bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leptin mediates the regulation of muscle mass and strength by adipose tissue
Authors: Collins Kelsey H. , Gui Chang , Ely Erica V. , Lenz Kristin L. , Harris Charles A. , Guilak Farshid , Meyer Gretchen A. 
Published: July 2022

AbstractAdipose tissue secretes numerous cytokines (termed ‘adipokines’) that have known or hypothesized actions on skeletal muscle. The majority of adipokines have been implicated in the pathological link between excess adipose and muscle insulin resistance, but approximately half also have documented in vitro effects on myogenesis and/or hypertrophy. This complexity suggests a potential dual role for adipokines in the regulation of muscle mass in homeostasis and the development of pathology. In this study, we used lipodystrophic ‘fat‐free’ mice to demonstrate that adipose tissue is indeed necessary for the development of normal muscle mass and strength. Fat‐free mice had significantly reduced mass (∼15%) and peak contractile tension (∼20%) of fast‐twitch muscles, a slowing of contractile dynamics and decreased cross‐sectional area of fast twitch fibres compared to wild‐type littermates. These deficits in mass and contractile tension were fully rescued by reconstitution of ∼10% of normal adipose mass, indicating that this phenotype is the direct consequence of absent adipose. We then showed that the rescue is solely mediated by the adipokine leptin, as similar reconstitution of adipose from leptin‐knockout mice fails to rescue mass or strength. Together, these data indicate that the development of muscle mass and strength in wild‐type mice is dependent on adipose‐secreted leptin. This finding extends our current understanding of the multiple roles of adipokines in physiology as well as disease pathophysiology to include a critical role for the adipokine leptin in muscle homeostasis.
imageKey points
Adipose‐derived cytokines (adipokines) have long been implicated in the pathogenesis of insulin resistance in obesity but likely have other under‐appreciated roles in muscle physiology.
Here we use a fat‐free mouse to show that adipose tissue is necessary for the normal development of muscle mass and strength.
Through add‐back of genetically modified adipose tissue we show that leptin is the key adipokine mediating this regulation.
This expands our understanding of leptin's role in adipose–muscle signalling to include development and homeostasis and adds the surprising finding that leptin is the sole mediator of the maintenance of muscle mass and strength by adipose tissue.
Physical transport of magmatic sulfides promotes copper enrichment in hydrothermal ore fluids
Authors: Heinrich Christoph A. , Connolly James A.D. 
Published: July 2022

AbstractLoss of magmatic sulfides to the mantle is posited to explain the copper deficit of evolved arc magmas and the depleted Cu/Ag ratio of the continental crust. We address the question of whether saturating sulfides may instead be mechanically entrained with rising magmas, and how this would affect their geochemical fate in the upper crust. Entrainment is plausible considering sulfide wetting properties and settling velocities relative to magma ascent velocities. Entrained sulfide increases the pressure at which magmas become saturated with respect to H-O-S fluids in the upper crust by 10–100 MPa, with the pressure difference increasing with temperature, water content, and oxidation. Bubbles are likely to nucleate on sulfide particles, allowing transfer of S and Cu from the sulfide to the fluid over a small crystallization interval without limitations by diffusion through the silicate melt. This sequence of processes gives magmatic sulfides an active role in ore metal transport and enrichment to form porphyry copper deposits, and may have global implications for crustal Cu budgets.
Prevention and management of minor complications in percutaneous endoscopic gastrostomy
Authors: Boeykens Kurt , Duysburgh Ivo , Verlinden Wim 
Published: July 2022

BackgroundPercutaneous endoscopic gastrostomy (PEG) was developed by Ponsky-Gauderer in the early 1980s. These tubes are placed through the abdominal wall mainly to administer fluids, drugs and/or enteral nutrition but can also be used for drainage or decompression. The tubes consist of an internal and external retention device. It is a generally safe technique but major or minor complications may arise during and after tube placement.MethodA narrative review of the literature investigating minor complications after PEG placement.ResultsThis review was written from a clinical viewpoint focusing on prevention and management of minor complications and documented with real cases from more than 21 years of clinical practice.ConclusionsDepending on the literature the incidence of minor complications after gastrostomy placement can be high. To decrease associated morbidity, prevention, early recognition and popper management of these complications are important.
Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
Authors: Dures Emma , Bridgewater Susan , Abbott Bryan , Adams Jo , Berry Alice , McCracken Lance M , Creanor Siobhan , Hewlett Sarah , Lomax Joe , Ndosi Mwidimi , Thorn Joanna , Urban Marie , Ewings Paul 
Published: July 2022

ObjectivesPatients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis (FREE-IA) study tested the feasibility of RHP training, intervention delivery and outcome collection ahead of a potential trial of clinical and cost-effectiveness.MethodsIn this single-arm feasibility study, eligible patients were ≥18 years, had a clinician-confirmed diagnosis of an inflammatory arthritis and scored ≥6/10 on the Bristol Rheumatoid Arthritis Fatigue (BRAF) Numerical Rating Scale (NRS) Fatigue Effect. Following training, RHPs delivered two to four sessions to participants. Baseline data were collected before the first session (T0) and outcomes at 6 weeks (T1) and 6 months (T2). The proposed primary outcome was fatigue impact (BRAF NRS Fatigue Effect). Secondary outcomes included fatigue severity and coping, disease impact and disability, and measures of therapeutic mechanism (self-efficacy and confidence to manage health).ResultsEight RHPs at five hospitals delivered 113 sessions to 46 participants. Of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 (9.4%) and 27 (19.6%) missing primary and secondary outcome responses, respectively. Results indicated improvements in all measures except disability, at either T1 or T2, or both.ConclusionsThis study showed it was feasible to deliver the intervention, including training RHPs, and recruit and follow-up participants with high retention. While there was no control group, observed within-group improvements suggest potential promise of the intervention and support for a definitive trial to test effectiveness.
COVID-19 outbreak rates and infection attack rates associated with the workplace: a descriptive epidemiological study
Authors: Chen Yiqun , Aldridge Timothy , Ferraro Claire , Khaw Fu-Meng 
Published: July 2022

ObjectivesA large number of COVID-19 outbreaks/clusters have been reported in a variety of workplace settings since the start of the pandemic but the rate of outbreak occurrence in the workplace has not previously been assessed. The objectives of this paper are to identify the geographical areas and industrial sectors with a high rate of outbreaks of COVID-19 and to compare infection attack rates by enterprise size and sector in England.MethodsPublic Health England (PHE) HPZone data on COVID-19 outbreaks in workplaces, between 18 May and 12 October 2020, were analysed. The workplace outbreak rates by region and sector were calculated, using National Population Database (NPD) with the total number of workplaces as the denominator. The infection attack rates were calculated by enterprise size and sector using PHE Situations of Interest data with the number of test-confirmed COVID-19 cases in a workplace outbreak as the numerator and using NPD data with the number employed in that workplace as the denominator.ResultsThe highest attack rate was for outbreaks in close contact services (median 16.5%), followed by outbreaks in restaurants and catering (median 10.2%), and in manufacturers and packers of non-food products (median 6.7%). The overall outbreak rate was 66 per 100 000 workplaces. Of the nine English regions, the North West had the highest workplace outbreak rate (155 per 100 000 workplaces). Of the industrial sectors, manufacturers and packers of food had the highest outbreak rate (1672 per 100 000), which was consistent across seven of the regions. In addition, high outbreak rates in warehouses were observed in the East Midlands and the North West.ConclusionsEarly identification of geographical regions and industrial sectors with higher rates of COVID-19 workplace outbreaks can inform interventions to limit transmission of SARS-CoV-2.
Moral and exhausting distress working in the frontline of COVID-19: a Swedish survey during the first wave in four healthcare settings
Authors: Svantesson Mia , Durnell Linda , Hammarström Erik , Jarl Gustav , Sandman Lars 
Published: July 2022

ObjectivesTo describe the prevalence and sources of experienced moral stress and anxiety by Swedish frontline healthcare staff in the early phase of COVID-19.DesignCross-sectional survey, quantitative and qualitative.Participants and setting1074 healthcare professionals (75% nurses) in intensive, ward-based, primary and municipal care in one Swedish county.MeasuresA study-specific closed-ended and an open-ended questionnaire about moral stress and the Generalised Anxiety Disorder 7-item scale measuring anxiety, followed by an open question about anxiety.FindingsMoral stress was experienced by 52% of respondents and anxiety by 40%. Moral stress in concern for others attributed to institutional constraints comprised experiences of being deprived of possibilities to respond to humane and professional responsibility. Staff experienced being restricted in fulfilling patients’ and families’ need for closeness and security as well as being compelled to provide substandard and inhumane care. Uncertainty about right and good, without blame, was also described. However, a burdensome guilt also emerged as a moral distress, blaming oneself. This comprised feeling complicit in the spread of COVID-19, inadequacy in care and carrying patients’ suffering. Staff also experienced an exhausting distress as a self-concern in an uncontrollable work situation. This comprised a taxing insecurity by being in limbo, being alone and fear of failing, despair of being deprived control by not being heard; unable to influence; distrusting management; as well as an excessive workload.ConclusionsWe have not only contributed with knowledge about experiences of being in the frontline of COVID-19, but also with an understanding of a demarcation between moral stress/distress as a concern for patients and family, and exhausting distress in work situation as self-concern. A lesson for management is that ethics support should first include acknowledgement of self-concern and mitigation of guilt before any structured ethical reflection. Preventive measures for major events should focus on connectedness between all parties concerned, preventing inhumane care and burn-out.
Post-COVID pain and quality of life in COVID-19 patients: protocol for a meta-analysis and systematic review
Authors: Miao Mengrong , Xu Yongxing , Yang Yitian , Li Pule , Jia Mengqi , Wen Zhaoyu , Yu Mengmeng , Zhang Jiaqiang , Gu Jianwen 
Published: July 2022

IntroductionDuring the COVID-19 pandemic, approximately 10%–35% of COVID-19 infected patients experience post-COVID sequela. Among these sequelae, pain symptoms should not be neglected. In addition, the sequelae of COVID-19 also decrease the quality of life of these populations. However, meta-analyses that systematically evaluated post-COVID pain are sparse.Methods and analysisA comprehensive screening will be performed by searching MEDLINE and Embase without language restriction from inception to August 2021. Cohort studies, case–control studies, cross-sectional studies and case series will be included. Case report and interventional studies will be excluded. Studies with less than 20 participants will be also excluded. We aim to investigate the prevalence of pain-related symptoms in patients after the acute phase of COVID-19. The impact of COVID-19 on the quality of life and pain symptoms among these populations in the post-acute phase will also be evaluated. ROBINS-I tool will be used to assess the risk of bias of cohort studies. The risk of bias tool developed by Hoy et al will be used to assess the risk of bias of prevalence studies. Metaprop command in Stata will be used to estimate the pooled prevalence of pain symptoms. DerSimonian and Laird random-effects models will be used to calculate the pooled relative risks. All analyses will be calculated using Stata software (V.15.0; StataCorp)Ethics and disseminationEthics approval is not required. Results of our study will be submitted to a peer-review journal.PROSPERO registration numberCRD42021272800.
Associations between physical exercise patterns and pain symptoms in individuals with endometriosis: a cross-sectional mHealth-based investigation
Authors: Ensari Ipek , Lipsky-Gorman Sharon , Horan Emma N , Bakken Suzanne , Elhadad Noémie 
Published: July 2022

ObjectivesThis study investigates the association of daily physical exercise with pain symptoms in endometriosis. We also examined whether an individual’s typical weekly (ie, habitual) exercise frequency influences (ie, moderates) the relationship between their pain symptoms on a given day (day t) and previous-day (day t-1) exercise.ParticipantsThe sample included 90 382 days of data from 1009 participants (~85% non-Hispanic white) living with endometriosis across 38 countries.Study designThis was an observational, retrospective study conducted using data from a research mobile app (Phendo) designed for collecting self-reported data on symptoms and self-management of endometriosis.Primary outcome measuresThe two primary outcomes were the composite day-level pain score that includes pain intensity and location, and the change in this score from previous day (Δ-score). We applied generalised linear mixed-level models to examine the effect of previous-day exercise and habitual exercise frequency on these outcomes. We included an interaction term between the two predictors to assess the moderation effect, and adjusted for previous-day pain, menstrual status, education level and body mass index.ResultsThe association of previous-day (day t-1) exercise with pain symptoms on day t was moderated by habitual exercise frequency, independent of covariates (rate ratio=0.96, 95% CI=0.95 to 0.98, p=0.0007 for day-level pain score, B=−0.14, 95% CI=−0.26 to −0.016, p=0.026 for Δ-score). Those who regularly engaged in exercise at least three times per week were more likely to experience favourable pain outcomes after having a bout of exercise on the previous day.ConclusionsRegular exercise might influence the day-level (ie, short-term) association of pain symptoms with exercise. These findings can inform exercise recommendations for endometriosis pain management, especially for those who are at greater risk of lack of regular exercise due to acute exacerbation in their pain after exercise.
Whole-of-community interventions that address alcohol-related harms: protocol for a scoping review
Authors: Okeyo Ida , Walmisley Ulla , De Jong Michelle , Späth Carmen , Doherty Tanya , Siegfried Nandi , Harker Nadine , Tomlinson Mark , George Asha S 
Published: July 2022

IntroductionAlcohol-related harm is a rising global concern particularly in low-income and middle-income countries where alcohol use fuels the high rates of violence, road traffic accidents and is a risk factor for communicable diseases such as HIV/AIDS and tuberculosis. Existing evidence to address alcohol-related harm recommends the use of intersectoral approaches, however, previous efforts have largely focused on addressing individual behaviour with limited attention to whole-of-community approaches. Whole-of-community approaches are defined as intersectoral interventions that are systematically coordinated and implemented across the whole community. The objective of this scoping review is to synthesise the existing literature on multisectoral, whole-of-community interventions which have been used to modify or prevent alcohol-related harms.Methods and analysisThis scoping review will follow the six-step approach that involves; (1) identifying the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarising and reporting the results and (6) expert consultation. Published literature from 2010 to 2021 will be accessed through PubMed, Web of Science, CINAHL Plus and Scopus databases. Search terms will focus on the concepts of ‘interventions’, ‘community-based’, ‘harm reduction’ and ‘alcohol’. There will be no restrictions on the type of study methodology or country of origin. Title and abstract followed by full-text screening will be conducted by two reviewers to identify relevant articles based on the inclusion and exclusion criteria. Data from selected articles will be extracted and charted in Excel software. Findings will be analysed qualitatively and presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Review.Ethics and disseminationThis review makes use of published and publicly available data and no ethics approval is required. The results from this study will be disseminated via publication in peer-reviewed journals and presentations at relevant academic research fora and conferences.
Morphine for chronic breathlessness in COPD: improvement predictors-cross-sectional study
Authors: Verberkt Cornelia A , van den Beuken-Everdingen Marieke H J , Schols Jos M G A , Wouters Emiel F M , Janssen Daisy J A 
Published: July 2022

ObjectiveMorphine is used as palliative treatment of chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD). Part of the patients does not experience a clinically meaningful improvement of breathlessness and it is unclear which characteristics are related to a clinically meaningful improvement of breathlessness after morphine. Therefore, this study assessed whether sensory breathlessness description, demographic and clinical characteristics are related with this improvement.MethodsCross-sectional secondary analysis of the intervention arm of a randomised controlled trial. 45 patients with COPD and moderate-to-very severe chronic breathlessness despite optimal treatment received 20–30 mg oral sustained-release morphine daily for 4 weeks. Using binary logistic regression, the relationship between a clinically meaningful improvement in breathlessness (≥1 point on 0–10 numeric rating scale) and the baseline variables sensory breathlessness descriptors, age, breathlessness and body mass index (BMI) was assessed.ResultsTwenty-one participants (42%) showed a clinically meaningful improvement. Baseline breathlessness (OR 1.51, 95% CI 1.04 to 2.21, p=0.03) and BMI (OR 1.13, 95% 1.02–1.28, p=0.02) were significant associated to a clinically meaningful improvement of breathlessness, while age and sensory breathlessness descriptors were not.ConclusionsWorse baseline breathlessness and higher BMI are associated to a clinically meaningful improvement of breathlessness in patients using 20–30 mg oral sustained-release morphine. Opioid treatment should be considered in patients with COPD with severe breathlessness, taking into account the patient’s BMI.
Care of the dying – medical student confidence and preparedness: mixed-methods simulation study
Authors: Wells Geoffrey , Llewellyn Carrie , Hiersche Andreas , Minton Ollie , Barclay David , Wright Juliet 
Published: July 2022

ObjectivesOf all doctors, Foundation Year 1 trainees spend the most time caring for dying patients yet report poor preparation and low confidence in providing this care. Despite documented effectiveness of simulation in teaching end-of-life care to undergraduate nurses, undergraduate medicine continues to teach this subject using a more theoretical, classroom-based approach. By increasing undergraduate exposure to interactive dying patient scenarios, simulation has the potential to improve confidence and preparedness of medical students to care for dying patients. The main study objective was to explore whether simulated experience of caring for a dying patient and their family can improve the confidence and preparedness of medical students to provide such care.MethodsA mixed-methods interventional study simulating the care of a dying patient was undertaken with serial measures of confidence using the Self Efficacy in Palliative Care (SEPC) tool. Significance testing of SEPC scores was undertaken using paired t-tests and analysis of variance. Post-simulation focus groups gathered qualitative data on student preparedness. Data were transcribed using NVivo software and interpreted using Thematic Analysis.ResultsThirty-eight 4th-year students participated. A statistically significant post-simulation increase in confidence was seen for all SEPC domains, with sustained confidence observed at 6 months. Focus group data identified six major themes: current preparedness, simulated learning environment, learning complex skills, patient centredness, future preparation and curriculum change.ConclusionUsing simulation to teach medical students how to care for a dying patient and their family increases student confidence and preparedness to provide such care.
Exposure to parks through the lens of urban mobility
Authors: Salgado Ariel , Yuan Ziyun , Caridi Inés , González Marta C. 
Published: July 2022

AbstractThis work presents a portable framework to estimate potential park demand and park exposure through bipartite weighted networks. We use mobility information and open spatial information. Mobility information comes in the form of daily activities sampled from a model based on Call Detail Records (CDR). Spatial information comprise parks represented through OpenStreetMaps polygons and census tracts from the 2010 decennial US Census. The framework summarizes each city’s information into one bipartite weighted network with the link weights representing the number of potential visits to a park from each census tract on an average weekday.We compare park exposure and park demand in Greater Los Angeles and Greater Boston in a pre-pandemic scenario. The park exposure of a census tract is calculated as the number of parks surrounding the daily activities of its inhabitants. The demand of a park is calculated as the number of daily activities surrounding it. We find that both cities’ distribution of park exposure have similar shape with Boston having a higher average. On the other hand, the distribution of park demand is very similar in both cities, although their park spatial distributions are different. We include racial/ethnic information from the Census to explore how the park exposure connects tracts of different racial/ethnic groups. We associate parks to racial/ethnic groups based on the number of visitors from each group. Parks within minorities’ tracts are mostly used by majority groups. Finally, through detecting communities in the network, we find that park exposure connects the cities locally, linking parks to their tracts nearby. Furthermore, we find a significant spatial correlation between network communities and different racial/ethnic composition in Los Angeles. This way, patterns of park exposure reproduce the separation among demographic groups of the city.