bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study
Authors: Zhao Peizhen , Tang Weiming , Cheng Huanhuan , Huang Shujie , Zheng Heping , Yang Bin , Wang Cheng 
Published: December 2020

ObjectivesUnderscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider’s ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China.DesignA cross-sectional study was performed between July 2016 and December 2016.SettingSeven STD clinics in Guangdong Province, China.ParticipantsHeterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing.Outcome measuresThe syphilis and HIV testing uptake determined by patient receipt of results.ResultsA total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake.ConclusionsThe low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.
Cross-sectional association between long working hours and liver function: the Kangbuk Samsung Health Study
Authors: Mun Eunchan , Lee Woncheol , Nam Min-Woo , Kim Hyun-Il , Kim Hyeongcheol , Lee Yesung , Park Soyoung 
Published: December 2020

ObjectivesAlthough the effects of long working hours on liver function remain unclear, in South Korea, there is a social perception that long working hours are associated with poor liver function. Thus, long working hours have recently become a major issue. This study aimed to determine the association between long working hours and liver function, as indicated by the alanine transaminase (ALT) levels.DesignCross-sectional study.SettingLarge university hospitals in Seoul and Suwon, South Korea.ParticipantsWorkers in formal employment who underwent a comprehensive health examination at the Kangbuk Samsung Hospital Total Healthcare Centre clinics in Seoul and Suwon, South Korea, between January 2011 and December 2018. Of the 386 488 participants, 212 421 met the inclusion criteria and were included in the analysis.Primary outcome measureALT elevation.ResultsThe participants were predominantly well-educated (86.1%), male (69.3%) and in their 30s (49.6%). In total, 13.4% of the participants presented ALT elevation (>40 IU/L). There was no significant association between working hours and ALT elevation in the general population and in the hepatitis B surface antigen (HBsAg)-negative group. Conversely, in the HBsAg-positive group, working >60 hours per week compared with 35–40 hours per week was significantly associated with ALT elevation. The association was more pronounced in those with ALT levels >80 IU/L (OR 1.94, 95% CI 1.24 to 3.01) than in those with ALT levels >40 IU/L (OR: 1.45, 95% CI 1.20 to 1.75). The p values for trend were <0.05.ConclusionsLong working hours were associated with ALT elevation only in hepatitis B virus carriers and not in the general population. Provided that there is adherence to the legal working hours, there is no need to further restrict working hours for liver health, irrespective of HBsAg status.
Randomised placebo-controlled multicentre effectiveness trial of adjunct betamethasone therapy in hospitalised children with community-acquired pneumonia: a trial protocol for the KIDS-STEP trial
Authors: Kohns Vasconcelos Malte , Meyer Sauteur Patrick M , Santoro Regina , Coslovsky Michael , Lurà Marco , Keitel Kristina , Wachinger Tanja , Beglinger Svetlana , Heininger Ulrich , van den Anker Johannes , Bielicki Julia Anna 
Published: December 2020

IntroductionCommunity-acquired pneumonia (CAP) causes around 10 hospitalisations per 1000 child-years, each associated with an average 13 non-routine days experienced and more than 4 parent workdays lost. In adults, steroid treatment shortens time to clinical stabilisation without an increase in complications in patients with CAP. However, despite promising data from observational studies, there is a lack of high-quality evidence for the use of steroids.Methods and analysisThe KIDS-STEP trial is a multicentre, randomised, double-blind, placebo-controlled superiority trial of betamethasone treatment on outcome of hospitalised children with CAP. Children are enrolled in paediatric emergency departments of hospitals across Switzerland and randomised to adjunct oral betamethasone for 2 days or matching placebo in addition to standard of care treatment. The co-primary outcomes are the proportion of children clinically stable 48 hours after randomisation and the proportion of children with CAP-related readmission within 28 days after randomisation. Secondary outcomes include length of hospital stay, time away from routine childcare and healthcare utilisation and total antibiotic prescriptions within 28 days from randomisation.Each of the co-primary outcomes will be analysed separately. We will test clinical stability rates using a proportion test; to test non-inferiority in readmission rates, we will construct 1−α % CI of the estimated difference and test if it contains the pre-defined margin of 7%. Success is conditional on both tests. A simulation-based sample size estimation determined that recruiting 700 patients will ensure a power of 80% for the study.Ethics and disseminationThe trial protocol and materials were approved by ethics committees in Switzerland (lead: Ethikkommission Nordwest und Zentralschweiz) and the regulatory authority Swissmedic. Participants and caregivers provide informed consent prior to study procedures commencing. The trial results will be published in peer-reviewed journals and at national and international conferences. Key messages will also be disseminated via press and social media where appropriate.Trial registration numberNCT03474991and SNCTP000002864.
Burden of diabetic macular oedema in patients receiving antivascular endothelial growth factor therapy in South Korea: a healthcare resource use and cost analysis
Authors: Jeon Ha-Lim , Lee Hyesung , Yoon Dongwon , Lee Yeonkyung , Kim Jae Hui , Jee Donghyun , Shin Ju-Young 
Published: December 2020

ObjectiveTo examine healthcare resource utilisation (HRU) and direct medical costs for patients with diabetic macular oedema (DME) treated with antivascular endothelial growth factor (anti-VEGF) in Korea by comparing with those for (1) patients with diabetes mellitus (DM) without retinopathy and (2) patients with neovascular age-related macular degeneration (nAMD) treated with anti-VEGF.DesignRetrospective cohort study.SettingThe Korean National Health Insurance (NHI) database from 1 January 2014 to 31 December 2016.ParticipantsWe identified 1398 patients older than 30 years of age who received anti-VEGF treatment for DME in 2015 after excluding patients who had a diagnosis of nAMD in 2015 and any cancer in the preceding year.Main outcome measuresOne-year healthcare resource use and direct medical costs of patients with DME treated with anti-VEGF.ResultsIn total, 1398 patients with DME receiving anti-VEGF, 12 813 patients with DM without retinopathy and 12 222 patients with nAMD receiving anti-VEGF were identified. Hospital admissions and outpatient visits were highest in patients with DME, while the number of licensed anti-VEGF injections in those with DME was about half that of those with nAMD (2.1 vs 3.9 per patient per year). Mean 1-year medical costs were also higher in patients with DME (US$6723) than in those with DM without retinopathy (US$2687) and nAMD (US$4980). In a multivariable analysis with matched cohorts, DME was associated with 66% higher medical costs for comorbid diseases (adjusted OR (aOR), 1.66; 95% CI 1.45 to 1.90) and 50% lower anti-VEGF injections (aOR, 0.50; 95% CI 0.46 to 0.54) compared with nAMD.ConclusionsThe overall HRU and economic burden for DME treated with anti-VEGF were higher than for DM without retinopathy or for nAMD treated with anti-VEGF. Meanwhile, the lower number of licensed anti-VEGF injections compared with nAMD may reflect a potential lack of ophthalmological treatment for DME supported by the NHI in Korea.
Indigenous communities’ responses to the COVID-19 pandemic and consequences for maternal and neonatal health in remote Peruvian Amazon: a qualitative study based on routine programme supervision
Authors: Reinders Stefan , Alva Angela , Huicho Luis , Blas Magaly M 
Published: December 2020

AimTo explore indigenous communities’ responses to the COVID-19 pandemic and its consequences for maternal and neonatal health (MNH) care in the Peruvian Amazon.MethodsMamás del Río is a community-based, MNH programme with comprehensive supervision covering monthly meetings with community health workers (CHW), community leaders and health facilities. With the onset of the lockdown, supervisors made telephone calls to discuss measures against COVID-19, governmental support, CHW activities in communities and provision of MNH care and COVID-19 preparedness at facilities. As part of the programme’s ongoing mixed methods evaluation, we analysed written summaries of supervisor calls collected during the first 2 months of Peru’s lockdown.ResultsBetween March and May 2020, supervisors held two rounds of calls with CHWs and leaders of 68 communities and staff from 17 facilities. Most communities banned entry of foreigners, but about half tolerated residents travelling to regional towns for trade and social support. While social events were forbidden, strict home isolation was only practised in a third of communities as conflicting with daily routine. By the end of April, first clusters of suspected cases were reported in communities. COVID-19 test kits, training and medical face masks were not available in most rural facilities. Six out of seven facilities suspended routine antenatal and postnatal consultations while two-thirds of CHWs resumed home visits to pregnant women and newborns.ConclusionsHome isolation was hardly feasible in the rural Amazon context and community isolation was undermined by lack of external supplies and social support. With sustained community transmission, promotion of basic hygiene and mask use becomes essential. To avoid devastating effects on MNH, routine services at facilities need to be urgently re-established alongside COVID-19 preparedness plans. Community-based MNH programmes could offset detrimental indirect effects of the pandemic and provide an opportunity for local COVID-19 prevention and containment.
Secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative in five Chinese cities: a pooled cross-sectional study
Authors: Duan Zongshuan , Wang Yu , Huang Jidong , Redmon Pamela B , Eriksen Michael P 
Published: December 2020

ObjectivesTo assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative.DesignCity-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were conducted in each participating city before and after the implementation of TFC.SettingFive large Chinese cities (Chengdu, Chongqing, Wuhan, Xiamen and Xi’an) participated in the TFC initiative.ParticipantsA total of 10 184 adults participated in the 2015 TQS survey, and 10 233 adults participated in the 2018 TQS survey, respectively.InterventionsThe TFC initiative, which included targeted media campaigns, educational programmes, implementing city-wide smoke-free policies and providing cessation interventions, was implemented in these five cities between 2015 and 2018.Main outcomeSelf-reported past 30-day (P30D) SHS exposure in indoor workplaces, restaurants and homes.Data analysisThe pre-TFC and post-TFC SHS exposure levels were compared among all residents and among certain population subgroups. Multivariate logistic regressions were used to estimate the adjusted associations between P30D SHS exposure and individual characteristics.ResultsAcross all five cities, the overall rate of self-reported P30D SHS exposure declined in indoor workplaces (from 49.6% (95% CI: 46.4% to 52.8%) to 41.2% (95% CI: 37.7% to 44.7%)), restaurants (from 72.4% (95% CI: 69.8% to 74.9%) to 61.7% (95% CI: 58.7% to 64.7%)) and homes (from 39.8% (95% CI: 36.9% to 42.7%) to 34.7% (95% CI: 31.5% to 37.8%)) from 2015 to 2018. These declines were statistically significant after controlling for individual characteristics. The P30D SHS exposure was associated with sex, age, education level, occupation and current smoking status. The associations varied by venues.ConclusionsOur analysis showed that compared with the nationwide SHS exposure levels reported in concurrent national surveys, the declines in P30D SHS exposure in five Chinese cities that implemented the TFC initiative were larger in indoor workplaces and restaurants. Our findings suggest that the TFC initiative was effective in reducing SHS exposure in Chinese cities.
Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
Authors: de Lima Juliana Beust , Soares Douglas dos Santos , Ferrari Filipe , Carvas Junior Nelson , Carvalho Gabriel , Tobar Leitão Santiago Alonso , Goldraich Lívia Adams , Clausell Nadine , Stein Ricardo 
Published: December 2020

IntroductionHeart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients.Methods and analysisWe will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.govand REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository.Ethics and disseminationGiven the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42020191192.
Masculinising testosterone treatment and effects on preclinical cardiovascular disease, muscle strength and power, aggression, physical fitness and respiratory function in transgender men: protocol for a 10-year, prospective, observational cohort study in Denmark at the Body Identity Clinic (BIC)
Authors: Lehmann Christensen Louise , Glintborg Dorte , Taulbjerg Kristensen Tine , Diederichsen Axel , T’Sjoen Guy , Frystyk Jan , Skovsager Andersen Marianne 
Published: December 2020

IntroductionThe number of individuals with gender dysphoria seeking gender-affirming treatment is increasing. The short-term and long-term effects of masculinising treatment with testosterone are debated as serum testosterone increases up to 20-fold compared with cisgender women. We will investigate short-term and long-term effects of masculinising testosterone treatment on preclinical and clinical coronary disease, muscle strength and power, oxygen consumption (VO2) max, cardiac and respiratory function and quality of life including aggression in transgender men.Methods and analysesProspective, single-centre, observational cohort study at the Body Identity Clinic (BIC), Odense University Hospital, Denmark. Investigations are performed at inclusion and following 1, 3, 5 and 10 years of testosterone therapy. Non-calcified coronary plaque volume and calcium score are estimated by coronary CT angiography. CT is only performed at inclusion and following 1 and 10 years. Upper body muscle strength and power are measured by a ‘low row’ weight stack resisted exercise machine. Evaluation of aggression and quality of life is assessed by questionnaires, VO2max is estimated by maximal testing on bike ergometer, and cardiac and respiratory functions are measured by echocardiography and spirometry, respectively. Markers of cardiovascular risk and inflammation and also cortisol and cortisone are assessed in blood, diurnal urine and/or hair samples. Our cohort (BIC), including dropouts, will be an embedded subcohort in a future national registry study in all individuals with gender dysphoria and controls. Data are available on International Statistical Classification of Diseases and Related Health Problems 10thversion diagnostic codes, prescriptions, socioeconomics and causes of death.Ethics and disseminationThe Regional Committee on Health Research Ethics for Southern Denmark (S-20190108) and the Danish Data Protection Agency (19/27572) approved the study. Signed informed consent will be obtained from all participants. All findings will be published in peer-reviewed journals or at scientific conferences.Trial registration numberNCT04254354.
Quantum corrections to the accretion onto a Schwarzschild black hole in the background of quintessence
Authors: Nozari Kourosh , Hajebrahimi Milad , Saghafi Sara 
Published: December 2020

AbstractIt is well known that quantum effects may lead to removal of the intrinsic singularity point of back holes. Also, the quintessence scalar field is a candidate model for describing late-time acceleration expansion. Accordingly, Kazakov and Solodukhin considered the existence of back-reaction of the spacetime due to the quantum fluctuations of the background metric to deform a Schwarzschild black hole, which led to a change of the intrinsic singularity of the black hole to a 2-sphere with a radius of the order of the Planck length. Also, Kiselev rewrote the Schwarzschild metric by taking into account the quintessence field in the background. In this study, we consider the quantum-corrected Schwarzschild black hole inspired by Kazakov–Solodukhin’s work, and the Schwarzschild black hole surrounded by quintessence deduced by Kiselev to study the mutual effects of quantum fluctuations and quintessence on the accretion onto the black hole. Consequently, the radial component of the 4-velocity and the proper energy density of the accreting fluid have a finite value on the surface of its central 2-sphere due to the presence of quantum corrections. Also, by comparing the accretion parameters in different kinds of black holes, we infer that the presence of a point-like electric charge in the spacetime is somewhat similar to some quantum fluctuations in the background metric.
Matter accretion onto a conformal gravity black hole
Authors: Abbas G. , Ditta A. 
Published: December 2020

AbstractThe accretion of test fluids flowing onto a black hole is investigated. Particularly, by adopting a dynamical Hamiltonian approach, we are capable to find the critical points for various cases of black hole in conformal gravity. In these cases, we have analyzed the general solutions of accretion employing the isothermal equations of state. The steady state and spherically symmetric accretion of different test fluids onto the conformal gravity black hole has been considered. Further, we have classified these flows in the context of equations of state and the cases of conformal gravity black hole. The new behavior of polytropic fluid accretion is also discussed in all three cases of black hole. Black hole mass accretion rate is the most important part of this research in which we have investigated that the Schwarzschild black hole produce a typical signature than the conformal gravity black hole and Schwarzschild–de Sitter black hole. The critical fluid flow and the mass accretion rate have been presented graphically by the impact parameters $$\beta $$
β
, $$\gamma $$
γ
, k and these parameters have great significance. Additionally, the maximum mass rate of accretion fall near the universal and Killing horizons and minimum rate of accretion occurs in between these regions. Finally, the results are compared with the different cases of black hole available in the literature.