bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing Disparities in Pre-Exposure Prophylaxis (PrEP) Access: Implementing a Community- Centered Mobile PrEP Program in South Florida
Authors: Butts Stefani , Young BreAnne , Blackmon Jakisha , Doblecki-Lewis Susanne 
Published: April 2023

Abstract
Background Pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but disparities in PrEP access remain considerable, particularly among Black and Latino men who have sex with men (MSM). To address this, the University of Miami Mobile PrEP Program was created, offering mobile HIV prevention/PrEP services in areas throughout South Florida where HIV incidence is high and PrEP access is geographically limited. Using a community-centered participatory approach, the program strategized and executed expansion into the Liberty City neighborhood of Miami. This study qualitatively assessed factors affecting Mobile PrEP implementation as perceived by community stakeholders, clients, and program staff.Methods Forty-one in-depth interviews were conducted with 21 Mobile PrEP clients, 10 key informants from local health organizations, and 10 program staff. Interview questions queried perceived organizational and positional barriers and facilitators to mobile clinic implementation. Service satisfaction, setting preferences, social factors, and likelihood of recommending Mobile PrEP were also assessed. A thematic content analysis was performed using the Consolidated Framework for Implementation Research (CFIR) taxonomy as the guiding constructs for the analysis.Results Participant statements indicated that providing no-cost services, convenient location, program-covered rideshares, individualized patient navigation, and a community-centric approach to patient care, which included staff members with shared lived experiences to increase positive interactions and renewed trust among poorly served communities, were facilitators of PrEP access and intervention uptake. The importance of program familiarization with the community before implementation, particularly for Black and African American communities, who may experience unique barriers to accessing sexual healthcare was strongly emphasized by participants.Conclusions The Mobile PrEP intervention was found to be an acceptable and accessible mode of HIV/STI preventive care. The importance of pre-implementation community engagement and preparation is emphasized. Future research is needed to refine understanding of the intervention's components and evaluate implementation determinants in other highly impacted neighborhoods.
Impedance of whole body plays a crucial role in the pathway from rheumatoid arthritis to prostate cancer: a Mendelian randomization study
Authors: Zhao Pin , zhan yonghao , Xue Shilong , Zhu Zhaowei , Zhang Xuepei 
Published: April 2023

Abstract
Background: An earlier observational study has indicated a potential link between rheumatoid arthritis and a higher chance of developing prostate cancer, but the exact causal direction and the role of impedance of whole body in this association remain unclear. To address this gap in knowledge, we conducted two-sample univariable and multivariable MR analyses to assess the total and direct effects of rheumatoid arthritis and whole-body impedance on prostate cancer risk.
Methods: The primary estimate was derived using the inverse-variance weighted method, and additional methods such as MR Pleiotropy. We conducted two-sample univariable and multivariable MR analyses to assess the total and direct effects of rheumatoid arthritis and whole-body impedance on prostate cancer risk. Two-sample Mendelian randomization (MR) was utilized to examine the independent causal effects of rheumatoid arthritis on whole-body impedance. The primary estimate was derived using the inverse-variance weighted method, and additional methods such as MR Pleiotropy RESidual Sum and Outlier, MR-Egger, and weighted median were employed to detect any heterogeneity or pleiotropy. In our meta-analysis, we found that both rheumatoid arthritis and impedance of whole body were associated with an increased risk of prostate cancer (rheumatoid arthritis: OR = 1.03, 95% CI = 1.01−1.05, p=0.003; impedance of whole body: OR =1.11, 95% CI =1.02 -1.20, P =0.015). Furthermore, the MR analysis provided evidence to support the notion that rheumatoid arthritis can increase the risk of impedance of whole body (OR= 1.01.95% confidence interval [CI] 1.004-1.013; p = 0.0002). There was little evidence that rheumatoid arthritis influenced prostate cancer once impedance of whole body was controlled for, whereas impedance of whole body could significantly affect prostate cancer independently of rheumatoid arthritis (IVW: p=0.018).
Results: Mendelian randomization study offers evidence to support the idea that impedance of whole body seems to have a significant impact on the link between rheumatoid arthritis and prostate cancer.
Clinical significance of metastatic tumor deposit foci in rectal cancer in the lateral pelvic lymph node area
Authors: Yamai Daisuke , Shimada Yoshifumi , Nakano Masato , Ozeki Hikaru , Matsumoto Akio , Abe Kaoru , Tajima Yosuke , Nakano Mae , Ichikawa Hiroshi , Sakata Jun , Nagai Takahiro , Ling Yiwei , Okuda Shujiro , Watanabe Gen , Nogami Hitoshi , Maruyama Satoshi , Takii Yasumasa , Wakai Toshifumi 
Published: April 2023

Abstract
Background
Although previous studies have demonstrated that tumor deposits (TDs) are associated with worse prognosis in colon cancer, their clinical significance in rectal cancer has not been fully elucidated, especially in the lateral pelvic lymph node (LPLN) area. This study aimed to clarify the clinical significance of TDs, focusing on the number of metastatic foci, including lymph node metastasis (LNM) and TD, in the LPLN area.
Methods
This retrospective study involved 226 consecutive patients with cStage II/III low rectal cancer who underwent LPLN dissection. Metastatic foci, including LNM and TD, in the LPLN area were defined as lateral pelvic metastasis (LP-M). LP-M was evaluated according to LP-M status: presence (absence vs presence), histopathological classification (LNM vs TD), and number (1 to 3 vs 4 or more). We evaluated the relapse-free survival of each model and compared them using the Akaike information criterion (AIC) and Harrell’s concordance index (c-index).
Results
Forty-nine of 226 patients (22%) had LP-M, and 15 patients (7%) had TDs. The median number of LP-M per patient was one (range, 1-9). The best risk stratification power was observed for number (AIC, 758; c-index, 0.668) compared with presence (AIC, 759; c-index, 0.665) or histopathological classification (AIC, 761; c-index, 0.664). The number of LP-M was an independent prognostic factor for both relapse-free and overall survival, and was significantly associated with cumulative local recurrence.
Conclusion
The number of metastatic foci, including LNM and TD, in the LPLN area is useful for risk stratification of patients with low rectal cancer.
Underestimating the pandemic: the Impact of Covid-19 on Income Distribution in US and Brazil
Authors: SCHETTINO FRANCESCO , CLEMENTI FABIO , Molini Vasco , Fabiani Michele , Alfani Federica 
Published: April 2023

Abstract
The COVID-19 has exposed people to different risks, increasing the chances of losing jobs and income, worsening well-being levels, as well as developing serious health problems or death. In Brazil and US, at least in the first phases, the respective governments underestimated the extent of the pandemic, employing policies not adequately pointed at reducing the virus diffusion and at improving the public health system. This attitude, progressively mitigated, probably assumed an important role on the pandemic impact dimension on the local population. Employing novel econometric methods on available microdata, emerges that a growth in COVID-19 prevalence significantly increases economic disparities. Also, the impact of COVID-19 on inequality increases over time, suggesting that this negative impact has intensified over the time. In the U.S., the results suggest that working from home, being unable to work or being prevented from seeking work significantly increases inequalities. Although more data are needed to validate the hypothesis, it is concluded that based on this preliminary evidence, the pandemic has significantly contributed to the inequality growth in two countries already characterized by increasing polarization and high degrees of social disparities.
JEL codes: D63, N30, P36
A Computational Study of Metal Monochalcogenides: Examining the Accuracy of the gga_x_gam-mpw1k Functional in Predicting Band Gaps
Authors: Toumiat Amor , May Abdelghani 
Published: April 2023

Abstract
In this work, we used the full potential linearized augmented plane wave method (FP-LAPW) in combination with the gga_x_gam-mpw1kfunctional to calculate the structural and electronic properties of Cd and Zn metal monochalcogenides (MMCs) in their wurtzite structure. We report results for lattice parameters, bandgap, band structure, and density of states, which are in good agreement with previous theoretical calculations and available experimental data. Our study also revealed that the effectiveness of these methods is due to their efficient treatment of d-state electrons.
Management of anesthesia and cardiopulmonary bypass of pediatric abdominal tumor invading inferior vena caval and right atrium: our clinical experience
Authors: Li Shangyingying , Xu Hongzhen , Li Jie , Zhang Ting , Cui Jie 
Published: April 2023

AbstractObjectiveAbdominal tumor with inferior vena caval (IVC) and right atrium tumor thrombus is relatively rare in children. In this paper,we summarize the management of anesthesia and cardiopulmonary bypass(CPB) during the multidisciplinary treatment(MDT).MethodsWe retrospectively analyzed the clinical data of children with abdominal tumor with inferior vena caval and right atrium tumor thrombus from January 2012 to December 2022,who had been performed surgeon under CPB. We summarize the management of anesthesia and CPB, intraoperative hemorrhage ,arterial blood gas, blood transfusion, postoperative outcome,follow-up and so on.Results6 pediatric patients with IVC and right atrium tumor thrombus from abdominal tumor underwent surgical treatment with CPB. The primary malignancies were nephroblastom (n = 2), renal clear cell carcinoma(n = 1) and hepatoblastoma (n = 3). In all cases the primary tumor and tumor thrombus were completely removed. In all these patients, the mean age was 25.8 months (range 14-41months). The mean operative time was 459.8 min (range 365–580 min) and the mean anaesthesia time was 553.1 min (range 450–745 min). The mean cardiopulmonary bypass time was 150.3 min (range 91–261) .The mean cardiopulmonary bypass time was 150.3 min (range 91–261 min). The mean aortic block time was 46.1min (range 24–68 min) and the mean hypothermic circulatory arrest time was 22 min (range 3–46 min).The mean volume of red blood concentrates (RBC) transfuion was 5.1U(range 3-9.5U). There were all survival and no serious complications occurred after operation untill December 2022 for the follow-up.ConclusionsPediatric abdominal tumor with IVC and right atrium tumor thrombus is relatively rare, and the management of anesthesia and CPB for this multidisciplinary surgical treatment have not been reported.Thus, our report provides clinical experience of the management of anesthesia and CPB. Induction of anesthesia steadily and intraoperative massive hemorrhage are the major challenges during anesthetic management, as well as the management of intraoperative critical situations.
Benign Acute Children Myositis: Five Years’ Experience in a Tertiary Care Pediatric Hospital
Authors: Attaianese Federica , Benucci Cristiana , Lasagni Donatella , Trapani Sandra 
Published: April 2023

Abstract
Purpose: Benign acute childhood myositis (BACM) is a self-limited childhood illness, and it is mainly caused by viral infections. Clinical and laboratory alterations usually normalize rapidly; generally, the only medical intervention required is supportive (hydration, analgesic medication). The low awareness about BACM often led to delayed diagnosis and unneeded ancillary investigations. This study aims to better characterize the clinical and laboratory features of BACM to improve the diagnostic process and inpatient and outpatient management.
Materials and methods: We conducted a retrospective study selecting all children admitted to Meyer's Children's Hospital-IRCCS (Florence, Italy) with a diagnosis of BACM over the last 5 years. Clinical, laboratory, and instrumental data were collected from electronic clinical records and analyzed.
Results: Sixteen patients were enrolled. The median age was 7.68 years (IQR 5.7-12.9). Male gender (62.5%) and Caucasian ethnicity (68.75%) were prevalent. Most of the patients were admitted during winter, and a second peak has been found in summer. All patients had bilateral calf pain at admission (87.5%), associated with asthenia, and refuse to walk (93.7%). Prodromal symptoms were fever (81.25%), cough (37.5%), coryza (43.5%), sore throat (50%), and vomiting (31.25%). The median value of CPK was 2,183.5 U/L (IQR 1,395.5-7,156.25) at peak. CPK median time to normalization was 7 days (IQR 7-8.5) from the nadir. Influenza B was the virus most frequently BACM associated, followed by influenza A; a novel association with Sars-CoV-2 has been detected. Two patients had pathogenic variants at the Next Generation Sequencing myopathies panel.
Conclusions: School-aged children admitted to the hospital with walking difficulty and myalgia generally after an upper respiratory tract infection with a moderate CPK elevation should remind at first of BACM. Rapid complaint resolution and biochemical markers normalization will prevent unnecessary tests and inappropriate therapies.
Health and Social Literacy Intervention to Improve Maternal Health: Study Protocol for a Randomized Pre-Post Test Design with a team-building intervention for primary healthcare teams and community needs assessment
Authors: Jafree Sara Rizvi , Ahsan Humna , Zakar Rubeena , Muzamill Anam , Burhan Syeda Khadija , Javed Ambreen , Durrani Rana Rubab , Malhi Fareena Noor , Fischer Florian 
Published: April 2023

Abstract
Background: The majority of poor, illiterate women of reproductive years in Pakistan are living in underdeveloped regions and are solely dependent on free primary health services provided by the state. This project aims 1) to collect baseline health and social data, 2) to deliver a health and social literacy intervention, 3) to deliver a team-building intervention for primary-level healthcare providers, and 4) to conduct a community needs assessment.
Methods: Electronic health and social data will be collected at baseline, which will be used to develop a comprehensive database and develop an index for Maternal Health and Wellbeing. A 24-month intervention will be delivered which will have 6 modules related to health and social literacy. The principal investigators will train the data collectors and intervention facilitators. Lady Health Workers will collect the electronic data and pre-post test data, and Community Social Workers will deliver the health and social literacy intervention. Cluster randomized sampling will be used to sample 6 BHUs across 6 different cities of Punjab, Pakistan. A total of 360 women will be sampled and assigned randomly to the experiment and control groups. The principal investigators will deliver the team-building intervention and conduct the community needs assessment. The participants for the latter will include doctors, nurses and community health workers; and for the former will include women from the community, women community health providers, community elders and religious leaders, and local government officials.
Discussion: Pakistan is falling behind on its sustainable development goals for maternal health, mainly due to the limitations of the existing services and literacy of women. There is critical need to support understaffing of current providers by partnering them with community social workers and training them for better care delivery. Similarly, women need support for gaps in both health and social literacy. Development of an index and community needs assessment report can support better identification of environmental and socio-cultural needs in the community and to advise policy makers and stakeholders about issues wider which directly and indirectly impact women’s health.
Trial registration: This study has been registered with ClinicalTrials.gov. The identification number is: NCT05389501.
Causal relationship between cholesterol-lowering therapy and Alzheimer Disease: evidence from genetic correlation and Mendelian randomization study
Authors: Huan Sheng , Gao Jing , YIN Guoping 
Published: April 2023

AbstractThe objective of this study was to investigate the causal relationship between cholesterol-lowering therapy and Alzheimer's disease (AD) using Mendelian Randomization (MR) with two sets of genetic instruments derived from UK Biobank, GLGC, and GWAS ATLAS. Instrumental variables were selected based on SNPs that were significantly associated with lipid-lowering drugs or targets, but not with outcome or confounding factors. The primary analysis was conducted using inverse variance weighted (IVW), MR-PRESSO, WM. Cochran Q, and MR pleiotropy tests to assess heterogeneity or pleiotropy. The results revealed that cholesterol-lowering drugs did not show a significant effect on AD risk with IVW (Atorvastatin: OR = 0.943, 95% CI = 0.612–1.453, p = 0.789; Pravastatin: OR = 6.857, 95% CI = 0.514–90.864, p = 0.144; Rosuvastatin: OR = 2.466, 95% CI = 0.333–18.278, p = 0.377; Simvastatin: OR = 1.138, 95% CI = 0.976–1.328, p = 0.098; Ezetimibe: OR = 1.292, 95% CI = 0.239-6,969, p = 0.766). Further multivariable and target MR analyses (HMGCR, NPC1L1, and PSCK9) also demonstrated that the combination of statins and ezetimibe, or their pharmacological targets, did not show a significant causal relationship with AD. Therefore, based on the current evidence, it can be concluded that there is no causal relationship between cholesterol-lowering drugs and AD.
Metabolic Syndrome Differences between Unilateral and Bilateral Staghorn Renal Stones and the Impact on Outcome of Percutaneous Nephrolithotomy
Authors: Shen Zhonghua , Xie Linguo , Luo Di , Xie Haijie , Chen Hongyang , Liu Chunyu 
Published: April 2023

Abstract
Purpose To evaluate the Metabolic syndrome(MetS) in patients with unilateral and bilateral staghorn calculus(SC) and compare the impact on the outcome of percutaneous nephrolithotomy(PCNL).Methods The patients who underwent PCNL for the treatment of SC were retrospectively reviewed between 2019–2022. SC were divided into unilateral and bilateral. The variables of the patients were calculated to evaluate the MetS difference between unilateral and bilateral SC and the impact on the outcome of PCNL.Results 1778 patients were received PCNL between 2019 and 2022, After screening computed tomography, A total of 379 patients with staghorn calculus, patients without follow-up and incomplete data were excluded, finaly 310 patients with SC were included. 84 with bilateral SC and 226 with unilateral. More higher body mass index, complete staghorn and metabolic syndrome were found in the patients with bilateral SC. Higher body mass index, hypertension, diabetes mellitus, hyperlipidemia, MetS were 62.58%, 44.84%, 21.94%, 60.65% and 27.42% in patients. 85 patients with MetS(+) resulted in higher rate of overall complication(Number(N)(%), 29(38.10) VS 54(23.89), p = 0.013) and comparable stone free rate with 225 MetS(-). Multivariable analysis confirmed that hyperlipidemia(p = 0.044, odds ratio[OR] = 1.991, 95% confidence interval[CI] 1.020–3.888) and MetS ( p = 0.005, OR = 2.427, 95%CI 1.316–4.477) were independent risk factors for overall complication.Conclusions MetS are strongly correlated with the formation of bilateral SC and is the core predictor in assessing overall complication for PCNL.
The Association of Different Types of Physical Activity and Sleep Disorder: Analysis from NHANES 2017-2018
Authors: Zhang Jipeng , Mo Hongfei , Feng Junkai , Jiao Zhipeng , Xue Zhengwei , Yang Wenjun , Feng Rui 
Published: April 2023

Abstract
Background: Sleep disorder is an important psychological and public health burden, which seriously endangers physical and psychological health. Physical activities are closely related to sleep disorder, while different types of physical activities may have different effects on sleep disorder.
Objective: The aim of this study was to evaluate the association of different types of physical activity on sleep disorder independent from each other.
Materials and Methods: We extracted data from NHANES 2017-2018, including demographic characteristics, sleep disorder and physical activity. A total of 4157 adults aged 20 years or older (mean age 51.05 ± 17.52 years, 2029 males and 2128 females) was included. Types of physical activity (work, transportation, recreational physical activity and sedentary behavior) were defined and assessed by the Global Physical Activity Questionnaire (GPAQ); sleep disorder was assessed by patient self-report in the Munich Chronotype Questionnaire (MCTQ). Chi-square test and Kruskal-Wallis tests was used to compare differences between groups; the associations of each type of physical activity and sleep disorder were analyzed through binary Logistic regressions.
Results: 1) 1211 participants were found to have sleep disorder, accounting for 29.1% of the total sample size; 2) There were significant differences in work physical activity (P=0.043), sedentary behavior (P<0.001) and recreational physical activity (P=0.001) among sleep disorder, the difference of transportation physical activity was close to significant (P=0.055). 3) Work physical activity (OR=1.249, 95% CI: 1.126-1.385, P<0.001) and sedentary behavior (OR=1.524, 95% CI: 1.330-1.745, P<0.001) were positively associated with sleep disorder, while recreational physical activity (OR=0.776, 95% Cl: 0.700-0.860, P<0.001) was negatively associated.
Conclusions: 1) There are no significant associations between transportation physical activity and sleep disorder. 2) Both work physical activity and sedentary behavior are risk factors for sleep disorder. 3) Recreational physical activity is a protective factor for sleep disorder.