bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peritoneal macrophages have an impaired immune response in obesity which can be reversed by subsequent weight loss
Authors: Willemsen Lisa , Neele Annette E , van der Velden Saskia , Prange Koen H M , den Toom Myrthe , van Roomen Cindy P A A , Reiche Myrthe E , Griffith Guillermo R , Gijbels Marion J J , Lutgens Esther , de Winther Menno P J 
Published: November 2019

IntroductionObesity is recognized as a risk factor for various microbial infections. The immune system, which is affected by obesity, plays an important role in the pathophysiology of these infections and other obesity-related comorbidities. Weight loss is considered the most obvious treatment for obesity. However, multiple studies suggest that the comorbidities of obesity may persist after weight loss. Deregulation of immune cells including adipose tissue macrophages of obese individuals has been extensively studied, but how obesity and subsequent weight loss affect immune cell function outside adipose tissue is not well defined.Research design and methodsHere we investigated the phenotype of non-adipose tissue macrophages by transcriptional characterization of thioglycollate-elicited peritoneal macrophages (PM) from mice with diet-induced obesity and type 2 diabetes (T2D). Subsequently, we defined the characteristics of PMs after weight loss and mimicked a bacterial infection by exposing PMs to lipopolysaccharide.Results and conclusionsIn contrast to the proinflammatory phenotype of adipose tissue macrophages in obesity and T2D, we found a deactivated state of PMs in obesity and T2D. Weight loss could reverse this deactivated macrophage phenotype. Anti-inflammatory characteristics of these non-adipose macrophages may explain why patients with obesity and T2D have an impaired immune response against pathogens. Our data also suggest that losing weight restores macrophage function and thus contributes to the reduction of immune-related comorbidities in patients.
Breastfeeding exposure is associated with better knowledge of and attitudes toward BF in Kuwaiti women
Authors: Alkazemi Dalal Usamah , Jackson Roberts 
Published: November 2019

ObjectivesBreastfeeding (BF) has many benefits for both infants and mothers. However, despite evidence in support of BF, its prevalence has remained low in Kuwait. The purpose of this study was to (1) assess and describe BF attitudes and knowledge among women at a college campus; (2) evaluate BF exposures and sociodemographic factors associated with attitudes toward BF; (3) determine the association between BF knowledge and attitudes.Materials and methodsThis survey was a cross-sectional descriptive study conducted from February to April 2016. A convenience sample of 330 women (students, faculty and staff) from the College of Life Sciences (CLS) at Kuwait University participated in the survey.ResultsMost of the participants respected women who breast fed (81.8%). Some participants believed that BF a baby is painful (43.3%), makes the breasts sag (35.8%), and restricts the mothers’ freedom (51.5%). Additionally, 47.6% of the participants reported that they would feel embarrassed if they saw a woman BF her baby. Acceptability of BF in public was low and most participants preferred BF only around friends and family (52.4%). A statistically significant positive association was observed between BF knowledge and attitudes (R2=6.5%, p<0.001); however, the relationship was not independent and was also associated with nationality and having been breast fed as a baby (R2=10.3%, p=0.021).ConclusionBF knowledge is important to encourage positive BF attitudes, and both are enforced with family values and practice across generations.
A school-based, multi-faceted health promotion programme to prevent obesity among children: protocol of a cluster-randomised controlled trial (the DECIDE-Children study)
Authors: Liu Zheng , Wu Yangfeng , Niu Wen-Yi , Feng Xiangxian , Lin Yi , Gao Aiyu , Zhang Fang , Fang Hai , GAO Pei , Li Hui-Juan , Wang Haijun 
Published: November 2019

IntroductionObesity is a public health concern that is becoming increasingly more serious worldwide. Effective and sustainable childhood obesity prevention strategies may help to reduce the prevalence of obesity and may have an impact on lifelong health. However, few such strategies have been rigorously evaluated for Chinese children in different regions of China.Methods and analysisThe Diet, ExerCIse and CarDiovascular hEalth-Children is a cluster-randomised controlled trial that aims to assess the effectiveness and sustainability of a school-based, multi-faceted intervention to prevent obesity among Grade 4 primary school students (8–10 years old) in China. Twenty-four schools (approximately 1200 students) from above average, average and below average developed regions in China will be randomised to an intervention (12 schools) or usual practice (12 schools) group. The intervention will last for one school year (9 months) and consists of activities towards students, parents and school environment. A smartphone application will be used to assist in providing information on, monitoring and providing feedback on the behaviours and body weight of the students. Data will be collected at baseline, 4 months, 9 months and 21 months. The primary outcome will be the difference between groups in the change in students’ body mass index at 9 months after the baseline investigation. The secondary outcomes will include the differences between groups in the changes in anthropometric measures, diet, physical activity levels and other measures at the follow-up visits. A variety of process evaluation methods will be used to evaluate the implementation process of the complex intervention.Ethics and disseminationThis study was approved by the Peking University Institution Review Board (IRB00001052-18021). The results will be disseminated through publication in peer-reviewed journals, presentations at conferences and in lay summaries provided to school staff and participants.Trial registration numberNCT03665857.
Preoperative bariatric surgery programme barriers facing Pacific patients in Auckland, New Zealand as perceived by health sector professionals: a qualitative study
Authors: Taylor Tamasin , Wrapson Wendy , Dewes Ofa , Taufa Nalei , Siegert Richard J 
Published: November 2019

Minority ethnic patient groups typically have the highest bariatric surgery preoperative attrition rates and lowest surgery utilisation worldwide. Eligible patients of Pacific Island ethnicity (Pacific patients) in New Zealand (NZ) follow this wider trend.ObjectivesThe present study explored structural barriers contributing to Pacific patients’ disproportionately high preoperative attrition rates from publicly-funded bariatric surgery in Auckland, NZ.SettingPublicly-funded bariatric surgery programmes based in the wider Auckland area, NZ.DesignSemi-structured interviews with health sector professionals (n=21) were conducted.Data were analysed using an inductive thematic approach.ResultsTwo primary themes were identified: (1)Confidence negotiating the medical system,which includedEmotional safety in clinical settingsandRelating to non-Pacific health professionalsand (2)Appropriate support to achieve preoperative goals,which includedCultural considerations, Practical supportandRelating health information. Clinical environments and an under-representation of Pacific staff were considered to be barriers to developing emotional safety, trust and acceptance of the surgery process with patients and their families. Additionally, economic deprivation and lower health literacy impacted preoperative goals.ConclusionsHealth professionals’ accounts indicated that Pacific patients face substantial levels of disconnection in bariatric surgery programmes. Increasing representation of Pacific ethnicity by employing more Pacific health professionals in bariatric teams and finding novel solutions to implement preoperative programme components have the potential to reduce this disconnect. Addressing cultural competency of staff, increasing consultancy times and working in community settings may enable staff to better support Pacific patients and their families. Programme structures could be more accommodating to practical barriers of attending appointments, managing patients’ preoperative health goals and improving patients’ health literacy. Given that Pacific populations, and other patients from minority ethnic backgrounds living globally, also face high rates of obesity and barriers accessing bariatric surgery, our findings are likely to have broader applicability.
Predictors of quality of life 1 year after minor stroke or TIA: a prospective single-centre cohort study
Authors: Lam Ka-Hoo , Blom Emma , Kwa Vincent I H 
Published: November 2019

ObjectivesIn patients after a transient ischaemic attack (TIA) or minor stroke, dysfunction is often underestimated by clinical measures due to invisible symptoms, including cognitive and emotional problems. Many of these patients need stroke care programme, but others do not. In this study, we aim to identify potential predictors of quality of life (QoL) in patients with TIA or minor stroke 1 year poststroke to be able to select which of these patients will need aftercare.DesignProspective observational cohort study.SettingSingle-centre hospital in the Netherlands.Participants120 patients, diagnosed with TIA or minor stroke and discharged without rehabilitation treatment, completed the study.Primary and secondary outcome measuresQoL (RAND-36), anxiety and depressive symptoms (Hospital Anxiety and Depression scale), the degree of disability or functional dependence after stroke (modified Rankin Scale (mRS)) and symptoms of anxiety and depression specific to stroke (SSADQ) were assessed at baseline (2–6 weeks poststroke) and compared with follow-up at 1 year poststroke.ResultsDepression (B=−1.35, p<0.001) and anxiety (B=−0.57, p=0.041) at baseline predicted a worse mental component of QoL after 1 year. Depression (B=−1.100, p<0.001) at baseline, but also age (B=−0.261, p=0.002) and female sex (B=4.101, p=0.034) predicted a worse physical component of QoL after 1 year.ConclusionWith the identification of these predictors, we might be able to select more efficiently and timely the patients with TIA or minor stroke who need stroke aftercare.
Relations of magnesium intake to cognitive impairment and dementia among participants in the Women’s Health Initiative Memory Study: a prospective cohort study
Authors: Lo Kenneth , Liu Qing , Madsen Tracy , Rapp Steve , Chen Jiu-Chiuan , Neuhouser Marian , Shadyab Aladdin , Pal Lubna , Lin Xiaochen , Shumaker Sally , Manson JoAnn , Feng Ying-Qing , Liu Simin 
Published: November 2019

ObjectiveTo examine the associations of dietary and supplemental magnesium (Mg) as assessed by a semi-quantitative food frequency questionnaire with cognitive outcomes among ageing women.DesignThis work conducts a prospective cohort study of participants enrolled in the Women’s Health Initiative Memory Study (WHIMS), which was subsequently extended and named WHIMS-Epidemiology of Cognitive Health.SettingForty clinical centres in the USA.ParticipantsPostmenopausal women aged 65–79 years without dementia on enrolment.Main outcome measuresPhysician-adjudicated mild cognitive impairment (MCI) and/or probable dementia (PD).ResultsParticipants were excluded (n=1006) if they had extreme values of dietary energy intake, had missing or extreme body mass index values, with prevalent MCI/PD at baseline, received only one cognitive assessment or had been followed up for <1 year. During >20 years of follow-up, 765 (11.8%) out of 6473 participants developed MCI/PD. For MCI/PD and MCI, the risks tended to be lower among participants in quintiles Q2–Q5 of Mg consumption compared with those in the lowest quintile. Participants in Q3 had a significantly lower risk of MCI/PD (HR 0.69, 95% CI 0.53 to 0.91) and MCI (HR 0.63, 95% CI 0.45 to 0.87) after multivariate adjustments. No significant association was observed between total Mg intake and PD. The association between total Mg intake, MCI/PD and MCI was non-linear as suggested by the likelihood test.ConclusionsTotal Mg intake between the estimated average requirement and the recommended dietary allowances may associate with a lower risk of MCI/PD and MCI.Trial registration numberNCT00685009.
Effects on renal outcome of concomitant acute pyelonephritis, acute kidney injury and obstruction duration in obstructive uropathy by urolithiasis: a retrospective cohort study
Authors: Lee Eung Hyun , Kim Su-Hyun , Shin Jung-ho , Park Sung Bin , Chi Byung Hoon , Hwang Jin Ho 
Published: November 2019

ObjectiveObstruction release from urolithiasis can be delayed with a lack of suggested time for preventing the deterioration of renal function. The objective of this study was to investigate the effect of obstruction duration, concomitant acute kidney injury (AKI) or acute pyelonephritis (APN) during the obstruction on the prognosis of renal function.DesignRetrospective cohort study.Setting and participants1607 patients from a urolithiasis-related obstructive uropathy cohort, between January 2005 and December 2015.Outcome measuresEstimated glomerular filtration rate (eGFR) decrease ≥30% and/or end-stage renal disease (ESRD), and eGFR decrease ≥50% and/or ESRD, according to obstruction duration, AKI and APN accompanied by obstructive uropathy.ResultsWhen the prognosis was divided by obstruction duration quartile, the longer the obstruction duration the higher the probability of eGFR reduction >50% (p=0.02). In patients with concomitant APN or severe AKI during hospitalisation with obstructive uropathy, an eGFR decrease of >30% and >50% occurred more frequently, compared with others (p<0.001). When we adjusted for sex, age, hypertension, diabetes mellitus, APN, AKI grades and obstruction release >7 days for multivariate analysis, we found that concomitant APN (HR 3.495, 95% CI 1.942 to 6.289, p<0.001), concomitant AKI (HR 3.284, 95% CI 1.354 to 7.965, p=0.009 for AKI stage II; HR 6.425, 95% CI 2.599 to 15.881, p<0.001 for AKI stage III) and an obstruction duration >7 days (HR 1.854, 95% CI 1.095 to 3.140, p=0.001) were independently associated with an eGFR decrease >50%. Tree analysis also showed that AKI grade 3, APN and an obstruction duration >7 days were the most important factors affecting renal outcome.ConclusionsIn patients with urolithiasis-related obstructive uropathy, concomitant APN was strongly associated with deterioration of renal function after obstruction release. The elapsed time to release the obstruction also affected renal function.
What consultation resources are available to support delivery of integrated sexual and reproductive health services? A scoping review
Authors: Walker Susan , Piercy Hilary , Shearn Katie , Acton Faye 
Published: November 2019

BackgroundContraceptive and sexual healthcare is increasingly delivered in an integrated setting in the UK and worldwide, requiring staff to be competent in differing styles of delivery, and to have a wide knowledge base.ObjectivesWe did a scoping review of the literature for evidence of the resources that exist for healthcare professionals to guide or structure the process of conducting an integrated sexual and reproductive health (SRH) consultation.Eligibility criteriaArticles were included in the review if (1) their primary focus was a consultation resource related to one or more aspects of an SRH consultation and (2) they provided details of the resource and/or its application including evaluation of use.Sources of evidencePeer-reviewed articles published in English, published non-peer-reviewed guides, and web-based guidelines addressing the conduct of a contraception or sexual health consultation were included. Date range: 1998–December 2018. Searches were carried out in the databases AMED (Ovid), ASSIA (ProQuest), CINAHL Complete (EBSCO), Cochrane Library (Wiley), HMIC (NHS Evidence), Medline (EBSCO), PsycINFO (Proquest) and Scopus (Elsevier) on 10 February 2017, and incremental searching performed until December 2018.ResultsA total of 12 peer-reviewed journal articles, two web-published guidelines from the Faculty of Sexual & Reproductive Healthcare and three published, non-peer-reviewed resources were included.ConclusionMany resources exist to guide either the contraceptive or sexual health consultations, but there is a lack of a comprehensive consultation resource to guide the conduct of an integrated consultation.
Using geographic information systems to map older people’s emergency department attendance for future health planning
Authors: O'Mahony Eoin , Ní Shé Éidín , Bailey Jade , Mannan Hasheem , McAuliffe Eilish , Ryan John , Cronin John , Cooney Marie Therese 
Published: November 2019

ObjectivesThis study aimed to assess the pattern of use of EDs, factors contributing to the visits, geographical distribution and outcomes in people aged 65 years or older to a large hospital in Dublin.MethodsA retrospective analysis of 2 years of data from an urban university teaching hospital ED in the southern part of Dublin was reviewed for the period 2014–2015 (n=103 022) to capture the records of attenders. All ED presentations by individuals 65 years and older were extracted for analysis. Address-matched records were analysed using QGIS, a geographic information systems (GIS) analysis and visualisation tool to determine straight-line distances travelled to the ED by age.ResultsOf the 49 538 non-duplicate presentations in the main database, 49.9% of the total are women and 49.1% are men. A subset comprised of 40 801 had address-matched records. When mapped, the data showed a distinct clustering of addresses around the hospital site but this clustering shows different patterns based on age cohort. Average distances travelled to ED are shorter for people 65 and older compared with younger patients. Average distances travelled for those aged 65–74 was 21 km (n=4177 presentations); for the age group 75–84, 18 km (n=2518 presentations) and 13 km for those aged 85 and older (n=2104 presentations). This is validated by statistical tests on the clustered data. Self-referral rates of about 60% were recorded for each age group, although this varied slightly, not significantly, with age.ConclusionsHealth planning at a regional level should account for the significant number of older patients attending EDs. The use of GIS for health planning in particular can assist hospitals to improve their understanding of the origin of the cohort of older ED patients.
Reciprocal associations between depression, anxiety and work-related injury
Authors: Gerasimaviciute Vaiva , Bültmann Ute , Diamond Pamela M , Tullar Jessica M , Delclos George L , Gimeno Ruiz de Porras David , Amick III Benjamin C 
Published: November 2019

ObjectiveTo examine the reciprocal longitudinal associations between depression or anxiety with work-related injury (WRI) at a large employer in the southwestern United States.MethodThree administrative datasets (2011–2013) were merged: employee eligibility, medical and prescription claims, and workers’ compensation claims. The sample contained 69 066 active employees. Depression and anxiety were defined as episodes of medical visits care (ie, claims) with corresponding ICD-9-CM codes. For an individual’s consecutive claims, a new case of depression or anxiety was defined if more than 8 weeks have passed since the prior episode. The presence of a workers’ compensation injury claim was used to identify WRI. Three-wave (health plan years 2011 or T1, 2012 or T2, and 2013 or T3) autoregressive cross-lagged models were used to estimate whether depression or anxiety predicted WRI, also if WRI predicted depression or anxiety in the following year(s).ResultsDepression predicted injury from T1 to T2 (β=0.127, p<0.001) and from T2 to T3 (β=0.092, p=0.001). Injury predicted depression from T1 to T3 (β=0.418, p<0.001). Effects of anxiety on WRI were small and inconsistent, from T1 to T2 (β=0.013, p=0.622) and from T2 to T3 (β=−0.043, p=0.031). T1 injury had a protective effect on T3 anxiety (β=−0.273, p<0.001).ConclusionsWe found evidence of reciprocal effects for depression with WRI after adjustment for prior injuries and depression. The evidence for the relationship between anxiety and WRI is less clear. WRI prevention and management programmes should incorporate depression prevention and management.
Interests and concerns of the Army Medical Services as reflected by the publications in theJournal of the Royal Army Medical Corps1903–2019
Authors: Barker Tom 
Published: November 2019

IntroductionTheJournal of the Royal Army Medical Corps(JRAMC) is published with the aim of propagating current knowledge and expertise while also acting as institutional memory for the practice of medicine within the military. This work aimed to examine how the interests of theJRAMC, and by inference the Army Medical Services, have changed over time as reflected by the articles published in the journal.MethodsA text mining analysis of the titles of all published articles in theJRAMCbetween 1903 and 2019 was performed. The most commonly used terms were identified and their relative frequency over the decades analysed to identify trends. Article content and contemporary events were compared with the observed trends to identify explanatory events and themes of interest.ResultsMedical topics of interest centred around specific infectious diseases, particularly during the early/mid-20th century, and trauma and battle injury. The medical specialties of surgery, anaesthetics and mental health were all well represented in nearly all decades, while primary care only came to prominence as a named specialty from the 1960s onwards. India, France, Egypt and wider Africa were the most commonly cited geographical regions, although there were spikes of interest associated with specific conflicts in the Falklands, Bosnia, Afghanistan and Iraq.ConclusionThe interests of theJRAMChave changed considerably over the years primarily driven by the geopolitical interests of Britain—in particular its colonial interests and the conflicts it has been involved in, but also by medical advances seen in contemporary society.