{"id":"https://openalex.org/W2464047046","doi":"https://doi.org/10.1002/bdra.23518","title":"What is standing in the way of complete prevention of folate preventable neural tube defects?","display_name":"What is standing in the way of complete prevention of folate preventable neural tube defects?","publication_year":2016,"publication_date":"2016-07-01","ids":{"openalex":"https://openalex.org/W2464047046","doi":"https://doi.org/10.1002/bdra.23518","mag":"2464047046","pmid":"https://pubmed.ncbi.nlm.nih.gov/27418028","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/4948865"},"language":"en","primary_location":{"id":"doi:10.1002/bdra.23518","doi":"https://doi.org/10.1002/bdra.23518","is_oa":false,"landing_page_url":"https://doi.org/10.1002/bdra.23518","pdf_url":null,"source":{"id":"https://openalex.org/S4394736882","display_name":"Birth Defects Research Part A Clinical and Molecular Teratology","issn_l":"1542-0752","issn":["1542-0752","1542-0760"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["jufo-1","poland-70"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Birth Defects Research Part A: Clinical and Molecular Teratology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/4948865","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5103077118","display_name":"James L. Mills","orcid":"https://orcid.org/0000-0003-4496-332X","observed_orcids":["https://orcid.org/0000-0003-4496-332X"]},"institutions":[{"id":"https://openalex.org/I1299303238","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88","country_code":"US","type":"government","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238"]},{"id":"https://openalex.org/I4210144228","display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05","country_code":"US","type":"facility","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238","https://openalex.org/I4210144228"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"James L. Mills","raw_affiliation_strings":["Epidemiology Branch, Division of Intramural Population Health Research, <i>Eunice Kennedy Shriver</i> National Institute of Child Health and Human Development National Institutes of Health Bethesda MD","Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Epidemiology Branch, Division of Intramural Population Health Research, <i>Eunice Kennedy Shriver</i> National Institute of Child Health and Human Development National Institutes of Health Bethesda MD","institution_ids":["https://openalex.org/I1299303238","https://openalex.org/I4210144228"]},{"raw_affiliation_string":"Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD","institution_ids":["https://openalex.org/I1299303238","https://openalex.org/I4210144228"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049911869","display_name":"Aggeliki Dimopoulos","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1299303238","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88","country_code":"US","type":"government","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238"]},{"id":"https://openalex.org/I4210144228","display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05","country_code":"US","type":"facility","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238","https://openalex.org/I4210144228"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aggeliki Dimopoulos","raw_affiliation_strings":["Epidemiology Branch, Division of Intramural Population Health Research, <i>Eunice Kennedy Shriver</i> National Institute of Child Health and Human Development National Institutes of Health Bethesda MD","Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Epidemiology Branch, Division of Intramural Population Health Research, <i>Eunice Kennedy Shriver</i> National Institute of Child Health and Human Development National Institutes of Health Bethesda MD","institution_ids":["https://openalex.org/I1299303238","https://openalex.org/I4210144228"]},{"raw_affiliation_string":"Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD","institution_ids":["https://openalex.org/I1299303238","https://openalex.org/I4210144228"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5016969160","display_name":"Regan Lucas Bailey","orcid":"https://orcid.org/0000-0003-0181-6223","observed_orcids":["https://orcid.org/0000-0003-0181-6223"]},"institutions":[{"id":"https://openalex.org/I219193219","display_name":"Purdue University West Lafayette","ror":"https://ror.org/02dqehb95","country_code":"US","type":"education","lineage":["https://openalex.org/I219193219"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Regan L. Bailey","raw_affiliation_strings":["Department of Nutrition Science, Purdue University, West Lafayette, Indiana"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nutrition Science, Purdue University, West Lafayette, Indiana","institution_ids":["https://openalex.org/I219193219"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.3545,"has_fulltext":false,"cited_by_count":3,"citation_normalized_percentile":{"value":0.69776516,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":94},"biblio":{"volume":"106","issue":"7","first_page":"517","last_page":"519"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10499","display_name":"Folate and B Vitamins Research","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10499","display_name":"Folate and B Vitamins Research","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11833","display_name":"Spinal Dysraphism and Malformations","score":0.0027000000700354576,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12741","display_name":"Maternal and Neonatal Healthcare","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/neural-tube-defects","display_name":"neural tube defects","score":0.984000027179718},{"id":"https://openalex.org/keywords/folic-acid","display_name":"folic acid","score":0.8180000185966492},{"id":"https://openalex.org/keywords/folic-acid-fortification","display_name":"folic acid fortification","score":0.7979999780654907},{"id":"https://openalex.org/keywords/mandatory-fortification","display_name":"mandatory fortification","score":0.8399999737739563},{"id":"https://openalex.org/keywords/folic-acid-supplementation","display_name":"folic acid supplementation","score":0.6899999976158142},{"id":"https://openalex.org/keywords/women-of-reproductive-age","display_name":"women of reproductive age","score":0.8429999947547913},{"id":"https://openalex.org/keywords/cancer-risk","display_name":"cancer risk","score":0.7459999918937683},{"id":"https://openalex.org/keywords/folate-deficiency","display_name":"folate deficiency","score":0.3630000054836273}],"concepts":[{"id":"https://openalex.org/C198211336","wikidata":"https://www.wikidata.org/wiki/Q57821","display_name":"Fortification","level":2,"score":0.8436650633811951},{"id":"https://openalex.org/C2992130864","wikidata":"https://www.wikidata.org/wiki/Q127060","display_name":"Folic acid","level":2,"score":0.728610634803772},{"id":"https://openalex.org/C2777900319","wikidata":"https://www.wikidata.org/wiki/Q15121266","display_name":"Food fortification","level":3,"score":0.7100117206573486},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6066306829452515},{"id":"https://openalex.org/C2779268580","wikidata":"https://www.wikidata.org/wiki/Q3447087","display_name":"Allowance (engineering)","level":2,"score":0.5060812830924988},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.49433326721191406},{"id":"https://openalex.org/C2776940978","wikidata":"https://www.wikidata.org/wiki/Q34956","display_name":"Vitamin","level":2,"score":0.4787144660949707},{"id":"https://openalex.org/C2779750884","wikidata":"https://www.wikidata.org/wiki/Q187706","display_name":"Vitamin B12","level":2,"score":0.4745821952819824},{"id":"https://openalex.org/C2780594696","wikidata":"https://www.wikidata.org/wiki/Q1127402","display_name":"Neural tube","level":3,"score":0.4692537486553192},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.34395328164100647},{"id":"https://openalex.org/C31903555","wikidata":"https://www.wikidata.org/wiki/Q1637030","display_name":"Food science","level":1,"score":0.15167075395584106},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.13845300674438477},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.11567464470863342},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.10136082768440247},{"id":"https://openalex.org/C185592680","wikidata":"https://www.wikidata.org/wiki/Q2329","display_name":"Chemistry","level":0,"score":0.08818146586418152},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.08511343598365784},{"id":"https://openalex.org/C196843134","wikidata":"https://www.wikidata.org/wiki/Q33196","display_name":"Embryo","level":2,"score":0.0},{"id":"https://openalex.org/C95444343","wikidata":"https://www.wikidata.org/wiki/Q7141","display_name":"Cell biology","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005492","descriptor_name":"Folic Acid","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":false},{"descriptor_ui":"D005492","descriptor_name":"Folic Acid","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007231","descriptor_name":"Infant, Newborn","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009436","descriptor_name":"Neural Tube Defects","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":true},{"descriptor_ui":"D011247","descriptor_name":"Pregnancy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016742","descriptor_name":"Preconception Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1002/bdra.23518","doi":"https://doi.org/10.1002/bdra.23518","is_oa":false,"landing_page_url":"https://doi.org/10.1002/bdra.23518","pdf_url":null,"source":{"id":"https://openalex.org/S4394736882","display_name":"Birth Defects Research Part A Clinical and Molecular Teratology","issn_l":"1542-0752","issn":["1542-0752","1542-0760"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["jufo-1","poland-70"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Birth Defects Research Part A: Clinical and Molecular Teratology","raw_type":"journal-article"},{"id":"pmid:27418028","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/27418028","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Birth defects research. Part A, Clinical and molecular teratology","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:4948865","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/4948865","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Birth Defects Res A Clin Mol Teratol","raw_type":"Text"}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:4948865","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/4948865","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Birth Defects Res A Clin Mol Teratol","raw_type":"Text"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0},{"display_name":"Zero hunger","id":"https://metadata.un.org/sdg/2","score":0.40450000762939453}],"study_designs":[],"awards":[{"id":"https://openalex.org/G1667031398","display_name":null,"funder_award_id":"Z99HD999999","funder_id":"https://openalex.org/F4320332161","funder_display_name":"National Institutes of Health"}],"funders":[{"id":"https://openalex.org/F4320306085","display_name":"U.S. Department of Health and Human Services","ror":"https://ror.org/033jnv181"},{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":12,"referenced_works":["https://openalex.org/W1984411932","https://openalex.org/W2017371975","https://openalex.org/W2068045945","https://openalex.org/W2100099365","https://openalex.org/W2106352068","https://openalex.org/W2116180848","https://openalex.org/W2160501076","https://openalex.org/W2161245837","https://openalex.org/W2173611394","https://openalex.org/W2177717617","https://openalex.org/W2500272160","https://openalex.org/W4235829199"],"related_works":["https://openalex.org/W2010963165","https://openalex.org/W6981856789","https://openalex.org/W2118860573","https://openalex.org/W1980141163","https://openalex.org/W4293276836","https://openalex.org/W4283368904","https://openalex.org/W7095698188","https://openalex.org/W2014145845","https://openalex.org/W2114307005","https://openalex.org/W2172064275"],"abstract_inverted_index":{"It":[0,157,335,391,512],"is":[1,6,42,183,185,210,336,350,414,500,524,588,609,630,668,695,715,856,984],"well":[2,941],"known":[3],"that":[4,18,28,40,62,118,161,282,291,340,396,516,571,587,679,703,710],"there":[5,821],"a":[7,267,371,378,401,418,503,509,533,585,591,605,631,677,720,913,959,985],"large":[8,39,240,592,650],"gap":[9,41],"between":[10],"the":[11,26,111,116,136,162,173,201,228,258,283,341,354,412,439,458,462,473,490,556,569,582,595,622,637,655,658,693,701,732,846,854,860,884,910,994,1007,1014,1017,1022,1030],"number":[12,27,380],"of":[13,64,124,128,138,164,178,188,195,227,231,242,253,256,271,343,381,460,536,546,568,581,594,654,660,814,849,912,916,930,1016,1020,1024,1045,1055,1063,1068],"neural":[14],"tube":[15],"defects":[16],"(NTDs)":[17],"could":[19,662,830,866,957],"be":[20,159,393,519,574,601,604,663,690,729,763,831,867,890,899,906,980],"prevented":[21,121],"by":[22,590,869,993],"folic":[23,68,139,165,245,344,616,712,759,863],"acid":[24,69,140,166,246,345,617,713,760,864],"and":[25,34,72,153,290,325,362,370,548,553,599,618,643,707,718,743,816,880,908,964,1010,1026,1058],"are":[29,51,142,148,367,636,646,806,822,897,939,1006],"actually":[30],"being":[31,58],"prevented.":[32,900],"Arth":[33,102],"colleagues":[35],"demonstrate":[36],"just":[37],"how":[38],"(Arth":[43],"et":[44,84,103,131,206,217,236,276,322,408,799],"al.,":[45,85,132,207,218,237,277,323,409,800],"2016).":[46,100],"The":[47,279,541,928,1000],"question":[48],"is:":[49],"why":[50],"so":[52,411],"many":[53,106],"potentially":[54],"preventable":[55,976],"NTDs":[56,129,215,349,366,896,938,977],"not":[57,109,222,287,415,477,905,979,1012],"prevented?":[59],"Campaigns":[60],"recommending":[61],"women":[63,194],"childbearing":[65,196],"age":[66],"take":[67],"supplements":[70],"routinely":[71],"voluntary":[73,494,517],"fortification":[74,89,113,141,177,301,398,426,444,495,518,523,629,645,727,761,865,934],"programs":[75,935],"have":[76,108,385],"had":[77],"only":[78],"modest":[79],"success":[80],"at":[81,597,731],"best":[82],"(Khoshnood":[83],"2015).":[86,334,364,801],"Therefore,":[87],"mandatory":[88,112,397,425,442,522,539,933],"has":[90,120,399,513,680,948],"been":[91,386,514,949],"instituted":[92,525],"in":[93,172,193,244,309,374,404,447,486,496,555,612,621,723,755,778,796,936,962,1003],"almost":[94],"80":[95],"countries":[96,107,384,456,497,531],"(Food":[97,560],"Fortification":[98,545,561],"Initiative,":[99,562],"As":[101],"al.":[104],"demonstrate,":[105],"embraced":[110],"approach,":[114],"despite":[115],"fact":[117],"it":[119,499,620,871,983],"an":[122,186,251,565,664,681,748,773,792,950],"average":[123,187,252],"40":[125],"to":[126,212,224,273,296,338,347,357,388,417,424,450,468,478,480,526,573,625,640,735,810,826,833,853,898,920,922,924,967],"50%":[127],"(Castillo-Lancellotti":[130],"2013).":[133,278],"Concerns":[134],"regarding":[135,317,751],"safety":[137],"one":[143],"reason.":[144],"Two":[145],"major":[146,721,960],"concerns":[147,315],"masking":[149,226],"vitamin":[150,232,843,878],"B12":[151,233],"deficiency":[152,234,406,788,945],"increasing":[154],"cancer":[155,263,318,375],"risk.":[156],"should":[158,392],"noted":[160,281],"amount":[163,342,355,624],"people":[167],"receive":[168],"from":[169,918],"fortified":[170,602],"food":[171,443,463,586],"United":[174,1031],"States,":[175],"where":[176,498,820],"enriched":[179],"cereal":[180],"grain":[181,608],"products":[182,483],"mandatory,":[184],"163":[189],"micrograms":[190],"per":[191],"day":[192],"age,":[197],"less":[198,352],"than":[199,300,353],"half":[200],"recommended":[202],"dietary":[203],"allowance":[204],"(Tinker":[205],"2010).":[208],"This":[209,989],"sufficient":[211],"prevent":[213,348,811],"folate-related":[214],"(Mosley":[216],"2009)":[219],"but":[220,328,982],"does":[221],"appear":[223],"cause":[225,358,958],"hematological":[229],"signs":[230],"(Mills":[235,361],"2003).":[238],"A":[239,787,879],"meta-analysis":[241],"participants":[243,293],"trials":[247],"demonstrated":[248],"that,":[249],"after":[250],"5":[254],"years":[255],"follow-up,":[257],"relative":[259],"risk":[260,319,598],"for":[261,441,791,803,862],"incident":[262],"was":[264,286,305,789,991],"1.06":[265],"with":[266,445,538,551,808,835,872],"95%":[268],"confidence":[269],"interval":[270],"0.99":[272],"1.13":[274],"(Vollset":[275],"authors":[280],"6%":[284],"increase":[285,308,373],"statistically":[288],"significant":[289,307],"trial":[292],"were":[294],"exposed":[295],"far":[297,351],"higher":[298],"doses":[299],"would":[302,376],"deliver.":[303],"There":[304],"no":[306],"any":[310],"individual":[311],"cancers":[312],"studied.":[313],"Nonetheless,":[314],"persist":[316],"(van":[320],"Wijngaarden":[321],"2014)":[324],"other":[326,422,491,766,812,836,873,968],"possible":[327,504],"unproved":[329],"risks":[330],"(National":[331],"Toxicology":[332],"Program,":[333,997],"important":[337,951],"note":[339],"needed":[346],"likely":[356],"adverse":[359],"effects":[360],"Dimopoulos,":[363],"Because":[365],"uncommon":[368],"events":[369],"small":[372,419,613],"affect":[377],"substantial":[379],"people,":[382],"some":[383,455,579],"reluctant":[387],"require":[389],"fortification.":[390,540],"noted,":[394],"however,":[395],"caused":[400,772],"dramatic":[402],"reduction":[403,961],"folate":[405,894,944,975],"(Pfeiffer":[407],"2012);":[410],"benefit":[413],"limited":[416],"group.":[420],"Several":[421],"obstacles":[423,888],"exist.":[427],"Although":[428],"European":[429],"Union":[430],"(EU)":[431],"regulation":[432],"No.":[433],"1925/2006":[434],"(European":[435],"Commission,":[436],"2006)":[437],"acknowledges":[438],"need":[440,572],"vitamins":[446,552],"member":[448],"states":[449],"address":[451],"public":[452,768,925],"health":[453,769,926],"concerns,":[454],"resist":[457],"idea":[459],"manipulating":[461],"supply.":[464],"Merchants":[465],"who":[466],"want":[467],"sell":[469],"their":[470,482],"goods":[471],"throughout":[472],"EU":[474],"may":[475,603,675,688],"choose":[476],"fortify":[479,834],"make":[481],"more":[484,669],"attractive":[485],"these":[487,887,902],"countries.":[488],"On":[489],"hand,":[492],"widespread":[493],"permitted":[501],"creates":[502],"problem":[505],"maintaining":[506],"exposure":[507],"within":[508],"safe":[510],"range.":[511],"suggested":[515],"regulated":[520],"as":[521,840,877],"avoid":[527],"excessive":[528],"exposure.":[529],"Developing":[530],"face":[532],"different":[534],"set":[535],"problems":[537,824,903],"report,":[542],"\"Strategic":[543],"Paper:":[544],"rice":[547,667,687,694,709],"wheat":[549],"flour":[550,656],"minerals":[554],"Western":[557],"Pacific":[558],"region\"":[559],"2013),":[563],"provides":[564],"excellent":[566],"outline":[567],"issues":[570],"resolved":[575],"before":[576],"implementation.":[577],"In":[578,818,971],"parts":[580],"world,":[583],"finding":[584],"consumed":[589],"proportion":[593],"population":[596],"can":[600],"problem.":[606,633],"Where":[607],"milled":[610],"locally":[611],"mills,":[614],"getting":[615],"mixing":[619],"proper":[623],"ensure":[626,736],"safe,":[627,931],"effective":[628,932],"serious":[632],"Large":[634],"mills":[635,651],"practical":[638],"place":[639],"fortify.":[641],"Wheat":[642],"maize":[644],"relatively":[647,716],"easy":[648,907],"when":[649],"produce":[652,676],"most":[653],"although":[657],"cost":[659,848],"equipment":[661],"obstacle.":[665],"Fortifying":[666],"difficult":[670],"(USAID,":[671],"2008).":[672],"Some":[673],"techniques":[674],"product":[678],"unacceptable":[682],"taste":[683],"or":[684,697,842,1029],"appearance.":[685],"Coating":[686],"also":[689],"ineffective":[691],"if":[692,892],"washed":[696],"rinsed.":[698],"Hot":[699],"extrusion,":[700],"technique":[702],"produces":[704],"normal":[705],"looking":[706],"tasting":[708],"retains":[711],"well,":[714],"expensive":[717],"requires":[719,909],"investment":[722],"processing":[724],"equipment.":[725],"Mandatory":[726],"must":[728,762,889],"mandated":[730],"national":[733],"level":[734],"good":[737],"coverage,":[738],"facilitate":[739],"quality":[740],"control":[741],"monitoring,":[742],"put":[744],"all":[745,893,974],"manufacturers":[746],"on":[747,883],"equal":[749],"footing":[750],"production":[752],"cost.":[753],"Finally,":[754],"resource":[756],"poor":[757],"countries,":[758],"weighed":[764],"against":[765],"pressing":[767],"needs.":[770],"HIV-AIDS":[771],"estimated":[774,793],"1.5":[775],"million":[776],"deaths":[777,795],"2013":[779,797],"(Global":[780],"Health":[781,1025,1048,1057],"Observatory":[782],"data":[783],"[2013]":[784],"http://www.who.int/gho/hiv/epidemic_status/deaths/en/).":[785],"Vitamin":[786],"responsible":[790],"105,000":[794],"(Stevens":[798],"Advocates":[802],"NTD":[804],"prevention":[805],"competing":[807],"interventions":[809],"causes":[813],"death":[815],"disability.":[817],"areas":[819],"multiple":[823],"related":[825,895],"nutritional":[827],"deficiencies,":[828],"strategies":[829],"developed":[832],"critical":[837,874],"micronutrients":[838,852,875,956],"such":[839,876],"iron":[841,881],"A.":[844],"Fortunately,":[845],"incremental":[847],"adding":[850],"additional":[851,955],"mix":[855],"quite":[857],"small.":[858],"Thus,":[859],"priority":[861],"raised":[868],"combining":[870],"depending":[882],"country.":[885],"All":[886],"overcome":[891],"Addressing":[901],"will":[904,978],"expertise":[911],"wide":[914],"range":[915],"authorities":[917],"engineers":[919],"chemists,":[921],"legislators,":[923],"experts.":[927],"benefits":[929],"preventing":[937,973],"very":[940],"documented.":[942],"Reducing":[943],"anemia":[946],"rates":[947],"fringe":[952],"benefit.":[953],"Adding":[954],"morbidity":[963],"mortality":[965],"due":[966],"micronutrient":[969],"deficiencies.":[970],"short,":[972],"easy,":[981],"goal":[986],"worth":[987],"pursuing.":[988],"work":[990],"supported":[992],"Intramural":[995,1046],"Research":[996],"NICHD,":[998],"NIH.":[999],"opinions":[1001],"expressed":[1002],"this":[1004],"article":[1005],"authors'":[1008],"own":[1009],"do":[1011],"reflect":[1013],"view":[1015],"National":[1018,1053,1061],"Institutes":[1019,1062],"Health,":[1021,1064],"Department":[1023],"Human":[1027,1059],"Services,":[1028],"States":[1032],"government.":[1033],"James":[1034],"L.":[1035,1040],"Mills,1":[1036],"Aggeliki":[1037],"Dimopoulos,1":[1038],"Regan":[1039],"Bailey,2":[1041],"1Epidemiology":[1042],"Branch,":[1043],"Division":[1044],"Population":[1047],"Research,":[1049],"Eunice":[1050],"Kennedy":[1051],"Shriver":[1052],"Institute":[1054],"Child":[1056],"Development,":[1060],"Bethesda,":[1065],"MD":[1066],"2Department":[1067],"Nutrition":[1069],"Science,":[1070],"Purdue":[1071],"University,":[1072],"West":[1073],"Lafayette,":[1074],"Indiana":[1075]},"counts_by_year":[{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":1},{"year":2017,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-07-22T00:00:00"}