bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can academic detailing reduce opioid prescriptions in chronic non-cancer pain?
Authors: Espnes Ketil Arne , Nøst Torunn Hatlen , Handal Marte , Skurtveit Svetlana O. , Langaas Harald C. 
Published: March 2023

Abstract
Background
One measure to support optimal opioid prescription is academic detailing (AD) with one-to-one visits by trained professionals (academic detailers) to general practitioners (GPs).
Objective: To investigate the usefulness of AD visits on GPs’ opioid prescribing patterns in Norway, and academic detailers’ experiences with AD visits to GPs on opioid prescription.

Methods
Design: A quantitative registry study on opioid prescriptions and a qualitative focus group interview study with academic detailers.
Participants: For the registry study, municipalities where more than 75% of the GPs had received an AD visit were considered intervention municipalities, whereas in the non-intervention municipalities no GPs had received AD-visits. In the focus groups, academic detailers who had conducted three or more AD-visits were invited to participate.
Intervention: A campaign on opioid prescription with AD visits using a brochure with key messages based on the national guideline for treatment of chronic non-cancer pain and updated evidence on the potential benefits and risks of prescribing opioids. The AD visits in the campaign were planned for 20–25 min in a one-to-one setting in the GP’s office.
Main Measures: The Norwegian Prescription Database (NorPD) was utilized for registry data. Data on amount of drugs dispensed are recoded as Defined Daily Doses (DDDs).

Results
Compared to non-intervention, the intervention resulted in a decrease in the number of prevalent and incident users of opioids and incident users of reimbursed opioids for chronic non-cancer pain in municipalities in Central Norway. The results from the focus group interviews were categorized into the themes: “To get in position”, “Adjusting messages”, “What did the GPs struggle with, in relation to opioid prescription?” and “Did we reach the right recipients with the visits?”.

Conclusions
In Central Norway, the intervention resulted in a desired effect on number of opioid users. According to the academic detailers, the GPs’ length of working experience and familiarity with the topic gave different presumptions for making use of the information presented in the AD-visits.
Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage
Authors: Niemelä Jarmo , Kallio Raija , Ohtonen Pasi , Saarnio Juha , Syrjälä Hannu 
Published: March 2023

Abstract
Purpose
To evaluate the impact of cholangitis on survival of patients with gastrointestinal cancer and malignant biliary obstruction treated with percutaneous transhepatic biliary drainage (PTBD).

Methods
A retrospective registry study was performed at a tertiary center from 2000 to 2016 in Northern Finland.

Results
The study included 588 patients, 258 (43.9%) patients with pancreatic cancer, 222 (37.7%) with biliary tract cancer, and 108 (18.4%) with metastasis from gastrointestinal cancers. Patient mean age was 70 years, range 26 − 93 years. There were 288 [49.0%] women. The 30-day mortality rate was 30.8% for 156 patients with cholangitis before PTBD, 19.5% for 215 patients with cholangitis after PTBD and 25.8% for 217 patients without cholangitis (P = 0.039). The median survival was 1.8 months for patients with cholangitis before PTBD, 3.0 months for patients with cholangitis after PTBD, and 3.2 months for patients without cholangitis (P = 0.002). The hazard ratio (HR) for 1-year mortality for patients with cholangitis before PTBD was 1.3 (95% CI 1.06 − 1.67, P = 0.015) compared to patients with cholangitis after PTBD. After successful PTBD, 54 out of 291 patients received chemotherapy; the median survival was 5.2 months with cholangitis before PTBD, 9.4 months with cholangitis after PTBD and 15.3 months without cholangitis.

Conclusion
In gastrointestinal cancers with malignant biliary obstruction, survival is poorer if cholangitis occurs before PTBD compared to cholangitis after PTBD. An oncologist’s consultation is essential for assessing the possibility of chemotherapy in successfully treated PTBD patients, because of the notable survival benefit.
Increased incidence and improved survival in endometrial cancer in Sweden 1960–2014: a population-based registry survey
Authors: Herbst Filip , Dickman Paul W. , Moberg Louise , Högberg Thomas , Borgfeldt Christer 
Published: March 2023

Abstract
Background
An investigation of trends of incidence and net survival (NS) for endometrial cancer in Sweden.

Methods
Morphologically verified endometrial carcinoma diagnosed 1960 to 2014 were collected from the nation-wide Swedish Cancer Registry. Endometrial cancer patients were assessed with regards to time trends for incidence and 54,825 cases remained for survival analyses. Cases diagnosed 1995 to 2014 were categorized according to detailed morphology and from 2005 to 2014 FIGO stage was also categorized.

Results
There was a trend of increasing incidence of endometrial carcinoma for women above 55 years of age. NS was improved at 5- and 10-year follow-up. The 5-year net survival in 2010–2014 was 86%. The most prominent improvement in NS was found in the elderly women above 75 years of age.

Conclusions
This study observed increased incidence of endometrial cancer in Sweden from 1960 to 2014. The progress in diagnostics and treatment, seem to have improved the net survival, especially in elderly women.
A scoping review on the impact of the COVID-19 pandemic on physical activity and sedentary behavior in Saudi Arabia
Authors: Evenson Kelly R. , Alothman Shaima A. , Moore Christopher C. , Hamza Mariam M. , Rakic Severin , Alsukait Reem F. , Herbst Christopher H. , Baattaiah Baian A. , AlAhmed Reem , Al-Hazzaa Hazzaa M. , Alqahtani Saleh A. 
Published: March 2023

AbstractBackgroundIn Saudi Arabia, stay-at-home orders to address the coronavirus disease 2019 (COVID-19) pandemic between March 15 and 23, 2020 and eased on May 28, 2020. We conducted a scoping review to systematically describe physical activity and sedentary behavior in Saudi Arabia associated with the timing of the lockdown.MethodsWe searched six databases on December 13, 2021 for articles published in English or Arabic from 2018 to the search date. Studies must have reported data from Saudi Arabia for any age and measured physical activity or sedentary behavior.ResultsOverall, 286 records were found; after excluding duplicates, 209 records were screened, and 19 studies were included in the review. Overall, 15 studies were cross-sectional, and 4 studies were prospective cohorts. Three studies included children and adolescents (age: 2–18 years), and 16 studies included adults (age: 15–99 years). Data collection periods were <  = 5 months, with 17 studies collecting data in 2020 only, one study in 2020–2021, and one study in 2021. The median analytic sample size was 363 (interquartile range 262–640). Three studies of children/adolescents collected behaviors online at one time using parental reporting, with one also allowing self-reporting. All three studies found that physical activity was lower during and/or following the lockdown than before the lockdown. Two studies found screen time, television watching, and playing video games were higher during or following the lockdown than before the lockdown. Sixteen adult studies assessed physical activity, with 15 utilizing self-reporting and one using accelerometry. Physical activity, exercise, walking, and park visits were all lower during or following the lockdown than before the lockdown. Six adult studies assessed sedentary behavior using self-report. Sitting time (4 studies) and screen time (2 studies) were higher during or following the lockdown than before the lockdown.ConclusionsAmong children, adolescents, and adults, studies consistently indicated that in the short-term, physical activity decreased and sedentary behavior increased in conjunction with the movement restrictions. Given the widespread impact of the pandemic on other health behaviors, it would be important to continue tracking behaviors post-lockdown and identify subpopulations that may not have returned to their physical activity and sedentary behavior to pre-pandemic levels to focus on intervention efforts.
Trends and quality of randomized controlled trials on acupuncture conducted in Japan by decade from the 1960s to the 2010s: a systematic review
Authors: Masuyama Shoko , Yamashita Hitoshi 
Published: March 2023

Abstract
Background
More new randomized controlled trials (RCTs) on acupuncture have been published in Japan since our last updated systematic review (2010). This systematic review aimed to evaluate the quality of RCTs on acupuncture conducted in Japan and understand the decade-wise changes in the methodological characteristics of the relevant RCTs.

Methods
The literature search was performed using Ichushi Web, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and our team’s compilation of relevant papers. We included full-length papers reporting RCTs that examined the clinical effects of acupuncture on patients in Japan published in or before 2019. We assessed the risk of bias (RoB), sample size, control setting, negative trial reporting, informed consent, ethics approval, trial registration, and adverse event reporting.

Results
A total of 99 articles reporting 108 eligible RCTs were identified. The number of RCTs published in each decade was 1, 6, 9, 5, 40, and 47 in the 1960s, 1970s, 1980s, 1990s, 2000s, and 2010s, respectively. Quality assessment using the Cochrane RoB tool revealed that “sequence generation” improved in and after 1990 (73%–80% of RCTs were rated as “low”) and “blinding of outcome assessors” slightly improved in and after the 2000s (40%–50% judged as “low”). However, “high” or “unclear” remained the dominant grades in other domains. Clinical trial registration and adverse events were reported only in 9% and 28% of the included RCTs even in the 2010s, respectively. A different acupuncture method or different point selection (e.g., deep vs. shallow insertion) was the most dominant control setting before 1990, while sham (or “placebo”) needling and/or sham acupoints became the most dominant in the 2000s. The proportion of RCTs with positive results was 80% in the 2000s and 69% in the 2010s.

Conclusions
The quality of RCTs on acupuncture conducted in Japan did not appear to have improved over the decades except for “sequence generation.” While the culture of submitting negative trial reports was prevalent in the Japanese acupuncture research milieu as late as the 1990s, the overall quality of the relevant trials needs to be further improved.
Knowledge and attitude towards pediatric pain management among nurses at Ethiopian tertiary hospitals; a multi-center study
Authors: Tagele Takele Dereje , Berhe Yophtahe Woldegerima , Lema Girmay Fitiwi 
Published: March 2023

Abstract
Background
Pain is the most disturbing and annoying symptom experienced by children. However, it obtains poor attention in low- and middle-income countries particularly. The objective of this study was to assess knowledge, attitude and factors associated with pediatric pain management among nurses in tertiary hospitals in Northwest Ethiopia.

Methodology
: A multi-center cross-sectional study was conducted from March 1 to April 30, 2021. The knowledge and attitude of nurses were measured by using Nurses’ Knowledge and Attitudes Survey regarding Pain (P-NKAS). Descriptive and binary logistic regression analyses were performed to determine factors associated with knowledge and attitude. The strength of the association was presented by using adjusted odds ratio with 95% confidence interval and p-value < 0.05 was considered as statistically significant.

Result
A total of 234 (86.03% response rate) nurses were included and 67.1% of nurses had good knowledge and 89.3% had favorable attitudes towards pediatric pain management. The factors associated with good knowledge were having Bachelor’s Degree and above [AOR = 2.1, P = 0.015], having in-service training [AOR = 2.4, P = 0.008] and favorable attitude [AOR = 3.3, CI = 0.008]. The nurses who demonstrated good knowledge [AOR = 3.3, P = 0.003] and those who had Bachelor’s Degree and above [AOR = 2.8, P = 0.03] were found to have favorable attitude.

Conclusion
The nurses who were working in pediatrics care areas had good knowledge and favorable attitude towards pediatrics pain management. However, improvements are needed to eradicate misconceptions; particularly, on pediatrics pain perception, opioid analgesia, multimodal analgesia, and non-pharmacologic pain therapies. Nurses who had higher level of education, in-service training, favorable attitude were found to be knowledgeable. Furthermore, nurses who had higher levels of education and knowledge were found to have favorable attitude.
Long-term ambient air pollution exposure and cardio-respiratory disease in China: findings from a prospective cohort study
Authors: Wright Neil , Newell Katherine , Chan Ka Hung , Gilbert Simon , Hacker Alex , Lu Yan , Guo Yu , Pei Pei , Yu Canqing , Lv Jun , Chen Junshi , Li Liming , Kurmi Om , Chen Zhengming , Lam Kin Bong Hubert , Kartsonaki Christiana 
Published: March 2023

Abstract
Background
Existing evidence on long-term ambient air pollution (AAP) exposure and risk of cardio-respiratory diseases in China is mainly on mortality, and based on area average concentrations from fixed-site monitors for individual exposures. Substantial uncertainty persists, therefore, about the shape and strength of the relationship when assessed using more personalised individual exposure data. We aimed to examine the relationships between AAP exposure and risk of cardio-respiratory diseases using predicted local levels of AAP.

Methods
A prospective study included 50,407 participants aged 30–79 years from Suzhou, China, with concentrations of nitrogen dioxide (NO2), sulphur dioxide (SO2), fine (PM2.5), and inhalable (PM10) particulate matter, ozone (O3) and carbon monoxide (CO) and incident cases of cardiovascular disease (CVD) (n = 2,563) and respiratory disease (n = 1,764) recorded during 2013–2015. Cox regression models with time-dependent covariates were used to estimate adjusted hazard ratios (HRs) for diseases associated with local-level concentrations of AAP exposure, estimated using Bayesian spatio–temporal modelling.

Results
The study period of 2013–2015 included a total of 135,199 person-years of follow-up for CVD. There was a positive association of AAP, particularly SO2 and O3, with risk of major cardiovascular and respiratory diseases. Each 10 µg/m3 increase in SO2 was associated with adjusted hazard ratios (HRs) of 1.07 (95% CI: 1.02, 1.12) for CVD, 1.25 (1.08, 1.44) for COPD and 1.12 (1.02, 1.23) for pneumonia. Similarly, each 10 µg/m3 increase in O3 was associated with adjusted HR of 1.02 (1.01, 1.03) for CVD, 1.03 (1.02, 1.05) for all stroke, and 1.04 (1.02, 1.06) for pneumonia.

Conclusions
Among adults in urban China, long-term exposure to ambient air pollution is associated with a higher risk of cardio-respiratory disease.
Exploring the psychometric properties of the professional issues in maternal mental health scale (PIMMHS) in a Chinese population
Authors: Lin Lu , Guo Huimin , Fang Qian , Martin Colin R. , Jin Aiying , Xie Congyan , Tian Li , Jomeen Julie 
Published: March 2023

Abstract
Background
The public health and economic implications of perinatal mental health problems are well documented. Maternity clinicians are ideally placed to effectively identify women at risk and facilitate early intervention. However, in China as globally a number of issues are implicated in a failure to recognise and treat.

Aim
The present study sought to develop and evaluate the Chinese version ‘professional issues in maternal mental health’ scale (PIMMHS), explore its psychometric properties and potential application.

Methods
A cross-sectional design and instrument translation and evaluation approach was taken to investigate the psychometric properties of the PIMMHS in a Chinese population. A total of 598 obstetricians, obstetric nurses, and midwives participated in this study from 26 hospitals across China.

Findings
The Chinese PIMMHS was not a good fit to the original two factor model. The emotion/communication subscale yielded an excellent fit to the data according to all fit indices, offering compelling evidence for a single factor solution. The training (PIMMHS: Training), proved problematic throughout the analysis with divergent validity for the training subscale also being poor with a concomitant impact on the total scale performance. The performance of this subscale may be related to the nature of medical training and PMH.

Conclusion
The Chinese PIMMHS comprises a unidimensional scale of emotion/ communication, which is simple and may provide insight into the emotional burden of providing PMH care, with the potential to mitigate that burden. Further development and investigation of the training sub-scale could be of value.
ERK-estrogen receptor α signaling plays a role in the process of bone marrow mesenchymal stem cell-derived exosomes protecting against ovariectomy-induced bone loss
Authors: Qi Hui , Shen Enpu , Shu Xiong , Liu Danping , Wu Cheng’ai 
Published: March 2023

Abstract
Background
Exosomes derived from bone marrow mesenchymal stem cells (BMSC-Exos) are considered as candidates for osteoporosis (OP) therapy. Estrogen is critical in the maintenance of bone homeostasis. However, the role of estrogen and/or its receptor in BMSC-Exos treatment of OP, as well as its methods of regulation during this process remain unclear.

Methods
BMSCs were cultured and characterized. Ultracentrifugation was performed to collect BMSC-Exos. Transmission electron microscopy, nanoparticle tracking analysis, and western blotting were used to identify BMSC-Exos. We examined the effects of BMSC-Exos on the proliferation, osteogenic differentiation, mineralization, and cell cycle distribution of MG-63 cells. The protein expression of estrogen receptor α (ERα) and the phosphorylation of ERK were investigated through western blotting. We determined the effects of BMSC-Exos on the prevention of bone loss in female rats. The female Sprague–Dawley rats were divided into three groups: the sham group, ovariectomized (OVX) group, and the OVX + BMSC-Exos group. Bilateral ovariectomy was performed in the OVX and OVX + BMSC-Exos groups, while a similar volume of adipose tissue around the ovary was removed in the sham group. The rats in OVX group and OVX + BMSC-Exos group were given PBS or BMSC-Exos after 2 weeks of surgery. Micro-CT scanning and histological staining were used to evaluate the in vivo effects of BMSC-Exos.

Results
BMSC-Exos significantly enhanced the proliferation, alkaline phosphatase activity, and the Alizarin red S staining in MG-63 cells. The results of cell cycle distribution demonstrated that BMSC-Exos increased the proportion of cells in the G2 + S phase and decreased the proportion of cells in the G1 phase. Moreover, PD98059, an inhibitor of ERK, inhibited both the activation of ERK and the expression of ERα, which were promoted by administration of BMSC-Exos. Micro-CT scan showed that in the OVX + BMSC-Exos group, bone mineral density, bone volume/tissue volume fraction, trabecular number were significantly upregulated. Additionally, the microstructure of the trabecular bone was preserved in the OVX + BMSC-Exos group compared to that in the OVX group.

Conclusion
BMSC-Exos showed an osteogenic-promoting effect both in vitro and in vivo, in which ERK-ERα signaling might play an important role.
Is proximal tibial tubercle osteotomy superior to distal tibial tubercle osteotomy for medial compartmental osteoarthritis? A meta-analysis
Authors: Song Min , Lin Xiaodong , Han Weichang , Li Jingyi , Liu Wengang 
Published: March 2023

Abstract
Background
Open-wedge high tibial osteotomy (OWHTO) is commonly performed for the treatment of medial compartment knee osteoarthritis (KOA), and is classified into proximal tibial tubercle osteotomy (PTO) and distal tibial tubercle osteotomy (DTO). The PTO osteotomy point is generally located about 3–4 cm below the joint of the proximal tibia, and the osteotomy line points to the upper part of the proximal tibiofibular joint. The DTO osteotomy point is generally located about 0.5–1.0 cm below the tibial tubercle, and the osteotomy line points to the contralateral cortex. However, there is currently no consensus on which surgical technique is superior. The purpose of our study was to investigate which among the two is superior for medial KOA, with respect to knee joint parameters, clinical function, and complications.

Methods
This study was conducted as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Cochrane Central Library, MEDLINE, Embase, PubMed, CNKI, and WanFang databases were systematically searched for trials comparing PTO and DTO in patients with medial compartment KOA, from inception until March 2022. The meta-analysis was conducted using RevMan 5.2 software. The Cochrane risk-of-bias tool was used to assess methodological quality. Statistical analysis was performed with Stata 12.0. Outcomes of interest included the Insall-Salvati index (ISI), Caton-Deschamps index (CDI), Blackburne-Peel index (BPI), posterior tibial slope (PTS), and the Hospital for Special Surgery (HSS) knee-rating scale.

Results
A total of 15 retrospective studies (910 knees) were included. There were no significant differences in the age or sex of included patients. There was a significant difference in the ISI, CDI, BPI, and PTS between the two groups (all p ≤ 0.05). Further, DTO was associated with a significantly greater number of postoperative complications (p < 0.05) compared to PTO. However, there was no significant difference in the femorotibial angle (FTA), mechanical medial proximal tibial angle (mMPTA), and HSS knee score (all p > 0.05).

Conclusions
Compared with DTO, PTO is associated with a greater incidence of postoperative patella baja and increased PTS, whereas DTO is associated with more postoperative complications. Nevertheless, both can significantly correct knee varus deformity and improve knee function; their early knee function scores are also similar.
Trial Registration. Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42021284443.
Priming of the murine mammary gland with Staphylococcus chromogenes IM reduces bacterial growth of Streptococcus uberis: a proof-of-concept study
Authors: Vander Elst Niels , Bellemans Julie , Steenbrugge Jonas , Geeroms Chloë , Breyne Koen , Piepers Sofie , Toledo-Silva Bruno , de Souza Fernando Nogueira , Haesebrouck Freddy , De Vliegher Sarne , Meyer Evelyne 
Published: March 2023

AbstractStreptococcus uberis is a major causative agent of bovine mastitis, an inflammation of the mammary gland with substantial economic consequences. To reduce antibiotic use in animal agriculture, alternative strategies to treat or prevent mastitis are being investigated. Bovine-associated non-aureus staphylococci are proposed in that respect due to their capacity to inhibit the in vitro growth of S. uberis. We demonstrate that priming the murine mammary gland with Staphylococcus chromogenes IM reduces S. uberis growth in comparison with non-primed glands. The innate immune system is activated by increasing IL-8 and LCN2, which may explain this decreased growth.