bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between gay app use and HIV testing among men who have sex with men in Shenzhen, China: a serial cross-sectional study
Authors: Wei Lan , Chen Lin , Zhang Haibo , Yang Zhengrong , Liu Shaochu , Tan Wei , Xie Wei , Liu Liegang , Zhao Jin , Cheng Jinquan 
Published: August 2019

ObjectivesTo investigate the relationship between gay app use and HIV testing among men who have sex with men (MSM).DesignSerial cross-sectional study.SettingA newly well-developed city in China.Participants4935 MSM were recruited through offline sampling methods from 2015 to 2017.Primary and secondary outcomesThe primary outcome is the difference in HIV testing between app and non-app users.Results2872 (58.2%) and 2159 (43.7%) participated MSM had been tested for HIV within lifetime and the past year, respectively. Compared with non-app-using MSM, app-using MSM had a significantly higher prevalence of HIV testing within lifetime (adjusted OR (AOR): 1.48, 95% CI 1.27 to 1.72) and the past year (AOR: 1.36, 95% CI 1.18 to 1.57). App-using MSM were more likely to take an HIV test at the Centers for Disease Control and Prevention (AOR: 1.48, 95% CI 1.24 to 1.76) and community-based organisations (AOR: 1.71, 95% CI 1.44 to 2.03), but less often at gay venues (AOR: 0.49, 95% CI 0.37 to 0.63). Meanwhile, app-using MSM were more likely to take self-testing (AOR: 1.61, 95% CI 1.21 to 2.14). Predictors of HIV testing in the past year were: having an education level of college or higher (AOR: 1.29, 95% CI 1.01 to 1.65), being self-identified as a homosexual (AOR: 1.23, 95% CI 1.02 to 1.46), being recruited through clinic-based sampling (AOR: 1.30, 95% CI 1.06 to 1.60), using gay app (AOR: 1.49, 95% CI 1.21 to 1.83), engaging in group sex (AOR: 1.64, 95% CI 1.23 to 2.19), having received HIV-related service (AOR: 5.49, 95% CI 4.57 to 6.60), having a high level of HIV-related knowledge (AOR: 1.33, 95% CI 1.10 to 1.61) and high-risk perception (AOR: 2.95, 95% CI 1.40 to 6.23).ConclusionsGay app use was significantly associated with increased HIV testing among MSM hard to reach by traditional outreach. Therefore, it is imperative to expand HIV testing among non-app-using MSM. Continued efforts, innovative strategies and increased resource are highly needed to realise the first ‘90’ target.
Media Coverage of the Benefits and Harms of Testing the Healthy: a protocol for a descriptive study
Authors: O'Keeffe Mary , Barratt Alexandra , Maher Christopher , Zadro Joshua , Fabbri Alice , Jones Mark , Moynihan Ray 
Published: August 2019

IntroductionMuch testing in medicine is aimed at healthy people to facilitate the early detection of health conditions. However, there is growing evidence that early detection is a double-edged sword that may cause harm in the form of overdiagnosis. The media can be seen as a major generator of consumer demand for health services. Previous research shows that media coverage tends to overstate the benefits and downplay the harms of medical interventions for the sick, and often fails to cover relevant conflicts of interest of those promoting those interventions. However, little is known about how the benefits and harms of testing the healthy are covered by media. This study will examine the media coverage of the benefits and harms of testing the healthy, and coverage of potential conflicts of interest of those promoting the testing.Methods and analysisWe will examine five tests: 3D mammography for the early detection of breast cancer; blood liquid biopsy for the early detection of cancer; blood biomarker tests for the early detection of dementia; artificial intelligence technology for the early detection of dementia; and the Apple Watch Series 4 electrocardiogram sensor for the early detection of atrial fibrillation. We will identify media coverage using Google News and the LexisNexis and ProQuest electronic databases. Sets of two independent reviewers will conduct story screening and coding. We will include English language media stories referring to any of the five tests from January 2016 to May 2019. We will include media stories if they refer to any benefits or harms of the test for our conditions of interest. Data will be analysed using categorical data analysis and multinomial logistic regression.Ethics and disseminationNo ethical approval is required for this study. Results will be presented at relevant scientific conferences and in peer-reviewed literature.
Access delays to essential surgical care using the Three Delays Framework and Bellwether procedures at Timor Leste’s national referral hospital
Authors: Bagguley Dominic , Fordyce Andrew , Guterres Jose , Soares Alito , Valadares Edgar , Guest Glenn Douglas , Watters David 
Published: August 2019

ObjectivesOur objectives were to characterise the nature and extent of delay times to essential surgical care in a developing nation by measuring the actual stages of delay for patients receiving Bellwether procedures.SettingThe study was conducted at Timor Leste’s national referral hospital in Dili, the country’s capital.ParticipantsAll patients requiring a Bellwether procedure over a 2-month period were included in the study. Participants whose procedure was undertaken more than 24 hours from initial hospital presentation were excluded.Primary and secondary outcome measuresData pertaining to the patient journey from onset of symptoms to emergency procedure was collected by interview of patients, their treating surgeons or anaesthetists and the medical records. Timelines were then calculated against the Three Delays Framework.ResultsFifty-six patients were entered into the study. Their mean delay from symptom onset to entering the anaesthesia bay for a procedure was 32.3 hours (+/-11.6). The second delay (4.1+/-2.5 hours) was significantly less than the first (20.9+/-11.5 hours; p<0.005) and third delays (7.2+/-1.2 hours; p<0.05). Additionally, patients with acute abdominal pain (of which 18/20 ultimately had open appendicectomy and two emergency laparotomies) had a delay time of 53.3 hours (+/-21.3), significantly more than that for emergency caesarean (22.9+/-18.6 hours; p<0.05) or management of an open long-bone fracture (15.5+/-5.56 hours; p<0.05).ConclusionsSubstantial delays were observed for all three stages and each Bellwether procedure. This study methodology could be used to measure access and the three delays to emergency surgical care in low/middle-income countries, although the actual reasons for delay may vary between regions and countries and would require a qualitative study.
A mixed-methods study of challenges experienced by clinical teams in measuring improvement
Authors: Woodcock Thomas , Liberati Elisa G , Dixon-Woods Mary 
Published: August 2019

ObjectiveMeasurement is an indispensable element of most quality improvement (QI) projects, but it is undertaken to variable standards. We aimed to characterise challenges faced by clinical teams in undertaking measurement in the context of a safety QI programme that encouraged local selection of measures.MethodsDrawing on an independent evaluation of a multisite improvement programme (Safer Clinical Systems), we combined a qualitative study of participating teams’ experiences and perceptions of measurement with expert review of measurement plans and analysis of data collected for the programme. Multidisciplinary teams of frontline clinicians at nine UK NHS sites took part across the two phases of the programme between 2011 and 2016.ResultsDeveloping and implementing a measurement plan against which to assess their improvement goals was an arduous task for participating sites. The operational definitions of the measures that they selected were often imprecise or missed important details. Some measures used by the teams were not logically linked to the improvement actions they implemented. Regardless of the specific type of data used (routinely collected or selected ex novo), the burdensome nature of data collection was underestimated. Problems also emerged in identifying and using suitable analytical approaches.ConclusionMeasurement is a highly technical task requiring a degree of expertise. Simply leveraging individual clinicians’ motivation is unlikely to defeat the persistent difficulties experienced by clinical teams when attempting to measure their improvement efforts. We suggest that more structural initiatives and broader capability-building programmes should be pursued by the professional community. Improving access to, and ability to use repositories of validated measures, and increasing transparency in reporting measurement attempts, is likely to be helpful.
The relationships between rugby union and health: a scoping review protocol
Authors: Griffin Steffan Arthur , Panagodage Perera Nirmala Kanthi , Murray Andrew , Hartley Catherine , Brooks John H M , Kemp Simon P T , Stokes Keith A 
Published: August 2019

IntroductionRugby union is played by over eight million people across the world and is considered a form of moderate-to-vigorous physical activity. Consequently, playing rugby may confer health benefits; however, to date, the principal focus of research has been on associated injuries and potential detrimental long-term health sequelae. This protocol outlines the methods behind studying any potential associations between rugby union and both physical and mental health.Methods and analysisBest practice methodological frameworks (Arksey and O'Malley, Levacet aland the Joanna Briggs Institute) and previously published scoping review protocols in sport informs the methodology of this protocol. This protocol enables us to map the key concepts and evidence available, summarise and share existing research ﬁndings, and identify research gaps in the current literature. A three-step search strategy will identify reviews, original research, and published and grey literature. An initial search will identify suitable search terms, followed by a search using keyword and index terms. Two reviewers will independently screen identiﬁed studies for final inclusion.DisseminationWhen publishing the scoping review, we will map key concepts and evidence both numerically and thematically, as well as identify key research priorities for further studies. The review will subsequently be disseminated to stakeholder groups, practitioners and policymakers through a variety of peer-reviewed and non-peer-reviewed publications, conferences and via multimedia platforms.
Flow diversion treatment for acutely ruptured aneurysms
Authors: ten Brinck Michelle F M , Jäger Maike , de Vries Joost , Grotenhuis J André , Aquarius René , Mørkve Svein H , Rautio Riitta , Numminen Jussi , Raj Rahul , Wakhloo Ajay K , Puri Ajit S , Taschner Christian A , Boogaarts Hieronymus D 
Published: August 2019

Background and purposeFlow diverters are sometimes used in the setting of acutely ruptured aneurysms. However, thromboembolic and hemorrhagic complications are feared and evidence regarding safety is limited. Therefore, in this multicenter study we evaluated complications, clinical, and angiographic outcomes of patients treated with a flow diverter for acutely ruptured aneurysms.MethodsWe conducted a retrospective observational study of 44 consecutive patients who underwent flow diverter treatment within 15 days after rupture of an intracranial aneurysm at six centers. The primary end point was good clinical outcome, defined as modified Rankin Scale score (mRS) 0–2. Secondary endpoints were procedure-related complications and complete aneurysm occlusion at follow-up.ResultsAt follow-up (median 3.4 months) 20 patients (45%) had a good clinical outcome. In 20 patients (45%), 25 procedure-related complications occurred. These resulted in permanent neurologic deficits in 12 patients (27%). In 5 patients (11%) aneurysm re-rupture occurred. Eight patients died resulting in an all-cause mortality rate of 18%. Procedure-related complications were associated with a poor clinical outcome (mRS 3–6; OR 5.1(95% CI 1.0 to 24.9), p=0.04). Large aneurysms were prone to re-rupture with rebleed rates of 60% (3/5) vs 5% (2/39) (p=0.01) for aneurysms with a size ≥20 mm and <20 mm, respectively. Follow-up angiography in 29 patients (median 9.7 months) showed complete aneurysm occlusion in 27 (93%).ConclusionFlow diverter treatment of ruptured intracranial aneurysms was associated with high rates of procedure-related complications including aneurysm re-ruptures. Complications were associated with poor clinical outcome. In patients with available angiographic follow-up, a high occlusion rate was observed.
We Got Your Back! Help Care Seeking and Caregiving in Mexican Indigenous Men With Ankylosing Spondylitis
Authors: Matamoros-Sanin Joan Francisco , Figueroa-Perea Juan Guillermo , Pacheco-Tena César , Peláez-Ballestas Ingris 
Published: August 2019

This article presents a study on the care provided by 11 men from different ethnic, health, and socioeconomic backgrounds to two indigenous Rarámuri males with ankylosing spondylitis. This chronic muscular and bone disease is known to evolve progressively, causing disability and immense suffering to the affected individual. Through anthropological research involving ethnographic description and interviews conducted in an urban setting of the City of Chihuahua in the state of Chihuahua, caring practices performed by men that contest prior assumptions about how men relate to each other in relation to their health and masculinity were encountered. To interpret findings, a “caring of the self” framework, along with elements of the discussion of personhood and masculinities, was used; this led to an analysis made through the elaboration of meaningful coding of patterns of caring practices. The patterns identified in the ethnographic data were organized into four groups, all of which represented caring practices performed by these men. The first three groups involve access to food, money, and infrastructure goods, which have a material nature that holds a positive relation to the well-being of the two Rarámuri males in regard to the implications of their disease. The last group is unique in that it pertains to circumstantial factors that required improvisations in the forms of favors exchanged by these males that also positively related to their well-being
Research assessment in a National Health Service organisation: a process for learning and accountability
Authors: Allbutt Helen , Irvine Stewart 
Published: August 2019

This paper describes the only known research assessment exercise to be undertaken by a health board. There is a growing imperative to evidence the impact of national health services, but no formal mechanism exists to quality-rate research or assess its effect on practice. This study describes how one healthcare organisation adapted a research impact framework along with impact dimensions and impact indicators to better identify research outcomes and account for research funding.
We know that research findings rarely impact on practice in a linear manner, that their effects are difficult to measure, and that they need adaptation within practice and professional contexts before use. We found that while links to practice and professional settings within our health board were strong, researchers tended not to plan for specific outcomes or impacts at project conception. Hence, although influence on practice and policy did occur, this seemed to be the result of extempore processes. This is despite an increasing emphasis in the health service on accountability in an era of severe financial constraint. Most of our successful research outcomes arose when researchers engaged in active dissemination with different audiences including end users and opinion/senior leaders.
The findings of this research assessment are helping us to better consider dissemination and knowledge translation strategies at the outset of projects. Being able to evidence specific research outcomes to senior managers and board members is enabling us to continue our modest investment in health services research.
Diffuse Villous Tumor Arising in Barrett's Esophagus Presenting With Aspiration Pneumonitis
Authors: Kaila Vishal , Thosani Nirav , Feldman Mark 
Published: August 2019

ABSTRACT
Barrett's esophagus (BE) is associated with an increased incidence of adenocarcinoma. The dysplasia in BE that precedes cancer is usually endoscopically flat. Unlike in the colon, polypoid dysplastic lesions superimposed on BE are uncommon. Furthermore, villous tumors of the esophagus are rare, and few cases have been reported in the literature. We report an 85-year-old man who was found to have a circumferential villiform-appearing esophageal tumor with mucus secretions with recurrent bronchopulmonary aspiration. A diffuse villiform tumor of the entire esophagus with mucin production is rare and, to our knowledge, has not been previously described in the literature.
Pengaruh Variasi Gula Pasir Terhadap Waktu Pengomposan Ditinjau Dari Rasio C/N Pada Sampah Sayuran di Pasar Jati Banyumanik Dengan Penambahan Bioaktivator Lingkungan
Authors: Hadiwidodo Mochtar , Sutrisno Endro , Sabrina Azzura 
Published: August 2019

Sampah sayuran di Pasar Jati Banyumanik biasa dibuang tanpa dilakukan pemanfaatan dan pengolahan. Sampah sayuran dimanfaatkan sebagai bahan baku pengomposan karena memiliki kandungan karbon, nitrogen, fosfor dan kalium yang dibutuhkan oleh tanaman dan kesuburan tanah. Penelitian ini bertujuan untuk mengetahui pengaruh variasi gula pasir terhadap waktu pengomposan ditinjau dari rasio c/n pada sampah sayuran di Pasar Jati Banyumanik dengan penambahan bioaktivator lingkungan. Variasi gula pasir yang digunakan yaitu 0 gram, 20 gram, 30 gram, 40 gram, 50 gram, dan 60 gram. Proses pengomposan dilakukan selama 14 hari. Kompos yang diperoleh dianalisis suhu, pH, kadar air, C-Organik, N-Total, P-Total, K-Total, penyusutan kompos, warna dan bau. Hasil analisis dibandingkan dengan SNI 19-7030-2004. Analisis kompos dilakukan pada hari ke 0, 3, 7, 10, dan 14. Waktu kematangan kompos optimum ditinjau dari rasio c/n yang dapat dicapai kompos dengan variasi gula pasir sebanyak 40 gram pada reaktor G3. Seluruh parameter yang diuji telah memenuhi standar kompos matang SNI 19-7030-2004.
Effect of Acid Slag Treatment on the Inclusions in GCr15 Bearing Steel
Authors: Liu Yang , Li Jing , Ge Jinpeng , Zheng Dingli 
Published: August 2019

Abstract
By laboratory slag/steel reaction equilibrim experiments, the viriation of oxygen content, inclusion compositions and inclusion sizes were studied. The effect of acid slag treatment on the transition mechanisms of D-type inclusions and the precipitation of TiN inclusions in GCr15 bearing steel were explored. The obtained results showed that the dominant inclusions in steel were plastic and smaller Al2O3-SiO2-MnO. The melting point were lower than 1400°C treated by the acid refining slag of 35.1%CaO-15%Al2O3-43.9%SiO2-6%MgO and there was no TiN found. The evolution of MgO·Al2O3 inclusions is: MgO·Al2O3
→ MgO·Al2O3·SiO2·MnO→ Al2O3·SiO2·MnO. Mg and Al from MgO·Al2O3 inclusions were displaced by [Si] and [Mn] in steel liquid , and formation of plastic Al2O3-SiO2-MnO inclusions finally, whose compositions distribution were uniform. Mg and Si, Mn were complementary in inclusions as to the spatial distribution.
Maintenance of Melanocyte Stem Cell Quiescence by GABA-A Signaling in Larval Zebrafish
Authors: Allen James R , Skeath James B , Johnson Stephen L 
Published: August 2019

Abstract
In larval zebrafish, melanocyte stem cells (MSCs) are quiescent, but can be recruited to regenerate the larval pigment pattern following melanocyte ablation. Through pharmacological experiments, we found that inhibition of γ-aminobutyric acid (GABA)-A receptor function, specifically the GABA-A ρ subtype, induces excessive melanocyte production in larval zebrafish. Conversely, pharmacological activation of GABA-A inhibited melanocyte regeneration. We used clustered regularly interspaced short palindromic repeats/Cas9 to generate two mutant alleles of gabrr1, a subtype of GABA-A receptors. Both alleles exhibited robust melanocyte overproduction, while conditional overexpression of gabrr1 inhibited larval melanocyte regeneration. Our data suggest that gabrr1 signaling is necessary to maintain MSC quiescence and sufficient to reduce, but not eliminate, melanocyte regeneration in larval zebrafish.
BEM ESTAR MENTAL EM INDIVÍDUOS SUBMETIDOS A TRATAMENTO FISIOTERAPÊUTICO EM UMA CLÍNICA ESCOLA UNIVERSITÁRIA.
Authors: Santos Jefferson Jovelino Amaral dos , Costa Telma Aparecida da , Abentroth Lilian Regina Lengler , Sena Jessica Da Silva 
Published: August 2019

O bem estar tem relação direta com os níveis de saúde mental e geral de uma população. O objetivo deste estudo foi verificar as diferenças nos níveis de bem estar mental em indivíduos submetidos a tratamento fisioterapêutico em uma clínica escola. Foram avaliados 37 indivíduos de ambos os sexos em relação às atividades de vida diária (AVD), satisfação com a fisioterapia, níveis de dor e de bem estar mental antes e após o tratamento fisioterapêutico. Todas as variáveis seguiram a distribuição normal (Gaussiana) e portanto, foram tratadas pela estatística paramétrica (Teste t de Student, p<0.05) e verificou-se que os níveis de dor diminuíram, simultaneamente os níveis de AVD e bem estar mental melhoraram. Encontrou-se também correlação entre os níveis de bem estar mental com os escores de dor e AVD. Concluiu-se que o tratamento fisioterapêutico melhorou os níveis de bem estar mental dos indivíduos avaliados e essa variável apresentou correlação com a escala de dor e níveis de AVD.
Revendo mais de 70 anos em menos de 7 meses: a tramitação da reforma trabalhista do governo Temer
Authors: Di Benedetto Roberto 
Published: August 2019

Resumo: A reforma trabalhista do Governo Temer, aprovada no primeiro semestre de 2017, no meio de uma grave crise política e econômica, modificou profundamente o direito do trabalho, o Poder Judiciário e a estrutura sindical. A rápida tramitação da reforma, sua extensão e a ausência de um debate público dificultaram a análise dos seus impactos. Neste estudo de caso teve-se por objetivo analisar a tramitação da reforma trabalhista no Congresso e os principais argumentos utilizados pelos deputados e senadores que discutiram a proposta. Com isso, espera-se contribuir com a discussão das normas aprovadas e com a análise de suas consequências no mercado de trabalho, no Poder Judiciário e na estrutura sindical.Palavras-chave: Reforma trabalhista. Justiça do trabalho. Estrutura sindical. Abstract: The Temer government’s labor reform, approved in the first half of 2017, in the middle of a serious political and economic crisis, changed labor law, the Judiciary, and the trade union structure. The fast reform process, its extension, and the absence of public debate made difficult to analyze its impacts. This leading case aimed to examine the process of labor reform in Congress and the main arguments used by the deputies and senators who discussed the proposal. With this, it is hoped to contribute to the discussion of the approved norms and the analysis of their consequences in the labor market, in the Judiciary and in the union structure.Keywords: Labor reform. Labor courts. Trade unions.