bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between social jetlag trajectories and body mass index among young adults
Authors: Chang Chia-Shuan , Chang Ling-Yin , Wu Chi-Chen , Chang Hsing-Yi 
Published: October 2023

Abstract

Study Objectives
This study employed longitudinal data collected repeatedly from individuals over the course of several years to examine the trajectories of social jetlag from ages 11 to 22 years and their associations with subsequent body mass index (BMI). Potential sex differences were also investigated.

Methods
Data were obtained from two longitudinal studies conducted in Taiwan (N = 4287). Social jetlag was defined as ≥ 2 hours of absolute difference in sleep midpoint between weekdays and weekends. BMI was calculated using weight (kg)/height(m)2 and categorized as underweight (&lt;18 kg/m2), normal weight (18 kg/m2 ≤ BMI &lt; 24 kg/m2), overweight (24 kg/m2 ≤ BMI &lt; 27 kg/m2), and obese (≥27 kg/m2). Group-based trajectory modeling and multinomial logistic regression were applied to investigate study objectives.

Results
Four distinct trajectories of social jetlag throughout the adolescent years were identified, with corresponding proportions as follows: low-stable (42%), moderate-decreasing (19%), low-increasing (22%), and chronic (17%) trajectories. Among males, the risk of being underweight (aOR, 1.96; 95% CI: 1.35 to 2.84) or obese (aOR, 1.40; 95% CI: 1.02 to 1.92) was higher in individuals with a low-increasing trajectory than in those with a low-stable trajectory. Among females, those with a low-increasing (aOR, 1.61; 95% CI: 1.02 to 2.54) or chronic (aOR, 2.04; 95% CI: 1.27 to 3.25) trajectory were at a higher risk of being obese relative to those with a low-stable trajectory.

Conclusions
Addressing the development of increasing or chronic social jetlag during adolescence can help prevent abnormal BMI in young adulthood. Practitioners should consider sex differences in treatment or consultation.
Does Local Political Representation Affect the Childcare Coverage Rate in Austrian Municipalities?
Authors: Walenta-Bergmann Carmen 
Published: October 2023

Abstract
Historically, the provision of childcare has been a forgotten area of Austrian family policy. During the last decade, much effort was made to catch up with other European countries, but notable differences persist between Austrian regions and municipalities. This article engages the following question: does local political representation affect the public childcare coverage rate in Austrian municipalities? Based on a unique longitudinal data set (2003–2018) containing yearly measures for 1,789 Austrian municipalities, several hierarchical regression models are calculated. The results reveal a positive effect of women and left-party share in the local councils as well as an interaction effect between the two. The findings suggest that women have an impact on the share of children in public childcare only in a right-wing-dominated political sphere.
Megasphaera elsdenii and Saccharomyces cerevisiae as direct fed microbials and their impact on ruminal microbiome during an acute acidosis challenge in continuous culture
Authors: Arce-Cordero Jose A , Liu Ting , Monteiro Hugo F , Jeong Kwang C , Faciola Antonio P 
Published: October 2023

Abstract
Our objective was to evaluate the effects of combinations of Saccharomyces cerevisiae and Megasphaera elsdenii as direct-fed microbials (DFM) on ruminal microbiome during an acute acidosis challenge in a continuous culture system. Treatments provided a DFM dose of 1 × 108 colony-forming unit (CFU)/mL, as follows: control (no DFM), YM1 (S. cerevisiae and M. elsdenii strain 1), YM2 (S. cerevisiae and M. elsdenii strain 2), and YMM (S. cerevisiae and half of the doses of M. elsdenii strains 1 and 2). We conducted four experimental periods of 11 d, which consisted of non-acidotic days (1 to 8) and acidotic challenge days (9 to 11) to establish acute ruminal acidosis conditions with a common basal diet containing 12% neutral detergent fiber and 58% starch. Treatments were applied from days 8 to 11, and samples of liquid and solid-associated bacteria were collected on days 9 to 11. Overall, 128 samples were analyzed by amplification of the V4 region of bacterial 16S rRNA, and data were analyzed with R and SAS for alpha and beta diversity, taxa relative abundance, and correlation of taxa abundance with propionate molar proportion. We observed a lower bacterial diversity (Shannon index, P = 0.02) when YM1 was added to the diet in comparison to the three other treatments. Moreover, compared to control, addition of YM1 to the diet increased relative abundance of phylum Proteobacteria (P = 0.05) and family Succinivibrioceae (P = 0.05) in the solid fraction and tended to increase abundance of family Succinivibrioceae (P = 0.10) and genus Succinivibrio (P = 0.09) in the liquid fraction. Correlation analysis indicated a positive association between propionate molar proportion and relative abundance of Proteobacteria (r = 0.36, P = 0.04) and Succinivibrioceae (r = 0.36, P = 0.05) in the solid fraction. The inclusion of YM1 in high-grain diets with a high starch content resulted in greater abundance of bacteria involved in succinate synthesis which may have provided the substrate for the greater propionate synthesis observed.
Macrophage RAGE deficiency prevents myocardial fibrosis by repressing autophagy‐mediated macrophage alternative activation
Authors: He Jiaqi , Wei Lan , Tan Shengan , Liang Birong , Liu Jing , Lu Lu , Wang Ting , Wang Junyan , Huang Yusheng , Chen Zixin , Li Huan , Zhang Lu , Zhou Zheng , Cao Yanhong , Ye Xiaohan , Yang Zhongqi , Xian Shaoxiang , Wang Lingjun 
Published: October 2023

AbstractMyocardial fibrosis (MF) is the characteristic pathological feature of various cardiovascular diseases that lead to heart failure (HF) or even fatal outcomes. Alternatively, activated macrophages are involved in the development of fibrosis and tissue remodeling. Although the receptor for advanced glycation end products (RAGE) is involved in MF, its potential role in regulating macrophage function in cardiac fibrosis has not been fully investigated. We aimed to determine the role of macrophage RAGE in transverse aortic constriction (TAC)‐induced MF. In this study, we found that RAGE expression was markedly increased in the infiltrated alternatively activated macrophages within mice hearts after TAC. RAGE knockout mice showed less infiltration of alternatively activated macrophages and attenuated cardiac hypertrophy and fibrosis compared to the wild‐type mice. Our data suggest that mice with macrophage‐specific genetic deletion of RAGE were protected from interstitial fibrosis and cardiac dysfunction when subjected to pressure overload, which led to a decreased proportion of alternatively activated macrophages in heart tissues. Our in vitro experiments demonstrated that RAGE deficiency inhibited the differentiation into alternatively activated macrophages by suppressing autophagy activation. In the co‐culture system, in vitro polarization of RAW264.7 macrophages toward an alternatively activated phenotype stimulated the expression of α‐smooth muscle actin and collagen in cardiac fibroblasts. However, the knockdown of RAGE and inhibition of autophagy in macrophages showed reduced fibroblast‐to‐myofibroblast transition (FMT). Collectively, our results suggest that RAGE plays an important role in the recruitment and activation of alternatively activated macrophages by regulating autophagy, which contributes to MF. Thus, blockage of RAGE signaling may be an attractive therapeutic target for the treatment of hypertensive heart disease.
Spirituality and health outcomes within the context of social determinants of health
Authors: Wedgeworth Monika , Cody Shameka L. 
Published: October 2023

Abstract:
Spirituality has a significant impact on patients' overall quality of life, however, it is often overlooked in the context of social determinants of health (SDOH). Nurses are well positioned to lead the expansion of SDOH models to include spirituality; however, routine nursing care does not emphasize spiritual assessment knowledge and skills. This article discusses spirituality and how it fits into the SDOH model, nursing education, and interdisciplinary healthcare. Spiritual care training may improve the confidence of nurses to integrate routine mental and spiritual assessments in clinical practice and serve as leaders in promoting spiritual care within interdisciplinary healthcare teams.
Patient Motivation to Reduce or Discontinue Opioids for Chronic Pain
Authors: Crouch Taylor B. , Donovan Emily , Smith Wally R. , Barth Kelly , Becker William C. , Svikis Dace 
Published: October 2023

Objectives:
This study aimed to assess levels and predictors of self-efficacy and motivation to change opioid use among a community sample of patients using opioids for CP, as well as patient-reported barriers to pursuing opioid discontinuation.

Methods:
Participants with a variety of chronic pain conditions, recruited from ResearchMatch.org, completed a battery of electronic, self-report questionnaires assessing demographic and medical characteristics, pain treatment history, and levels of readiness, self-efficacy, and other attitudes toward reducing or discontinuing opioid use. Multiple regression analyses and analyses of variance were conducted to examine predictors of readiness and self-efficacy to change opioid use. A modified version of rapid qualitative analysis was utilized to analyze themes in participant responses to an open-ended item about “what it would take” to consider opioid discontinuation.

Results:
The final sample included N=119 participants, the majority of whom were female (78.2%), Caucasian (77.3%), and well-educated. Readiness and self-efficacy to decrease or stop opioid use were fairly low on a 0-10 Visual Analog Scale (2.6-3.8) and significantly higher to decrease than stop (P<0.01). Higher readiness to change was predicted by lower pain severity and higher concern about opioids, whereas higher self-efficacy was predicted by shorter pain duration. Results from the qualitative analyses revealed that availability of an alternative treatment option was the most commonly cited requirement to consider opioid discontinuation.

Discussion:
Patients with lower pain severity, shorter duration of pain, and higher concerns about opioids may be a prime target from a motivation standpoint for interventions addressing opioid tapering and discontinuation.
Anterior Cervical Discectomy and Fusion Versus Cervical Disc Replacement for a Workers’ Compensation Population in an Ambulatory Surgical Center
Authors: Patel Madhav R. , Jacob Kevin C. , Prabhu Michael C. , Shah Vivek P. , Vanjani Nisheka N. , Pawlowski Hanna , Singh Kern 
Published: October 2023

Study Design:
Retrospective Cohort.

Objective:
To evaluate patient-reported outcome measures (PROM) and minimal clinically important difference (MCID) achievement outcomes between anterior cervical discectomy and fusion (ACDF) and cervical disk replacement (CDR) in the Workers’ Compensation (WC) population.

Summary of Background Data:
No studies to our knowledge have compared PROMs and MCID attainment between ACDF and CDR among patients with WC insurance undergoing surgery in an outpatient ambulatory surgical center (ASC).

Methods:
WC insurance patients undergoing primary, single/double-level ACDF/CDR in an ASC were identified. Patients were divided into ACDF versus CDR. PROMs were collected at preoperative/6-week/12-week/6-month/1-year timepoints, including PROMIS-PF, SF-12 PCS/MCS, VAS neck/arm, and NDI.

Results:
Seventy-nine patients were included, 51 ACDF/28 CDR. While operative time (56.4 vs. 54.4 min), estimated blood loss (29.2 vs. 25.9 mL), POD0 pain (4.9 vs. 3.8), and POD0 narcotic consumption (21.2 vs. 14.5 oral morphine equivalents) were higher in ACDF patients, none reached statistical significance (P>0.050, all). One-year arthrodesis rate was 100.0% among ACDF recipients with available imaging (n=36). ACDF cohort improved from preoperative for PROMIS-PF from 12 weeks to 1 year, SF-12 PCS at 6 months, all timepoints for VAS neck/arm, and 12 weeks/6 months for NDI (P≤0.044, all). CDR cohort improved from preoperative for PROMIS-PF at 6 months, VAS neck/arm from 12 weeks to 1 year, and NDI at 12 weeks/6 months (P≤0.049, all). CDR cohort reported significantly lower VAS neck at 12 weeks/1 year and VAS arm at 12 weeks (P≤0.039, all). MCID achievement rates did not differ.

Conclusion:
While operative duration/estimated blood loss/acute postoperative pain/narcotic consumption were, on average, higher among ACDF recipients, these were not statistically significant, possibly due to the limited sample size. ACDF and CDR ASC patients generally demonstrated comparable arm pain/disability/physical function/mental health, though neck pain was significantly lower at multiple timepoints among CDR patients. Clinically meaningful PROM improvements were comparable. Larger, multicentered studies are required to confirm our results.
Bioenergetic Crisis in ICU-Acquired Weakness Gene Signatures Was Associated With Sepsis-Related Mortality: A Brief Report
Authors: Kobara Seibi , Rad Milad G. , Grunwell Jocelyn R. , Coopersmith Craig M. , Kamaleswaran Rishikesan 
Published: October 2023

OBJECTIVES:
To investigate the relationship between ICU-acquired weakness (ICUAW) signatures and sepsis-related mortality using gene expression from the blood within 24 hours of sepsis onset.

DESIGN:
Observational study using differential gene expression analysis.

SETTING:
Publicly available gene expression profile GSE54514, single-center medical and surgical ICU.

PATIENTS:
Patients with primary bacteremia- and respiratory-triggered sepsis including 8 nonsurvivors and 13 survivors who were 18 years old and older and admitted to ICU.

MEASUREMENTS AND MAIN RESULTS:
Among validated 526 ICUAW gene signatures, differential gene expression analysis controlling for age identified 38 significantly expressed genes between nonsurvivors and survivors. Functional enrichment analysis of differentially expressed ICUAW genes identified impaired cadherin binding, sarcomere formation, and energy metabolism among nonsurvivors.

CONCLUSIONS:
Our findings demonstrated a biological association between sepsis-related mortality and ICUAW signatures in the early phase of sepsis. Defects in energy metabolism and muscle fiber formation were associated with sepsis-related mortality.
Patient’s Perspective of Awake Proning: A Cross-Sectional Interview-Based Survey From COVID-19–Recovered Patients
Authors: Sethi Sher M. , Hirani Sana , Iqbal Rodaba , Ahmed Amber S. 
Published: October 2023

IMPORTANCE AND OBJECTIVES:To assess the knowledge, attitude, and practice of the patients who underwent prone positioning during their COVID-19 illness in the hospital.DESIGN:Cross-sectional study.SETTING:Aga Khan University Hospital, Karachi, Pakistan.PARTICIPANTS:COVID-19–recovered patients.INTERVENTIONS:None.MAIN OUTCOMES AND MEASURES:Knowledge was assessed by five questions with a dichotomous response (yes/no). An yes response was awarded 1 score. Since there were five questions, five would be the highest score. Patients’ perceptions of the therapy were assessed by four questions, each scored on a Likert scale of 5 (5 = strongly agree, 4 = agree, 3 = neither agree nor disagree, 2 = disagree, and 1 = strongly disagree). As it had four questions, the maximum score achieved could therefore be 20. Proning practices were assessed using seven questions: four were used to calculate practice scores, whereas three were open-ended regarding the patient’s experience. Each question carries a different score, and the maximum score was 8.RESULTS:The study included 98 patients. The mean age of the patients was 57 years (sd, 12.2 yr). Majority of the patients were males (70.4%). 69.1% of males and 76.6% of females fell in the poor knowledge group. The poor knowledge cohort had an educational level of 48% in high school, 45.5% in graduates, and 6% in postgraduates. Compared with 56.5% of males, 73% of females preferred prone positioning. Sixty percent of those with a high school education viewed prone positioning favorably, whereas 46% of those with graduate and postgraduate did. Seventy-nine percent of males and 63% of females scored positively on the practice questionnaire. Eighty percent of graduates and postgraduates preferred proning practices to 67% of participants with high school education levels.CONCLUSIONS AND RELEVANCE:Our study population had a little understanding of awake proning, found it unpleasant, and practiced for a shorter period than advised. Despite the overall negative attitude toward the position, our patients highly recommend this position to future patients.
Exposure to Perfluoroalkyl Substances and Hyperlipidemia Among Adults
Authors: Xing Weilong , Liang Mengyuan , Gu Wen , Wang Zhen , Fan Deling , Zhang Bing , Sun Shuai , Wang Lei , Shi Lili 
Published: October 2023

Background
The present study aims to explore the relationship between perfluoroalkyl substances (PFAS) exposure and hyperlipidemia using data from the National Health and Nutrition Examination Survey.

Methods
A total of 1600 subjects were included in the analysis, and nine kinds of PFAS were measured. Multivariate logistic regression analysis was performed to explore the association between serum PFAS and hyperlipidemia.

Results
Compared with the lowest quartile of perfluoromethylheptane sulfonic acid isomers (Sm-PFOS), the percentage change for hyperlipidemia was 57% and 41% in the third and highest quartile of PFOS. The positive association between Sm-PFOS and hyperlipidemia remained significant in population younger than 60 years, and the odds ratio for hyperlipidemia in fourth quartile of Sm-PFOS was 1.81.

Conclusions
These findings indicated that serum Sm-PFOS was independently associated with a higher risk for hyperlipidemia. The epidemiological study warrants further study to elucidate the causal relationship between them.
Excellence in Academic Physical Therapy: Promoting a Culture of Data Sharing
Authors: North Sara E. , Kosior Ken , Altenburger Peter , Binder-Macleod Stuart , Brechter Jacklyn , Deoghare Harsha , Topp Kimberly 
Published: October 2023

Background and Purpose.Data analytics are increasingly important in health professions education to identify trends and inform organizational change in rapidly evolving environments. Unfortunately, limitations exist in data currently available to determine physical therapy (PT) academic excellence. It is imperative that the American Council of Academic Physical Therapy (ACAPT) be able to demonstrate data-informed progress in addressing the common challenges faced by Doctor of Physical Therapy programs.Position and Rationale.The Task Force to Explore Data and Technology to Evaluate Program Outcomes was convened by ACAPT to explore current and desired data and the needs, technology, and costs that would be required for ACAPT to assess program outcomes relative to excellence criteria. The Task Force performed a gap analysis of measures of excellence, provided evidence-based recommendations for advancing the use of data and technology systems in academic PT, and generated a comprehensive Assessment Excellence Map that subsequently led to a new streamlined Excellence Framework in the launch of the ACAPT Center for Excellence.Discussion and Conclusion.The vision of universal excellence in PT education necessitates clear alignment and centralization of common data to support efficient processes to assess excellence. The transformative nature of data is untapped in PT academic endeavors, and nascent work to establish and sustain a culture of centralized data sharing and assessment will help to drive program-level and profession-level excellence in PT education.
Determinants of Cochlear Implant Satisfaction and Decisional Regret in Adult Cochlear Implant Users
Authors: Shannon Christian M. , Schvartz-Leyzac Kara C. , Dubno Judy R. , McRackan Theodore R. 
Published: October 2023

Objective
Determine associations expected and actual cochlear implant (CI) outcomes, decisional regret, and satisfaction in experienced adult CI users.

Study Design
Cross-sectional cohort study.

Setting
Tertiary medical center.

Patients
Thirty-nine adult CI users meeting traditional bilateral hearing loss indications with ≥12 months CI experience.

Interventions/Main Outcome Measures
Patients completed the validated Satisfaction with Amplification in Daily Living and Decisional Regret instruments. Pre- and post-CI outcomes (CI Quality of Life [CIQOL]-Expectations; CIQOL-35 Profile; CNC words, AzBio Sentences) were obtained from a prospectively maintained clinical database.

Results
Using established cutoff scores, 29% of patients reported a substantial degree of post-CI decisional regret. For each CIQOL domain, patients without decisional regret obtained post-CI outcome scores closer to pre-CI expectations compared with patients with decisional regret (d = 0.34 to 0.91); similar results were observed with higher CI user satisfaction (d = 0.17–0.83). Notably, the degree of pre- to post-CI improvement in CNC or AzBio scores did not differ between patients with and without decisional regret or with lower and higher satisfaction. Finally, greater pre-/postimprovement in CIQOL-35 Profile domain scores demonstrated far stronger associations with lower decisional regret and higher satisfaction than changes in speech recognition scores.

Conclusions
Patients with better alignment of their pre-CI expectations and post-CI outcomes and greater pre-/post-CIQOL improvement had lower decisional regret and higher satisfaction. This emphasizes the importance of evidence-based pre-CI counseling regarding real-world CI benefits and caution against assuming that improvements in speech recognition are related to patient satisfaction.
Anatomic Location of Tissue Expander Placement Is Not Associated With Delay in Adjuvant Therapy in Women With Breast Cancer
Authors: Elder Erin , Fasola Carolina , Clavin Nicholas , Hecksher Anna , Trufan Sally , Schepel Courtney , Donahue Erin , Warren Yancey , White Richard L. , Hadzikadic-Gusic Lejla 
Published: October 2023

BackgroundTissue expanders in breast reconstruction are traditionally placed retropectoral. Increasingly, patients are undergoing prepectoral placement. The impact of this placement on the initiation of adjuvant treatment is unknown.MethodsA retrospective review was conducted to identify women diagnosed with breast cancer who underwent mastectomy followed by radiation and/or chemotherapy. Women were divided into 3 groups: prepectoral tissue expander placement, retropectoral tissue expander placement, and no immediate reconstruction. A treatment delay was defined as greater than 8 weeks between tissue expander placement and adjuvant therapy.ResultsOf 634 women, 205 (32%) underwent tissue expander placement, and 429 (68%) did not have immediate reconstruction. Of those with tissue expanders placed, 84 (41%) had prepectoral placement, and 121 (59%) had retropectoral placement. The median time to adjuvant therapy was 49 days for the entire cohort: no reconstruction, 47 days; prepectoral, 57 days; and retropectoral, 55 days. Treatment delays were observed in 34% of women: no reconstruction, 28%; prepectoral, 51%; and retropectoral, 46% (P< 0.001). Tissue expander placement was associated with a delay to adjuvant therapy when compared with no reconstruction (P <0.001). The location of the tissue expander did not impact the odds of having a delay. On multivariable analysis, having reconstruction, having postoperative infection, not undergoing chemotherapy treatment, and being a current smoker were associated with a delay to adjuvant therapy. A delay to treatment was not associated with worse survival.ConclusionsPlacement of a tissue expander delayed adjuvant therapy. The location of tissue expander placement, retropectoral versus prepectoral, did not impact the time to adjuvant treatment.