bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between gender social norms and cardiovascular disease mortality and life expectancy: an ecological study
Authors: Lyell Iona , Khan Sadiya S , Limmer Mark , O’Flaherty Martin , Head Anna 
Published: April 2023

ObjectiveExamine the association between country-level gender social norms and (1) cardiovascular disease mortality rates; (2) female to male cardiovascular disease mortality ratios; and (3) life expectancy.DesignEcological study with the country as the unit of analysis.SettingGlobal, country-level data.ParticipantsGlobal population of countries with data available on gender social norms as measured by the Gender Social Norms Index (developed by the United Nations Development Programme).Main outcome measuresCountry-level female and male age-standardised cardiovascular disease mortality rates, population age-standardised cardiovascular disease mortality rates, female to male cardiovascular disease mortality ratios, female and male life expectancy at birth. Outcome measure data were retrieved from the WHO and the Institute for Health Metrics and Evaluation. Multivariable linear regression models were fitted to explore the relationship between gender social norms and the outcome variables.ResultsHigher levels of biased gender social norms, as measured by the Gender Social Norms Index, were associated with higher female, male and population cardiovascular disease mortality rates in the multivariable models (β 4.86, 95% CIs 3.18 to 6.54; β 5.28, 95% CIs 3.42 to 7.15; β 4.89, 95% CIs 3.18 to 6.60), and lower female and male life expectancy (β −0.07, 95% CIs −0.11 to −0.03; β −0.05, 95% CIs −0.10 to −0.01). These results included adjustment within the models for potentially confounding country-level factors including gross domestic product per capita, population mean years of schooling, physicians per 1000 population, year of Gender Social Norms Index data collection and maternal mortality ratio.ConclusionsOur analysis suggests that higher levels of biased gender social norms are associated with higher rates of population cardiovascular disease mortality and lower life expectancy for both sexes. Future research should explore this relationship further, to define its causal role and promote public health action.
Effect of Fu’s subcutaneous needling for cancer pain management: protocol for a pragmatic randomised controlled trial
Authors: Xu Danghan , Yu Zhanbo , Cai Ximin , Lin Jietao , Lin Tengjiao , Sun Jian , Liu Zhaoxi , Cao Yang , He Yihan 
Published: April 2023

IntroductionPain is a common symptom in patients with cancer, and pain management is crucial for these patients. Fu’s subcutaneous needling (FSN) is a modern acupuncture therapy based on basic medicine commonly used in patients with pain. However, evidence of its effectiveness in treating cancer pain has not been systematically proven. Therefore, this pragmatic randomised controlled trial aims to evaluate the effectiveness and safety of FSN for cancer pain management.Methods and analysisOverall, 120 eligible patients will be recruited and randomly assigned into two groups using block randomisation. Both groups will be administered analgesic drugs according to the National Comprehensive Cancer Network guidelines. The treatment group will receive FSN therapy one time a day for 6 days. Additionally, we will assess analgesic consumption as the primary outcome and the Numerical Rating Scale, outbreak pain, symptom assessment and adverse events as secondary outcomes to evaluate the effect and safety of FSN in treating cancer pain. The incidence of adverse events will be monitored to assess the safety of FSN.Ethics and disseminationEthics approval was obtained from the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (approval No: K(2021)096). The results will be published in a peer-reviewed journal, and trial participants will be informed via email and/or phone calls.Trial registration numberChiCTR2200056348.
Exposure of medical students to sexism and sexual harassment and their association with mental health: a cross-sectional study at a Swiss medical school
Authors: Barbier Jeanne Marie , Carrard Valerie , Schwarz Joelle , Berney Sylvie , Clair Carole , Berney Alexandre 
Published: April 2023

ObjectivesTo assess the self-reported prevalence of sexism and sexual harassment at a Swiss medical school, and to investigate their association with mental health. Research hypotheses were an association between sexism/sexual harassment and poor mental health and a higher prevalence of sexism/sexual harassment in clinical rotations.DesignCross-sectional study as a part of ETMED-L project, an ongoing cohort study of interpersonal competences and mental health of medical students.SettingSingle-centre Swiss study using an online survey submitted to medical students.ParticipantsFrom 2096 registered students, 1059 were respondents (50.52%). We excluded 26 participants (25 due to wrong answers to attention questions, and 1 who did not answer the sexism exposure question). The final sample (N=1033) included 720 women, 300 men and 13 non-binary people.MeasuresPrevalence of self-reported exposure to sexism/sexual harassment. Multivariate regression analyses of association between being targeted by sexism or sexual harassment and mental health (depression, suicidal ideation, anxiety, stress, burnout, substance use and recent mental health consultation). Regression models adjusted for gender, academic year, native language, parental education level, partnership and an extracurricular paid job.ResultsBeing targeted by sexism or sexual harassment was reported by 16% of participants with a majority of women (96%). The prevalence increased with clinical work. After adjusting for covariates, we found association between being targeted by sexism/harassment and risk of depression (OR 2.29, 95% CI 1.54 to 3.41, p<0.001), suicidal ideation (B coefficient (B) 0.37, p<0.001) and anxiety (B 3.69, p<0.001), as well as cynicism (B 1.46, p=0.001) and emotional exhaustion (B 0.94, p=0.044) components of burnout, substance use (B 6.51, p<0.001) and a recent mental health consultation (OR 1.78, 95% CI 1.10 to 2.66, p=0.005).ConclusionsSexism and sexual harassment, although less common than usually reported, are behaviours of concern in this medical school and are significantly associated with mental health.
How do hospitals address health inequalities experienced by children and young people: a grey literature scoping review protocol
Authors: Brennan Louise , Brewster Liz , Lunn Judith , Egboko Fiona , Pestotnik Stres Dora , Patel Pallavi , Isba Rachel 
Published: April 2023

IntroductionHealth inequalities are unfair, systematic differences in health between people. In the UK, the Health and Social Care Act 2012 recognised health inequalities as a responsibility of the National Health Service (NHS). Health inequalities were foregrounded in the publication of 2019 NHS Long Term Plan and during the SARS-CoV-2/COVID-19 pandemic. Hospitals are well placed to address health inequalities through their role as anchor institutions. While many hospitals have begun to address inequalities, children are often overlooked or assumed to have the same needs as adult populations. This grey literature scoping review aims to identify, collate and present approaches taken by hospitals to address health inequalities in children and young people.Methods and analysisThis scoping review will follow Joanna Briggs Institute guidance. A four-step approach to identifying grey literature will be used. Literature will be examined to identify approaches that aim to address health inequalities. Literature must describe the health inequality they aim to address and be initiated by the hospital. It will exclude literature not available in English and published before 2010. Two reviewers will independently review the results of the searches using the inclusion and exclusion criteria. Data will be extracted using a data extraction tool. Study findings will be presented in tabular form detailing the interventions identified.DisseminationThe review will synthesise information on worldwide hospital approaches to addressing child health inequalities. The findings will be used to inform guidelines for children’s hospitals in the UK and will be disseminated through national and international professional bodies, conferences and research papers.
Development and validation of the paediatric elbow trauma (PET) rules as a decision rule for radiography in traumatic elbow injuries: a study protocol
Authors: Saris Tim Frans Frederik , van Bergen Christiaan J A , The Bertram , Boele van Hensbroek Pieter , Schep Niels W L , van Boekel Leonieke C , Eygendaal Denise 
Published: April 2023

BackgroundTraumatic elbow injuries in children occur frequently and are among the most common traumatic injuries seen in the emergency department (ED) and in general practice. The use of a validated decision rule to enhance selective radiography in paediatric patients with possible elbow fractures may reduce unnecessary exposure to radiation in children.Method and analysisThis study is designed as a multicentre prospective cohort study. An expert panel of orthopaedic elbow surgeons, paediatric orthopaedic surgeons and trauma surgeons will initially determine clinical parameters that provide a possible predictive value for elbow fractures. Four hundred children between the ages of 2 and 17 years visiting the ED with pain following elbow trauma will then be included. The clinical parameters will be collected via patient history and physical examination. Elbow radiographs will be obtained in all patients to identify fractures. The data will be processed in a multivariable logistic regression analysis to determine which clinical parameters predict the presence of an elbow fracture. Only the clinical parameters that predict a fracture will be used to formulate the new decision rule: the paediatric elbow trauma (PET) rules. Internal validation of the prediction model will take place after inclusion is complete and by means of a bootstrap analysis on the acquired data. A calculation will be made to determine how many radiographs can potentially be reduced by applying the PET rules and a cost analysis will be performed.Ethics and disseminationThe study will be conducted according to the principles of the Declaration of Helsinki and in accordance with the Medical Research Involving Human Subjects Act. The Medical Research Ethics Committees United stated on 16 May 2022 that The Medical Research Involving Human Act (WMO) does not apply to this study and an official approval by the committee is not required, reference number; project W22.086.
Reducing opioid use for chronic non-cancer pain in primary care using an evidence-based, theory-informed, multistrategic, multistakeholder approach: a single-arm time series with segmented regression
Authors: Moffat Anna K , Apajee Jemisha , Le Blanc Vanessa T , Westaway Kerrie , Andrade Andre Q , Ramsay Emmae N , Blacker Natalie , Pratt Nicole L , Roughead Elizabeth Ellen 
Published: April 2023

BackgroundMany countries have high opioid use among people with chronic non-cancer pain. Knowledge about effective interventions that could be implemented at scale is limited. We designed a national intervention that included audit and feedback, deprescribing guidance, information on catastrophising assessment, pain neuroscience education and a cognitive tool for use by patients with their healthcare providers.MethodWe used a single-arm time series with segmented regression to assess rates of people using opioids before (January 2015 to September 2017), at the time of (October 2017) and after the intervention (November 2017 to August 2019). We used a cohort with historical comparison group and log binomial regression to examine the rate of psychologist claims in opioid users not using psychologist services prior to the intervention.Results13 968 patients using opioids, 8568 general practitioners, 8370 pharmacies and accredited pharmacists and 689 psychologists were targeted. The estimated difference in opioid use was −0.51 persons per 1000 persons per month (95% CI −0.69, –0.34; p<0.001) as a result of the intervention, equating to 25 387 (95% CI 24 676, 26 131) patient-months of opioid use avoided during the 22-month follow-up. The targeted group had a significantly higher rate of incident patient psychologist claims compared with the historical comparison group (rate ratio: 1.37, 95% CI 1.16, 1.63; p<0.001), equating to an additional 690 (95% CI 289, 1167) patient-months of psychologist treatment during the 22-month follow-up.ConclusionsOur intervention addressed the cognitive, affective and sensory factors that contribute to pain and consequent opioid use, demonstrating it could be implemented at scale and was associated with a reduction in opioid use and increasing utilisation of psychologist services.
Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial
Authors: Requena Manuel , Vanden Bavière Henri , Verma Sanjay , Gerrits Carin , Kokhuis Tom , Tomasello Alejandro , Molina Carlos A , Ribo Marc 
Published: April 2023

BackgroundThe ANGIOCAT trial showed a clinical benefit of direct to angiography suite (DTAS) for patients with large vessel occlusion (LVO) stroke admitted within 6 hours after symptom onset in decreased hospital workflow time and improved clinical outcome. However, the impact of DTAS implementation on hospital costs is unknown. This economic evaluation aims to assess the cost-utility of DTAS from the provider (hospital) perspective.MethodsA cost-utility analysis was applied to compare DTAS with the standard direct to CT (DTCT) suite approach using direct cost and health outcomes data. The time horizon was 90 days. One-way sensitivity analysis as well as probabilistic sensitivity analysis was performed, varying the model parameters by ±25%. Measures included costs, quality-adjusted life years, and incremental cost-effectiveness ratios. Health outcomes, classified according to the modified Rankin Scale, were obtained from the ANGIOCAT trial. Respective utilities were obtained from the literature.ResultsDTAS is the dominant strategy. The incremental cost-effectiveness ratio is −€89 110 (−$97 600) with cost saving per patient of –€2848 (–$3120). The improved clinical outcome is directly related with a decrease in costs for the hospital, mainly due to the decrease in costs of hospital stay, improved clinical outcome and fewer complications.ConclusionsFor patients with LVO admitted within 6 hours after symptom onset, the DTAS not only improves clinical outcome but also decreases the costs (dominant option) compared with the standard DTCT. Multicentric international randomized clinical trials are ongoing to determine the replicability of our findings.
Deep machine learning for the PANDA software trigger
Authors: Jiang Peiyong , Götzen Klaus , Kliemt Ralf , Nerling Frank , Peters Klaus ,   the P.A.N.D.A. Collaboration
Published: April 2023

AbstractDeep machine learning methods have been studied for the software trigger of the future PANDA experiment at FAIR, using Monte Carlo simulated data from the GEANT-based detector simulation framework PandaRoot. Ten physics channels that cover the main physics topics, including electromagnetic, exotic, charmonium, open charm, and baryonic reaction channels, have been investigated at four different anti-proton beam momenta. Different classification concepts and network architectures have been studied. Finally a residual convolutional neural network with four residual blocks in a binary classification scheme has been chosen due to its extendability, performance and stability. The presented study represents a feasibility study of a completely software-based trigger system. Compared to a conventional selection method, the deep machine learning approach achieved a significant efficiency gain of up to 200%, while keeping the background reduction factor at the required level of 1/1000. Furthermore, it is shown that the use of additional input variables can improve the data quality for subsequent analysis. This study shows that the PANDA software trigger can benefit greatly from the deep machine learning methods.
Evidence of a lepto-hadronic two-zone emission in flare states
Authors: Aguilar-Ruiz E. , Fraija N. , Galván-Gámez A. 
Published: April 2023

AbstractThe BL Lac Markarian 501 exhibited two flaring activities in the very-high-energy (VHE) band in May 2009. The lack of correlation between X-rays and TeV gamma-rays without increasing in other bands suggested that more than one emission zone could be involved. Moreover, fast variability in the flaring state was observed, indicating that the emission zones responsible must have small sizes. We use a lepto-hadronic model with two-zone emission to explain the spectral energy distribution during quiescent and these flaring states. In the proposed scenario, the photopion processes explain the VHE flaring activities successfully, and variability constraints place the activity in a zone located near the jet’s base or named inner blob, while synchrotron self-Compton emission describing the X-ray signature during that flaring state occurs in the zone situated far the central engine or named outer blob.
A Very Long-acting Exatecan and Its Synergism with DNA Damage Response Inhibitors
Authors: Fontaine Shaun D. , Carreras Christopher W. , Reid Ralph R. , Ashley Gary W. , Santi Daniel V. 
Published: April 2023

Exatecan (Exa) is a very potent inhibitor of topoisomerase I and anticancer agent. It has been intensively studied as a single agent, a large macromolecular conjugate and as the payload component of antigen-dependent antibody–drug conjugates. The current work describes an antigen-independent conjugate of Exa with polyethylene glycol (PEG) that slowly releases free Exa. Exa was conjugated to a 4-arm 40 kDa PEG through a β-eliminative cleavable linker. Pharmacokinetic studies in mice showed that the conjugate has an apparent circulating half-life of 12 hours, which reflects a composite of both the rate of renal elimination (half-life ∼18 hours) and release of Exa (half-life ∼40 hours). Remarkably, a single low dose of 10 μmol/kg PEG-Exa—only approximately 0.2 μmol/mouse—caused complete suppression of tumor growth of BRCA1-deficient MX-1 xenografts lasting over 40 days. A single low dose of 2.5 μmol/kg PEG-Exa administered with low but efficacious doses of the PARP inhibitor talazoparib showed strong synergy and caused significant tumor regression. Furthermore, the same low, single dose of PEG-Exa administered with the ATR inhibitor VX970 at doses of the DNA damage response inhibitor that do not affect tumor growth show high tumor regression, strong synergy, and synthetic lethality.

Significance:
A circulating conjugate that slowly releases Exa is described. It is efficacious after a single dose and synergistic with ATR and PARP inhibitors.
Гостра непрохідність тонкої кишки. Деякі можливі напрямки оптимізації хірургічного лікування
Authors: Бенедикт В. В. , Продан А. М. , Багрій В. М. 
Published: April 2023

Мета роботи: покращення результатів хірургічного лікування хворих на гостру непрохідність тонкої кишки шляхом оптимізації надання медичної допомоги в стаціонарних умовах.
Матеріали і методи. Проведено комплексне клінічне, інструментальне і лабораторне обстеження 221 хворих на гостру непрохідність тонкої кишки. Визначали індекс коморбідності, ступінь компенсації функціонального стану пацієнта і операційно-анестезіологічний індекс за шкалою ASA.
Результати досліджень та їх обговорення. Використання запропонованого комплексу хірургічної допомоги під час операції і медикаментозної корекції моторики травного каналу після операції дозволило прискорити відновлення моторно-евакуаторної функції шлунка, кишечника після різних типів хірургічного лікування на 2–3 доби, перейти на ентеральне харчування в ранньому післяопераційному періоді, зменшити кількість гнійно-септичних ранових та респіраторних ускладнень і знизити терміни стаціонарного лікування хворих майже на 5 діб. Для підвищення ефективності хірургічного лікування є раннє відновлення моторики тонкої кишки із застосуванням есенціальних фосфоліпідів, антиоксидантів, енергетичних донаторів, препаратів кальцію або його антагоністів залежно від характеру перистальтики в післяопераційному періоді.
Структурні зміни в серці, легенях та нирках при перитоніті у тварин із метаболічним синдромом
Authors: Малевич Н. М. , Дацко Т. В. 
Published: April 2023

Мета роботи: встановити особливості морфологічних змін внутрішніх органів при метаболічному синдромі на фоні перитоніту в експерименті.
Матеріали і методи. Дослідження проведено на 16 статевозрілих нелінійних білих щурах-самцях. Гострий поширений перитоніт моделювали шляхом введення 10 % профільтрованої калової суспензії у черевну порожнину в дозі 0,5 мл на 100 г маси тварини за Лазаренком В. А. і співавт. (2008). Самців щурів контрольної групи годували звичайною дієтою. Щурів-самців основ­ної групи (n=8) годували дієтою з високим вмістом жиру (понад 60 % енергії від жирів) впродовж 16 тижнів. Гістологічні зрізи готували на роторному мікротомі Amos AMR-400 товщиною 3–5 мкм (не менше двох зрізів на кожне гістологічне скло), забарвлювали гематоксиліном та еозином. Проводили дослідження та фотореєстрацію препаратів за допомогою мікроскопа Eclipse Ci-E (Японія) з цифровою фотокамерою Sigeta M3CMOS 14000 при різних збільшення х100, х200, х400.
Результати досліджень та їх обговорення. У тварин із метаболічним синдромом при моделюванні перитоніту в ранні періоди візуалізувалися виражені (прогресуючі та наростаючі) структурні зміни у міокарді та легенях, які проявляються дистрофічними, дистрофічно-некротичними змінами, запальною інфільтрацією строми та гострими прогресуючими розладами кровообігу порівняно із тваринами без метаболічного синдрому. Менш вразливими у наших дослідженнях виявились нирки тварин, структурні прояви в яких аналогічні як у тварин без метаболічного синдрому.