bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of income on medical school admissions in Canada: a retrospective cohort study
Authors: Pitre Tyler , Thomas Alexander , Evans Kyle , Jones Aaron , Mountjoy Margo , Costa Andrew P. 
Published: July 2020

Abstract
Background
The socioeconomic status of applicants to Canadian medical schools has been understudied in the past two decades. Institutional efforts have been made to address the lack of socioeconomic diversity across Canada during this time. We investigated the income characteristics of medical school applicants, as well as the relationship between applicant income and offer of admission, to characterize the current state of socioeconomic diversity in medical admissions.

Methods
We conducted a retrospective cohort study on 26,120 applicants at one Ontario medical school from 2013 to 2018. Characteristics of applicants who were offered admission were compared to the general population and applicants not offered admission. Regression analyses were used to investigate the association between median total neighborhood income and successful admission.

Results
The median total neighborhood income for medical school applicants was $98,816, which was approximately $28,480 higher than the Canadian general population. Those not admitted to the medical school had a median total neighborhood income of $98,304 compared to $105,984 for those offered admission (p < 0.001). This trend was seen in every province and territory in Canada. Median total neighborhood income was a predictor of an offer of admission; applicants in the >75th percentile income group had 54% increased odds of being offered admission when compared to applicants in the <25th percentile in our unadjusted model. Income was not significant in our adjusted models but showed that the income medians drastically shifted between pre-interview and post-interview periods, from $98,816 to $104,960 (p < 0.001).

Conclusion
Medical school applicants are from higher economic strata compared to the general population. Despite already representing a high economic stratum, a higher median total neighborhood income relative to other applicants was associated with an offer of admission.
An exploratory study of public’ awareness about robotics-assisted surgery in Kuwait
Authors: Buabbas Ali Jasem , Aldousari Saad , Shehab Abrar Abdulmohsen 
Published: July 2020

Abstract
Background
The adoption of robotic-assisted surgery (RAS) requires a clear willingness, not only from healthcare organization to operate the robotic system but also from the public that is going to perceive it. This study aims to explore public’s awareness, understanding and their perceptions towards RAS in Kuwait.

Methods
This cross-sectional study used a survey questionnaire that was disseminated on a tablet device to people at their convenience in governmental institutions.

Results
A total of 1087 people agreed to participate in this study. The study results showed that only 36.8% of respondents had heard of RAS and 27.1% knew what RAS is. Moreover, 47.6% of the respondents were uncertain about its safety, while 29.7% thought RAS was safe. The results also showed that 40.9 and 34.4% of respondents thought that RAS is more precise and faster than conventional surgical procedures, respectively, whereas 30.6% feared malfunctioning issues during surgical procedures.

Conclusion
This public survey among a Middle Eastern population reveals lack of awareness and limited understanding of RAS. However, there was a tendency towards believing that RAS may have potential advantages in terms of better outcomes compared to conventional surgical procedures.
Validation of the Partners at Care Transitions Measure (PACT-M): assessing the quality and safety of care transitions for older people in the UK
Authors: Oikonomou Eirini , Page Bethan , Lawton Rebecca , Murray Jenni , Higham Helen , Vincent Charles 
Published: July 2020

Abstract
Background
The Partners at Care Transitions Measure (PACT-M) is a patient-reported questionnaire for evaluation of the quality and safety of care transitions from hospital to home, as experienced by older adults. PACT-M has two components; PACT-M 1 to capture the immediate post discharge period and PACT-M 2 to assess the experience of managing care at home. In this study, we aim to examine the psychometric properties, factor structure, validity and reliability of the PACT-M.

Methods
We administered the PACT-M over the phone and by mail, within one week post discharge with 138 participants and one month after discharge with 110 participants. We performed principal components analysis and factors were assessed for internal consistency, reliability and construct validity.

Results
Reliability was assessed by calculating Cronbach’s alpha for the 9-item PACT-M 1 and 8-item PACT-M 2 and exploratory factor analysis was performed to evaluate dimensionality of the scales. Principal components analysis was chosen using pair-wise deletion. Both PACT-M 1 and PACT-M 2 showed high internal consistency and good internal reliability values and conveyed unidimensional scale characteristics with high reliability scores; above 0.8.

Conclusions
The PACT-M has shown evidence to suggest that it is a reliable measure to capture patients’ perception of the quality of discharge arrangements and also on patients’ ability to manage their care at home one month post discharge. PACT-M 1 is a marker of patient experience of transition and PACT-M 2 of coping at home.
Patient perspectives on interventional pain management: thematic analysis of a qualitative interview study
Authors: Hambraeus Johan , Hambraeus Kjerstin S. , Sahlen Klas-Göran 
Published: July 2020

Abstract
Background
Chronic pain is a widespread problem that is usually approached by focusing on its psychological aspects or on trying to reduce the pain from the pain generator. Patients report that they feel responsible for their pain and that they are disempowered and stigmatized because of it. Here, we explored interventional pain management from the patient’s perspective to understand the process better.

Methods
A purposive sample of 19 subjects was interviewed by an independent interviewer. The interviews were transcribed into text and thematic analysis was performed.

Results
The subjects’ perceptions covered three key themes: themselves as objects; the caregivers, including the process of tests and retests, the encounters and interactions with professionals, and the availability of the caregivers; and finally the outcomes, including the results of the tests and treatments and how these inspired them to think of other people with pain. Linking these themes, the subjects reported something best described as “gained empowerment” during interventional pain management; they were feeling heard and seen, they gained knowledge that helped them understand their problem better, they could ask questions and receive answers, and they felt safe and listened to.

Conclusions
Many of the themes evolved in relation to the subjects’ contact with the healthcare services they received, but when the themes were merged and structured into the model, a cohesive pattern of empowerment appeared. If empowerment is a major factor in the positive effects of interventional pain management, it is important to facilitate and not hinder empowerment.

Trial registration
Clinicaltrials.gov 2013-04-24 (Protocol ID SE-Dnr-2012-446-31 M-3, ClinicalTrials ID NCT01838603).
The prevalence and economic burden of pain on middle-aged and elderly Chinese people: results from the China health and retirement longitudinal study
Authors: Qiu Yudian , Li Hu , Yang Ziyi , Liu Qiang , Wang Kai , Li Rujun , Xing Dan , Hou Yunfei , Lin Jianhao 
Published: July 2020

AbstractBackgroundTo estimate the prevalence of pain among people aged 45 years and older in China, to analyze the effect factors of pain and pain related economic burden.MethodsNationally representative sample was derived from China Health and Retirement Longitudinal Study (CHARLS). Pain data, medical cost data were obtained, as well as information of demographic characteristics, social structure, social-economic status, other health needs and health behaviors. The prevalence of pain in 2011, 2013, and 2015 was calculated. Univariate analysis and multivariate analysis were used to find the effect factors of pain. An optimization two-part model was used to calculate the range of the direct medical costs caused by pain.ResultsThe prevalence of pain among people 45 years or older in China was 31.73% in 2011, 37.27% in 2013 and 28.62% in 2015. When evaluating factors lead a higher prevalence of pain, the results of the multi-variable after one-way analysis were older age, female, lower education, rural residents, without insurance status, abstained from alcohol and lower body mass index (BMI). Through the optimization of two-part model, the direct medical costs caused by pain was 898.9–1563.0 yuan in 2011, 2035.8–2568.7 yuan in 2013 and 2628.8–3945.7 yuan in 2015 (129.9US$ - 225.9US$ in 2011, 294.2 US$ - 371.2US$ in 2013 and 379.9US$ - 570.2US$ in 2015, converted to 2010 RMB).ConclusionThe prevalence of pain among middle-aged and elderly Chinese is high. Residents with older age, female, lower education, rural residents, without insurance status, abstained from alcohol and lower BMI seem to have a higher pain prevalence. Pain can cause extra direct medical costs and will cause more economic loss with the progress of time. Future research should pay more attention to effective treatment, management and prevention of pain to decrease its burden.
Access to hip and knee replacement surgery in patients with chronic diseases according to patient-reported pain and functional status
Authors: Podmore Bélène , Hutchings Andrew , Konan Sujith , Robson John , van der Meulen Jan 
Published: July 2020

Abstract
Background
An increasing number of patients undergoing hip or knee replacement have chronic diseases. It has been suggested that the presence of chronic diseases may affect access to this type of surgery in the English National Health Service (NHS). We examined the access to hip and knee replacement surgery in patients with and without chronic diseases according to preoperative patient-reported pain, functional status and symptom duration.

Methods
We analysed data of 640,832 patients who had hip or knee surgery between 2009 and 2016 in England. Multivariable regression was used to estimate the impact of 11 chronic diseases on severity of joint problems as measured on a scale from 0 to 48 by Oxford Hip (OHS) and Knee Scores (OKS) just before surgery and on likelihood of long-standing joint problems (> 5 years pre-operatively).

Results
Patients with chronic diseases reported more severe joint problems than patients without (OHS differences ranged from 1.1 [95% CI 0.93, 1.2] to 2.5 [95% CI 2.3, 2.7] and OKS differences from 0.5 [95% CI 0.3, 0.7] to 2.6 [95% CI 2.4, 2.7] for the 11 chronic diseases) but the differences remain small. When analysed separately, patients with chronic diseases reported both more severe pain and poorer functional status. Six chronic diseases in hip patients and two in knee patients increased the likelihood that they had long-standing joint problems. The severity of joint problems just before surgery increased with the number of chronic diseases (OHS differences; one chronic disease (1.5 [95% CI 1.4, 1.5]) to four or more (5.8 [95% CI 5.6, 6.0])).

Conclusions
Patients with chronic diseases reported more severe joint problems immediately before hip or knee replacement surgery suggesting they have hip or knee replacement later in the course of their joint disease.
Female Pakistani carers’ views on future formal and informal care for their older relatives in Norway
Authors: Arora Sanjana , Rechel Bernd , Bergland Astrid , Straiton Melanie , Debesay Jonas 
Published: July 2020

AbstractBackgroundThe aging of Pakistani immigrants in Norway raises questions related to their increased need for care and help from relatives, as well as those concerning what future formal and informal care and healthcare accessibility for older immigrants may look like. The hidden nature of family caregiving means that the circumstances of carers, their views and their dilemmas related to future care are largely invisible. In this study, we explored female Pakistani carers’ views of future care and healthcare accessibility for their older relatives in Norway.MethodsOur data included interviews with family carers between the ages of 23 and 40 years old, living in Oslo, Norway. We recruited ten family carers, out of which eight were daughters and two were daughters-in-law. Interviews were conducted by the first author in Urdu or English and were recorded and transcribed verbatim.ResultsOur findings revealed several factors that influenced participants’ perceptions about formal and informal caregiving, which can be organised into the following themes: 1) caring for family in Norway as in Pakistan, 2) worries about being ‘dropped off’ at a care home, 3) concerns about being cared for by outsiders, 4) questions about what other people might say and 5) adhering to society’s expectations of a ‘good’ carer.ConclusionFamily carers’ traditional views of filial piety do not entirely determine the use of or access to healthcare services of their older relatives. There is a need to develop culturally sensitive healthcare systems so that immigrant families and their carers have more options in choosing care in old age, which in turn will ease their families’ care burden. Healthcare professionals and policymakers should not assume that immigrant families will take care of their own older members but should instead secure adequate support for older immigrants and their family carers.
Haem oxygenase protects against thrombocytopaenia and malaria-associated lung injury
Authors: de Azevedo-Quintanilha Isaclaudia G. , Medeiros-de-Moraes Isabel M. , Ferreira André C. , Reis Patrícia A. , Vieira-de-Abreu Adriana , Campbell Robert A. , Weyrich Andrew S. , Bozza Patricia T. , Zimmerman Guy A. , Castro-Faria-Neto Hugo C. 
Published: July 2020

Abstract
Background
Malaria-triggered lung injury can occur in both severe and non-severe cases. Platelets may interact with parasitized erythrocytes, leukocytes and endothelium. These interactions can lead to microvessel obstructions and induce release of inflammatory mediators. Induction of the haem oxygenase enzyme is important in the host’s response to free haem and to several other molecules generated by infectious or non-infectious diseases. In addition, an important role for the haem oxygenase-1 isotype has been demonstrated in experimental cerebral malaria and in clinical cases. Therefore, the present work aims to determine the influence of haem oxygenase in thrombocytopaenia and acute pulmonary injury during infection with Plasmodium berghei strain NK65.

Methods
C57BL/6 mice were infected with P. berghei and analysed 7-10 days post-infection. For each experiment, Cobalt Protoporphyrin IX/CoPPIX or saline were administered. Bronchoalveolar lavage fluid was used for total and differential leukocyte count and for protein measurement. Lungs were used for histological analyses or for analysis of cytokines and western blotting. The lung permeability was analysed by Evans blue dye concentration. Platelet-leukocyte aggregate formation was assayed using the flow cytometer.

Results
Plasmodium berghei NK65 infection generated an intense lung injury, with increased levels of inflammatory mediators, oedema, and cell migration into the lung. Plasmodium berghei infection was also accompanied by marked thrombocytopaenia and formation of platelet-leukocyte aggregates in peripheral blood. Treatment with the HO-1 inducer cobalt protoporphyrin IX (CoPPIX) modified the inflammatory response but did not affect the evolution of parasitaemia. Animals treated with CoPPIX showed an improvement in lung injury, with decreased inflammatory infiltrate in the lung parenchyma, oedema and reduced thrombocytopaenia.

Conclusion
Data here presented suggest that treatment with CoPPIX inducer leads to less severe pulmonary lung injury and thrombocytopaenia during malaria infection, thus increasing animal survival.
Three-dimensional printing versus conventional machining in the creation of a meatal urethral dilator: development and mechanical testing
Authors: Chen Michael Y. , Skewes Jacob , Daley Ryan , Woodruff Maria A. , Rukin Nicholas J. 
Published: July 2020

Abstract
Background
Three-dimensional (3D) printing is a promising technology, but the limitations are often poorly understood. We compare different 3D printing methods with conventional machining techniques in manufacturing meatal urethral dilators which were recently removed from the Australian market.

Methods
A prototype dilator was 3D printed vertically orientated on a low-cost fused deposition modelling (FDM) 3D printer in polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS). It was also 3D printed horizontally orientated in ABS on a high-end FDM 3D printer with soluble support material, as well as on an SLS 3D printer in medical nylon. The dilator was also machined in stainless steel using a lathe. All dilators were tested mechanically in a custom rig by hanging calibrated weights from the handle until the dilator snapped.

Results
The horizontally printed ABS dilator experienced failure at a greater load than the vertically printed PLA and ABS dilators, respectively (503 g vs 283 g vs 163 g, p < 0.001). The SLS nylon dilator and machined steel dilator did not fail. The steel dilator is the most expensive with a quantity of five at 98 USD each, but this decreases to 30 USD each for a quantity of 1000. In contrast, the cost for the SLS dilator is 33 USD each for five and 27 USD each for 1000.

Conclusions
Low-cost FDM 3D printing is not a replacement for conventional manufacturing. 3D printing is best used for patient-specific parts, prototyping or manufacturing complex parts that have additional functionality that cannot otherwise be achieved.
Health inequity in workers of Latin America and the Caribbean
Authors: Silva-Peñaherrera Michael , Lopez-Ruiz María , Merino-Salazar Pamela , Gómez-García Antonio Ramón , Benavides Fernando G. 
Published: July 2020

Abstract
Background
Latin America and the Caribbean (LAC) is the world’s most inequitable region in terms of wealth distribution. The full scale of social inequalities in health has been hidden by the lack of reliable data. This study aimed to measure and compare health inequalities in the working population within and between 15 countries of LAC.

Methods
A sample of 180,163 workers aged 18 years and older was drawn from the most recent national surveys of working conditions or health in 15 LAC countries. Poor self-perceived health (P-SPH) was used as a health indicator, and age, education level, and occupational category as inequality stratifiers. We calculated four measures: absolute and relative population-attributable risks, the Kuznets and weighted Keppel indexes.

Results
P-SPH prevalence ranged from 9% in men from Uruguay to 50% in women from Nicaragua. It was higher in women than in men in most countries. A clear gradient was shown, in which young people in non-manual skilled jobs and high education had the lowest prevalence. Nearly 45% of cases that reported P-SPH among men and 35% among women could be avoided if all the groups received a higher level of education. Also, approximately 42% of P-SPH reported by men and 31% by women could be avoided if they all shared the working and employment conditions of non-manual skilled jobs.

Conclusions
Wide health inequalities were found between occupational and educational groups in LAC. However, country borders appear to be an even more important stratifier in the production of health inequalities. Urgent interventions to improve worker’s health are needed in countries where prevalence of poor self-perceived health is high. Strengthening occupational health surveillance system in LAC countries should become a priority, in order to track the interventions to reduce occupational health inequity.
A large prospective investigation of outdoor light at night and obesity in the NIH-AARP Diet and Health Study
Authors: Zhang Dong , Jones Rena R. , Powell-Wiley Tiffany M. , Jia Peng , James Peter , Xiao Qian 
Published: July 2020

AbstractBackgroundResearch has suggested that artificial light at night (LAN) may disrupt circadian rhythms, sleep, and contribute to the development of obesity. However, almost all previous studies are cross-sectional, thus, there is a need for prospective investigations of the association between LAN and obesity risk. The goal of our current study was to examine the association between baseline LAN and the development of obesity over follow-up in a large cohort of American adults.MethodsThe study included a sample of 239,781 men and women (aged 50–71) from the NIH-AARP Diet and Health Study who were not obese at baseline (1995–1996). We used multiple logistic regression to examine whether LAN at baseline was associated with the odds of developing obesity at follow-up (2004–2006). Outdoor LAN exposure was estimated from satellite imagery and obesity was measured based on self-reported weight and height.ResultsWe found that higher outdoor LAN at baseline was associated with higher odds of developing obesity over 10 years. Compared with the lowest quintile of LAN, the highest quintile was associated with 12% and 19% higher odds of developing obesity at follow-up in men (OR (95% CI) = 1.12 (1.00, 1.250)) and women (1.19 (1.04, 1.36)), respectively.ConclusionsOur findings suggest that high LAN exposure could predict a higher risk of developing obesity in middle-to-older aged American adults.
An adiponectin-S1P autocrine axis protects skeletal muscle cells from palmitate-induced cell death
Authors: Botta Amy , Elizbaryan Kazaros , Tashakorinia Parastoo , Lam Nhat Hung , Sweeney Gary 
Published: July 2020

AbstractBackgroundThe prevalence of type 2 diabetes, obesity and their various comorbidities have continued to rise. In skeletal muscle lipotoxicity is well known to be a contributor to the development of insulin resistance. Here it was examined if the small molecule adiponectin receptor agonist AdipoRon mimicked the effect of adiponectin to attenuate palmitate induced reactive oxygen species (ROS) production and cell death in L6 skeletal muscle cells.MethodsL6 cells were treated ±0.1 mM PA, and ± AdipoRon, then assays analyzing reactive oxygen species (ROS) production and cell death, and intracellular and extracellular levels of sphingosine-1 phosphate (S1P) were conducted. To determine the mechanistic role of S1P gain (using exogenous S1P or using THI) or loss of function (using the SKI-II) were conducted.ResultsUsing both CellROX and DCFDA assays it was found that AdipoRon reduced palmitate-induced ROS production. Image-IT DEAD, MTT and LDH assays all indicated that AdipoRon reduced palmitate-induced cell death. Palmitate significantly increased intracellular accumulation of S1P, whereas in the presence of AdipoRon there was increased release of S1P from cells to extracellular medium. It was also observed that direct addition of extracellular S1P prevented palmitate-induced ROS production and cell death, indicating that S1P is acting in an autocrine manner. Pharmacological approaches to enhance or decrease S1P levels indicated that accumulation of intracellular S1P correlated with enhanced cell death.ConclusionThis data indicates that increased extracellular levels of S1P in response to adiponectin receptor activation can activate S1P receptor-mediated signaling to attenuate lipotoxic cell death. Taken together these findings represent a possible novel mechanism for the protective action of adiponectin.