bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint associations of leisure-time physical activity and sitting time with emotional wellbeing, physical functioning and work ability: an occupational study among young and early midlife Finnish municipal employees
Authors: Lahti Jouni , Salmela Jatta , Kouvonen Anne , Rahkonen Ossi , Lallukka Tea 
Published: December 2023

Abstract
Background
Physical inactivity and sedentary behaviour are major public health problems. We examined the individual and joint associations of leisure-time physical activity (LTPA) and total sitting time with emotional wellbeing, physical functioning and work ability in young and early midlife employees.

Methods
Cross-sectional questionnaire survey data were collected in 2017 among 19–39-year-old employees of the City of Helsinki (response rate 51.5%). LTPA (including commuting PA) was converted into a metabolic equivalent (MET) index. We classified the participants into four groups according to PA recommendations and participation in vigorous intensity activities. Total sitting time was classified into three groups using tertile cut-points (5.5 and 8.5 h/day). For joint analyses, we truncated LTPA into three groups and sitting time into two groups yielding a six-category variable. Emotional wellbeing and physical functioning were measured using the RAND-36 questionnaire and work ability with a scale ranging from 0 to 100. Linear regression analysis was used to estimate adjusted means and their 95% confidence intervals (CIs). The analytical sample included 4544 participants (80% females).

Results
Adjusting for age and sex, high sitting time (> 8.5 h/day) was associated only with poorer emotional wellbeing. LTPA, especially vigorous activity, showed clear positive associations with emotional wellbeing, physical functioning and work ability. For emotional wellbeing, the low activity groups with low (70.51, 95% CI 69.1–71.9) and high (67.5, 65.5–69.5) sitting time and the moderate activity groups with low (72.5, 71.3–73.7) and high (70.4, 68.6–72.1) sitting time had statistically significantly lower mean scores than the corresponding vigorous activity groups with low (74.9, 74.2–75.7) and high (72.7, 71.6–73.9) sitting time. For physical functioning, the vigorous activity groups with low (96.3, 95.8–96.7) and high (96.2, 95.5–96.9) sitting time had significantly higher scores than the other groups. For work ability, the vigorous activity groups with low (82.0, 81.3–82.6) and high (80.8, 79.8–81.8) sitting time had significantly higher scores than the other groups. Adjusting for covariates only slightly attenuated these associations.

Conclusions
Promoting PA among employees can contribute to better physical and mental health as well as better work ability.
Appetite- and Weight-Regulating Neuroendocrine Circuitry in Hypothalamic Obesity
Authors: Gan Hoong-Wei , Cerbone Manuela , Dattani Mehul Tulsidas 
Published: November 2023

Abstract
Since hypothalamic obesity (HyOb) was first described over 120 years ago by Joseph Babinski and Alfred Fröhlich, advances in molecular genetic laboratory techniques have allowed us to elucidate various components of the intricate neurocircuitry governing appetite and weight regulation connecting the hypothalamus, pituitary gland, brainstem, adipose tissue, pancreas, and gastrointestinal tract. On a background of an increasing prevalence of population-level common obesity, the number of survivors of congenital (eg, septo-optic dysplasia, Prader–Willi syndrome) and acquired (eg, central nervous system tumors) hypothalamic disorders is increasing, thanks to earlier diagnosis and management as well as better oncological therapies. Although to date the discovery of several appetite-regulating peptides has led to the development of a range of targeted molecular therapies for monogenic obesity syndromes, outside of these disorders these discoveries have not translated into the development of efficacious treatments for other forms of HyOb. This review aims to summarize our current understanding of the neuroendocrine physiology of appetite and weight regulation, and explore our current understanding of the pathophysiology of HyOb.
An Undetected Pheochromocytoma Leading to Fulminant Adrenergic Myocarditis Complicated by Cardiogenic Shock
Authors: Tran Nam Q , Tran Hieu T N , Tran Thang V , Nguyen Thuan T 
Published: December 2023

Abstract
Pheochromocytomas are rare catecholamine-secreting neuroendocrine tumors. Their episodic nature is correlated with abrupt catecholamine release and clinical manifestations that mimic other vascular conditions, leading to delayed diagnosis and potentially life-threatening complications, such as acute myocarditis and pheochromocytoma crises. In this report, we described the case of fulminant adrenergic myocarditis-induced cardiogenic shock requiring extracorporeal membrane oxygenation support in a Vietnamese middle-aged man with a 5-year history of Brugada syndrome, hypertension, and previously undiagnosed pheochromocytoma. After stabilization, the patient was medically treated with a combination of α- and β-blockers before undergoing laparoscopic right adrenalectomy.
Caution on the Use of 68Ga-DOTATATE for the Diagnosis of Pheochromocytoma: A Report of 2 Cases
Authors: Needleman Leor , Enamandram Sheila , Annes Justin P 
Published: December 2023

Abstract
Pheochromocytomas are intra-adrenal sympathetic neuroendocrine tumors that arise from chromaffin cells. Paragangliomas similarly arise from chromaffin cells, although at extra-adrenal sites such as sympathetic paraganglia in the abdomen/thorax, or parasympathetic paraganglia in the head/neck. Collectively, pheochromocytomas and paragangliomas are important to diagnose and resect because they may secrete harmful levels of catecholamines, have mass effects, hemorrhage, and/or metastasize. Anatomic imaging of pheochromocytomas is usually completed with computed tomography or magnetic resonance imaging; however, functional imaging may be used to provide additional localization, staging, and/or biologic information. Accordingly, selection of the proper functional imaging modality can be critical to developing the optimal therapeutic strategy. 68Gallium- and 64Copper-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotate positron emission tomography computed tomography (68Ga- and 64Cu-DOTATATE) are widely used in evaluating pheochromocytomas and paragangliomas, although data regarding the sensitivity for diagnosing pheochromocytoma are limited. We report 2 cases of pheochromocytoma that showed nondiagnostic 68Ga-DOTATATE uptake but were subsequently visualized using alternative functional imaging modalities. Additionally, we provide a review of the literature to highlight the underappreciated limitations of functional adrenal imaging with somatostatin-based compounds.
The effect of surface topography on the ball-rolling ability of Kheper lamarcki (Scarabaeidae)
Authors: Bijma Nienke N. , Billeschou Peter , Baird Emily , Dacke Marie , Kovalev Alexander , Filippov Alexander E. , Manoonpong Poramate , Gorb Stanislav N. 
Published: November 2023

ABSTRACT
The most effective way to avoid intense inter- and intra-specific competition at the dung source, and to increase the distance to the other competitors, is to follow a single straight bearing. While ball-rolling dung beetles manage to roll their dung balls along nearly perfect straight paths when traversing flat terrain, the paths that they take when traversing more complex (natural) terrain are not well understood. In this study, we investigate the effect of complex surface topographies on the ball-rolling ability of Kheper lamarcki. Our results reveal that ball-rolling trajectories are strongly influenced by the characteristic scale of the surface structure. Surfaces with an increasing similarity between the average distance of elevations and the ball radius cause progressively more difficulties during ball transportation. The most important factor causing difficulties in ball transportation appears to be the slope of the substrate. Our results show that, on surfaces with a slope of 7.5 deg, more than 60% of the dung beetles lose control of their ball. Although dung beetles still successfully roll their dung ball against the slope on such inclinations, their ability to roll the dung ball sideways diminishes. However, dung beetles do not seem to adapt their path on inclines such that they roll their ball in the direction against the slope. We conclude that dung beetles strive for a straight trajectory away from the dung pile, and that their actual path is the result of adaptations to particular surface topographies.
Knowledge, perceptions, interest, and use of integrative medicine among U.S. allopathic medical students
Authors: Loy Michelle 
Published: December 2023

Background: Acceptance, interest, and demand for Complementary Integrative Medicine (CIM) has been steadily growing within the US. Yet despite increased use, patient non-disclosure and physician lack of comfort in discussion is common. Medical students (MS) express interest in CIM. Educational exposure affects attitudes, cultural competence, interprofessional education, knowledge, and clinical skills. A few studies include US MS; however, most studies have been done outside the US. Aims: Our study examined first year US allopathic MS knowledge, perception, and attitudes toward IM for patient care, current personal use, and modalities of interest. Methods: The study was conducted on first year MS from 2020-2022 who participated in a 3-hour IM session within the required Essential Principles of Medicine course at a US allopathic medical school. Five questions were disseminated through Poll Everywhere during a lecture given by an IM board certified physician and students were invited to respond. Questions assessed student definition of IM, perception of patient barriers in discussing IM, perception of physician barriers in discussing IM, personal use, and modalities of interest. Results: MS attitude toward IM was generally positive based on word choice. MS perception of patient barriers in discussing IM focused on emotional factors rather than knowledge and understanding, whereas medical student perception of physician barriers revolved around lack of familiarity, knowledge, and training. Students self-reported physical activity and sleep as the top ranked favorite stress-reducing self-care practice followed by cooking/eating, music, and yoga. Students were most interested in exploring pet therapy, Traditional Chinese Medicine (TCM) and yoga. Conclusions: Further study with the integrative medicine attitude questionnaire (IMAQ) is recommended to determine whether results are generalizable. Integrating IM education and experience into the conventional medical curriculum is of interest to allopathic US MS and may prepare students for optimizing future patient care as well as clinician wellness.
Conventional versus lateral fasciotomy for prevention of lateral femoral cutaneous nerve injury in the non-fan-type nerve in total hip arthroplasty with direct anterior approach
Authors: Tanabe Hiroki , Baba Tomonori , Ozaki Yu , Yanagisawa Naotake , Homma Yasuhiro , Nagao Masashi , Kaneko Kazuo , Ishijima Muneaki 
Published: December 2023

AimsLateral femoral cutaneous nerve (LFCN) injury is a potential complication after the direct anterior approach for total hip arthroplasty (DAA-THA). The aim of this study was to determine how the location of the fasciotomy in DAA-THA affects LFCN injury.MethodsIn this trial, 134 patients were randomized into a lateral fasciotomy (n = 67) or a conventional fasciotomy (n = 67) group. This study was a dual-centre, double-blind, prospective randomized controlled two-arm trial with parallel group design and a 1:1 allocation ratio. The primary endpoint was the presence of LFCN injury, which was determined by the presence of numbness, decreased sensation, tingling, jolt-like sensation, or pain over the lateral aspect of the thigh, excluding the surgical scar, using a patient-based questionnaire. The secondary endpoints were patient-reported outcome measures (PROMs) using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), and the Forgotten Joint Score-12 (FJS-12). Assessments were obtained three months after surgery.ResultsThe incidence of LFCN injury tended to be lower in the lateral fasciotomy group (p = 0.089). In the lateral fasciotomy group, there were no significant differences in the mean PROM scores between patients with and without LFCN injury (FJS-12: 54.42 (SD 15.77) vs 65.06 (SD 26.14); p = 0.074; JHEQ: 55.21 (SD 12.10) vs 59.72 (SD 16.50); p = 0.288; WOMAC: 82.45 (SD 6.84) vs 84.40 (SD 17.91); p = 0.728). In the conventional fasciotomy group, there were significant differences in FJS-12 and JHEQ between patients with and without LFCN injury (FJS-12: 43.21 (SD 23.08) vs 67.28 (SD 20.47); p < 0.001; JHEQ: 49.52 (SD 13.97) vs 59.59 (SD 15.18); p = 0.012); however, there was no significant difference in WOMAC (76.63 (SD 16.81) vs 84.16 (SD 15.94); p = 0.107).ConclusionThe incidence of LFCN injury at three months after THA was comparable between the lateral and conventional fasciotomy groups. Further studies are needed to assess the long-term effects of these approaches.Cite this article: Bone Joint J 2023;105-B(12):1252–1258.
Older age at surgery and postoperative leg length discrepancy are risk factors for unfavourable patient-reported outcome measures of knee tumour endoprostheses following resection for musculoskeletal tumour of the lower limb
Authors: Kokubu Yasuhiko , Fujiwara Toshifumi , Matsumoto Yoshihiro , Endo Makoto , Setsu Nokitaka , Iida Keiichiro , Nabeshima Akira , Nakashima Yasuharu 
Published: December 2023

AimsTo evaluate mid-to long-term patient-reported outcome measures (PROMs) of endoprosthetic reconstruction after resection of malignant tumours arising around the knee, and to investigate the risk factors for unfavourable PROMs.MethodsThe medical records of 75 patients who underwent surgery between 2000 and 2020 were retrospectively reviewed, and 44 patients who were alive and available for follow-up (at a mean of 9.7 years postoperatively) were included in the study. Leg length discrepancy was measured on whole-leg radiographs, and functional assessment was performed with PROMs (Toronto Extremity Salvage Score (TESS) and Comprehensive Outcome Measure for Musculoskeletal Oncology Lower Extremity (COMMON-LE)) with two different aspects. The thresholds for unfavourable PROMs were determined using anchor questions regarding satisfaction, and the risk factors for unfavourable PROMs were investigated.ResultsThe thresholds for favourable TESS and COMMON were 64.8 and 70.4 points, respectively. Multivariate analysis showed that age at surgery (p = 0.004) and postoperative leg length discrepancy (p = 0.043) were significant risk factors for unfavourable TESS results, while age at surgery (p < 0.001) was a significant risk factor for unfavourable COMMON-LE results. Following receiver operating characteristic analysis, the threshold for both TESS and COMMON-LE was 29 years of age at surgery. Additionally, a leg length discrepancy of 8.2 mm was the threshold for unfavourable TESS.ConclusionPatients aged > 29 years at the time of surgery require appropriate preoperative counselling and adequate postoperative physical and socioemotional support. Reconstruction equivalent to the length of the resected bone can reduce the risk of functional disabilities in daily living.Cite this article: Bone Jt Open 2023;4(12):906–913.
Health professionals’ knowledge on vaccine cold chain management and associated factors in Ethiopia: Systematic review and meta-analysis
Authors: Kasahun Abebaw Wasie , Zewdie Amare , Mose Ayenew , Adane Haimanot Abebe 
Published: November 2023

Background
Vaccines are playing a great role in prevention of many infectious diseases worldwide. Health professionals’ knowledge towards vaccine cold chain management is an essential element of maintaining vaccine’s potency at shelf and during transportation. Studies on health professionals’ knowledge on vaccine cold chain management system and associated factors in Ethiopia have inconclusive findings. This systematic review and meta-analysis is aimed to produce the overall level of health professionals’ knowledge on vaccine cold chain management system and to identify its associated factors in Ethiopia.

Methods
Systematic review and meta-analysis was conducted on health professionals’ knowledge on vaccine cold chain management in Ethiopia. It is registered under PROSPERO website with registration number CRD42023391627. Literature search was made on international data bases using medical subject heading and key words. Data were extracted using Microsoft excel and imported to STATA version 17 for analysis. Heterogeneity was checked using Cochrane Q test and I2 statistics. Weighted Inverse variance random effect model was used to estimate the pooled level of health professionals’ knowledge on vaccine cold chain management. Publication bias was checked using funnel plot and using Egger’s test.

Results
A total of nine studies were included in the review. The pooled health professionals’ good knowledge on vaccine cold chain management in Ethiopia is 49.92% with 95% CI (48.06–51.79). Having five years or more experience AOR 2.27 95% CI (1.72–2.99), being nurse AOR 3.03 95% CI (1.47–6.27), received on job training AOR 6.64 95% CI (4.60–9.57), EPI guideline available at facility AOR 2.46 95% CI (1.75.-3.48) are factors positively associated with health professionals’ knowledge on vaccine cold chain management in Ethiopia.

Conclusion
The pooled prevalence of good knowledge on vaccine cold chain management among health professionals is much lower than the expected level. There is a need to plan on job trainings for all vaccine handlers and other health professionals supposed to work on vaccination program.
Health services satisfaction and medical exclusion among migrant youths in Gauteng Province of South Africa: A cross-sectional analysis of the GCRO survey (2017−2018)
Authors: Akokuwebe Monica Ewomazino , Osuafor Godswill Nwabuisi , Likoko Salmon , Idemudia Erhabor Sunday 
Published: November 2023

BackgroundMedical xenophobia of migrant (either in-migrants or immigrants) youths is an ongoing problem in contemporary South African society. Medical mistreatment by healthcare workers and social phobia from migrant youths have been attributed to major obstacles to healthcare utilization as well as health services satisfaction. This study aimed to determine the prevalence and factors contributing to health services satisfaction and medical exclusion among migrant youths in Gauteng province in South Africa.MethodsThe Round 5 Gauteng City-Region Observatory (GCRO) Quality of Life (QoL) survey was conducted in 2017‒2018, a nationally representative survey piloted every two years in South Africa, was utilized in this study. A 2-year cohort study of 24,889 respondents aged 18 to 29 and a baseline data consisted of 4,872 respondents, comprising non-migrants, in-migrants and immigrants, from where 2,162 in-migrants and immigrants were utilized as the sample size. The data was analysed using descriptive statistics, Chi-Square analysis and logistic regression.ResultsA total of 2,162 migrants, comprising 35.4% in-migrants and 9.0% of immigrants, from the 4,872 respondents, were included in the analysis. The prevalence of medical exclusion of in-migrant and immigrant youths were 5.5% and 4.2%, and the majority of them reported the use of public health facilities (in-migrants ‒ 84.3% vs. immigrants ‒ 87.1%). At the bivariate level, demographic (age, sex, and population group), economic (employed and any income) and health-related (no medical aid and household member with mental health) factors were significantly associated with medical exclusion (ρ≤0.05). The adjusted odds ratio showed that only female gender (AOR: 1.07, 95% CI: 0.678, 1.705), no medical aid cover (AOR: 1.23, 95% CI: 0.450, 3.362), and neither (AOR: 1.59, 95% CI: 0.606, 4.174) or dissatisfied (AOR: 4.29, 95% CI: 2.528, 7.270) were independent predictors of medical exclusion.ConclusionHaving no medical aid cover, being a female and dissatisfied, or neither satisfied nor dissatisfied with health services significantly increased the odds of medical exclusion among migrant youths. To increase healthcare utilization and ensuring adequate medical care of migrant youths, opting for medical aid insurance without increasing costs should be guaranteed. Therefore, there should be no consequences for lack of residence status or correct documentation papers when accessing healthcare services among migrant youths in South Africa.
The impact of restricted provision of publicly funded elective hip and knee joints replacement during the COVID-19 pandemic in England
Authors: Penfold Chris M. , Blom Ashley W. , Redaniel Maria Theresa , Jones Tim , Eyles Emily , Keen Tim , Elliott Andrew , Judge Andrew 
Published: November 2023

Aims
Elective hip and knee replacement operations were suspended in April 2020 due to the COVID-19 pandemic. The impact of this suspension and continued disruption to the delivery of joint replacement surgery is still emerging. We describe the impact of the pandemic on the provision of publicly funded elective hip and knee replacement surgery at one teaching hospital in England and on which patients had surgery.

Methods
We included all elective primary and revision hip and knee replacements performed at one hospital between January 2016 and June 2021. Using data for the years 2016–2019, we estimated the expected number of operations and beds occupied per month in January 2020 to June 2021 using time series linear models (adjusting for season and trend). We compared the predictions with the real data for January 2020 to June 2021 to assess the impact of the pandemic on the provision of elective hip and knee replacements. We compared the length of stay and characteristics (age, gender, number of comorbidities, index of multiple deprivation) of patients who had surgery before the pandemic with those who had surgery during the pandemic.

Results
We included 6,964 elective primary and revision hip and knee replacements between January 2016 and June 2021. Between January 2020 and June 2021 primary hip replacement volume was 59% of predicted, and 47% for primary knee replacements. Revision hip replacement volume was 77% of predicted, and 42% for revision knee replacement. Median length of stay was one day shorter for primary (4 vs 3 days) and revision (6 vs 5 days) operations during the pandemic compared with before. Patients operated on during the pandemic were younger and had slightly more comorbidities than those operated on before the pandemic.

Conclusions
The restricted provision of elective hip and knee replacements during the COVID-19 pandemic changed the patient casemix, but did not introduce new inequalities in access to these operations. Patients were younger, had more comorbidities, and stayed in hospital for less time than those treated before the pandemic. Approximately half the number of operations were performed during the pandemic than would have been expected and the effect was greatest for revision knee replacements.