bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air pollution, residential greenness, and metabolic dysfunction biomarkers: analyses in the Chinese Longitudinal Healthy Longevity Survey
Authors: Liu Linxin , Yan Lijing L. , Lv Yuebin , Zhang Yi , Li Tiantian , Huang Cunrui , Kan Haidong , Zhang Junfeng , Zeng Yi , Shi Xiaoming , Ji John S. 
Published: May 2022

Abstract
Background
We hypothesize higher air pollution and fewer greenness exposures jointly contribute to metabolic syndrome (MetS), as mechanisms on cardiometabolic mortality.

Methods
We studied the samples in the Chinese Longitudinal Healthy Longevity Survey. We included 1755 participants in 2012, among which 1073 were followed up in 2014 and 561 in 2017. We used cross-sectional analysis for baseline data and the generalized estimating equations (GEE) model in a longitudinal analysis. We examined the independent and interactive effects of fine particulate matter (PM2.5) and Normalized Difference Vegetation Index (NDVI) on MetS. Adjustment covariates included biomarker measurement year, baseline age, sex, ethnicity, education, marriage, residence, exercise, smoking, alcohol drinking, and GDP per capita.

Results
At baseline, the average age of participants was 85.6 (SD: 12.2; range: 65–112). Greenness was slightly higher in rural areas than urban areas (NDVI mean: 0.496 vs. 0.444; range: 0.151–0.698 vs. 0.133–0.644). Ambient air pollution was similar between rural and urban areas (PM2.5 mean: 49.0 vs. 49.1; range: 16.2–65.3 vs. 18.3–64.2). Both the cross-sectional and longitudinal analysis showed positive associations of PM2.5 with prevalent abdominal obesity (AO) and MetS, and a negative association of NDVI with prevalent AO. In the longitudinal data, the odds ratio (OR, 95% confidence interval-CI) of PM2.5 (per 10 μg/m3 increase) were 1.19 (1.12, 1.27), 1.16 (1.08, 1.24), and 1.14 (1.07, 1.21) for AO, MetS and reduced high-density lipoprotein cholesterol (HDL-C), respectively. NDVI (per 0.1 unit increase) was associated with lower AO prevalence [OR (95% CI): 0.79 (0.71, 0.88)], but not significantly associated with MetS [OR (95% CI): 0.93 (0.84, 1.04)]. PM2.5 and NDVI had a statistically significant interaction on AO prevalence (pinteraction: 0.025). The association between PM2.5 and MetS, AO, elevated fasting glucose and reduced HDL-C were only significant in rural areas, not in urban areas. The association between NDVI and AO was only significant in areas with low PM2.5, not under high PM2.5.

Conclusions
We found air pollution and greenness had independent and interactive effect on MetS components, which may ultimately manifest in pre-mature mortality. These study findings call for green space planning in urban areas and air pollution mitigation in rural areas.
A state-wide education program on opioid use disorder: influential community members’ knowledge, beliefs, and opportunities for coalition development
Authors: Hohmann Lindsey , Phillippe Haley , Marlowe Karen , Jeminiwa Ruth , Hohmann Natalie , Westrick Salisa , Fowler Amanda , Fox Brent 
Published: May 2022

Abstract
Background
Deep South states, particularly Alabama, experience disproportionately higher opioid prescribing rates versus national rates. Considering limited opioid use disorder (OUD) providers in this region, collaborative efforts between non-healthcare professionals is critical in mitigating overdose mortality. The Alabama Opioid Training Institute (OTI) was created in 2019 to empower community members to take action in combatting OUD in local regions. The OTI included: 1) eight full-day in-person conferences; and 2) an interactive mobile-enabled website (https://alabamaoti.org). This study assessed the impact of the OTI on influential community members’ knowledge, abilities, concerns, readiness, and intended actions regarding OUD and opioid overdose mitigation.

Methods
A one-group prospective cohort design was utilized. Alabama community leaders were purposively recruited via email, billboards, television, and social media advertisements. Outcome measures were assessed via online survey at baseline and post-conference, including: OUD knowledge (percent correct); abilities, concerns, and readiness regarding overdose management (7-point Likert-type scale, 1 = strongly disagree to 7 = strongly agree); and actions/intended actions over the past/next 6 months (8-item index from 0 to 100% of the time). Conference satisfaction was also assessed. Changes were analyzed using McNemar or Marginal Homogeneity tests for categorical variables and two-sided paired t-tests for continuous variables (alpha = 0.05).

Results
Overall, 413 influential community members participated, most of whom were social workers (25.7%), female (86.4%), and White (65.7%). Community members’ OUD knowledge increased from mean [SD] 71.00% [13.32] pre-conference to 83.75% [9.91] post-conference (p < 0.001). Compared to pre-conference, mean [SD] ability scale scores increased (3.72 [1.55] to 5.15 [1.11], p < 0.001) and concerns decreased (3.19 [1.30] to 2.64 [1.17], p < 0.001) post-conference. Readiness was unchanged post-conference. Attendees’ intended OUD-mitigating actions in the next 6 months exceeded their self-reported actions in the past 6 months, and 92% recommended the OTI to others.

Conclusions
The Alabama OTI improved community leaders’ knowledge, abilities, and concerns regarding OUD management. Similar programs combining live education and interactive web-based platforms can be replicated in other states.
Prevalence, awareness, treatment and control of hypertension, diabetes and hypercholesterolemia, and associated risk factors in the Czech Republic, Russia, Poland and Lithuania: a cross-sectional study
Authors: Lu Wentian , Pikhart Hynek , Tamosiunas Abdonas , Kubinova Ruzena , Capkova Nadezda , Malyutina Sofia , Pająk Andrzej , Bobak Martin 
Published: May 2022

Abstract
Background
Empirical evidence on the epidemiology of hypertension, diabetes and hypercholesterolemia is limited in many countries in Central and Eastern Europe. We aimed to estimate the prevalence, awareness, treatment and control of hypertension, diabetes and hypercholesterolemia in the Czech Republic, Russia, Poland and Lithuania, and to identify the risk factors for the three chronic conditions.

Methods
We analysed cross-sectional data from the HAPIEE study, including adults aged 45–69 years in the Czech Republic, Russia, Poland and Lithuania, collected between 2002 and 2008 (total sample N = 30,882). Among prevalent cases, we estimated awareness, treatment, and control of hypertension, diabetes and hypercholesterolemia by gender and country. Multivariate logistic regression was applied to identify associated risk factors.

Results
In each country among both men and women, we found high prevalence but low control of hypertension, diabetes, and hypercholesterolemia. Awareness rates of hypertension were the lowest in both men (61.40%) and women (69.21%) in the Czech Republic, while awareness rates of hypercholesterolemia were the highest in both men (46.51%) and women (51.20%) in Poland. Polish participants also had the highest rates of awareness (77.37% in men and 79.53% in women), treatment (71.99% in men and 74.87% in women) and control (30.98% in men and 38.08% in women) of diabetes. The common risk factors for the three chronic conditions were age, gender, education, obesity and alcohol consumption.

Conclusions
Patterns of awareness, treatment and control rates of hypertension, diabetes and hypercholesterolemia differed by country. Efforts should be made in all four countries to control these conditions, including implementation of international guidelines in everyday practice to improve detection and effective management of these conditions.
Intergenerational transmission of body mass index and associations with educational attainment
Authors: Alrouh Hekmat , van Bergen Elsje , de Zeeuw Eveline , Dolan Conor , Boomsma Dorret I. 
Published: May 2022

Abstract
Background
Individual differences in educational attainment (EA) and physical health, as indexed by body mass index (BMI), are correlated within persons and across generations. The present aim was to assess these associations while controlling for parental transmission.

Methods
We analyzed BMI and EA obtained for 8,866 families from the Netherlands. Data were available for 19,132 persons, including 6,901 parents (mean age 54) and 12,234 of their adult offspring (mean age 32). We employed structural equation modeling to simultaneously model the direct and indirect transmission of BMI and EA from parents to offspring, spousal correlations, and the residual within-person BMI-EA association and tested for gender differences in the transmission parameters.

Results
We found moderate intergeneration transmission for BMI (standardized beta ~ .20) and EA (~ .22), and substantial spousal correlations for BMI (.23) and EA (.51). Cross-trait parent to offspring transmission was weak. The strength of transmission was largely independent of parent or offspring gender. Negative within person EA-BMI correlations were observed for all family members (fathers, -0.102; mothers, -0.147; sons, -0.154; daughters, -0.173). About 60% of the EA-BMI correlation in offspring persisted after taking into account the intergeneration transmission.

Conclusions
The intergenerational transmission for BMI and EA is mainly predictive within traits. Significant spousal and within person correlations in the parental generation are responsible for the effect of parental EA on offspring BMI. Offspring EA and BMI are further correlated beyond parental influences.
Facilitators and barriers to social distancing for young people during the COVID-19 pandemic
Authors: Berry Emma , Jenkins Chris , Allen Sarah 
Published: May 2022

Abstract
Background
Social (or physical) distancing is an important transmission-prevention behaviour that has been endorsed to minimize COVID-19 transmission. This qualitative study explores the facilitators of and barriers to social distancing for young people during the COVID-19 pandemic, with recognition that young people represent a unique demographic group, with differing psychosocial needs and experiences to other age cohorts.

Methods
Qualitative data was collected as part of a larger Qualtrics survey between July 28th 2020 and August 24th 2020. Eligible participants were young people living on the Island of Ireland, aged 16-25 years. The survey design was underpinned by the Capability, Opportunity, and Motivation model of behaviour change (COM-B). Semi-inductive thematic analysis was used to analyse comments collected via three free-text survey items. The COM-B model provided a thematic framework to organise subthemes extracted.

Results
A total of N = 477 young people completed the survey, of which N = 347 provided comments for at least one of three free-text survey items. The majority of respondents lived in Northern Ireland (96%), the average age was 21 years, and most respondents were female (73%) and were students (81%). Key barriers identified included lack of environmental support for social distancing (lack of physical Opportunity to social distance), observing other people not social distancing (lack of social Opportunities supporting social distancing), and missing physical interaction from others (relating to the dissuading influence of automatic Motivational factors i.e. the influence of loneliness). Key facilitators included presence of clear and consistent environmental cues and availability of space to support social distancing (increasing physical Opportunity to social distance), increasing awareness and perceived consequences of risk of transmission (enhancing reflective Motivational factors i.e. perceived benefits (versus costs) of social distancing), and increasing opportunities to observe others’ adhering to guidelines (increasing social Opportunities supporting social distancing).

Conclusions
These findings suggest that the actions and endorsement of peers and the physical design of environments have a key role in influencing social distancing behaviour among young people living in NI. The COM-B factors identified in this study can inform the development of tailored interventions using models such as the Behaviour Change Wheel. The findings of this study suggest that intervention functions based on peer modelling and physical environmental restructuring and enablement should be priortitised, however it is imperative that interventions are co-designed with young people to foster collaboration and empowerment.
Transbronchial lung biopsy versus transbronchial lung cryobiopsy in critically ill patients with undiagnosed acute hypoxemic respiratory failure: a comparative study
Authors: Wang Shiyao , Feng Yingying , Zhang Yi , Tian Ye , Gu Sichao , Wu Xiaojing , Feng Yiming , Zhao Ling , Liu Min , Wang Dan , Li Ying , Tian Zheng , Wang Shumeng , Huang Xu , Zhou Guowu , Zhan Qingyuan 
Published: May 2022

Abstract
Background
In patients with acute hypoxemic respiratory failure whose diagnosis is not established after initial evaluation, obtaining a histopathological diagnosis may improve the patients’ prognosis. This study aims to compare the safety profile and diagnostic yields between transbronchial lung biopsy (TBLB) and transbronchial lung cryobiopsy (TBLC) in these patients.

Methods
A retrospective comparative study was conducted in a 26-bed intensive care unit over a 5-year period. The consecutive patients with acute hypoxemic respiratory failure who underwent TBLB or TBLC were included to determine the potential etiology. Patients characteristics, procedure related complications, pathological and multidisciplinary discussion (MDD) diagnostic yields, treatment modification and 28-day survival were analyzed. Prognostic factors were identified by Cox regression analysis.

Results
Forty-five and 25 consecutive patients underwent TBLB and TBLC, respectively. The patients underwent TBLC were more critical. There was no significant difference in overall procedure related complications of patients underwent TBLB and TBLC [15.6% (7/45) vs 28.0% (7/25), p = 0.212]. The rate of pathological diagnostic yield [72.0% (18/25) vs 37.8% (17/45), p = 0.006], MDD diagnostic yield [84.0% (21/25) vs 55.6% (25/45), p = 0.016] and subsequent treatment modification [84.0% (21/25) vs 57.8% (26/45), p = 0.025] in patients underwent TBLC were significantly higher than those in patients underwent TBLB. Multivariate analysis revealed that MDD diagnosis [HR 0.193 (95% CI 0.047–0.792), p = 0.022] and treatment modification [HR 0.204 (95% CI 0.065–0.638), p = 0.006] may be prognostic protective factors.

Conclusions
TBLC can lead to an increased chance of establishing a diagnosis, which could significantly improve the patients’ prognosis, with an acceptable safety profile.
Increased serum levels of advanced glycation end products are negatively associated with relative muscle strength in patients with type 2 diabetes mellitus
Authors: Wu Tsung-Hui , Tsai Shiow-Chwen , Lin Hsuan-Wei , Chen Chiao-Nan , Hwu Chii-Min 
Published: May 2022

Abstract
Background
In this study, we investigated whether serum levels of advanced glycation end products (AGEs) independently correlated with relative muscle strength after adjustment for clinical variables including diabetic peripheral neuropathy in patients with type 2 diabetes. Relative muscle strength was defined as muscle strength (in decinewtons, dN) divided by total muscle mass (in kg).

Methods
We enrolled 152 ambulatory patients with type 2 diabetes. Each participant underwent measurements of muscle strength and total muscle mass. Serum levels of AGEs were determined. The Michigan Neuropathy Screening Instrument Physical Examination (MNSI-PE) was performed to assess diabetic peripheral neuropathy.

Results
The participants were divided into three groups on the basis of tertiles of serum AGEs levels. Significant differences were observed among the three groups in relative handgrip strength (71.03 ± 18.22, 63.17 ± 13.82, and 61.47 ± 13.95 dN/kg in the low-tertile, mid-tertile, and high-tertile groups, respectively, P = 0.005). The relative muscle strength of the ankle plantar flexors was higher in the low-tertile group than in the mid-tertile and high-tertile groups (107.60 ± 26.53, 94.97 ± 19.72, and 94.18 ± 16.09 dN/kg in the low-tertile, mid-tertile, and high-tertile groups, respectively, P = 0.002). After adjustment for MNSI-PE score and other clinical variables in partial correlation analysis, the correlations between serum levels of AGEs and the relative muscle strength of handgrip, ankle dorsiflexor, and ankle plantar flexor remained significant. Serum AGEs level was the only variable that remained significantly related to the relative muscle strength of handgrip, ankle dorsiflexor, and ankle plantar flexor when AGEs level, fasting plasma glucose, and glycated hemoglobin (HbA1c) were entered into multiple regression models simultaneously.

Conclusions
After adjustment for multiple factors including diabetic peripheral neuropathy, this study demonstrated that increased serum levels of AGEs were independently associated with decreased relative muscle strength in patients with type 2 diabetes. Compared with fasting plasma glucose and HbA1c, serum level of AGEs is more strongly associated with relative muscle strength.
Prescription trends at the end of life in a palliative care unit: observational study
Authors: Peralta Tatiana , Castel-Branco Maria Margarida , Reis-Pina Paulo , Figueiredo Isabel Vitória , Dourado Marília 
Published: May 2022

Abstract
Background
Symptomatic control is essential in palliative care, particularly in end-of-life, in which the pathophysiological changes that characterize this last phase of life strengthen the need to carry out an early therapeutic review. Hence, we aim to evaluate the prescribing pattern at a palliative care unit at two different time points: on admission and the day of the patient’s death.

Methods
Quantitative, analytic, longitudinal, retrospective and observational study. Participants were adult patients who were admitted and died in a palliative care unit, in Portugal. Sociodemographic, clinical and pharmacological data were collected, including frequencies and routes of administration of schedule prescribed drugs and rescue drugs, from the day of admission until the day of death.

Results
115 patients were included with an average age of 70.0 ± 12.9 years old, 53.9 were male, mostly referred by the Hospital Palliative Care Support Teams. The most common pathology was cancer, mainly in advanced stage. On admission, the median scheduled prescription was seven and “as needed” was three drugs. On the day of death, a decrease of prescriptions was observed. Opioids were always the most prescribed drugs. Near death, there was a higher tendency to prescribe butylscopolamine, midazolam, diazepam and levomepromazine. The most frequent route of drug administration was oral on admission and subcutaneous on the day of death.

Conclusions
Polypharmacy is a reality in palliative care despite specialist palliative care teams. A reduction of prescribed drugs was verified, essentially due less comorbidity-oriented drugs. Further studies are required to analyse the importance of Hospital Palliative Care Support Teams.
Nursing students’ perception of gender-defined roles in nursing: a qualitative descriptive study
Authors: Prosen Mirko 
Published: May 2022

Abstract
Background
Gender stereotypes influence both women and men who work as nurses as well as individuals considering nursing as a profession. The aim of this study was to explore male and female nursing students’ experiences and perspectives regarding gender-defined roles as well as how they view their future professional roles.

Methods
The study used a descriptive qualitative design. A convenience sample included 72 full-time second- and third-year undergraduate nursing students. Data were collected in 2017 using a self-administered qualitative questionnaire consisting of 11 essay-type questions. As an additional data collection method, a drawing method was applied. The data were analysed by content analysis separately for the male and female perspectives.

Results
Altogether, eight themes emerged, with half explaining the male and the other half the female students’ perspectives. Students choose nursing for altruistic, opportunistic and organisational reasons. Among the female students, another reason “family and social incentives” was also identified. Female students’ vision of their future professional role included altruism and positive representations of ‘being a nurse’, whereas the male students’ vision included management and leadership, and technical aspects of nursing.

Conclusions
Both male and female nursing students face the limits of their own gender roles, yet they are prepared to challenge these gender-based perceptions. Tackling stereotypes and raising public awareness, using gender-inclusive language and strategies for recruitment, ensuring gender diversity in nursing teams and revising the nursing curriculum where appropriate, are just some of the implications that arise to help overcome gender differences.
Knowledge, attitude, and practice of health professionals for oxygen therapy working in South Gondar zone hospitals, 2021: multicenter cross-sectional study
Authors: Demilew Basazinew Chekol , Mekonen Agegnehu , Aemro Agazhe , Sewnet Nakachew , Hailu Banchiayehu Alebachew 
Published: May 2022

AbstractIntroductionTherapeutic oxygen should be administered by competent healthcare providers who possess the required competencies of knowledge, skill, and judgment/abilities to make clinical decisions regarding the administration of oxygen. Therefore, this study aimed to assess the knowledge, attitude, and practice of health professionals towards oxygen therapy.MethodsA multicenter institutional-based cross-sectional study was conducted among 218 health professionals. The assessment was done with a total of 31 questions. After data cleanup analysis was done with SPSS software. Descriptive, chi-square test, bivariable and multivariable analysis were done accordingly. Ap-value of ≤0.05 was considered to have a significant association with the outcome variables.ResultsAmong 218 participants, most of the participants (92.7%) were in the age range of less than 40 years old. Nurses were the most responding professions followed by physicians and midwifes. From the participants, around 54.6, 54.6, and 65.1% of respondents answered above the means score of knowledge, attitude and practice questions respectively. Getting training (AOR- 4.15, CI- 1.15-14.6), work experiences of less than 4 years (AOR- 2.54, 95%CI- (1.28-5.05), and availability of guidelines (AOR- 11.5, CI- 3.35-39.6) were significantly associated with knowledge level. Also work experience of fewer than 4 years (AOR- 3.41, 95%CI- (1.58-7.35) and presence of periodic maintenance and supply of oxygen therapy devices (AOR- 4.32, 95% CI- (1.44-12.9) were associated with practice level. Similarly, work experiences < 4 years (AOR- 8.6, 95%CI- (2.6-29) and getting training (AOR- 21.4, 95%CI-(2.7- 27.3) has a positive (direct) association with the level of attitude, and poor level of knowledge (AOR- 12.1, 95%CI (3.42-42.9) was contributed for negative attitude.ConclusionThis study concluded that 54.6, 54.6, and 65.1% of participants have a good level of knowledge, positive attitude, and good level of practice towards oxygen therapy respectively.