bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-sectional associations between the neighborhood built environment and physical activity in a rural setting: the Bogalusa Heart Study
Authors: Gustat Jeanette , Anderson Christopher E. , Chukwurah Queendaleen C. , Wallace Maeve E. , Broyles Stephanie T. , Bazzano Lydia A. 
Published: September 2020

Abstract
Background
Insufficient physical activity (PA) is a common health risk and more prevalent in rural populations. Few studies have assessed relationships between the built environment and PA in rural settings, and community policy guidance to promote PA through built environment interventions is primarily based on evidence from urban studies.

Methods
Participants in the Bogalusa Heart Study, a longitudinal study in rural Louisiana, with International Physical Activity Questionnaire data from 2012 to 2013 and a valid residential address (N = 1245) were included. PA was summarized as the number of weekly metabolic equivalent (MET)-minutes of total, transportation, and leisure time PA. The Rural Active Living Assessment street segment audit tool and Google Street View were used to assess features of the built environment overall and in six categories (path features, pedestrian safety features, aesthetics, physical security, destinations and land use) that influence PA. Scores for street segment built environment (overall and in categories) were calculated, for segments and buffers of 0.25, 0.50, 1.00 and 1.50 miles. Associations between built environment scores and PA were assessed with generalized estimating equations.

Results
Participants reported little weekly total, leisure time, and transportation PA (mean 470, 230 and 43 MET-minutes per week, respectively). A 1-point increase in the overall built environment score was associated with 10.30 additional weekly leisure time MET-minutes within a 1.50 mile buffer (p-value 0.05), with a similar magnitude observed for a 1.00-mile buffer. A 1-point increase in the aesthetic score was associated with significantly higher leisure time PA for all geographic units (from 22.21 to 38.75 MET-minutes weekly) when adjusted for individual covariates, but was attenuated and only significant for the segment of the residence after accounting for other neighborhood characteristics.

Conclusions
Significant associations between features of the environment (overall and aesthetic scores) with leisure time PA were observed among adults in this rural population. Built environment interventions in rural settings face additional barriers of lower population density and greater distances for infrastructure projects, and it is important to identify approaches that are both feasible for rural communities and can promote PA.
The meta-analysis for ideal cytokines to distinguish the latent and active TB infection
Authors: Wei Zhenhong , Li Yuanting , Wei Chaojun , Li Yonghong , Xu Hui , Wu Yu , Jia Yanjuan , Guo Rui , Jia Jing , Qi Xiaoming , Li Zhenhao , Gao Xiaoling 
Published: September 2020

Abstract
Background
One forth whole-world population is infected with Mycobacterium tuberculosis (Mtb), but 90% of them are asymptotic latent infection without any symptoms but positive result in IFN-γ release assay. There is lack of ideal strategy to distinguish active tuberculosis (TB) and latent tuberculosis infection (LTBI). Some scientist had focused on a set of cytokines as biomarkers besides interferon- gamma (IFN-γ) to distinguish active TB and LTBI, but with considerable variance of results. This meta-analysis aimed to evaluate the overall discriminative ability of potential immune molecules to distinguish active TB and LTBI.

Methods
PubMed, the Cochrane Library, and Web of Science databases were searched to identify studies assessing diagnostic roles of cytokines for distinguishing active TB and LTBI published up to August 2018. The quality of enrolled studies was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled diagnostic sensitivity and specificity of each cytokine was calculated by using Meta-DiSc software. Area under the summary receiver operating characteristic curve (AUC) was used to summarize the overall diagnostic performance of each biomarker.

Results
Fourteen studies with 982 subjects met the inclusion criteria, including 526 active TB and 456 LTBI patients. Pooled sensitivity, specificity and AUC for discriminating between active TB and LTBI were analyzed for IL-2 (0.87, 0.61 and 0.9093), IP-10 (0.77, 0.73 and 0.8609), IL-5 (0.64, 0.75 and 0.8533), IL-13 (0.75, 0.71 and 0.8491), IFN-γ (0.67, 0.75 and 0.8031), IL-10 (0.68, 0.74 and 0.7957) and TNF-α (0.67, 0.64 and 0.7783). The heterogeneous subgroup analysis showed that cytokine detection assays, TB incidence, and stimulator with Mtb antigens are main influence factors for their diagnostic performance.

Conclusions
The meta-analysis showed cytokine production could assist the distinction between active TB and LTBI, IL-2 with the highest overall accuracy. No single biomarker is likely to show sufficiently diagnostic performance due to limited sensitivity and specificity. Further prospective studies are needed to identify the optimal combination of biomarkers to enhanced diagnostic capacity in clinical practice.
Determinants of nurse job dissatisfaction - findings from a cross-sectional survey analysis in the UK
Authors: Senek Michaela , Robertson Steven , Ryan Tony , King Rachel , Wood Emily , Taylor Bethany , Tod Angela 
Published: September 2020

Abstract
Background
A lower recruitment and high turnover rate of registered nurses have resulted in a global shortage of nurses. In the UK, prior to the COVID-19 epidemic, nurses’ intention to leave rates were between 30 and 50% suggesting a high level of job dissatisfaction.

Methods
In this study, we analysed data from a cross-sectional mixed-methods survey developed by the Royal College of Nursing and administered to the nursing workforce across all four UK nations, to explore the levels of dissatisfaction and demoralisation- one of the predictors of nurses’ intention to leave. We carried out logistic regression analysis on available data in order to determine what impacts job dissatisfaction.

Results
In total, 1742 nurses responded to questions about working conditions on their last shift. We found that nearly two-thirds of respondents were demoralised. Nurses were five times more likely (OR 5.08, 95% CI: 3.82–6.60) to feel demoralised if they reported missed care. A perceived lack of support had nearly the same impact on the level of demoralisation (OR 4.8, 95% CI: 3.67–6.38). These findings were reflected in the qualitative findings where RNs reported how staffing issues and failures in leadership, left them feeling disempowered and demoralised.

Conclusion
A large proportion of nurses reported feeling dissatisfied and demoralised. In order to reduce the negative impact of dissatisfaction and improve retention, more research needs to investigate the relationship dynamics within healthcare teams and how the burden experienced by RNs when unsupported by managers impacts on their ability to provide safe, good-quality care. These findings predate the current Covid-19 pandemic outbreak which may have had a further detrimental effect on job satisfaction in the UK and other nation’s nursing workforce.
Trends, determinants and differences in antibiotic use in 68 residential aged care homes in Australia, 2014–2017: a longitudinal analysis of electronic health record data
Authors: Raban M. Z. , Lind K. E. , Day R. O. , Gray L. , Georgiou A. , Westbrook J. I. 
Published: September 2020

Abstract
Background
Internationally, point prevalence surveys are the main source of antibiotic use data in residential aged care (RAC). Our objective was to describe temporal trends in antibiotic use and antibiotics flagged for restricted use, resident characteristics associated with use, and variation in use by RAC home, using electronic health record data.

Methods
We conducted a retrospective cohort study of 9793 unique residents aged ≥65 years in 68 RAC homes between September 2014 and September 2017, using electronic health records. We modelled the primary outcome of days of antibiotic therapy /1000 resident days (DOT/1000 days), and secondary outcomes of number of courses/1000 days and the annual prevalence of antibiotic use. Antibiotic use was examined for all antibiotics and antibiotics on the World Health Organization’s (WHO) Watch List (i.e. antibiotics flagged for restricted use).

Results
In 2017, there were 85 DOT/1000 days (99% CI: 79, 92), 8.0 courses/1000 days (99% CI: 7.6, 8.5), and 63.4% (99% CI: 61.9, 65.0) of residents received at least one course of antibiotics. There were 7.7 DOT/1000 days (99% CI: 6.69, 8.77) of antibiotics on the WHO Watch List administered in 2017. Antibiotic use increased annually by 4.09 DOT/1000 days (99% CI: 1.18, 6.99) before adjusting for resident factors, and 3.12 DOT/1000 days (99% CI: − 0.05, 6.29) after adjustment. Annual prevalence of antibiotic use decreased from 68.4% (99% CI: 66.9, 69.9) in 2015 to 63.4% (99% CI: 61.9, 65.0) in 2017, suggesting fewer residents were on antibiotics, but using them for longer. Resident factors associated with higher use were increasing age; chronic respiratory disease; a history of urinary tract infections, and skin and soft tissue infections; but dementia was associated with lower use. RAC home level antibiotic use ranged between 44.0 to 169.2 DOT/1000 days in 2016. Adjusting for resident factors marginally reduced this range (42.6 to 155.5 DOT/1000 days).

Conclusions
Antibiotic course length and RAC homes with high use should be a focus of antimicrobial stewardship interventions. Practices in RAC homes with low use could inform interventions and warrant further investigation. This study provides a model for using electronic health records as a data source for antibiotic use surveillance in RAC.
A qualitative study of perceived barriers to hepatitis C care among people who did not attend appointments in the non-urban US South
Authors: Sherbuk Jacqueline E. , Tabackman Alexa , McManus Kathleen A. , Kemp Knick Terry , Schexnayder Julie , Flickinger Tabor E. , Dillingham Rebecca 
Published: September 2020

Abstract
Background
Most people diagnosed with hepatitis C virus (HCV) have not linked to care, despite the availability of safe and effective treatment. We aimed to understand why people diagnosed with HCV have not pursued care in the non-urban Southern United States.

Methods
We conducted a survey and semi-structured interview with participants referred to an HCV clinic who did not attend an appointment between 2014 and 2018. Our clinic is located in a non-urban region of Virginia at a university hospital. Qualitative data collection was guided by the Health Belief Model (HBM). Data was analyzed using qualitative content analysis to identify key factors influencing patient perceptions regarding HCV and pursuit of care.

Results
Over half of previously referred patients (N = 200) could not be reached by phone. Eleven participants enrolled, including 7 men and 4 women. Based on survey responses, unreliable transportation, unstable housing, substance use, and lack of insurance were common. Participants demonstrated good knowledge of HCV disease, complications, and treatment. On qualitative analysis of semi-structured interviews, final themes emerged from within and between HBM constructs. Emerging themes influencing patient perceptions included (1) structural barriers, (2) stigma, (3) prior experiences of HCV disease and treatment, (4) discordance between the recognized severity of HCV and expected impacts on one’s own health, and (5) patient-provider relationship. Substance use was not identified to be a barrier to care.

Conclusions
Participants perceived individual and structural barriers to linking to care. A strong HCV knowledge base was not sufficient to motivate pursuit of care. Efforts to improve linkage to care must address barriers at multiple levels, and system-level changes are needed. As the majority of previously referred patients could not be contacted by phone, current approaches to patient engagement are not effective for reaching these populations. Expansion of HCV care to primary care settings with an established patient-provider relationship or co-located treatment within substance use treatment programs may serve to increase access to HCV treatment.
Total resection of a giant retroperitoneal and mediastinal ganglioneuroma—case report and systematic review of the literature
Authors: Kirchweger Patrick , Wundsam Helwig Valentin , Fischer Ines , Rösch Christiane Sophie , Böhm Gernot , Tsybrovskyy Oleksiy , Alibegovic Vedat , Függer Reinhold 
Published: September 2020

Abstract
Background
Ganglioneuromas (GNs) are extremely rare, slowly growing, benign tumors that can arise from Schwann cells, ganglion cells, and neuronal or fibrous tissues. Due to their origin from the sympathetic neural crest, they show neuroendocrine potential; however, most are reported to be hormonally inactive. Nevertheless, complete surgical removal is recommended for symptom control or for the prevention of potential malignant degeneration.

Case Report
A 30-year-old female was referred to our oncologic center due to a giant retroperitoneal and mediastinal mass detected in computed tomography (CT) scans. The initial symptoms were transient nausea, diarrhea, and crampy abdominal pain. There was a positive family history including 5 first- and second-degree relatives. Presurgical biopsy revealed a benign ganglioneuroma. Total resection (TR) of a 35 × 25 × 25 cm, 2550-g tumor was obtained successfully via laparotomy combined with thoracotomy and partial incision of the diaphragm. Histopathological analysis confirmed the diagnosis. Surgically challenging aspects were the bilateral tumor invasion from the retroperitoneum into the mediastinum through the aortic hiatus with the need of a bilateral 2-cavity procedure, as well as the tumor-related displacement of the abdominal aorta, the mesenteric vessels, and the inferior vena cava. Due to their anatomic course through the tumor mass, the lumbar aortic vessels needed to be partially resected. Postoperative functioning was excellent without any sign of neurologic deficit.

Conclusion
Here, we present the largest case of a TR of a GN with retroperitoneal and mediastinal expansion. On review of the literature, this is the largest reported GN resected and was performed safely. Additionally, we present the first systematic literature review for large GN (> 10 cm) as well as for resected tumors growing from the abdominal cavity into the thoracic cavity.
Self-care and remote care during pregnancy: a new paradigm?
Authors: Gülmezoglu A. Metin , Ammerdorffer Anne , Narasimhan Manjulaa , Wilson Alyce N. , Vogel Joshua P. , Say Lale , Tunçalp Özge 
Published: September 2020

AbstractSelf-care interventions and remote care offer innovative and equitable ways to strengthen access to sexual and reproductive health services. Self-isolation during COVID-19 provided the opportunity for obstetric facilities and healthcare providers to integrate and increase the usage of interventions for self-care and remote care for pregnant women and to improve the quality of care overall.
Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial
Authors: Kasepalu Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Vähi Mare , Kals Jaak 
Published: September 2020

Abstract
Background
Vascular surgery patients have reduced tissues` blood supply, which may lead to mitochondrial dysfunction and accumulation of acylcarnitines (ACs).
It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function.
The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients.

Methods
This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open surgical repair of abdominal aortic aneurysm, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 min of ischaemia, followed by 5 min of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 h postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria).

Results
Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p = 0.023)—there was a decrease (− 0.007 µmol/L, ± 0.020 µmol/L, p = 0.0233) in the RIPC group and increase (0.002 µmol/L, ± 0.015 µmol/L, p = 0.481) in the sham group. Additionally, a decrease from baseline to 24 h after surgery (p < 0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was an increase (p < 0.05) in the levels of C0 (carnitine) and a decrease in the level of C18:1-OH. In the RIPC group, a decrease (p < 0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2.

Conclusions
It can be concluded that RIPC may have an effect on the levels of ACs and might therefore have protective effects on mitochondria in the vascular surgery patients. Further larger studies conducted on homogenous populations are needed to make more definite conclusions about the effect of RIPC on the metabolism of ACs.

Trial registration
ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414.
Ultraviolet irradiation improves the hydrophilicity and osteo-conduction of hydroxyapatite
Authors: Kaneko Sho , Yamamoto Yuji , Wada Kanichiro , Kumagai Gentaro , Harada Yoshifumi , Yamauchi Ryota , Ishibashi Yasuyuki 
Published: September 2020

Abstract
Background
Treating a titanium or titanium alloy implant with ultraviolet (UV) light is known to improve its associated cell growth and osseointegration. However, little is known about the effect of UV irradiation on hydroxyapatite (HA), which is also used frequently in orthopaedic and dental surgery. Here we examined the effect of UV irradiation on the hydrophilicity of HA, and on its osteoconduction ability in rats.

Methods
HA implants of low and high porosity were treated with UV light, and photofunctionalisation was assessed by the contact angle of a water drop on the surface. HA implants were also inserted into rat femurs, and the rats were killed 2 or 4 weeks later. The bone volume and bone area ratio were calculated from microcomputed tomography and histological data.

Results
The contact angle of a water drop on HA implants of both porosities was significantly reduced after UV irradiation. In the rat femurs, there was no significant difference in the bone volume between the UV light-treated and control implants at 2 or 4 weeks. The bone area ratio for the UV light-treated versus control implants was significantly increased at 2 weeks, but there was no significant difference at 4 weeks.

Conclusions
The surface of UV-irradiated HA disks was hydrophilic, in contrast to that of non-irradiated HA disks. Photofunctionalisation accelerated the increase in the bone area ratio in the early healing stage. This technology can be applied to surgical cases requiring the early fusion of bone and HA.
The underlying mechanism of partial anterior cruciate ligament injuries to the meniscus degeneration of knee joint in rabbit models
Authors: Wang Dalin , Wang Zhe , Li Mingcheng , Xu Songbao 
Published: September 2020

Abstract
Background
The diagnosis, treatment, and efficacy evaluation of anterior cruciate ligament (ACL) partial rupture remains controversial. This research aims to investigate the underlying mechanism of partial ACL injuries to the meniscus degeneration in the rabbit knee.

Methods
Sixty New Zealand white rabbits were randomly divided into three groups including an experimental group, a sham group (n = 6), and a blank control group (n = 6). The experimental group is composed of an anteromedial bundle (AMB) rupture group (n = 24) and a posterolateral bundle (PLB) rupture group (n = 24). Rabbits in the experimental group were subjected to right hind limbs knee surgery to induce ACL part injury under the arthroscopy. Finally, eight rabbits including 6 in the model group and 2 in the control group were sampled randomly on the 2nd, 4th, and 8th weeks respectively. We observed the typical form of the meniscus through HE staining. Expressions of inflammatory factors including interleukin-1β (IL-1β) and IL-17 in the knee joint fluid were determined by means of an ELISA. Analysis of the mRNA expressions of matrix metalloproteinases-13(MMP-13) was performed to evaluate the inflammatory mediators in the pathogenesis of the meniscus.

Results
HE staining results showed that the surface was rough and the tissues were loose displaying collagen fibers of varying thickness. Both IL-1β and IL-17 in the synovial fluid and the positive rate of MMP-13 in addition to MMP-13 mRNA showed a demonstrable increase treads from the 2nd to the 8th week. The significant difference was found (P < 0.05) compared to the control group.

Conclusion
We conclude that the elevated levels of IL-1β and IL-17, along with increased MMP13 expression, resulted in meniscus degradation in the rabbit knee joint model with partial ACL injury.
Increase in excitability of hippocampal neurons during novelty-induced hyperlocomotion in dopamine-deficient mice
Authors: Fujita Masayo , Ochiai Yukiko , Takeda Taishi-Clark , Hagino Yoko , Kobayashi Kazuto , Ikeda Kazutaka 
Published: September 2020

AbstractDopamine is involved in many important brain functions, including voluntary motor movement. Dysfunction of the dopaminergic system can induce motor impairments, including Parkinson’s disease. We previously found that dopamine-deficient (DD) mice became hyperactive in a novel environment 72 h after the last injection of L-3,4-dihydroxyphenylalanine (L-DOPA) when dopamine was almost completely depleted. In the present study, we investigated neuronal activity in hippocampal subregions during hyperactivity by measuring Fos expression levels using immunohistochemistry. Dopamine-deficient mice were maintained on daily intraperitoneal injections of 50 mg/kg L-DOPA. Seventy-two hours after the last L-DOPA injection, DD mice were exposed to a novel environment for 1, 2, or 4 h, and then brains were collected. In wildtype mice, the number of Fos-immunopositive neurons significantly increased in the hippocampal CA1 region after 1 h of exposure to the novel environment and then decreased. In DD mice, the number of Fos-immunopositive neurons gradually increased and then significantly increased after 4 h of exposure to the novel environment. The number of Fos-immunopositive neurons also significantly increased in the CA3 region and dentate gyrus in DD mice after 4 h of exposure to the novel environment. These results indicate that the delayed and prolonged excitation of hippocampal neurons in the CA1, CA3, and dentate gyrus that is caused by dopamine depletion might be involved in hyperactivity in DD mice.