bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Mediators of Mental Health Service Use Among Transgender Individuals in Ontario, Canada
Authors: Abramovich Alex , Gould W. Ariel , Pang Nelson , de Oliveira Claire , Iwajomo Tomisin , Vigny-Pau Myriam , MacKinnon Kinnon , Lam June Sing Hong , Kurdyak Paul 
Published: May 2023

Objectives To determine if and to what degree neighbourhood-level marginalization mediates mental health service use among transgender individuals. Methods This retrospective cohort study identified 2,085 transgender individuals through data obtained from 4 outpatient community and hospital clinics in 3 large cities in Ontario, which were linked with administrative health data between January 2015 and December 2019. An age-matched 1:5 comparison cohort was created from the general population of Ontario. Outcome measures were analysed from March 2020 to May 2022. The primary outcome was mental health service utilization, which included mental health-related visits to primary care providers, psychiatrists, mental health- and self-harm-related emergency department visits, and mental health hospitalizations. Mediation variables included ethnic concentration, residential instability, dependency, and material deprivation at the neighbourhood level and were derived from the Ontario Marginalization Index. Results This study identified 2,085 transgender individuals from participating outpatient community and hospital clinics, who were matched to the general population ( n = 10,425). Overall, neighbourhood-level marginalization did not clinically mediate mental health service use. However, transgender individuals were more likely to be exposed to all forms of neighbourhood-level marginalization, as well as having higher rates of health service use across all outcome measures. Conclusions In this study, mental health service use among transgender individuals was not clinically mediated by marginalization at the neighbourhood level. This study highlights the need to explore marginalization and mental health service use at the individual level to better understand the mental health disparities experienced by transgender individuals and to ensure that health-care services are inclusive and affirming.
Factors associated with teenage pregnancy in the Scandinavian countries
Authors: Bennetsen Ane K.K. , Faber Mette T. , Nygaard Mari , Sundström Karin , Hansen Bo T. , Thomsen Louise T. , Munk Christian , Frederiksen Kirsten , Kjaer Susanne K. 
Published: May 2023

Aims: Teenage pregnancy may have negative consequences for the mother and the infant. The aim of the study was to examine whether selected individual factors occurring early in life were associated with teenage pregnancy. Methods: In a population-based, cross-sectional questionnaire study among 34,455 women from Denmark, Norway, and Sweden aged 20–45 years, who had first sexual intercourse (FSI) at age 13–19 years, we assessed the association between early smoking and drinking initiation (i.e., before the age of 13), contraceptive use at FSI, and teenage pregnancy. Log-linear binary regression models were fitted to estimate the relative risk (RR) with 95% confidence intervals (CIs) of teenage pregnancy according to the three exposure variables, overall and by age at FSI. Furthermore, the outcomes of the teenage pregnancies were examined according to age at FSI. Results: Teenage pregnancy occurred in 11% of the population. Both early smoking initiation (RR: 1.6; 95% CI: 1.4–1.8), early drinking initiation (RR: 1.2; 95% CI: 1.0–1.4), and non-use of contraceptives at FSI (RR: 1.9; 95% CI: 1.8–2.0) were associated with teenage pregnancy. The associations for early smoking initiation and non-use of contraceptives remained when analyses were stratified by age at FSI. Almost 60% of all teenage pregnant women had an induced abortion and less than 30% gave birth. Conclusions: Individual factors, including early smoking and drinking initiation, and non-use of contraceptives at FSI, were associated with teenage pregnancy regardless of age at FSI. This emphasizes the necessity of focusing on early risk-taking behavior as a potential modifier to prevent teenage pregnancy.
Does Exercise Attenuate Disease Progression in People With Parkinson’s Disease? A Systematic Review With Meta-Analyses
Authors: Li Jiecheng A , Loevaas Marte B. , Guan Catherine , Goh Lina , Allen Natalie E. , Mak Margaret K. Y. , Lv Jinglei , Paul Serene S. 
Published: May 2023

Introduction Exercise has many benefits for people with Parkinson’s disease (PD) and has been suggested to modify PD progression, but robust evidence supporting this is lacking. Objective This systematic review (PROSPERO registration: CRD42020169999) investigated whether exercise may have neuroplastic effects indicative of attenuating PD progression. Methods Six databases were searched for randomized controlled trials (RCTs) that compared the effect of exercise to control (no or sham exercise) or to another form of exercise, on indicators of PD progression (eg, brain-derived neurotrophic factor [BDNF], brain activation, “off” Unified Parkinson’s Disease Rating Scale [UPDRS] scores). Trial quality was assessed using the Physiotherapy Evidence Database Scale. Random-effects meta-analyses were performed where at least 3 comparable trials reported the same outcome; remaining results were synthesized narratively. Results Forty-nine exercise trials involving 2104 PD participants were included. Compared to control, exercise improved “off” UPDRS motor scores (Hedge’s g −0.39, 95% CI: −0.65 to −0.13, P = .003) and BDNF concentration (Hedge’s g 0.54, 95% CI: 0.10-0.98, P = .02), with low to very low certainty of evidence, respectively. Narrative synthesis for the remaining outcomes suggested that compared to control, exercise may have neuroplastic effects. The exercise versus exercise comparisons were too heterogenous to enable pooling of results. Discussion This review provides limited evidence that exercise may have an attenuating effect on potential markers of PD progression. Further large RCTs are warranted to explore differential effects by exercise type, dose and PD stage, and should report on a core set of outcomes indicative of PD progression.
The Role of Epigenomics in Mapping Potential Precursors for Foot and Ankle Tendinopathy: A Systematic Review
Authors: Williams Samantha , Ligas Chandler , Oloff Lawrence , Klein Teri E. 
Published: May 2023

Tendinopathy of the foot and ankle is a common clinical problem for which the exact etiology is poorly understood. The field of epigenetics has been a recent focus of this investigation. The purpose of this article was to review the genomic advances in foot and ankle tendinopathy that could potentially be used to stratify disease risk and create preventative or therapeutic agents. A multi-database search of PubMed, Cochrane, Google Scholar, and clinicaltrials.gov from January 1, 2000 to July 1, 2022 was performed. A total of 18 articles met inclusion and exclusion criteria for this review. The majority of such research utilized case-control candidate gene association to identify different genetic risk factors associated with chronic tendinopathy. Polymorphisms in collagen genes COL5A1, COL27A1, and COL1A1 were noted at a significantly higher frequency in Achilles tendinopathy versus control groups. Other allelic variations that were observed at an increased incidence in Achilles tendinopathy were TNC and CASP8. The extracellular matrix (ECM) demonstrated macroscopic changes in Achilles tendinopathy, including an increase in aggrecan and biglycan mRNA expression, and increased expression of multiple matrix metalloproteinases. Cytokine expression was also influenced in pathology and aberrantly demonstrated dynamic response to mechanical load. The pathologic accumulation of ECM proteins and cytokine expression alters the adaptive response normal tendon has to physiologic stress, further propagating the risk for tendinopathy. By identifying and understanding the epigenetic mediators that lead to tendinopathy, therapeutic agents can be developed to target the exact underlying etiology and minimize side effects. Level of Evidence: Level IV: Systematic Review of Level II-IV Studies
Examining the Impact of Elastomeric Half Mask Respirator Knowledge and User Barriers on Safety Climate Perceptions in Health Care Settings
Authors: Haas Emily J. , Yoon Katherine , McClain Caitlin , Sietsema Margaret , Hornbeck Adam , Hines Stella , Chalikonda Sricharan , Angelilli Sara , Waltenbaugh Hope , Thurman Paul , Napoli Meghan , Fernando Rohan 
Published: May 2023

Background: Availability of personal protective equipment (PPE) and its effective use may influence safety climate perceptions among health care personnel (HCP). It is unclear how health care organizations can leverage the effective use of respiratory protection to engage in continuous improvement of their safety climate, which can inform opportunities for employee education and engagement. Methods: After using an elastomeric half mask respirator (EHMR) as their primary form of respiratory protection for several months, 1,080 HCP provided feedback in an electronic survey about respiratory protection training, confidence in EHMR use, barriers during use, and perceived safety climate. Ordinal logistic regressions were used as nonlinear models to test relationships between these variables. Findings: We observed that an increase in user confidence ( p < .013), training content ( p < .001), training formats ( p < .001), and a decrease in EHMR barriers ( p < .001) were associated with a statistically significant increase in proactive safety climate. In the second model, an increase in user confidence ( p < .006) and training content ( p < .001), and a decrease in barriers ( p < .001), was associated with a statistically significant increase in compliant safety climate. Conclusions/Application to Practice: HCP EHMR confidence was positively associated with safety climate perceptions, underscoring the value of competency building by respiratory protection leaders prior to implementation. Because fewer barriers experienced while using an EHMR were associated with a more positive perception of safety climate, it is important to first communicate with end users about potential barriers and, second, to continue research with end users and manufacturers to improve the design of EHMRs moving forward.
Survivorship of Allologous Structural Bone Graft at a Minimum of 2 Years When Used to Address Significant Glenoid Bone Loss in Revision Shoulder Arthroplasty: A Computed Tomographic and Clinical Review
Authors: Viswanath Aparna , Newell Amy K , Cunningham Lindsay J , Walton Mike , Monga Puneet , Bale Steve , Trail Ian A 
Published: May 2023

Background This study assesses outcomes in revision shoulder replacements where the glenoid bone loss was managed using a structural allograft (donated femoral head) in combination with a trabecular titanium (TT) implant. Methods We contacted patients who had undergone revision shoulder arthroplasty using the Lima Axioma TT metal-backed glenoid with an allologous bone graft as a composite who were over 2 years since surgery. Patients underwent computerd tomography evaluation, clinical review, and scoring preoperatively, at 6 months and the latest follow-up. Results Fifteen patients were included with a mean age of 59 (33-76). The average follow-up period was 40.5 months (24-51). 80% showed satisfactory bone graft incorporation and peg integration at the latest follow-up. Three had signs of significant bone graft resorption, although in 2 patients the pegs were still soundly fixed in the host bone. Clinically all patients showed a statistically significant improvement in pain relief, movement, and function. No unusual complications were reported. Conclusion Results show femoral head structural allograft in combination with TT metal-backed glenoid baseplate is a viable option for revision total shoulder replacement in the context of massive glenoid bone loss. We do, however, acknowledge that this resorption rate is higher than in other reported series where autograft is used.
Critical vulnerabilities for diversion of controlled substances in the emergency department: Observations and healthcare failure mode and effect analysis
Authors: de Vries Maaike , Fan Mark , Tscheng Dorothy , Hamilton Michael , Trbovich Patricia 
Published: May 2023

Objectives Drug theft by healthcare workers is a recognized problem in emergency departments (EDs) that can lead to patient, healthcare worker, and organization harm. Diversion takes various forms, including tampering with syringes, pilfering from waste containers and falsely documenting drug administration. Before implementing risk-mitigating interventions, we need a detailed understanding of the vulnerabilities in ED medication-use processes. This study sought to identify the critical failure modes (CFMs) within EDs that increase diversion risk and characterize the system factors contributing to CFMs. Methods Between June 2018 and February 2019, we conducted observations in two Ontario EDs. Observers recorded tasks carried out by nurses, pharmacists, and physicians. We performed a Healthcare Failure Mode and Effect Analysis, informed by the observation data, to proactively identify CFMs in the medication-use processes. Failure modes were coded for their effects on diversion risk and the contributing system factors. Results We identified 28 CFMs that increase diversion risk by enabling inappropriate access to controlled substances or compromising documentation. CFMs are multifactorial, stemming primarily from factors related to person (e.g., intent to divert) and tools/technology (e.g., limited automatic reconciliation of records), followed by organization (e.g., practices that diffuse accountability), environment (e.g., workspaces that obscure illicit behaviours), and task (e.g., unstructured processes leading to lapses). Conclusion The study findings inform opportunities to revise vulnerable processes and bolster safeguards, decreasing diversion risk and protecting patients and healthcare workers.
The Comparison of Pulsatility Index, Resistance Index, and Diameter of the Temporal, Carotid, and Vertebral Arteries During Active Migraine Headaches to Non-Headache Intervals
Authors: Akhoundi Neda , Rezazadeh Elmira , Siami Alireza , Komijani Bozchelouei Javad , Ramezani Mahtab , Nosrati Maryam 
Published: May 2023

Objective: Migraine is a debilitating disease affecting a large number of young people. In this study, he aim was to assess the extracranial arteries during migraine headaches and non-headache headache intervals using sonography. Materials and Methods: The study enrolled 210 patients with confirmed migraine headaches. The vertebral arteries, superficial temporal arteries, internal carotid arteries (ICAs), and common carotid arteries were assessed using a sonographic method. Grayscale and spectral doppler criteria, such as the diameter of arteries, peak systolic velocity (PSV), and pulsatility index (PI), during migraine headaches and non-headache headache intervals were measured. Results: Assessing the vertebral and external carotid arteries, a significant difference was observed between the diameter of the arteries during active headaches and that during non-headache headache periods. The mean PSV of ICA during active headaches was 60.05 cm/s, which was lower than that during non-headache headache periods, which was 69.35 cm/s ( P = .016). Conclusion: In this cohort’s migraine headaches, the diameter of the superficial temporal artery and ICA are increased and the diameter of the vertebral artery is decreased. Decreased PSV of the vertebral artery in contrast with increased PSV of the temporal artery is seen during headaches. These diagnostic findings may be useful in predicting migraine headaches and should be replicated with other patients.
Employees of the banking sector in Guizhou Province in China: prevalence of migraine, symptoms, disability and occupational risk factors
Authors: Wei Du , Loganathan Tharani , Wong Li Ping 
Published: May 2023

Abstract
Background
Although studies have identified a high prevalence of migraine among employees in the banking sector, the symptoms of migraine, related disability and occupational risk factors are not well understood.

Aims
To determine migraine prevalence, symptoms and disability among bank employees in Guizhou province in China and to examine occupational risk factors associated with migraine positivity and symptoms.

Methods
In a cross-sectional survey, two-stage probability sampling was used to select bank employees in Guizhou province, China. From May to October 2022, uniformly trained interviewers conducted face-to-face interviews using the HARDSHIP questionnaire. Logistic regression was used to examine factors associated with migraine positivity and symptoms.

Results
Of 1,985 contactable eligible subjects, 1,929 (male 45.4%, female 54.6%) completed the survey. The one-year prevalence of migraine was 27.2% (95% CI 25.2–29.2%). Of migraine-positive individuals, 11.2% had a monthly frequency ≥ 15 days, 11.8% had an attack duration > 72 h, and 14.9% had severe pain intensity. The median of days lost from work, housework and social activities due to migraine during a three-month period was 4, 3 and 2 days, respectively, with more than half (52.8%) patients reporting Grade III or IV disability. In multivariable analyses, positions in data analysis (OR = 1.8 [95% CI 1.2–2.8], p < 0.01) and information technology (OR = 3.8 [95% CI 1.7–8.3], p < 0.01) were occupational risk factors for migraine positivity. It was also found that professional positions were predictive of migraine attacks ≥ 15 days per month, administrative positions were predictive of duration > 72 h and severe pain intensity of migraine attacks, and working in remote branches was predictive of duration > 72 h.

Conclusions
Migraine is prevalent among employees in the banking sector in Guizhou province in China, with a large proportion of sufferers carrying a high burden of symptoms and disability. The practical implication of this study is that the risk factors identified here could be translated to the focus of workplace monitoring and interventions to manage and prevent migraine.
BGWAS: Bayesian variable selection in linear mixed models with nonlocal priors for genome-wide association studies
Authors: Williams Jacob , Xu Shuangshuang , Ferreira Marco A. R. 
Published: May 2023

AbstractBackgroundGenome-wide association studies (GWAS) seek to identify single nucleotide polymorphisms (SNPs) that cause observed phenotypes. However, with highly correlated SNPs, correlated observations, and the number of SNPs being two orders of magnitude larger than the number of observations, GWAS procedures often suffer from high false positive rates.ResultsWe propose BGWAS, a novel Bayesian variable selection method based on nonlocal priors for linear mixed models specifically tailored for genome-wide association studies. Our proposed method BGWAS uses a novel nonlocal prior for linear mixed models (LMMs). BGWAS has two steps: screening and model selection. The screening step scans through all the SNPs fitting one LMM for each SNP and then uses Bayesian false discovery control to select a set of candidate SNPs. After that, a model selection step searches through the space of LMMs that may have any number of SNPs from the candidate set. A simulation study shows that, when compared to popular GWAS procedures, BGWAS greatly reduces false positives while maintaining the same ability to detect true positive SNPs. We show the utility and flexibility of BGWAS with two case studies: a case study on salt stress in plants, and a case study on alcohol use disorder.ConclusionsBGWAS maintains and in some cases increases the recall of true SNPs while drastically lowering the number of false positives compared to popular SMA procedures.
Research recruitment and consent methods in a pandemic: a qualitative study of COVID-19 patients’ perspectives
Authors: Small Serena S , Lau Erica , McFarlane Kassandra , Archambault Patrick M , Longstaff Holly , Hohl Corinne M 
Published: May 2023

Abstract
Background
Virtual data collection methods and consent procedures adopted in response to the COVID-19 pandemic enabled continued research activities, but also introduced concerns about equity, inclusivity, representation, and privacy. Recent studies have explored these issues from institutional and researcher perspectives, but there is a need to explore patient perspectives and preferences. This study aims to explore COVID-19 patients’ perspectives about research recruitment and consent for research studies about COVID-19.

Methods
We conducted an exploratory qualitative focus group and interview study among British Columbian adults who self-identified as having had COVID-19. We recruited participants through personal contacts, social media, and REACH BC, an online platform that connects researchers and patients in British Columbia. We analyzed transcripts inductively and developed thematic summaries of each coding element.

Results
Of the 22 individuals recruited, 16 attended a focus group or interview. We found that autonomy and the feasibility of participation, attitudes toward research about COVID-19, and privacy concerns are key factors that influence participants’ willingness to participate in research. We also found that participants preferred remote and virtual approaches for contact, consent, and delivery of research on COVID-19.

Conclusions
Individuals who had COVID-19 are motivated to participate in research studies and value autonomy in their decision to participate, but researchers must be sensitive and considerate toward patient preferences and concerns, particularly as researchers adopt virtual recruitment and data collection methods. Such awareness may increase research participation and engagement.
Human T-cell lymphotropic virus type 1 (HTLV-1) proposed vaccines: a systematic review of preclinical and clinical studies
Authors: Seighali Niloofar , Shafiee Arman , Rafiee Mohammad Ali , Aminzade Dlnya , Mozhgani Sayed-Hamidreza 
Published: May 2023

Abstract
Background
Numerous vaccination research experiments have been conducted on non-primate hosts to prevent or control HTLV-1 infection. Therefore, reviewing recent advancements for status assessment and strategic planning of future preventative actions to reduce HTLV-1 infection and its consequences would be essential.

Methods
MEDLINE, Scopus, Web of Science, and Clinicaltrials.gov were searched from each database's inception through March 27, 2022. All original articles focusing on developing an HTLV-1 vaccine candidate were included.

Results
A total of 47 studies were included. They used a variety of approaches to develop the HTLV-1 vaccine, including DNA-based, dendritic-cell-based, peptide/protein-based, and recombinant vaccinia virus approaches. The majority of the research that was included utilized Tax, Glycoprotein (GP), GAG, POL, REX, and HBZ as their main peptides in order to develop the vaccine. The immunization used in dendritic cell-based investigations, which were more recently published, was accomplished by an activated CD-8 T-cell response. Although there hasn't been much attention lately on this form of the vaccine, the initial attempts to develop an HTLV-1 immunization depended on recombinant vaccinia virus, and the majority of results seem positive and effective for this type of vaccine. Few studies were conducted on humans. Most of the studies were experimental studies using animal models. Adenovirus, Cytomegalovirus (CMV), vaccinia, baculovirus, hepatitis B, measles, and pox were the most commonly used vectors.

Conclusions
This systematic review reported recent progression in the development of HTLV-1 vaccines to identify candidates with the most promising preventive and therapeutic effects.