Mu’min (A Pragmatics Study)
Authors: Bisriyah Sholichatul 
Published: August 2022

This paper aims to examine the directive speech acts form and the wisdom values in Q.S. Al Mu’min. This is qualitative research applying library research design. Using the Qur’an published by PT Surya Prisma Sinergi in 2012, the research data is in the form of sentence structure of directive speech acts. The results found as many as 75 forms of directive speech acts, with the classification of 25 types of directive speech acts of command, 9 types of directive speech acts of prohibition, 6 types of directive speech acts of request, 4 types of directive speech acts of the question, and 31 types of directive speech acts of advice. Furthermore, it was found that the types of directive speech acts of request with the function of begging and asking; the question with the function of asking; command with the function of commanding, requiring, and ordering; prohibition with the function of prohibiting; and advice with the function of advising, calling, warning, and reminding. In addition, there are found wisdom values, in 13 verses over 85 verses, including courage, firmness of faith, non-abusive power, empathy, and tawakkal.
EXPERIENCE OF USING A DIODE LASER IN THE COMPLEX TREATMENT OF EARLY MANIFESTATIONS OF CHRONIC INFLAMMATION IN PERIODONTAL TISSUES
Authors: Usmanova Irina , Gerasimova Larisa , Lakman Irina , Kuznetsova Lilia , Chuykin Sergey , Gumerova Mar'yam , Shangareeva Alia 
Published: August 2022

The article presents data on the effect of a low-intensity diode laser and applications of adhesive plates based on biogel in the treatment of initial manifestations of chronic inflammation in periodontal tissues. Materials and methods. 3 equal randomized groups of 35 patients each with manifestations of chronic inflammation in periodontal tissues were created. In accordance with the protocol of local treatment, all patients underwent a complex of professional oral hygiene and motivation to conduct individual hygiene. In the main clinical subgroups, patients additionally received laser therapy and applications of adhesive plates on the gum, or treatment according to clinical protocols of StAR, 2001. The quantitative assessment of the periodontal condition was carried out using OHI-S indices – SBI, PMA, GI, PI.
The aim of the study is to evaluate the change in hygienic and periodontal indices in patients with early manifestations of chronic inflammation in periodontal tissues after using laser therapy in combination with applications of adhesive plates based on biogel and methods of local treatment according to the clinical protocols of Dental Association of Russia, 2001. Results. A comparative evaluation of the effectiveness of the effect of a diode laser and applications of adhesive plates based on biogel and local treatment according to the clinical protocols of Dental Association of Russia, 2001 was confirmed by dynamic observation and monitoring of changes in reversible and irreversible indices. Conclusions. The observed qualitative decrease in indices in patients against the background of laser therapy and applications of adhesive plates based on biogel from the initial indicators was 8.2, 7.3 and 3.4 times for OHI-S, 7.2, 6.8 and 1.9 times for PMA, 5.9, 3.9, 2.6 times for SBI, 6.2, 4.5, 0.98 times for GI times, for PI 6,3,1 and 0.57 times (p < 0.001). In clinical subgroups, against the background of local treatment, according to the clinical protocols of Dental Association of Russia, 2001, the decrease in the index of OHY-S from the initial indicators occurred 3.3, 4.4, 1.8 times, for the PMA index 2.3, 4.5 times, for the SBI index 3.0, 2.6 times, for the GI index on average 2.1 times, for the PI index 2.5, 1.4 times, while its increase was observed in the subgroup with clinically intact periodontal disease by 6 months of dynamic follow-up and a decrease by 1.4 times by the year of follow-up (p < 0.001).