bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential impacts of ridesharing on alcohol-related crashes by socioeconomic municipalities: rate of technology adoption matters
Authors: Blazquez Carola , Laurent José Guillermo Cedeño , Nazif-Munoz José Ignacio 
Published: November 2021

Abstract
Background
An emergent group of studies have examined the extent under which ridesharing may decrease alcohol-related crashes in countries such as United States, United Kingdom, Brazil, and Chile. Virtually all existent studies have assumed that ridesharing is equally distributed across socioeconomic groups, potentially masking differences across them. We contribute to this literature by studying how socioeconomic status at the municipal level impacts Uber’s effect on alcohol-related crashes.

Methods
We use data provided by Chile’s Road Safety Commission considering all alcohol-related crashes, and fatal and severe alcohol-related injuries that occurred between January 2013 and September 2013 (before Uber) and January and September 2014 (with Uber) in Santiago. We first apply spatial autocorrelation techniques to examine the level of spatial dependence between the location of alcohol-related crashes with and without Uber. We then apply random-effects meta-analysis to obtain risk ratios of alcohol-related crashes by considering socioeconomic municipality differences before and after the introduction of Uber.

Results
In both analyses, we find that the first 9 months of Uber in Santiago is associated with significant rate ratio decreases (RR = 0.71 [95% Confidence Interval (C.I.) 0.56, 0.89]) in high socioeconomic municipalities in all alcohol-related crashes and null (RR = 1.10 [95% C.I. 0.97, 1.23]) increases in low socioeconomic municipalities. No concomitant associations were observed in fatal alcohol-related crashes regardless of the socioeconomic municipality group.

Conclusions
One interpretation for the decline in alcohol-related crashes in high socioeconomic municipalities is that Uber may be a substitute form of transport for those individuals who have access to credit cards, and thus, could afford to pay for this service at the time they have consumed alcohol. Slight increases of alcohol-related crashes in low socioeconomic municipalities should be studied further since this could be related to different phenomena such as increases in alcohol sales and consumption, less access to the provision of public transport services in these jurisdictions, or biases in police reports.
Parental support and monitoring as associated with adolescent alcohol and tobacco use by gender and age
Authors: Mills Rosalina , Mann Michael J. , Smith Megan L. , Kristjansson Alfgeir L. 
Published: November 2021

Abstract
Background
Parental support (PS) and parental monitoring (PM) are known protective factors against adolescent substance use (SU). However, little is known about whether PS and PM may affect SU outcomes differently by gender and age. This study examined the relationship between PS and PM and adolescent SU, specifically alcohol and tobacco use, stratified by gender and age group.

Methods
Middle and high school students (n = 2351, 48.5% Female) completed surveys of self-reported SU, perceived PS and PM, and socioeconomic background. Age group was defined dichotomously as grade 7–8 Middle school and grade 9–10 High school students. PS and PM were each measured using previously validated tools. SU was measured by lifetime and past 30 days cigarette/alcohol use. One-way ANOVA and binary logistic regression models were completed. Odds ratios and means were reported.

Results
PS and PM were significantly and negatively related to all outcome variables regardless of gender and age group. Mean differences in PS and PM were insignificant between age groups. Between genders, PM scores were significantly higher for girls (14.05) compared to boys (13.48) (p < 0.01). Odds Ratios of all four SU types (for alcohol and tobacco use) increased with higher age group, with ORs ranging from 1.45–2.61 (p < .05).

Conclusions
PS and PM were protective against SU for all participants, consistent with previous literature. Girls reported greater parental monitoring than boys, irrespective of age-group. While girls experienced higher levels of monitoring, they did not report lower SU than boys. This suggests that monitoring girls more closely than boys appears unnecessary in preventing adolescent SU. Finally, PS was a more significant factor in preventing SU for older adolescents (high school aged group) than for younger adolescents, irrespective of gender suggesting that PS may be more impactful and important as adolescents age. As children mature, particularly from middle school to high school, PS may play a larger role in preventing SU for older adolescents compared to younger ones.
Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
Authors: Lu Yueh-Hsiu , Lin Hsi-Hsien , Chen Hsuan-Ying , Chou Po-Hsin , Wang Shih-Tien , Liu Chien-Lin , Chang Ming-Chau 
Published: November 2021

Abstract
Background
Involvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease. Only few cases of this condition have been reported. We revealed eighteen cases of CPPD in cervical ligamentum flavum that diagnosed at a single medical center. In our case series, clinical characteristics and magnetic resonance imaging findings of patients are described.

Methods
We retrospectively reviewed the medical charts and imaging studies of the eighteen patients with pseudogout attack of the cervical ligamentum flavum. In addition, we discussed the differences between this disease and ossification of ligamentum flavum in image manifestations.

Results
There were fourteen men and four women aged between 59 and 87 years. Diabetes mellitus and hypertension were the most common comorbidities. Myelopathy and neck pain were presented in most patients. C4–5 and C5–6 were attacked most frequently, and multiple- rather than single-level involvement could be observed in our series. “Acute on chronic phenomenon” was a specific magnetic resonance image finding in patients whose symptom durations were between 2 to 5 months. Compared to ossification of ligamentum flavum, calcium pyrophosphate dihydrate crystal deposition had different image signs, including morphology, side of the involved ligament, no continuity with the lamina, acute on chronic phenomenon, and presence of retro-odontoid mass.

Conclusions
Nodular calcifications in cervical ligamentum flavum raise highly suspicion for calcium pyrophosphate dihydrate deposition and must be diagnosed by histological examination and polarized light microscopy. This disease is different from ossification of ligamentum flavum, and it could be recognized by specific image features.
Persistent hypercalcemia with similar familial Hypocalciuric hypercalcemia features: a case report and literature review
Authors: Zahedi Maryam , Hizomi Arani Reyhane , Rafati Maryam , Amouzegar Atieh , Hadaegh Farzad 
Published: November 2021

Abstract
Background
Primary hyperparathyroidism (PHPT) and familial hypocalciuric hypercalcemia (FHH) are the most important differential diagnosis of parathyroid hormone (PTH)-dependent hypercalcemia. The clinical features of FHH and PHPT can overlap in some cases. Therefore, these two diseases must be differentiated to prevent unnecessary parathyroidectomy. Here, we present a case that was not entirely matched with any of the known differential diagnoses of hypercalcemia.

Case presentation
A 19-year-old girl with no history of any disease presented with persistent hypercalcemia without any specific musculoskeletal complaint. We found persistent hypercalcemia in her routine laboratory data from 3 years ago; while no data was available during the childhood period. Her dietary calcium intake was normal. She did not mention any history of renal stone, bone fracture as well as family history of hypercalcemia. Biochemical features showed normal values of serum creatinine, high normal serum calcium (range, 10.3–11.3 mg/dL; (normal range: 8.8–10.4)), and non-suppressed PTH levels (range, 37.2–58.1 pg/mL; (normal range: 10–65)). Serum 25 OH vitamin D level at the first visit was 16.1 ng/mL that treated by vitamin D supplementation. Since then, all 25 OH vitamin D levels were in the acceptable range. After correction of vitamin D deficiency during the follow-up period the calcium creatinine clearance ratio(s) (CCCR) were calculated in the range of 0.009 to 0.014 (means below 1%). The clinical and laboratory data indicate more FHH rather than PHPT. Genetic studies were negative for the common genes associated with FHH (CASR, GNA11, and AP2S1 genes) and multiple endocrine neoplasia type1 (MEN1). On the other hand, no evidence of autoimmunity was found in her to support an autoimmune FHH-like syndrome. Hence, the case did not match completely to any diagnosis of FHH and PHPT, so we decided to follow her.

Conclusion
We presented a patient with FHH phenotype whose common genetic tests were negative. Further research is needed to ascertain other causes leading to similar manifestations.
How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England
Authors: Bu Feifei , Fancourt Daisy 
Published: November 2021

Abstract
Background
There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department.

Methods
Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable.

Results
Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission.

Conclusions
This study has provided strong empirical evidence from England linking patient activation with healthcare service utilisation. It suggests the value of supporting patient activation as a potential pathway to ease the burden of healthcare system.
Contextual factors and mechanisms that influence sustainability: a realist evaluation of two scaled, multi-component interventions
Authors: Flynn Rachel , Mrklas Kelly , Campbell Alyson , Wasylak Tracy , Scott Shannon D. 
Published: November 2021

Abstract
Background
In 2012, Alberta Health Services created Strategic Clinical NetworksTM (SCNs) to develop and implement evidence-informed, clinician-led and team-delivered health system improvement in Alberta, Canada. SCNs have had several provincial successes in improving health outcomes. Little research has been done on the sustainability of these evidence-based implementation efforts.

Methods
We conducted a qualitative realist evaluation using a case study approach to identify and explain the contextual factors and mechanisms perceived to influence the sustainability of two provincial SCN evidence-based interventions, a delirium intervention for Critical Care and an Appropriate Use of Antipsychotics (AUA) intervention for Senior’s Health. The context (C) + mechanism (M) = outcome (O) configurations (CMOcs) heuristic guided our research.

Results
We conducted thirty realist interviews in two cases and found four important strategies that facilitated sustainability: Learning collaboratives, audit & feedback, the informal leadership role, and patient stories. These strategies triggered certain mechanisms such as sense-making, understanding value and impact of the intervention, empowerment, and motivation that increased the likelihood of sustainability. For example, informal leaders were often hands-on and influential to front-line staff. Learning collaboratives broke down professional and organizational silos and encouraged collective sharing and learning, motivating participants to continue with the intervention. Continual audit-feedback interventions motivated participants to want to perform and improve on a long-term basis, increasing the likelihood of sustainability of the two multi-component interventions. Patient stories demonstrated the interventions’ impact on patient outcomes, motivating staff to want to continue doing the intervention, and increasing the likelihood of its sustainability.

Conclusions
This research contributes to the field of implementation science, providing evidence on key strategies for sustainability and the underlying causal mechanisms of these strategies that increases the likelihood of sustainability. Identifying causal mechanisms provides evidence on the processes by which implementation strategies operate and lead to sustainability. Future work is needed to evaluate the impact of informal leadership, learning collaboratives, audit-feedback, and patient stories as strategies for sustainability, to generate better guidance on planning sustainable improvements with long term impact.
Rifaximin-mediated gut microbiota regulation modulates the function of microglia and protects against CUMS-induced depression-like behaviors in adolescent rat
Authors: Li Haonan , Xiang Yujiao , Zhu Zemeng , Wang Wei , Jiang Zhijun , Zhao Mingyue , Cheng Shuyue , Pan Fang , Liu Dexiang , Ho Roger C. M. , Ho Cyrus S. H. 
Published: November 2021

Abstract
Background
Chronic unpredictable mild stress (CUMS) can not only lead to depression-like behavior but also change the composition of the gut microbiome. Regulating the gut microbiome can have an antidepressant effect, but the mechanism by which it improves depressive symptoms is not clear. Short-chain fatty acids (SCFAs) are small molecular compounds produced by the fermentation of non-digestible carbohydrates. SFCAs are ubiquitous in intestinal endocrine and immune cells, making them important mediators of gut microbiome-regulated body functions. The balance between the pro- and anti-inflammatory microglia plays an important role in the occurrence and treatment of depression caused by chronic stress. Non-absorbable antibiotic rifaximin can regulate the structure of the gut microbiome. We hypothesized that rifaximin protects against stress-induced inflammation and depression-like behaviors by regulating the abundance of fecal microbial metabolites and the microglial functions.

Methods
We administered 150 mg/kg rifaximin intragastrically to rats exposed to CUMS for 4 weeks and investigated the composition of the fecal microbiome, the content of short-chain fatty acids in the serum and brain, the functional profiles of microglia and hippocampal neurogenesis.

Results
Our results show that rifaximin ameliorated depressive-like behavior induced by CUMS, as reflected by sucrose preference, the open field test and the Morris water maze. Rifaximin increased the relative abundance of Ruminococcaceae and Lachnospiraceae, which were significantly positively correlated with the high level of butyrate in the brain. Rifaximin increased the content of anti-inflammatory factors released by microglia, and prevented the neurogenic abnormalities caused by CUMS.

Conclusions
These results suggest that rifaximin can regulate the inflammatory function of microglia and play a protective role in pubertal neurodevelopment during CUMS by regulating the gut microbiome and short-chain fatty acids.
Using individual networks to identify treatment targets for eating disorder treatment: a proof-of-concept study and initial data
Authors: Levinson Cheri A. , Hunt Rowan A. , Keshishian Ani C. , Brown Mackenzie L. , Vanzhula Irina , Christian Caroline , Brosof Leigh C. , Williams Brenna M. 
Published: November 2021

Abstract
Background
Eating disorders (EDs) are severe mental illnesses, with high morbidity, mortality, and societal burden. EDs are extremely heterogenous, and only 50% of patients currently respond to first-line treatments. Personalized and effective treatments for EDs are drastically needed.

Methods
The current study (N = 34 participants with an ED diagnosis collected throughout the United States) aimed to investigate best methods informing how to select personalized treatment targets utilizing idiographic network analysis, which could then be used for evidence based personalized treatment development. We present initial data collected via experience sampling (i.e., ecological momentary assessment) over the course of 15 days, 5 times a day (75 total measurement points) that were used to select treatment targets for a personalized treatment for EDs.

Results
Overall, we found that treatment targets were highly variable, with less than 50% of individuals endorsing central symptoms related to weight and shape, consistent with current treatment response rates for treatments designed to target those symptoms. We also found that different aspects of selection methods (e.g., number of items, type of centrality measure) impacted treatment target selection.

Conclusions
We discuss implications of these data, how to use idiographic network analysis to personalize treatment, and identify areas that need future research.
Trial registration: Clinicaltrials.gov, NCT04183894. Registered 3 December 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04183894. NCT04183894 (ClinicalTrials.gov identifier).
COVID-19’s impact on neglected pharmaceutical staff: wake-up call for needed research
Authors: Powell Richard Antony , Lakhani Shivali , Alter Marsha , Guan Steven , Jesuthasan Jehanita , Nicholls Dasha 
Published: November 2021

AbstractDiscussion of the necessity of the compulsory vaccination of UK patient-facing care workers as an employment conditionality has deflected from the initial and ongoing impact of Coronavirus disease on relatively neglected occupational groups themselves, including community pharmacists. This commentary highlights the relative lack of research investigating the mental health and wellbeing impact of the pandemic on this occupational group in England and urges further study of their needs and experiences to inform evidence-based supportive psychological interventions.
Movers and stayers in STEM enrollment in Italy: who performs better?
Authors: D’Agostino Antonella , Ghellini Giulio , Lombardi Gabriele 
Published: November 2021

AbstractRecently, the mobility behavior of Italian university students has garnered increasing interest from both social scientists and politicians. The very particular geographical characteristics of the country, together with the recognized persistence of a significant economic gap between the southern and northern regions, drive a large number of students to move from the first macro-region to the latter. As this phenomenon has several economic and social implications for policy-makers—at both central and local levels—it has led to various theories and prejudices. The present article will study the differences between the performance of STEM students who have decided to move from the south to the north and those who have decided to stay close to their hometowns. We devised multilevel modelling techniques to analyze this issue using administrative microdata from the Italian Ministry for Universities and Research (MUR), including eight cohorts of students from AY 2008–2009 to AY 2015–16, who enrolled in STEM fields after earning their high school diploma. One of the main findings is that individuals who moved from the south show lower levels of performance than their stayer counterparts who are enrolled in northern or central universities.
Mitochondrial DNA haplogroup study: residents of Sulaymaniyah city in the Iraqi Kurdistan Region may be genetically closer to European lineage
Authors: Fadhl Han Nihad Mohammed , Mohammed Shad Arif , Abdulkarim Farhad M. 
Published: November 2021

Abstract
Background
Being the native inhabitants of the Neolithic Fertile Crescent, Kurds were included in several maternal lineage studies concerning the Eurasian population. However, no study was performed on the Kurdish population of Sulaymaniyah city (latitude 33.314690 and longitude 44.376759). This study was carried out on a sample of Sorani Kurds living in Sulaymaniyah for the identification of population-related single nucleotide polymorphisms (SNPs) and modes of maternal lineage.

Results
In this study, 36 randomly selected healthy unrelated Kurdish subjects were enrolled. Whole mitochondrial DNA sequencing was performed. HaploGrep 2.0 and neutrality test (Tajima’s D) were employed for haplogroup identification and historical demography determination. When the outcomes were compared with previous studies in Kurds and the neighbouring nations, the identified haplogroups in the sample of study were members of the Western Eurasian haplogroups with a predominance of haplogroup H.

Conclusions
The whole mitochondrial DNA sequence is superior to the traditional analysis of the non-coding (control) region. Our study indicates a stronger relation of the studied group to the European lineage than to their neighbouring nations.