bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis B virus infection among men who have sex with men and transgender women living with or at risk for HIV: a cross sectional study in Abuja and Lagos, Nigeria
Authors: Adeyemi Olusegun A. , Mitchell Andrew , Shutt Ashley , Crowell Trevor A. , Ndembi Nicaise , Kokogho Afoke , Ramadhani Habib O. , Robb Merlin L. , Baral Stefan D. , Ake Julie A. , Charurat Manhattan E. , Peel Sheila , Nowak Rebecca G. ,   on behalf of the TRUST/RV368 study group, Charurat Manhattan , Ake Julie , Abayomi Aka , Adebajo Sylvia , Baral Stefan , Crowell Trevor , Eluwa George , Gaydos Charlotte , Kokogho Afoke , Malia Jennifer , Makanjuela Olumide , Michael Nelson , Ndembi Nicaise , Nowak Rebecca , Olawore Oluwasolape , Parker Zahra , Peel Sheila , Ramadhani Habib , Robb Merlin , Rodriguez-Hart Cristina , Sanders-Buell Eric , Tovanabutra Sodsai , Vasan Sandhya 
Published: July 2021

Abstract
Background
Despite the development of a safe and efficacious hepatitis B vaccine in 1982, the hepatitis B virus (HBV) remains a public health burden in sub-Saharan Africa. Due to shared risk factors for virus acquisition, men who have sex with men (MSM) and transgender women (TGW) living with HIV are at increased risk of HBV. We estimated the prevalence of HBV and associated factors for MSM and TGW living with or without HIV in Nigeria.

Methods
Since March 2013, TRUST/RV368 has recruited MSM and TGW in Abuja and Lagos, Nigeria using respondent driven sampling. Participants with HIV diagnosis, enrollment as of June 2015, and available plasma were selected for a cross-sectional study and retrospectively tested for hepatitis B surface antigen and HBV DNA. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with prevalent HBV infection.

Results
A total of 717 MSM and TGW had a median age of 25 years (interquartile range [IQR]: 21–27), 5% self-reported HBV vaccination, 61% were living with HIV, 10% had prevalent HBV infection and 6% were HIV-HBV co-infected. HIV mono-infected as compared to HIV-HBV co-infected had a higher median CD4 T cell count [425 (IQR: 284–541) vs. 345 (IQR: 164–363) cells/mm3, p = 0.03] and a lower median HIV RNA viral load [4.2 (IQR: 2.3–4.9) vs. 4.7 (IQR: 3.9–5.4) log10copies/mL, p < 0.01]. The only factor independently associated with HBV was self-report of condomless sex at last anal intercourse (OR: 2.2, 95% CI: 1.3, 3.6). HIV infection was not independently associated with HBV (OR: 1.0, 95% CI: 0.7–1.6).

Conclusion
HBV prevalence was moderately high but did not differ by HIV in this cohort of MSM and TGW. Recent condomless sex was associated with elevated HBV risk, reinforcing the need to increase communication and education on condom use among key populations in Nigeria. Evaluating use of concurrent HIV antiretroviral therapy with anti-HBV activity may confirm the attenuated HBV prevalence for those living with HIV.
Chemotherapy in the treatment of different histological types of appendiceal cancers: a SEER based study
Authors: Wang Gang , Li Qiken , Chen Weiping 
Published: July 2021

Abstract
Background
Due to its rarity and high heterogeneity, neither established guidelines nor prospective data are currently available for using chemotherapy in the treatment of appendiceal cancer. This study was to determine the use of chemotherapy and its potential associations with survival in patients with different histological types of the cancer.

Methods
Patients with histologically different appendiceal cancers diagnosed during 1998–2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. The role and effect of chemotherapy were examined in the treatment of the disease. The Kaplan-Meier method was applied to construct survival curves and significance was examined by Log-rank test. Cox proportional hazard models were used to analyze the impact of chemotherapy and other variables on survival in these patients.

Results
A total of 8733 appendiceal cancer patients were identified from the database. Chemotherapy was administrated at highly variable rates in different histological types of appendiceal cancer. As high as 64.0% signet ring cell carcinoma (SRCC), 46.4% of mucinous adenocarcinomas (MAC), 40.6% of non-mucinous adenocarcinoma (NMAC) and 43.9% of mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) were treated with chemotherapy, whereas only 14.7% of goblet cell carcinoma (GCC), 5% neuroendocrine tumors (NETs) and 1.6% carcinomas (NEC) received chemotherapy. In all patients combined, chemotherapy significantly improved overall survival during the entire study period and cancer-specific survival was improved during in cases from 2012–2016. Further multivariate analysis showed that both cancer-specific and overall survival was significantly improved with chemotherapy in patients with MAC, NMAC and SRCC, but not for patients with GCC, MiNENs, NETs and NECs. Number (> 12) of lymph node sampled was associated with survival of patients with most histological types of cancer under study. Other prognostic factors related to individual histological types were identified.

Conclusions
Chemotherapy is administrated at highly variable rates in different histological types of appendiceal cancer. Efficacy of chemotherapy in the treatment of these cancers has been improved in recent years and is significantly associated with better survival for patients with NMAC, MAC, and SRCC. Adequate lymph node sampling may result in a survival benefit for most of these patients.
Molecular identification of an immunity- and Ferroptosis-related gene signature in non-small cell lung Cancer
Authors: Liu Taisheng , Luo Honglian , Zhang Jinye , Hu Xiaoshan , Zhang Jian 
Published: July 2021

Abstract
Background
Lung cancer is one of the dominant causes of cancer-related deaths worldwide. Ferroptosis, an iron-dependent form of programmed cell death, plays a key role in cancer immunotherapy. However, the role of immunity- and ferroptosis-related gene signatures in non-small cell lung cancer (NSCLC) remain unclear.

Methods
RNA-seq data and clinical information pertaining to NSCLC were collected from The Cancer Genome Atlas dataset. Univariate and multivariate Cox regression analyses were performed to identify ferroptosis-related genes. A receiver operating characteristic (ROC) model was established for sensitivity and specificity evaluation. Gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed to explore the function roles of differentially expressed genes.

Results
A signature composed of five ferroptosis-related genes was established to stratify patients into high- and low-risk subgroups. In comparison with patients in the low-risk group, those in the high-risk one showed significantly poor overall survival in the training and validation cohorts (P < 0.05). Multivariate Cox regression analysis indicated risk score to be an independent predictor of overall survival (P < 0.01). Further, the 1-, 2-, and 3-year ROCs were 0.623 vs. 0.792 vs. 0.635, 0.644 vs. 0.792 vs. 0.634, and 0.631 vs. 0.641 vs. 0.666 in one training and two validation cohorts, respectively. Functional analysis revealed that immune-related pathways were enriched and associated with abnormal activation of immune cells.

Conclusions
We identified five immunity- and ferroptosis-related genes that may be involved in NSCLC progression and prognosis. Targeting ferroptosis-related genes seems to be an alternative to clinical therapy for NSCLC.
Characterization of urinary cotinine concentrations among non-smoking adults in smoking and smoke-free homes in the Korean national environmental health survey (KoNEHS) cycle 3 (2015–2017)
Authors: Kim Jeonghoon , Shim In-Keun , Won Soo Ran , Ryu Jungmin , Lee Jongchun , Chung Hyen-Mi 
Published: July 2021

Abstract
Background
Although many indoor public places have implemented smoke-free regulations, private homes have remained sources of tobacco smoke pollutants. This study examined differences in urinary cotinine concentrations in the Korean non-smoking adult population between living in smoking and smoke-free homes, and the relationship of urinary cotinine concentrations with socio-demographic factors in smoke-free homes.

Methods
Samples from 2575 non-smoking adults (≥19 years old) in the Korean National Environmental Health Survey cycle 3 (2015–2017), a representative Korean study, were used. Smoking and smoke-free homes were defined based on whether there were smokers at homes. Weighted linear regression models were used to determine urinary cotinine concentrations and identify factors associated with urinary cotinine.

Results
The geometric mean of urinary cotinine concentrations for non-smoking adults living in smoking homes was 2.1 μg/L (95% confidence interval [CI] = 1.8–2.4), which was significantly higher than the mean of 1.3 μg/L (95% CI = 1.2–1.4) for those living in smoke-free homes. Urinary cotinine concentrations were different significantly by home smoking status in most socio-demographic subgroups. Data from smoke-free home showed urinary cotinine concentration in adults was significantly higher in those who lived in homes with ventilation duration < 30 min/day, those who spent more time indoors at home, those who spent less time outdoors, and those who worked in non-manual or manual occupations.

Conclusions
The urinary cotinine concentration in Korean non-smoking adults living in smoking homes was higher than that in adults living in smoke-free homes. Even in smoke-free homes, home-related factors, such as ventilation duration and time spent indoors, were associated with urinary cotinine concentration. Further study is warranted to examine potential sources of tobacco smoke pollution in smoke-free homes.
Associations of musculoskeletal disorders with occupational stress and mental health among coal miners in Xinjiang, China: a cross-sectional study
Authors: Li Xue , Yang Xu , Sun Xuemei , Xue Qiaoyun , Ma Xiaofan , Liu Jiwen 
Published: July 2021

AbstractBackgroundMusculoskeletal disorders (MSDs), a common type of occupational diseases, have become the main cause of absenteeism and early retirement in the occupational population, as well as a major risk factor for occupational disability. The purpose of this study was to investigate the effects of occupational stress and mental health on MSDs in coal miners in Xinjiang, China, to provide a theoretical basis for reducing the incidence of MSDs in coal miners and improving their physical and mental health.MethodsIn this study, stratified cluster random sampling was used to randomly select six coal mining companies in Xinjiang, and 1675 coal miners were surveyed by questionnaire. The status of occupational stress, mental health and MSDs among coal miners was investigated by means of the Effort–Reward Imbalance questionnaire (ERI), Symptom Checklist-90(SCL-90), and Musculoskeletal disorders scale (MSDs) questionnaire.ResultsThe prevalence of MSDs among coal miners was higher, and there were statistical differences among different sexes, ages, working years, shifts, types of work, educational level and monthly income (P < 0.001). The prevalence of MSDs in different body parts in the occupational stress group and mental disorder group was higher than that in the normal group. The results of multivariate logistic regression analysis showed that females had an increased risk of developing MSDs (OR = 2.23, 95%CI.:1.50,3.33). The risk of MSDs was higher with age < 30 years (30-39 years,OR = 2.39, 95%CI.,1.68,3.40; 40-49 years,OR = 2.15, 95%CI.:1.52,3.04; 50-60 years:OR = 3.25, 95%CI.:2.09,5.07), and the longer the working years, the higher the risk of MSDs (OR = 1.90, 95%CI.:1.38,2.62). The two shifts group (OR = 2.18, 95%CI.:1.59,2.98) had an increased risk of developing MSDs compared with the fixed day shift group. The risk of MSDs was lower in heading drivers (OR = 0.41, 95%CI.:0.29,0.60,) and transport workers (OR = 0.30, 95%CI.:0.20,0.43). The higher the education level, the lower the risk of MSDs (high school:OR = 0.46, 95%CI.:0.34,0.62, junior college and above:OR = 0.12, 95%CI.:0.08,0.17), and the higher the monthly income, the lower the risk of MSDs (OR = 0.50, 95%CI.:0.34,0.74). Occupational stress (OR = 1.32, 95%CI.:1.05,1.67) and mental disorder(OR = 2.94, 95%CI.:2.25,3.84) increased the risk of MSDs. A Bayesian network diagram showed that occupational stress and MSDs have direct effects on mental disorders, and occupational stress can have indirect effects on mental disorders through MSDs.ConclusionOur research shows that MSDs are common among coal miners. Occupational stress and psychological disorders can increase the incidence of MSDs.
Are all MVPA minutes equal? Associations between MVPA characteristics, independent of duration, and childhood adiposity
Authors: Miatke Aaron , Maher Carol , Fraysse François , Dumuid Dot , Olds Tim 
Published: July 2021

Abstract
Background
The inverse relationship between moderate-to-vigorous physical activity (MVPA) duration and childhood adiposity is well established. Less is known about how characteristics of MVPA accumulation may be associated with adiposity, independent of MVPA duration. This study aimed to investigate how the MVPA characteristics of children, other than duration (bout length, time of day, day-to-day consistency, intensity), were associated with adiposity.

Methods
Cross-sectional study of the Australian arm of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) (participants: n = 424, age range 9–11, 44% male). Adiposity was determined by percent body fat via bioelectrical impedance. MVPA duration and characteristics (bout length, time of day, consistency, intensity) were derived from 7-day, 24-h accelerometry. Generalised estimating equations were used to examine the individual and multivariate associations between MVPA characteristics and adiposity.

Results
Univariate analyses showed that higher MVPA duration (β range = − 0.26,-0.15), longer bouts of MVPA (β range = 0.15,0.22) and higher MVPA intensity (β range = − 0.20,-0.13) were all inversely associated with adiposity (all p < 0.05). When models were adjusted for MVPA duration, only MVPA intensity (β range = − 0.16,-0.04) showed consistent significant associations with adiposity.

Conclusions
Characteristics of MVPA other than duration and intensity appear to be unrelated to adiposity.
Mortality of major cardiovascular emergencies among patients admitted to hospitals on weekends as compared with weekdays in Taiwan
Authors: Lai Chao-Lun , Kuo Raymond Nien-Chen , Wang Ting-Chuan , Chan K. Arnold 
Published: July 2021

Abstract
Background
Several studies have found a so-called weekend effect that patients admitted at the weekends had worse clinical outcomes than patients admitted at the weekdays. We performed this retrospective cohort study to explore the weekend effect in four major cardiovascular emergencies in Taiwan.

Methods
The Taiwan National Health Insurance (NHI) claims database between 2005 and 2015 was used. We extracted 3811 incident cases of ruptured aortic aneurysm, 184,769 incident cases of acute myocardial infarction, 492,127 incident cases of ischemic stroke, and 15,033 incident cases of pulmonary embolism from 9,529,049 patients having at least one record of hospitalization in the NHI claims database within 2006 ~ 2014. Patients were classified as weekends or weekdays admission groups. Dates of in-hospital mortality and one-year mortality were obtained from the Taiwan National Death Registry.

Results
We found no difference in in-hospital mortality between weekend group and weekday group in patients with ruptured aortic aneurysm (45.4% vs 45.3%, adjusted odds ratio [OR] 1.01, 95% confidence interval [CI] 0.87–1.17, p = 0.93), patients with acute myocardial infarction (15.8% vs 16.2%, adjusted OR 0.98, 95% CI 0.95–1.00, p = 0.10), patients with ischemic stroke (4.1% vs 4.2%, adjusted OR 0.99, 95% CI 0.96–1.03, p = 0.71), and patients with pulmonary embolism (14.6% vs 14.6%, adjusted OR 1.02, 95% CI 0.92–1.15, p = 0.66). The results remained for 1 year in all the four major cardiovascular emergencies.

Conclusions
We found no difference in either short-term or long-term mortality between patients admitted on weekends and patients admitted on weekdays in four major cardiovascular emergencies in Taiwan.
The impact of audit and feedback to support change behaviour in healthcare organisations - a cross-sectional qualitative study of primary care centre managers
Authors: Glenngård Anna H. , Anell Anders 
Published: July 2021

AbstractBackgroundThis article addresses the role of audit and feedback (A&F) to support change behaviour and quality improvement work in healthcare organisations. It contributes to the sparse literature on primary care centre (PCC) managers´ views on A&F practices, taking into account the broad scope of primary care. The purpose was to explore if and how different types of A&F support change behaviour by influencing different forms of motivation and learning, and what contextual facilitators and barriers enable or obstruct change behaviour in primary care.MethodsA qualitative research approach was used. We explored views about the impact of A&F across managers of 27 PCCs, in five Swedish regions, through semi-structured interviews. A purposeful sampling was used to identify both regions and PCC managers, in order to explore multiple perspectives. We used the COM-B framework, which describes how Capability, Opportunity and Motivation interact and generate change behaviour and how different factors might act as facilitators or barriers, when collecting and analysing data.ResultsExisting forms of A&F were perceived as coercive top-down interventions to secure adherence to contractual obligations, financial targets and clinical guidelines. Support to bottom-up approaches and more complex change at team and organisational levels was perceived as limited. We identified five contextual factors that matter for the impact of A&F on change behaviour and quality improvement work: performance of organisations, continuity in staff, size of organisations, flexibility in leadership and management, and flexibility offered by the external environment.ConclusionsExternal A&F, perceived as coercive by recipients of feedback, can have an impact on change behaviour through ‘know-what’ and ‘know-why’ types of knowledge and ‘have-to’ commitment but provide limited support to complex change. ‘Want-to’ commitment and bottom-up driven processes are important for more complex change. Similar to previous research, identified facilitators and barriers of change consisted of factors that are difficult to influence by A&F activities. Future research is needed on how to ensure co-development of A&F models that are perceived as legitimate by health care professionals and useful to support more complex change.
A model for measuring healthcare accessibility using the behavior of demand: a conditional logit model-based floating catchment area method
Authors: Jang Hoon 
Published: July 2021

Abstract
Background
Estimating realistic access to health services is essential for designing support policies for healthcare delivery systems. Many studies have proposed a metric to calculate accessibility. However, patients’ realistic willingness to use a hospital was not explicitly considered. This study aims to derive a new type of potential accessibility that incorporates a patient’s realistic preference in selecting a hospital.

Methods
This study proposes a floating catchment area (FCA)-type metric combined with a discrete choice model. Specifically, a new FCA-type metric (clmFCA) was proposed using a conditional logit model. Such a model estimates patients’ realistic willingness to use health services. The proposed metric was then applied to calculate the accessibility of obstetric care services in Korea.

Results
The clmFCA takes advantage of patients’ realistic preferences. Specifically, it can represent each patient’s heterogeneous characteristics regarding hospital choice. Such characteristics include bypassing behavior, which could not be considered using prior FCA metrics. Empirical analysis reveals that the clmFCA avoids the misestimation of accessibility to health services to an extent.

Conclusions
The clmFCA offers a new framework that more realistically estimates patients’ accessibility to health services. This is achieved by accurately estimating the potential demand for a service. The proposed method’s effectiveness was verified through a case study using nationwide data.
The association between polymorphisms near TMEM18 and the risk of obesity: a meta-analysis
Authors: Koj Natalia , Grochowalski Łukasz , Jarczak Justyna , Wójtowicz Weronika , Sobalska-Kwapis Marta , Słomka Marcin , Marciniak Błażej , Strapagiel Dominik 
Published: July 2021

AbstractBackgroundMany studies have proposed that the pathogenesis of obesity has a genetic basis, with an important risk factor being the presence of polymorphisms in the region of theTMEM18gene, which plays a significant role in feeding behaviour; however, subsequent studies among different ethnic populations and age groups have shown inconsistent results. Therefore, this present meta-analysis examines the relationship betweenTMEM18polymorphisms with the risk of obesity with regard to age group and ethnic population.MethodsA literature database search was conducted for available relevant studies investigating the association between obesity risk and the presence of rs6548238, rs4854344, rs11127485, rs2867125 and rs7561317 polymorphisms inTMEM18. Pooled odds ratio (OR) and 95% confidence intervals (95% CI) were calculated by either a fixed-effects model or random effect model based on a heterogeneity test. The meta-analysis of rs6548238 and its surrogates examined the relationships between 53 395 obesity cases and 123 972 healthy controls from 27 studies and published data from the POPULOUS collection (Poland).ResultsA significant association is observed between rs6548238 (and surrogate) and obesity risk, with OR = 1.25 (95% CI: 1.08–1.45). Regarding population type, a significant association was revealed among groups of Europeans with OR = 1.32 (1.10–1.59) and Mexicans with OR = 1.39 (1.13–1.73). However, a lack of statistical significance was noticed in groups in Asia with OR = 1.11 (95% CI: 0.86–1.42). Regarding age, a significant association was observed among children with OR = 1.28 (95% CI: 1.18–1.39) but not in adults OR = 1.21 (95% CI: 0.92–1.58).ConclusionsThe polymorphisms nearTMEM18appear to play a role in the development of obesity. Our findings indicate that differences exist between ethnic populations and age groups, supporting those of a previous study showing the various effects of genetic factors on age and ethnic groups.