bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for cholesterol polyp formation in the gallbladder are closely related to lipid metabolism
Authors: Yu Zhihao , Yang Changlin , Bai Xuesong , Yao Guibin , Qian Xia , Gao Wei , Huang Yue , Tian Xiaodong , Cheng Shi , Zheng Yamin 
Published: March 2021

Abstract
Background
The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder.

Methods
This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups.

Results
A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037).

Conclusions
Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.
Prevalence of mental health problems in frontline healthcare workers after the first outbreak of COVID-19 in China: a cross-sectional study
Authors: Guo Wen-Ping , Min Qing , Gu Wei-Wei , Yu Liang , Xiao Xiao , Yi Wei-Bing , Li Hong-Liang , Huang Bei , Li Jun-Li , Dai Ya-Jun , Xia Jian , Liu Jie , Li Bei , Zhou Ben-Hong , Li Minglun , Xu Hong-Xi , Wang Xuan-Bin , Shi Wen-Yuan 
Published: March 2021

Abstract
Background
More than 210,000 medical workers have fought against the outbreak of Coronavirus Disease 2019 (COVID-19) in Hubei in China since December 2019. However, the prevalence of mental health problems in frontline medical staff after fighting COVID-19 is still unknown.

Methods
Medical workers in Wuhan and other cities in Hubei Province were invited to participate a cross-sectional and convenience sampling online survey, which assessed the prevalence of anxiety, insomnia, depression, and post-traumatic stress disorder (PTSD).

Results
A total of 1,091 responses (33% male and 67% female) were valid for statistical analysis. The prevalence was anxiety 53%, insomnia 79%, depression 56%, and PTSD 11%. Healthcare workers in Wuhan were more likely to face risks of anxiety (56% vs. 52%, P = 0.03) and PTSD (15% vs. 9%, P = 0.03) than those in other cities of Hubei. In terms of educational attainment, those with doctoral and masters’ (D/M) degrees may experience more anxiety (median of 7.0, [interquartile range (IQR) 2.0–8.5] vs. median 5.0 [IQR 5.0–8.0], P = 0.02) and PTSD (median 26.0 [IQR 19.5–33.0] vs. median 23.0 [IQR 19.0–31.0], P = 0.04) than those with lower educational degrees.

Conclusions
The mental problems were an important issue for the healthcare workers after COVID-19. Thus, an early intervention on such mental problems is necessary for healthcare workers.
Effect and safety of intraoperative intraperitoneal chemotherapy on patients suffering from colorectal cancer
Authors: Shang An , Wang Shuang , Yang Yongping , Li Liping , Zhao Zeyun , Li Donglin , Guo Yu , Wang Min 
Published: March 2021

Abstract
Background
Colorectal cancer (CRC), the third most commonly diagnosed malignant carcinoma and the third most common cause of carcinoma-related mortality, continues to be a major international health problem. And approximately 33% of patients suffer from recurrence after radical surgery. Free malignant cell implanting in the peritoneum is generally accepted as one of the main reasons of such outcome. We did this present clinical study with the aim of evaluating the effects and safety of intraoperative intraperitoneal chemotherapy (IOC) on patients suffering from colorectal cancer, with hoping to find a novel, effective, and available approach to deal with malignant cell implanting during surgeries.

Methods
In total, 391 patients who went through colorectal radical surgery were considered eligible between June 1, 2017, and December 31, 2018. 220 patients were treated with surgery without IOC, while other 171 patients received surgery plus IOC. Clinical characteristics, operative findings, postoperative short-term outcomes, disease-free survival (DFS), and overall survival (OS) were compared between these above 2 groups in the selected population.

Result
The present research included 391 patients (251 men and 140 women) who underwent surgery without IOC (n = 171) or surgery plus IOC (n = 220), with a mean (SD) age of 60.4 (9.7) years in the surgery without IOC group and 60.6 (8.7) in the surgery plus IOC group (P=.85). No significant differences were witnessed between the two groups in surgery-related information and postoperative complications. It is worth noting that IOC independent of other factors was associated with a favor prognosis in CRC patients with stage II/III (HR 0.50, 95%CI 0.30–0.82, P=.006). Moreover, for patients with stage II colorectal carcinoma, DFS did not differ between two groups (P=.553, Kaplan-Meier log-rank), and OS was no exception. In stage III CRC patients, the estimated DFS rate for patients receiving IOC was 82.2% and patients without IOC was 66.4% after 3 years, which demonstrated that IOC was associated with a favorable prognosis in stage III patients (P=.012, Kaplan-Meier log-rank). Furthermore, the differences were still remained between the two groups when considering the influence about postoperative chemotherapy (P=.014, Kaplan-Meier log-rank). IOC can also significantly improve patients’ overall survival whether they get treatment with POC (P=.006, Kaplan-Meier log-rank; P=.025, Kaplan-Meier log-rank).

Conclusions
In the present study, we have found that surgery plus IOC generated a favorable prognosis for stage III CRC patients but not stage II without any side-effects when the dosage of lobaplatin was 0.1g/L. As a new, safe, and simple procedure, IOC therapy is easily performed—and does not require any special devices or techniques. Thus, IOC is a promising and exciting therapeutic strategy for patients with CRC.
Mechanisms of scaling up: combining a realist perspective and systems analysis to understand successfully scaled interventions
Authors: Koorts Harriet , Cassar Samuel , Salmon Jo , Lawrence Mark , Salmon Paul , Dorling Henry 
Published: March 2021

AbstractBackgroundSustainable shifts in population behaviours require system-level implementation and embeddedness of large-scale health interventions. This paper aims to understand how different contexts of scaling up interventions affect mechanisms to produce intended and unintended scale up outcomes.MethodsA mixed method study combining a realist perspective and systems analysis (causal loop diagrams) of scaled-up physical activity and/or nutrition interventions implemented at a state/national level in Australia (2010–18). The study involved four distinct phases:Phase 1expert consultation, database and grey literature searches to identify scaled-up interventions;Phase 2generating initial Context-Mechanism-Outcome configurations (CMOs) from the WHO ExpandNet framework for scaling up;Phase 3testing and refining CMOs via online surveys and realist interviews with academics, government and non-government organisations (NGOs) involved in scale up of selected interventions (Phase 1); andPhase 4generating cross-case mid-range theories represented in systems models of scaling up; validated by member checking. Descriptive statistics were reported for online survey data and realist analysis for interview data.ResultsSeven interventions were analysed, targeting nutrition (n = 1), physical activity (n = 1), or a combination (n = 5). Twenty-six participants completed surveys; 19 completed interviews. Sixty-three CMO pathways underpinned successful scale up, reflecting 36 scale up contexts, 8 key outcomes; linked via 53 commonly occurring mechanisms. All five WHO framework domains were represented in the systems models. Most CMO pathways included ‘intervention attributes’ and led to outcomes ‘community sustainability/embeddedness’ and ‘stakeholder buy-in/perceived value’. Irrespective of interventions being scaled in similar contexts (e.g., having political favourability); mechanisms still led to both intended and unintended scale up outcomes (e.g., increased or reduced sustainability).ConclusionThis paper provides the first evidence for mechanisms underpinning outcomes required for successful scale up of state or nationally delivered interventions. Our findings challenge current prerequisites for effective scaling suggesting other conditions may be necessary. Future scale up approaches that plan for complexity and encourage iterative adaptation throughout, may enhance scale up outcomes. Current linear, context-to-outcome depictions of scale up oversimplify what is a clearly a complex interaction between perceptions, worldviews and goals of those involved. Mechanisms identified in this study could potentially be leveraged during future scale up efforts, to positively influence intervention scalability and sustainability.
Parental control and support for physical activity predict adolescents’ moderate to vigorous physical activity over five years
Authors: Doggui Radhouene , Gallant François , Bélanger Mathieu 
Published: March 2021

Abstract
Background
Social factors are important determinants of youth physical activity (PA), but the longitudinal association between parental behaviours and adolescent PA has not been clearly assessed. This prospective study examined average and lagged associations between perceived parental support and control with adolescents’ moderate to vigorous PA (MVPA); and assessed the independent associations between specific parental support and control behaviours and adolescents’ MVPA.

Methods
Data from three cycles of the MATCH study, when 374 participants were 12, 16 and 17 years old, were included in this analysis. At each cycle, participants self-reported questionnaires on perceived tangible parental support, intangible support, and control behaviours as well as number of days per week attaining at least 60 min of MVPA. Mixed effect models were used to assess the longitudinal relationship between parental behaviours and MVPA. Cross-lagged panel design was used to assess the association of parental behaviours during early adolescence with MVPA during late adolescence.

Results
Overall parental support (coef. = 0.46, P < 0.0001), tangible support (coef. = 0.37, P < 0.0001), encouragement (coef. = 0.12, P = 0.025) and transportation (coef. = 0.25, P < 0.0001) were positively associated with MVPA, whereas parental control was a negative predictor of MVPA (coef. = − 0.18, P = 0.003). Perceived parental behaviours appeared to have long term associations (5 y.) with MVPA as parent support (coef. = 0.40, P = 0.006) and co-participation (coef. = 0.33, P = 0.017) reported around age 12 were positively associated with MVPA measured 5 years later.

Conclusions
Parental support for PA, particularly in the form of tangible support, may be a key factor to include in interventions aiming to promote PA during adolescence. In contrast, parents should be encouraged to avoid control behaviours as these appear to lead to lower MVPA among adolescents.
Poor physical activity levels and cardiorespiratory fitness among patients with childhood-onset takayasu arteritis in remission: a cross‐sectional, multicenter study
Authors: Astley Camilla , Gil Saulo , Clemente Gleice , Terreri Maria Teresa , Silva Clovis Artur , Campos Lucia Maria Arruda , Aikawa Nadia Emi , de Sá Pinto Ana Lúcia , Pereira Rosa Maria R. , Roschel Hamilton , Gualano Bruno 
Published: March 2021

Abstract
Background
It is currently unknown whether patients with childhood-onset Takayasu disease (c-TA) are prone to physical inactivity and poor aerobic capacity. In this study, we assessed physical activity levels and cardiorespiratory fitness along with health-related quality of life (HRQL) and various traditional and non-traditional risk factors in patients with c-TA vs. healthy controls.

Methods
c-TA patients with non-active disease (n = 17) and age- and sex-matched healthy controls (n = 17) were enrolled in the study. We assessed physical activity levels, aerobic capacity, body composition, systemic inflammation, cardiometabolic markers, disease-related parameters, and HRQL.

Results
c-TA patients showed greater time spent in sedentary behavior (P = 0.010), and lower moderate-to-vigorous physical activity (P > 0.001) and lower step counts per day (P > 0.001). VO2peak (P < 0.001) and chronotropic response (P = 0.016) were significantly lower in patients with c-TA and they had worse HRQL in physical domain (P < 0.001), lower bone mineral content and density, and higher insulin levels vs. healthy controls (all P ≤ 0.05).

Conclusions
c-TA patients exhibited reduced physical activity levels and aerobic capacity, worse cardiometabolic risk factors and HRQL parameter compared with healthy peers. Physical inactivity and aerobic deconditioning emerge as potentially novel risk factors for c-TA. The role of physical activity interventions in preventing poor outcomes and improving HRQL in c-TA remains to be explored.
Optimizing the design of a contraceptive microarray patch: a discrete choice experiment on women’s preferences in India and Nigeria
Authors: Callahan Rebecca L. , Brunie Aurélie , Lebrun Victoria , Chen Mario , Godwin Christine L. , Lakhwani Kanchan , OlaOlorun Funmilola M. 
Published: March 2021

Abstract
Background
Efforts are underway to develop an easy-to-use contraceptive microarray patch (MAP) that could expand the range of self-administrable methods. This paper presents results from a discrete choice experiment (DCE) designed to support optimal product design.

Methods
We conducted a DCE survey of users and non-users of contraception in New Delhi, India (496 women) and Ibadan, Nigeria (two versions with 530 and 416 women, respectively) to assess stated preferences for up to six potential product attributes: effect on menstruation, duration of effectiveness, application pain, location, rash after application, and patch size. We estimated Hierarchical Bayes coefficients (utilities) for each attribute level and ran simulations comparing women’s preferences for hypothetical MAPs with varying attribute combinations.

Results
The most important attributes of the MAP were potential for menstrual side effects (55% of preferences in India and 42% in Nigeria) and duration (13% of preferences in India and 24% in Nigeria). Women preferred a regular period over an irregular or no period, and a six-month duration to three or one month. Simulations show that the most ideal design would be a small patch, providing 6 months of protection, that would involve no pain on administration, result in a one-day rash, and be applied to the foot.

Conclusions
To the extent possible, MAP developers should consider method designs and formulations that limit menstrual side effects and provide more than one month of protection.
Virtual reality‐based assessment of cognitive‐locomotor interference in healthy young adults
Authors: Deblock-Bellamy Anne , Lamontagne Anouk , McFadyen Bradford J. , Ouellet Marie-Christine , Blanchette Andreanne K. 
Published: March 2021

Abstract
Background
A recent literature review emphasized the importance of assessing dual-task (DT) abilities with tasks that are representative of community ambulation. Assessing DT ability in real-life activities using standardized protocols remains difficult. Virtual reality (VR) may represent an interesting alternative enabling the exposure to different scenarios simulating community walking. To better understand dual-task abilities in everyday life activities, the aims of this study were (1) to assess locomotor and cognitive dual-task cost (DTC) during representative daily living activities, using VR, in healthy adults; and 2) to explore the influence of the nature and complexity of locomotor and cognitive tasks on DTC.

Methods
Fifteen healthy young adults (24.9 ± 2.7 years old, 8 women) were recruited to walk in a virtual 100 m shopping mall corridor, while remembering a 5-item list (DT condition), using an omnidirectional platform and a VR headset. Two levels of difficulty were proposed for the locomotor task (with vs. without virtual agent avoidance) and for the cognitive task (with vs. without items modification). These tasks were also performed in single task (ST) condition. Locomotor and cognitive DTC were measured by comparing performances in ST and DT conditions. Locomotor performance was characterized using walking speed, walking fluidity, and minimal distance between the participant and the virtual agent during avoidance. Cognitive performance was assessed with the number of items correctly recalled. Presence of DTC were determined with one-sample Wilcoxon signed-rank tests. To explore the influence of the tasks’ complexity and nature on DTC, a nonparametric two-way repeated measure ANOVA was performed.

Results
No locomotor interference was measured for any of the outcomes. A cognitive DTC of 6.67% was measured (p = .017) while participants performed simultaneously both complex locomotor and cognitive tasks. A significant interaction between locomotor task complexity and cognitive task nature (p = .002) was identified on cognitive DTC.

Conclusions
In challenging locomotor and cognitive conditions, healthy young adults present DTC in cognitive accuracy, which was influenced by the locomotor task complexity task and the cognitive task nature. A similar VR-based protocol might be used to investigate DT abilities in older adults and individuals with a stroke.
Towards the validation of high-throughput sequencing (HTS) for routine plant virus diagnostics: measurement of variation linked to HTS detection of citrus viruses and viroids
Authors: Bester Rachelle , Cook Glynnis , Breytenbach Johannes H. J. , Steyn Chanel , De Bruyn Rochelle , Maree Hans J. 
Published: March 2021

AbstractBackgroundHigh-throughput sequencing (HTS) has been applied successfully for virus and viroid discovery in many agricultural crops leading to the current drive to apply this technology in routine pathogen detection. The validation of HTS-based pathogen detection is therefore paramount.MethodsPlant infections were established by graft inoculating a suite of viruses and viroids from established sources for further study. Four plants (one healthy plant and three infected) were sampled in triplicate and total RNA was extracted using two different methods (CTAB extraction protocol and the Zymo Research Quick-RNA Plant Miniprep Kit) and sent for Illumina HTS. One replicate sample of each plant for each RNA extraction method was also sent for HTS on an Ion Torrent platform. The data were evaluated for biological and technical variation focussing on RNA extraction method, platform used and bioinformatic analysis.ResultsThe study evaluated the influence of different HTS protocols on the sensitivity, specificity and repeatability of HTS as a detection tool. Both extraction methods and sequencing platforms resulted in significant differences between the data sets. Using a de novo assembly approach, complemented with read mapping, the Illumina data allowed a greater proportion of the expected pathogen scaffolds to be inferred, and an accurate virome profile was constructed. The complete virome profile was also constructed using the Ion Torrent data but analyses showed that more sequencing depth is required to be comparative to the Illumina protocol and produce consistent results. The CTAB extraction protocol lowered the proportion of viroid sequences recovered with HTS, and the Zymo Research kit resulted in more variation in the read counts obtained per pathogen sequence. The expression profiles of reference genes were also investigated to assess the suitability of these genes as internal controls to allow for the comparison between samples across different protocols.ConclusionsThis study highlights the need to measure the level of variation that can arise from the different variables of an HTS protocol, from sample preparation to data analysis. HTS is more comprehensive than any assay previously used, but with the necessary validations and standard operating procedures, the implementation of HTS as part of routine pathogen screening practices is possible.
A longitudinal study of mental health before and during COVID-19 lockdown in the French population
Authors: Ramiz Leila , Contrand Benjamin , Rojas Castro Madelyn Yiseth , Dupuy Marion , Lu Li , Sztal-Kutas Catherine , Lagarde Emmanuel 
Published: March 2021

Abstract
Background
The impact of general population lockdown implemented in the face of the COVID-19 epidemic needs to be evaluated. We describe here a longitudinal study on the mental health of adults in France.

Methods
We did a secondary analysis of a web-based cohort, initially set up to study home and leisure injuries, in order to measure the consequences of the national lockdown implemented in France from 17 March 2020 to 11 May 2020, and to assess potential vulnerability and resilience factors. Eligible participants were invited to answer an online questionnaire designed to assess their living conditions and health during lockdown. Comparisons were done with answers provided 4.8 years earlier on average.

Results
On 15th April 2020, we sent email invitations to 9598 participants recruited between November 2014 and December 2019 and 1237 volunteers took part in the study by completing the online questionnaire. The proportion of those with anxiety symptoms markedly increased from 17.3 to 20.1%. The average self-rated level of mental health decreased from 7.77 to 7.58. Women, the elderly and the youngest appeared to be more vulnerable. A small living space (less than 30 m2) was associated with an increase in depression symptoms (PHQ-9 score), and poorer self-rated physical health at recruitment was associated with an increase in anxiety symptoms (GAD-7 score). On the contrary, the average self-rated level of physical health markedly increased from 7.44 to 7.94 between recruitment and lockdown, and the proportion of those who reported a level of 9 or 10 jumped from 25.7% at recruitment to 43.1% during lockdown.

Conclusions
Mental health deteriorated during lockdown in France during the 2020 COVID-19 crisis. Overall, self-rated physical health improved but those who experienced a worse physical health were more likely to report anxiety symptoms.