bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term exposure to ozone and asthma exacerbation in adults: A longitudinal study in China
Authors: Fang Xinyi , Huang Suijie , Zhu Yixiang , Lei Jian , Xu Yanyi , Niu Yue , Chen Renjie 
Published: January 2023

BackgroundThe relationships between short-term ozone exposure and the acute exacerbations of asthma in adults have not been fully studied. Existing studies commonly ignored the effects of ozone on mild or early asthma exacerbations.ObjectiveTo investigate the associations between short-term ozone exposure and asthma exacerbations in Chinese adults.MethodsWe administered health management for adult asthma patients through the Respiratory Home Platform and required them to monitor their lung function every morning and evening by themselves. Finally, a total of 4,467 patients in 18 Chinese cities were included in the current analyses, with 79,217 pairs of lung function records. The maximum daily 8-h average ozone concentrations were collected from fixed-site air quality monitoring stations. We calculated diurnal peak expiratory flow (PEF) variation using morning and evening measurements of PEF and then defined different severity of asthma exacerbations with diurnal PEF variations &gt;10, 15, and 20%, respectively. A binomial distributed generalized additive mixture model combined with distribution non-linear models was applied to examine the association of ozone with asthma exacerbations. We further conducted stratified analyses by sex, age, season of lung function tests, and region.Measurements and resultsWe found that short-term ozone exposure was independently associated with an elevated risk of asthma exacerbations defined by lung function and the effects could last for about 2 days. At lag 0–2 days, each 10 μg/m3 increment in ozone concentration was associated with odds ratios of 1.010 [95% confidence interval (CI): 1.003, 1.017], 1.014 (95% CI: 1.005, 1.023), and 1.017 (95% CI: 1.006, 1.028) for asthma exacerbations that were defined by diurnal PEF variation over 10, 15, and 20%, respectively. The associations remained significant after adjusting for other pollutants, and became unstable when using 24-h average ozone concentration. We also found that the associations were relatively stronger in males, those aged 45 years and older, and in the warm season.ConclusionsOur results suggest that short-term ozone exposure can increase the risk of asthma exacerbations, even in the early stage of exacerbation. Male and older asthma patients may be more vulnerable to ozone air pollution, especially in the warm season.
Does the built environment of settlements affect our sentiments? A multi-level and non-linear analysis of Xiamen, China, using social media data
Authors: Fan Chenjing , Gai Zhenyu , Li Shiqi , Cao Yirui , Gu Yueying , Jin Chenxi , Zhang Yiyang , Ge Yanling , Zhou Lin 
Published: January 2023

IntroductionHumans spend most of their time in settlements, and the built environment of settlements may affect the residents' sentiments. Research in this field is interdisciplinary, integrating urban planning and public health. However, it has been limited by the difficulty of quantifying subjective sentiments and the small sample size.MethodsThis study uses 147,613 Weibo text check-ins in Xiamen from 2017 to quantify residents' sentiments in 1,096 neighborhoods in the city. A multilevel regression model and gradient boosting decision tree (GBDT) model are used to investigate the multilevel and nonlinear effects of the built environment of neighborhoods and subdistricts on residents' sentiments.ResultsThe results show the following: (1) The multilevel regression model indicates that at the neighborhood level, a high land value, low plot ratio, low population density, and neighborhoods close to water are more likely to improve the residents' sentiments. At the subdistrict level, more green space and commercial land, less industry, higher building density and road density, and a smaller migrant population are more likely to promote positive sentiments. Approximately 19% of the total variance in the sentiments occurred among subdistricts. (2) The proportion of green space and commercial land, and the density of buildings and roads are linearly correlated with residents' sentiments. The land value is a basic need and exhibits a nonlinear correlation with sentiments. The plot ratio, population density, and the proportions of industrial land and the migrant population are advanced needs and are nonlinearly correlated with sentiments.DiscussionThe quantitative analysis of sentiments enables setting a threshold of the influence of the built environment on residents' sentiments in neighborhoods and surrounding areas. Our results provide data support for urban planning and implementing targeted measures to improve the living environment of residents.
Emergency shelter allocation planning technology for large-scale evacuation based on quantum genetic algorithm
Authors: Yin Yang , Zhao Xiangcheng , Lv Wei 
Published: January 2023

IntroductionShelter allocation is one of the most important measures in urban disaster prevention and mitigation planning. Meanwhile, it is essentially a comprehensive planning problem combining resource allocation and traffic routing. A reasonable allocation scheme can avoid congestion, improve evacuation efficiency, and reduce the casualty rate. Owing to the large region and large evacuation population demand, quickly solving the complex allocation problem is somewhat challenging, and thus, the optimal results are difficult to obtain with the increase of evacuation scale by traditional allocation methods.MethodsThis article aims to establish a shelter allocation model for large-scale evacuation, which employs an improved quantum genetic algorithm (IQGA) based on spreading operation and considering the total evacuation distance, the capacity constraint of evacuation sites, and the dispersion of allocation results, and compare allocation schemes of the spreading model with those of models that consider different constraints.Results and discussionResults show that the allocation model with the spreading operation has better allocation results than that without the spreading operation. For the allocation model with spreading operation, the spreading model with different spreading speeds is more reasonable than that with the same spreading speed, and the allocation results are closer to the ideal results with the increase of constraints. In addition, according to the allocation results, the evacuation route map and the evacuation heat map are drawn to intuitively understand the distribution scheme of each shelter.
Spatial accessibility of emergency medical services in Chongqing, Southwest China
Authors: Zou Yang , Jia Ling , Chen Saijuan , Deng Xinyi , Chen Zhiyi , He Ying , Wang Qiuting , Xing Dianguo , Zhang Yan 
Published: January 2023

BackgroundTimely access to emergency medical services (EMS) can significantly reduce mortality. In China, the evidence of the accessibility of complete EMS which considers two related trips and involves large rural areas is insufficient. This study aimed to explore the accessibility of ambulance services and complete EMS in Chongqing and its regional differences, and to provide a reference for improving spatial accessibility of EMS in Chongqing and optimizing allocation of EMS resources.MethodsThe nearest neighbor method was used to measure spatial accessibility of ambulance services and complete EMS. Spatial aggregation patterns and influencing factors of spatial accessibility of complete EMS were analyzed using Moran's I index, Pearson correlation and multiple linear regression.ResultsThe medians of shortest travel time for ambulance, monitoring ambulance, primary EMS and advanced EMS in Chongqing were 7.0, 18.6, 36.2, and 47.8 min. The shortest travel time for complete EMS showed significant spatial aggregation characteristics. The Low-Low types that referred to cluster of short EMS travel time mainly distributed in city proper. The High-High types that referred to cluster of long EMS travel time mainly distributed in northeast and southeast of Chongqing. Urbanization rate was a negative influencing factor on shortest travel time for primary EMS, while average elevation and the number of settlements were positive influencing factors. GDP per capita and urbanization rate were negative influencing factors on shortest travel time for advanced EMS, while the number of settlements was a positive influencing factor.ConclusionThis study evaluated the accessibility of EMS which considers two related trips in Chongqing. Although the accessibility of ambulances in Chongqing was relatively high, the accessibility of monitoring ambulance was relatively low. Regional and urban-rural differences in the accessibility of complete EMS integrating two related trips were obvious. It was recommended to increase financial investment in economic backward areas, increase high-quality EMS resources, enhance EMS capacity of central township health centers, strengthen road construction in mountainous areas, and provide reasonable planning of rural settlements for improving the spatial accessibility of EMS, narrowing the urban-rural gap and improving equity in getting EMS for all the people.
Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
Authors: Mohd Hassan Nor Zam Azihan , Bahari Mohd Shahri , Aminuddin Farhana , Mohd Nor Sham Kunusagaran Mohd Shaiful Jefri , Zaimi Nur Amalina , Mohd Hanafiah Ainul Nadziha , Kamarudin Fakarudin 
Published: January 2023

IntroductionAmbulance services are pivotal in any country's healthcare system. An efficient ambulance service not only decreases patient mortality rate but also allows resource prioritization for better outputs. This study aims to measure the efficiency of ambulance services provided by health facilities in the Ministry of Health (MOH), Malaysia.MethodsThis cross-sectional study analyzed the efficiency of 76 Decision-Making Units (DMUs) or health facilities, consisting of 62 health clinics and 14 hospitals. Data Envelopment Analysis (DEA) was used for computing efficiency scores while adopting the Variable Return to Scale (VRS) approach. The analysis was based on input orientation. The input was the cost of ambulance services, while the output for this analysis was the distance coverage (in km), the number of patients transferred, and hours of usage (in hours). Subsequent analysis was conducted to test the Overall Technical Efficiency (OTE), the Pure Technical Efficiency (PTE), the Scale Efficiency (SE), and the Return to Scale with the type of health facilities and geographical areas using a Mann-Whitney U-test and a chi-square test.ResultsThe mean scores of OTE, PTE, and SE were 0.508 (±0.207), 0.721 (±0.185), and 0.700 (±0.200), respectively. Approximately, 14.47% of the total health facilities were PTE. The results showed a significant difference in OTE and SE between ambulance services in hospitals and health clinics (p&lt; 0.05), but no significant difference in PTE between hospitals and clinics (p&gt;0.05). There was no significant difference in efficiency scores between urban and rural health facilities in terms of ambulance services except for OTE (p&lt; 0.05).DiscussionThe ambulance services provided in healthcare facilities in the MOH Malaysia operate at 72.1% PTE. The difference in OTE between hospitals and health clinics' ambulance services was mainly due to the operating size rather than PTE. This study will be beneficial in providing a guide to the policymakers in improving ambulance services through the readjustment of health resources and improvement in the outputs.
Getting to implementation: Adaptation of an implementation playbook
Authors: Yakovchenko Vera , Rogal Shari S. , Goodrich David E. , Lamorte Carolyn , Neely Brittney , Merante Monica , Gibson Sandra , Scott Dawn , McCurdy Heather , Nobbe Anna , Morgan Timothy R. , Chinman Matthew J. 
Published: January 2023

IntroductionImplementation strategies supporting the translation of evidence into practice need to be tailored and adapted for maximum effectiveness, yet the field of adapting implementation strategies remains nascent. We aimed to adapt “Getting To Outcomes”® (GTO), a 10-step implementation playbook designed to help community-based organizations plan and evaluate behavioral health programs, into “Getting To Implementation” (GTI) to support the selection, tailoring, and use of implementation strategies in health care settings.MethodsOur embedded evaluation team partnered with operations, external facilitators, and site implementers to employ participatory methods to co-design and adapt GTO for Veterans Health Administration (VA) outpatient cirrhosis care improvement. The Framework for Reporting Adaptations and Modifications to Evidenced-based Implementation Strategies (FRAME-IS) guided documentation and analysis of changes made pre- and post-implementation of GTI at 12 VA medical centers. Data from multiple sources (interviews, observation, content analysis, and fidelity tracking) were triangulated and analyzed using rapid techniques over a 3-year period.ResultsAdaptations during pre-implementation were planned, proactive, and focused on context and content to improve acceptability, appropriateness, and feasibility of the GTI playbook. Modifications during and after implementation were unplanned and reactive, concentrating on adoption, fidelity, and sustainability. All changes were collaboratively developed, fidelity consistent at the level of the facilitator and/or implementer.ConclusionGTO was initially adapted to GTI to support health care teams' selection and use of implementation strategies for improving guideline-concordant medical care. GTI required ongoing modification, particularly in steps regarding team building, context assessment, strategy selection, and sustainability due to difficulties with step clarity and progression. This work also highlights the challenges in pragmatic approaches to collecting and synthesizing implementation, fidelity, and adaptation data.Trial registrationThis study was registered on ClinicalTrials.gov (Identifier: NCT04178096).
Sterilization of micronized indomethacin
Authors: Krupianskaya Karyna , Croonenborghs Bart , Gillet Annick , Appeltans Bernard , Meyers Anke , DeMent Aaron , Van den Mooter Guy , Van Schepdael Ann , Haghedooren Erik 
Published: January 2023

Sterilization is a pivotal topic in the pharmaceutical industry, whereby the nomenclature of “sterile” refers to the absence of viable microorganisms. Since microorganisms can reproduce in the body and cause potentially fatal infections, it is critical to sterilize parenteral products to prevent this. In recent years, 70%–90% of potential drugs and 40% of marketed drugs have demonstrated a low solubility. Micronization is a widely spread approach to increase the dissolution rate. A subset of micronized products require sterilization, but published studies on the effects of sterilization on micronized products are currently lacking. The effect of sterilization on the micronized active pharmaceutical ingredient indomethacin was explored in this study. The sterilization methods in scope were one photon-based method using gamma irradiation and one gas-based method with nitrogen dioxide gas. Indomethacin was micronized using two micronization techniques, cryomilling and spray drying. Different conditions were used for cryomilling where the number of grinding balls in the ball mill and the degree of filling were varied. The solid state of all samples was evaluated after micronization, and only the effectively micronized samples were selected for sterilization with gamma rays and nitrogen dioxide. Gamma irradiation was performed with the active pharmaceutical ingredient stored at −80°C at a commonly used industry standard target dose of 25 kGy. Nitrogen dioxide sterilization took place at 21°C, a concentration of 10 mg/L, a relative humidity of 30% and using two NO2pulses. Before and after sterilization, all samples were analyzed by high performance liquid chromatography with UV detection, whereby the assay of indomethacin was examined as well as the peak purity and the formation of impurities. In comparison to the non-micronized reference, both sterilization methods demonstrate a significant decrease of content of micronized samples and an increase of the impurity profile. The non-micronized sample showed no significant difference after sterilization. It could be observed that micronized indomethacin samples demonstrate more degradation and are subsequently more susceptible to degradation upon sterilization with gamma rays and nitrogen dioxide gas, driving towards the need for assessment of the micronization impact combined with sterilization approach.
Extraction of bioactives from brown seaweed using sub and supercritical fluids: Influence of the extract on the storage stability of fish oil enrich mayonnaise
Authors: Hermund Ditte B. , Liu Wei , Holdt Susan Løvstad , Jacobsen Charlotte , Getachew Adane Tilahun 
Published: January 2023

This study aimed at extracting lipophilic and hydrophilic compounds from Nordic brown seaweed Fucus vesiculosus and to evaluate the extract’s ability to maintain the physical and oxidative stability of fish oil-enriched mayonnaise (80% fat, 1:4 fish oil: rapeseed oil) during storage (dark, up to 28 days). Three different types of extracts were obtained, one using supercritical carbon dioxide (lipophilic extract) and two using subcritical water extraction (hydrophilic extracts)—one on dry seaweed (Subcritical water extract (SCWE) and one on the residue from supercritical carbon dioxide extraction after extracting the lipophilic compounds (Subcritical water extract (SCWER). The extracts were characterized with respect to their antioxidant composition and in vitro antioxidant properties. Moreover, the extracts were added in concentrations of 2 g/kg mayonnaise, both individually or in combination to study synergistic effects between antioxidants with different polarity and locations in the mayonnaise system. Results showed that both types of extractsdelayed the oxidation of lipids; The hydrophilic extracts (SCWE and SCWER) were able toretard the formation of hydroperoxides, and subsequent formation of secondary oxidation products. However, no synergetic effect was found for the hydrophilic and hydrophobic extracts when they were applied in different phases of the mayonnaise. The metal chelating ability is suggested to be responsible for the observed better performance of the hydrophilic extracts. However, further studies are required to understand which specific components in the extract have contributed to metal chelating ability. In conclusion, the findings of the present study suggest hydrophilic and hydrophobic compounds from the Nordic seaweed F. vesiculosus can retard lipid oxidation in mayonnaise.
Case Report: Effect of low energy availability and training load on sleep in a male combat sport athlete
Authors: Thomas Craig , Langan-Evans Carl , Germaine Mark , Artukovic Mario , Jones Helen , Whitworth-Turner Craig , Close Graeme L. , Louis Julien 
Published: January 2023

PurposeThe aim of this case report was to describe the sleep responses in a male combat sport athlete, who was engaging in both chronic (CWL) and acute (AWL) weight loss practices in order to reduce body mass for a national competition.MethodsDuring the first seven weeks of training (Phases 1 and 2), the athlete adhered to a daily energy intake (EI) equating to their resting metabolic rate (1700 kcal·day−1) followed by a reduction in EI (915–300 kcal·day−1) in the 5 days before weighing in (Phase 3). Nocturnal sleep was monitored throughout the 8-week training period using wristwatch actigraphy and frequent measurements of body mass/composition, daily exercise energy expenditure and training load (TL) were taken.ResultsThe athlete was in a state of low energy availability (LEA) during the entire training period. There was a very large decrease in LEA status during phase 3 compared with phases 1 and 2 (3 vs. 20 kcal·kgFFM·day−1) and there was a small decrease in TL during phase 3 compared with phase 2 (410 vs. 523 AU). The athlete's sleep efficiency increased throughout the training period, but total sleep time displayed a small to moderate decrease in phase 3 compared with phases 1 and 2 (386 vs. 429 and 430 min). However, correlational analysis demonstrated trivial to small, non-significant relationships between sleep characteristics and the athlete's LEA status and TL.ConclusionThese findings suggest that CWL and AWL practices that cause fluctuations in LEA and TL may be implemented without compromising the sleep of combat sport athletes.
Postmenopausal osteoporosis: Effect of moderate-intensity treadmill exercise on bone proteomics in ovariectomized rats
Authors: Yang Yong-Jie , Li Ye , Gao Li 
Published: January 2023

ObjectivesThis study aimed to identify the key proteins in the bone mass of ovariectomized (OVX) rats after a period of regular moderate-intensity treadmill exercise and to investigate their effects using tag mass spectrometry and quantitative proteomics with a view to improving the understanding and treatment of postmenopausal osteoporosis.MethodsSixty three-month-old female Sprague-Dawley tats of specific-pathogen-free grade were randomly and equally divided into a sham operation group, ovariectomized group (OVX) and ovariectomized combined exercise (OVX + EX) group, and the latter took moderate-intensity treadmill exercise for 17 weeks. After this period of time, body composition and bone density were measured using dual-energy x-ray absorptiometry, and serum bone metabolism indicators were measured using an enzyme immunoassay. In addition, the bone microstructure was examined using micro-computed tomography and scanning of the femur, and femur proteins were subject to proteomic analysis.ResultsCompared with the rats in the OVX group, the bone metabolism indicators in the OVX + EX group decreased significantly, femur bone density increased significantly, the number of the trabeculae increased, and continuity was higher. In the OVX + EX group, 17 proteins were significantly upregulated and 33 significantly downregulated. The main gene ontology and signaling pathways enriched by the proteins were identified as the tumor necrosis factor-mediated signaling pathways. The protein-protein interaction network identified the key proteins, and the correlation analysis of these proteins and the bone parameters found histone deacetylase 8(HDAC8) and leucine-rich transmembrane and O-methyltransferase domain containing (LRTOMT) and trimethylguanosine synthase 1(TGS1) and ankyrin repeat domain 46(ANKRD46) to be the key targets of exercise in relation to postmenopausal osteoporosis.ConclusionModerate-intensity treadmill exercise significantly improved the bone mass of OVX rats, and differentially expressed proteins, such as HDAC8 and LRTOMT and TGS1 and ANKRD46, could be the target of moderate-intensity treadmill exercise.