bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of the intestinal microbiome in cystic fibrosis in early life
Authors: Price Courtney E. , Hampton Thomas H. , Valls Rebecca A. , Barrack Kaitlyn E. , O’Toole George A. , Madan Juliette C. , Coker Modupe O. 
Published: July 2023

ABSTRACT

Cystic fibrosis (CF) is a heritable disease that causes altered physiology at mucosal sites; these changes result in chronic infections in the lung, significant gastrointestinal complications as well as dysbiosis of the gut microbiome, although the latter has been less well explored. Here, we describe the longitudinal development of the gut microbiome in a cohort of children with CF (cwCF) from birth through early childhood (0–4 years of age) using 16S rRNA gene amplicon sequencing of stool samples as a surrogate for the gut microbiota. Similar to healthy populations, alpha diversity of the gut microbiome increases significantly with age, but diversity plateaus at ~2 years of age for this CF cohort. Several taxa that have been associated with dysbiosis in CF change with age toward a more healthy-like composition; notable exceptions include
Akkermansia
, which decreases with age, and
Blautia
, which increases with age. We also examined the relative abundance and prevalence of nine taxa associated with CF lung disease, several of which persist across early life, highlighting the possibility of the lung being seeded directly from the gut early in life. Finally, we applied the Crohn’s Dysbiosis Index to each sample, and found that high Crohn’s-associated dysbiosis early in life (<2 years) was associated with significantly lower
Bacteroides
in samples collected from 2 to 4 years of age. Together, these data comprise an observational study that describes the longitudinal development of the CF-associated gut microbiota and suggest that early markers associated with inflammatory bowel disease may shape the later gut microbiota of cwCF.

IMPORTANCE
Cystic fibrosis is a heritable disease that disrupts ion transport at mucosal surfaces, causing a buildup of mucus and dysregulation of microbial communities in both the lungs and the intestines. Persons with CF are known to have dysbiotic gut microbial communities, but the development of these communities over time beginning at birth has not been thoroughly studied. Here, we describe an observation study following the development of the gut microbiome of cwCF throughout the first 4 years of life, during the critical window of both gut microbiome and immune development. Our findings indicate the possibility of the gut microbiota as a reservoir of airway pathogens and a surprisingly early indication of a microbiota associated with inflammatory bowel disease.
Supplemental Material: Dune interactions record changes in boundary conditions
Authors: Marvin M. Colin , al. et 
Published: July 2023

<p>Supplemental text describing methods for dune-field digitization, digitization sensitivity analysis, sediment flux calculations, and turnover time scales; validation for turnover time scales; terrestrial wind data sensitivity analysis; three supplemental tables and five figures; and all compiled data. ERA5-Land data are available from the Copernicus Climate Data Store (https://cds.climate.copernicus.eu/). </p>
Trauma-related Lyme arthritis
Authors: Roberts John , Merchant Elisabeth 
Published: July 2023

A man in his 40s with no prior orthopaedic history presented to an infectious disease clinic with persistent left knee pain and swelling following a traumatic meniscal tear and ensuing prodromal period of fever and chills. Aspiration of the left knee joint revealed a white cell count of 21.0 ×109/L (83% neutrophils) with negative Gram stain and culture. However, Lyme PCR was positive and accompanied by serologies consistent with Lyme arthritis. He was treated with a standard course of antibiotic therapy with subsequent resolution of joint effusion and significant improvement in pain.This is to our knowledge the first report in the literature of Lyme arthritis seemingly provoked by traumatic knee injury. We propose disruption of normal joint anatomy and ensuing inflammation in response to acute injury incited and accelerated migration of previously latentBorrelia burgdorferispirochetal infection into surrounding synovial tissue, leading to enhanced inflammatory activity and exacerbation of knee pain.
Sexual and reproductive health issues and associated factors among female night school students in Amhara Region, Ethiopia: an institution-based cross-sectional study
Authors: Mihretie Gedefaye Nibret , Goshu Yitayal Ayalew , Belay Habtamu Gebrehana , Tassew Habtamu Abie , Ayalew Abeba Belay , Beshah Mekonnen Haile , Muche Tewachew Liyeh 
Published: July 2023

ObjectiveThis study aimed to assess the prevalence of sexual and reproductive health (SRH) issues and associated factors among female night school students in the Amhara Region, Ethiopia.DesignInstitution-based cross-sectional study.Setting16 night schools were selected from 4 zones in the Amhara Region. The data were collected between 1 January and 28 February 2019.Participants1428 female night school students aged 15–24 years.OutcomesPrevalence of SRH issues, defined as those who had experienced at least one SRH issue during their lifetime (including sexual violence, sexually transmitted diseases, teenage pregnancy, unwanted pregnancy, early marriage and abortion). Bivariable and multivariable logistic regression models were used in the analysis.ResultsThe prevalence of SRH issues was 32.7% (95% CI 29.5% to 35.9%). Having secondary education (adjusted (OR) AOR = 1.49, 95% CI 1.19 to 1.86), being single in marital status (AOR = 1.33, 95% CI 1.01 to 1.74), not discussing SRH issues with their families (AOR = 2.69, 95% CI 2.13 to 3.40) and poor knowledge of SRH services (AOR = 2.63, 95% CI 2.08 to 3.32) were significantly associated with SRH issues.ConclusionThe lifetime prevalence of SRH issues among female night school students was high. Being single, having a secondary education, not discussing SRH issues with family, and having a poor understanding of SRH services were associated with SRH issues. Qualitative studies should be conducted to explore students’ feelings and intentions about SRH issues.
SARS-CoV-2 self-testing in Peru: a cross-sectional survey of values and attitudes of the general population
Authors: Martínez-Pérez Guillermo Z , Shilton Sonjelle , Mallma Salazar Patricia Silvia , Pflucker Oses Paola , Torres-Slimming Paola Alejandra , Batheja Deepshikha , Banerji Abhik , Mallery Amber , Ivanova Reipold Elena , Carcamo Cesar 
Published: July 2023

ObjectivesTo assess the values of and attitudes towards the use of rapid SARS-CoV-2 antigen-detection tests for self-testing in a rural and an urban area in Peru.DesignCross-sectional, street-based population survey.SettingA series of over 400 randomly selected street points in Valle del Mantaro and in Lima.Participants438 respondents (203 female) participated. They were all older than 17 years and provided informed consent for participation.InterventionAll respondents answered on the spot, a 35-item questionnaire developed in KoboToolbox.Primary and secondary outcome measuresPrimary outcomes of interest were: likelihood to use a SARS-CoV-2 self-test; willingness to pay for a SARS-CoV-2 self-test and likelihood to comply with recommended actions following a positive SARS-CoV-2 self-test result. Bivariate analyses and Poisson regression (PR) analyses were performed to identify significant associations between dependent variables and independent variables pertaining to respondents’ characteristics, risk perception and previous experiences with conventional COVID-19 testing.ResultsOf the 438 respondents, 51.49% had previous experience with conventional COVID-19 testing; 20.37% had COVID-19 disease; 86.96% accepted the idea of SARS-CoV-2 self-testing; and, 78.95% would be likely to use it if needed. Almost all (94.75%) would pay for a self-testing device (mean acceptable payment: US$10.4) if it was not provided free of charge by health authorities. Overall, 93.12%, 86.93% and 85.32% would self-isolate, report the results and warn their contacts, respectively. Being a female (adjusted PR 1.05, 95% CI 1.00 to 1.09, p<0.018), having completed secondary education (adjusted PR 1.18, 95% CI 1.02 to 1.37, p<0.024) and expressing likelihood to use self-testing (adjusted PR 1.08, 95% CI 1.01 to 1.16, p<0.0.24) could be predictors of willingness to pay for a self-test.ConclusionsSelf-testing is perceived as an acceptable approach. Health authorities in Peru should facilitate access to this approach to complement healthcare facilities-led testing efforts for COVID-19. Future research is necessary to understand the impact of self-testing in case detection and pandemic control.
Comparison of patient exit interviews with unannounced standardised patients for assessing HIV service delivery in Zambia: a study nested within a cluster randomised trial
Authors: Sikombe Kombatende , Pry Jake M , Mody Aaloke , Rice Brian , Bukankala Chama , Eshun-Wilson Ingrid , Mutale Jacob , Simbeza Sandra , Beres Laura K , Mukamba Njekwa , Mukumbwa-Mwenechanya Mpande , Mwamba Daniel , Sharma Anjali , Wringe Alison , Hargreaves James , Bolton-Moore Carolyn , Holmes Charles , Sikazwe Izukanji T , Geng Elvin 
Published: July 2023

ObjectivesTo compare unannounced standardised patient approach (eg, mystery clients) with typical exit interviews for assessing patient experiences in HIV care (eg, unfriendly providers, long waiting times). We hypothesise standardised patients would report more negative experiences than typical exit interviews affected by social desirability bias.SettingCross-sectional surveys in 16 government-operated HIV primary care clinics in Lusaka, Zambia providing antiretroviral therapy (ART).Participants3526 participants aged ≥18 years receiving ART participated in the exit surveys between August 2019 and November 2021.InterventionSystematic sample (every nthfile) of patients in clinic waiting area willing to be trained received pre-visit training and post-visit interviews. Providers were unaware of trained patients.Outcome measuresWe compared patient experience among patients who received brief training prior to their care visit (explaining each patient experience construct in the exit survey, being anonymous, without manipulating behaviour) with those who did not undergo training on the survey prior to their visit.ResultsAmong 3526 participants who participated in exit surveys, 2415 were untrained (56% female, median age 40 (IQR: 32–47)) and 1111 were trained (50% female, median age 37 (IQR: 31–45)). Compared with untrained, trained patients were more likely to report a negative care experience overall (adjusted prevalence ratio (aPR) for aggregate sum score: 1.64 (95% CI: 1.39 to 1.94)), with a greater proportion reporting feeling unwelcome by providers (aPR: 1.71 (95% CI: 1.20 to 2.44)) and witnessing providers behaving rude (aPR: 2.28 (95% CI: 1.63 to 3.19)).ConclusionTrained patients were more likely to identify suboptimal care. They may have understood the items solicited better or felt empowered to be more critical. We trained existing patients, unlike studies that use ‘standardised patients’ drawn from outside the patient population. This low-cost strategy could improve patient-centred service delivery elsewhere.Trial registration numberAssessment was nested within a parent study;www.pactr.orgregistered the parent study (PACTR202101847907585).
Bidirectional association between depressive symptoms and cardiovascular disease in the middle-aged and elderly Chinese: a 5-year longitudinal study
Authors: Ziwei Zhang , Hua Yumeng , Liu Aiping 
Published: July 2023

ObjectiveDepressive symptoms and cardiovascular diseases (CVDs) are important issues affecting the health of the middle-aged and elderly population in China. This study aimed to investigate the bidirectional association between depressive symptoms and CVD in middle-aged and elderly people in China.DesignA 5-year longitudinal study.Setting and participantsWe included 6702 middle-aged and elderly participants from China Health and Retirement Longitudinal Study (CHARLS), which is a nationwide longitudinal household survey that started in 2011 (T1) and followed up every 2 years in 2013 (T2) and 2015 (T3).Outcome measuresDepressive symptoms were measured by the Center for Epidemiological Studies Depression Scale. Binary logistic regression was used to identify the influencing factors of depressive symptoms and CVD at T1. The cross-lagged panel model was used to analyse the association between depressive symptoms and CVD at T1, T2 and T3.ResultsThe CHARLS is a representative longitudinal survey of people aged ≥45 years. Using data extracted from the CHARLS, overall, at T1, 2621 (39.10%) participants had depressive symptoms and 432 (6.4%) had CVD, and at T3, 2423 (36.2%) had depressive symptoms and 760 (11.3%) had CVD, respectively. Depressive symptoms at T1 had a effect on CVD at T2 (β=0.015, p=0.009), and depressive symptoms at T2 had an effect on CVD at T3 (β=0.015, p=0.034). CVD at T1 predicted depressive symptoms at T2 (β=0.036, p=0.002).ConclusionsThere is a bidirectional predictive effect between depressive symptoms and CVD. The effect of depressive symptoms on CVD is stable, and CVD has an effect on depressive symptoms in a short period of time.
Impact of COVID-19 pandemic control measures on amblyopia treatment: a retrospective study of records from a tertiary eye hospital in China
Authors: Liu Jing , Ye Qingqing , Xiao Chutong , Zhuang Yijing , Feng Lei , He Yunsi , Xu Zixuan , Zhou Yusong , Chen Xiaolan , Yao Ying , Jiang Rengang , Pang Yangfei , Yu Wentong , Wen Yun , Yuan Junpeng , Thompson Benjamin , Li Jinrong 
Published: July 2023

ObjectivesAmblyopia is the most common cause of unilateral visual impairment in children and requires long-term treatment. This study aimed to quantify the impact of pandemic control measures on amblyopia management.Design and settingThis was a retrospective cohort study of data from a large amblyopia management database at a major tertiary eye care centre in China.ParticipantsOutpatients with amblyopia who visited the hospital from 1 June 2019, through 28 February 2022.Primary and secondary outcome measuresThe primary outcome was the number of first and follow-up in-person visits to the hospital for amblyopia treatment. Secondary outcomes included the time interval between consecutive visits and improvement of vision (visual acuity, contrast sensitivity and stereopsis). Patient records were grouped into prepandemic and during pandemic periods.ResultsA total of 10 060 face-to-face visits for 5361 patients (median age 6.7 years, IQR 5.4, 8.9) that spanned two lockdown periods were included in the analysis, of which 28% were follow-up visits. Pandemic control measures caused a sharp decline in the number of outpatient visits (3% and 30% of prepandemic levels in the months directly after the start of the first (2020) and second (2021) periods of pandemic control measures, respectively). However, these drops were followed by pronounced rebounds in visits that exceeded prepandemic levels by 51.1% and 108.5%, respectively. The interval between consecutive visits increased significantly during the pandemic from a median (IQR) of 120 (112, 127) days in 2019 to 197 (179, 224) in 2020 (p<0.001) and 189 (182, 221) in 2021 (p<0.001). There were no significant differences in the improvement of visual function or treatment compliance between the prepandemic and postpandemic groups.ConclusionsThe number of amblyopia patient hospital visits spiked well above prepandemic levels following lockdown periods. This pattern of patient behaviour can inform planning for amblyopia treatment services during and after public health-related disruptions.
Predictors of specialist somatic healthcare utilization among older people with intellectual disability and their age-peers in the general population: a national register study
Authors: Sandberg Magnus , Axmon Anna , Ahlström Gerd , Kristensson Jimmie 
Published: July 2023

ObjectivesTo compare somatic healthcare usage among older people with intellectual disabilities (ID) to that of their age-peers in the general population, taking into account health and demographic factors, and to identify predictors for somatic healthcare usage among older people with ID.ParticipantsEqually sized cohorts, one with people with ID and one referent cohort, one-to-one-matched by sex and year of birth, were created. Each cohort comprised 7936 people aged 55+ years at the end of 2012.DesignRetrospective register-based study.SettingAll specialist inpatient and outpatient healthcare clinics in Sweden.Outcome measuresData regarding planned/unplanned and inpatient/outpatient specialist healthcare were collected from the Swedish National Patient Register for 2002–2012. Diagnoses, previous healthcare usage, sex, age and cohort affiliation was used to investigate potential impact on healthcare usage.ResultsCompared with the referent cohort, the ID cohort were more likely to have unplanned inpatient and outpatient care but less likely to have planned outpatient care. Within the ID cohort, sex, age and previous use of healthcare predicted healthcare usage.ConclusionsOlder people with ID seem to have lower risks of planned outpatient care compared with the general population that could not be explained by diagnoses. Potential explanations are that people with ID suffer from communication difficulties and experience the healthcare environment as unfriendly. Moreover, healthcare staff lack knowledge about the particular needs of people with ID. Altogether, this may lead to people with ID being exposed to discrimination. Although these problems are known, few interventions have been evaluated, especially related to planned outpatient care.
Experience-based codesign approach to improve care in Australian emergency departments for complex consumer cohorts: the MyED project protocol, Stages 1.1–1.3
Authors: Cheek Colleen , Hayba Nema , Richardson Lieke , Austin Elizabeth E , Francis Auton Emilie , Safi Mariam , Ransolin Natália , Vukasovic Matthew , De Los Santos Aaron , Murphy Margaret , Harrison Reema , Churruca Kate , Long Janet C , Hibbert Peter D , Carrigan Ann , Newman Bronwyn , Hutchinson Karen , Mitchell Rebecca , Cutler Henry , Holt Leanne , Braithwaite Jeffrey , Gillies Donna , Salmon Paul M , Walpola Ramesh Lahiru , Zurynski Yvonne , Ellis Louise A , Smith Kylie , Brown Anthony , Ali Reza , Gwynne Kylie , Clay-Williams Robyn 
Published: July 2023

IntroductionEmergency department (ED) care must adapt to meet current and future demands. In Australia, ED quality measures (eg, prolonged length of stay, re-presentations or patient experience) are worse for older adults with multiple comorbidities, people who have a disability, those who present with a mental health condition, Indigenous Australians, and those with a culturally and linguistically diverse (CALD) background. Strengthened ED performance relies on understanding the social and systemic barriers and preferences for care of these different cohorts, and identifying viable solutions that may result in sustained improvement by service providers. A collaborative 5-year project (MyED) aims to codesign, with ED users and providers, new or adapted models of care that improve ED performance, improve patient outcomes and improve patient experience for these five cohorts.Methods and analysisExperience-based codesign using mixed methods, set in three hospitals in one health district in Australia. This protocol introduces the staged and incremental approach to the whole project, and details the first research elements: ethnographic observations at the ED care interface, interviews with providers and interviews with two patient cohorts—older adults and adults with a CALD background. We aim to sample a diverse range of participants, carefully tailoring recruitment and support.Ethics and disseminationEthics approval has been obtained from the Western Sydney Local Health District Human Research Ethics Committee (2022/PID02749-2022/ETH02447). Prior informed written consent will be obtained from all research participants. Findings from each stage of the project will be submitted for peer-reviewed publication. Project outputs will be disseminated for implementation more widely across New South Wales, Australia.
Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use—protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study)
Authors: Wood Grace , Goodyear Victoria , Adab Peymane , Al-Janabi Hareth , Fenton Sally , Jones Kirsty , Michail Maria , Morrison Breanna , Patterson Paul , Sitch Alice J , Wade Matthew , Pallan Miranda 
Published: July 2023

IntroductionSmartphone and social media use is prevalent during adolescence, with high levels of use associated with lower levels of mental well-being. Secondary schools in the UK have introduced policies that restrict daytime use of smartphones and social media, but there is no evaluation on the impact of these policies on adolescent mental well-being. The SMART Schools Study aims to determine the impact of daytime restrictions of smartphone and social media use on indicators of adolescent mental well-being, anxiety, depression, physical activity, sleep, classroom behaviour, attainment and addictive social media use.Methods and analysisThis is a natural experimental observational study using mixed methods. Secondary schools within a 100 mile radius of the recruiting centre in the West Midlands (UK) have been categorised into two groups: Schools that restrict (intervention) and permit (comparator) daytime use of smartphones. We aim to recruit 30 schools (20 restrictive, 10 permissive) and 1170 pupils aged 12–13 and 14–15 years. We will collect data on mental well-being, anxiety and depressive symptoms, phone and social media use, sleep and physical activity from pupil surveys, and accelerometers. Policy implementation measures and data on individual pupil factors will be collected through school staff surveys, and website/policy analysis. Six case study schools will explore individual, school and family/home factors that influence relationships between school smartphone policies, smartphone/social media use, and mental well-being. Economic evaluation will be completed through a cost–consequence analysis from an education sector perspective.Ethics and disseminationEthical approval was obtained from the University of Birmingham’s Research Ethics Committee (ERN_22-0723). Parents/carers of pupil participants can complete a form to opt their child out of the study. Pupil, school staff and parent/carer participants are asked to complete online/written consent (or assent). Findings will be disseminated through policy briefings, resources for schools, social media, reports, and open access publications.Trial registration numberISRCTN77948572.