bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal trend and spatial analysis of the HIV epidemic in young men who have sex with men in the second largest Brazilian Amazonian province
Authors: Seabra Iaron Leal , Pedroso Andrey Oeiras , Rodrigues Taymara Barbosa , Ferreira Glenda Roberta Oliveira Naiff , da Silva Ferreira Ana Lucia , Arcêncio Ricardo Alexandre , Gomes Dulce , da Silva Richardson Augusto Rosendo , Botelho Eliã Pinheiro 
Published: February 2022

Abstract
Background
After 40 years of its starting, the HIV epidemic in Brazilian Amazon region remains on an increasing trend. The young men who have sex with men (MSM) have been the most impacted by the HIV in the last decade. However, much more than attributing the risk behavior to HIV uniquely to the individual, behaviors are shaped by social determinants of health (SDH). Despite the problem, there is a scarcity of studies evaluating the impact of SDH on HIV among young MSM and none of them were done in the Northern of Brazil. Therefore, the main goal of this study was to analyse the HIV epidemic among Brazilian Amazonian young MSM using temporal trends and spatial analysis.

Methods
We conducted an ecological study using reported cases of HIV/AIDS in young MSM living in Pará, the second larger Brazilian Amazonian province, between 2007 and 2018. Data were obtained from the Information System for Notifiable Diseases. For the temporal analysis, we employed a Seasonal and Trend decomposition using Loess Forecasting model (STLF), which is a hybrid time-series forecast model, that combines the Autoregressive-Integrated Moving Average (ARIMA) forecasting model with the Seasonal-Trend by Loess (STL) decomposition method. For the spatial analysis, Moran’s spatial autocorrelation, spatial scan, and spatial regression techniques were used.

Results
A total of 2192 notifications were included in the study. Greater variabilities in HIV/AIDS population-level diagnosis rates were found in the festive months. The HIV/AIDS population-level diagnosis rates exhibited an upward trend from 2013 and this trend is forecasted to continue until 2022. Belém, the capital of Pará, presented the highest spatial risk for HIV/AIDS and was the only city to present spatiotemporal risk from 2014 to 2018. The geographic variation of the HIV epidemic was associated with the number of men with formal jobs, the average salary of men, and the percentage of people over 18 years old with elementary education.

Conclusion
The upward trend of HIV/AIDS population-level diagnosis rate forecasted until 2022 and the variability of the epidemic promoted by the SDH brings an alert and subsidies to health authorities to implement more efficient and focalized public policies against HIV among young MSM in Pará.
Age at childbirth and change in BMI across the life-course: evidence from the INCAP Longitudinal Study
Authors: Mazariegos Mónica , Varghese Jithin Sam , Kroker-Lobos Maria F , DiGirolamo Ann M , Ramirez-Zea Manuel , Ramakrishnan Usha , Stein Aryeh D 
Published: February 2022

Abstract
Background
Parity has been associated with both short- and long-term weight gain in women. However, it is not clear if timing of parity across the reproductive age has different associations with BMI.

Methods
To prospectively assess the association between age at childbirth and maternal change in BMI, we analyzed data from the ongoing INCAP Longitudinal Study, which started in 1969 in four villages in Guatemala. Cohort women (n=778) provided information on reproductive history and anthropometric measures were measured in 1988-89 (adolescence, 15 to 25y), 2002-04 (early adulthood, 26 to 36y) and 2015-17 (mid adulthood, 37 to 55y). We evaluated the associations of number of live births in the period preceding each study wave (1969-77 to 1988-89, 1988-89 to 2002-04 and 2002-04 to 2015-17) with BMI change in the same period using multivariable linear regression models.

Results
Number of live births between 1988 and 89 and 2002-04 was positively associated with increased BMI, while there was not an association between number of live births and BMI in the other intervals. Women who had one, two, or three or more children between 1988 and 89 and 2002-04 had 0.90 (kg/m2, 95% CI: -0.55, 2.35), 2.39 (kg/m2, 95% CI: 1.09, 3.70) and 2.54 (kg/m2, 95% CI: 1.26, 3.82) higher BMI, respectively, than women who did not give birth in the same period.

Conclusions
Our findings suggest that women who had three or more children during early adulthood gained more weight compared to women who had no children in the same period. In contrast, women who had children earlier or later in their reproductive lives did not gain additional weight compared to those who did not have children during that period. Childbirth may have different associations with BMI based on the mother’s age.
U-shaped association between sleep duration and subjective cognitive complaints in Chinese elderly: a cross-sectional study
Authors: Lin Li-Hua , Xu Wen-Qi , Wang Shi-Bin , Hu Qing , Zhang Ping , Huang Jia-Hao , Ke Yun-Fei , Ding Kai-Rong , Hou Cai-Lan , Jia Fu-Jun 
Published: February 2022

Abstract
Background
Subjective cognitive decline (SCD) may be the early screening signal to distinguish susceptible population with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Subjective cognitive complaints (SCCs) have been proved strongly associated with SCD. This study aimed to explore the association between sleep duration and SCCs in the Chinese elderly.

Methods
We conducted a cross-sectional study involving 688 participants aged 60 years and older in Guangdong Province, China. SCCs were assessed by the Subjective Cognitive Decline questionnaire 9 (SCD-Q9), which contained 9 items with two dimensions, including the overall memory function and time comparison (OMTC) and daily activity ability (DAA). Restricted cubic splines and generalized additive model (GAM) were used to fit the association between sleep duration and SCD-Q9 score.

Results
There were significant U-shaped associations between sleep duration and overall score of SCD-Q9 (EDF = 3.842, P < 0.001), as well as the OMTC dimension (EDF = 4.471, P < 0.001) in the age- and gender-adjusted GAM. The lowest points on the overall score of SCD-Q9 and OMTC score were observed in those sleeping 8 h per night. After further adjusting for other demographic characteristics, lifestyle behaviors, hypertension and diabetes, the U-shaped associations between sleep duration and the overall score of SCD-Q9 (EDF = 3.575, P = 0.004), sleep duration and the OMTC score (EDF = 4.478, P = 0.010) were still found. The daily activity ability (DAA) score was also non-linear associated with sleep duration both in the age- and gender-adjusted GAM (EDF = 2.314, P < 0.001) and further adjusted GAM (EDF = 2.080, P = 0.010).

Conclusions
Both longer sleep duration (> 8 h) and shorter duration (< 8 h) were linked to worse SCCs. Future studies should explore the protective effect of managing sleep duration on SCD and its progression to dementia.
Pride-based violence, intoxicated sex and poly-drug use: a vocational school-based study of heterosexual and LGBT students in Bangkok
Authors: Kongjareon Yamol , Samoh Nattharat , Peerawaranun Pimnara , Guadamuz Thomas E. 
Published: February 2022

Abstract
Background
In Thailand, drug use is widely observed, especially among vocational-school students, who are more inclined to use various types of drugs and to experience pride-based violence (violence based on institutional pride, honor, or on seniority status) than any other groups of students. Drug use contexts differ based on sexual orientation and gender identity (e.g., clubs). This study aims to examine the prevalence and correlates of poly-drug use (the use of at least three types of drugs) among vocational-school students, with a focus on sexual orientation and gender identity.

Methods
In this study, 638 vocational school students living in Bangkok metropolitan area participated in a three-year longitudinal survey of four vocational schools. Experiences of violence, sexual behaviours, and poly-drug use were assessed and analyzed using multivariable logistic regression.

Results
About one tenth of all students (11.3%) reported poly-drug use, a fifth among Lesbian, Gay, Bisexual and Transgender (LGBT) students (20.2%) and almost a tenth of heterosexual students (9.8%). In the multivariable logistic model of LGBT students, GPA, pride-based violence, intoxicated sex, and counseling needs were significantly associated with poly-drug use (AOR = 4.62; 95% CI 1.17–18.29, AOR = 6.01; 95% CI 1.31–27.32, AOR = 5.17; 95% CI 1.10–24.28, AOR = 4.64; 95% CI 1.16–18.54, respectively). Likewise, among heterosexual students, GPA and intoxicated sex were significantly associated with poly-drug use (AOR = 2.02; 95% CI 1.09–3.75, AOR = 5.31; 95% CI 2.81–10.04, respectively).

Conclusions
LGBT vocational-school students have significantly higher prevalence of poly-drug use than their heterosexual peers. Correlates include lower GPA, having experienced pride-based violence and intoxicated sex. School-based intervention programs should also address pride-based violence and intoxicated sex in their harm reduction programs.
A core outcome set for randomised controlled trials of physical activity interventions: development and challenges
Authors: Crocker Helen , Peters Michele , Foster Charlie , Black Nick , Fitzpatrick Ray 
Published: February 2022

Abstract
Background
Core outcome sets are standardised sets of outcomes that should be collected and reported for all clinical trials. They have been widely developed and are increasingly influential in clinical research, but despite this, their use in public health has been limited to date. The aim of this study was to develop a core outcome set for public health trials evaluating interventions to promote physical activity in the general adult population.

Methods
The core outcome set was developed using a three-stage approach: stage one: a review of literature to identify potential domains for inclusion in the core outcome set; stage two: a Delphi survey was carried out to reach consensus about which outcome domains to include in the core outcome set; and stage three: a second Delphi survey was conducted to determine how best to measure the outcome domains included in the core outcome set.

Results
A classification of 13 outcome domains of physical activity was developed (stage one). Twenty people completed round one of the first Delphi survey (stage two), reaching a consensus to include two domains in the core outcome set, ‘device-based level of physical activity’ (80.0%, n = 16) and ‘health-related quality of life’ (70.0%, n = 14). No further consensus on the remaining outcome domains was reached in round two. Nineteen people completed the second Delphi survey (stage three). Participants rated the accelerometer (mean rating = 3.89, on a scale of 1 (do not recommend) to 5 (highly recommend)) as the best device to measure level of physical activity, and the EQ-5D (73.7%, n = 14) as the most appropriate measure of health-related quality of life.

Conclusions
This study has made progress towards the development of a core outcome set for use in physical activity trials, however, there was limited consensus about which domains to include. The development of the core outcome set was challenged by the need for trial-specific outcomes, and the complexities of collecting, processing and reporting device-based data.
An exploration of the statutory Healthy Start vitamin supplementation scheme in North West England
Authors: Moonan May , Maudsley Gillian , Hanratty Barbara , Whitehead Margaret 
Published: February 2022

Abstract
Background
Government nutritional welfare support from the English ‘Healthy Start’ scheme is targeted at low-income pregnant women and preschool children, but take-up of its free food vouchers is much better than its free vitamin vouchers. While universal implementation probably requires a more extensive scheme to be cost-effective, the everyday experience of different ways of receiving or facilitating Healthy Start, especially via children’s centres, also requires further evidence. This study therefore aimed to explore (in the context of low take-up levels) perceptions of mothers, health professionals, and commissioners about Healthy Start vitamin and food voucher take-up and compare experiences in a targeted and a universal implementation-area for those vitamins.

Methods
Informed by quantitative analysis of take-up data, qualitative analysis focused on 42 semi-structured interviews with potentially eligible mothers and healthcare staff (and commissioners), purposively sampled via children’s centres in a similarly deprived universal and a targeted implementation-area of North West England.

Results
While good food voucher take-up appeared to relate to clear presentation, messaging, practicality, and monetary (albeit low) value, poor vitamin take-up appeared to relate to overcomplicated procedures and overreliance on underfunded centres, organizational goodwill, and families’ resilience.

Conclusion
Higher ‘universal’ vitamin take-up may well have reflected fewer barriers when it became everyone’s business to be vitamin-aware. Substantive Healthy Start reform in England (not just cosmetic tinkering) is long overdue. Our study highlights that ‘policy, politics, and problem’ should be aligned to reach considerable unmet need.
Calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures
Authors: Song Hui , Chang Shi-Min , Hu Sun-Jun , Du Shou-Chao , Xiong Wen-Feng 
Published: February 2022

Abstract
Background
Maintaining anteromedial cortical support is essential for controlling sliding and decreasing postoperative implant-related complications. However, adequate fracture reduction with cortical support in immediate postoperative fluoroscopy is not invariable in postoperative follow-ups. This study was conducted to investigate the risk factors leading to anteromedial cortical support failure in follow up for pertrochanteric femur fractures treated with cephalomedullary nails.

Methods
This retrospective study enrolled 159 patients with pertrochanteric fractures (AO/OTA- 31A1 and 31A2) that fixed with cephalomedullary nails. All patients were evaluated as adequate fracture reduction in immediate postoperative fluoroscopy before leaving the operation theater. The patients were separated into two groups based on the condition of the anteromedial cortex in the postoperative 3D CT with full-range observation: those with calcar support maintained in Group 1 and those with calcar support lost in Group 2. Demographic information, fracture classification, TAD (tip-apex distance), Cal-TAD, Parker ratio, NSA (neck-shaft angle), reduction quality score, and calcar fracture gapping were collected and compared. Logistic regression analysis was conducted to explore the risk factors leading to anteromedial cortex change.

Results
Anteromedial cortical support failure was noted in 46 cases (29%). There was no significant difference between the two groups concerning age, sex, side injury, TAD, Cal-TAD, Parker ratio, or NSA. There was a significant difference in the AO/OTA fracture classification in univariate analysis but no difference in the multivariable analysis. The reduction quality score, calcar fracture gapping in the AP (anteroposterior), and lateral views were significantly associated with anteromedial cortical support failure in follow-up after cephalomedullary nailing in the multivariable analysis. The threshold value of calcar fracture gapping for the risk of loss was 4.2 mm in the AP and 3.8 mm in the lateral fluoroscopies. Mechanical complications (lateral sliding and varus) were frequently observed in the negative anteromedial cortical support group.

Conclusions
Good reduction quality was a protective factor, and larger calcar fracture gapping in the AP and lateral views were risk factors leading to the postoperative loss of anteromedial cortical support. Therefore, we should pay close attention to fracture reduction and minimize the calcar fracture gap during surgery.
Vibrotactile somatosensory stimulus to assist the transition from level walking to stair ascent in the elderly: a pilot study
Authors: Kwak Kiyoung , Ko Seunghun , Kim Dongwook 
Published: February 2022

Abstract
Background
Although, in daily living, almost all stair ambulation is conducted posterior to level walking, or vice versa, there are only a few studies related to the transition compared to the studies on steady-state stair walking.
Furthermore, neuromotor control in the instant of the transition is different from that of the steady-state stair walking. However, there are only a few studies investigating the transition from level walking to stair ascent in the elderly by comparing with young adults, and there is no study on the assistance of the transition movement in the elderly who are experiencing neurophysiological changes.
Thus, this pilot study aimed to compare the flat surface-to-stair ascent transition by the elderly to that seen in young adults, and to investigate how vibrotactile somatosensory stimulus (VSS), which has a positive effect on muscle performance and gait, affects the transition tasks in elderly people.

Results
In the first half of the stance phase, the elderly exhibited a higher moment and power of the hip extensor and a less moment and power of the knee extensor compared with young adults. In the second half of the stance phase, positive plantar-flexor power and support moment was higher in the elderly. In addition, during the single-limb support phase, dorsiflexion was maintained in the elderly, whereas young adults appeared to have decreased dorsiflexion.
When the VSS was applied, the moment and power of the hip extensor, the plantar-flexor moment, and the support moment in the entire of the stance phase were increased. In addition, it was found that the degree of the kinetics parameters was different depending on the frequencies of the VSS.

Conclusions
This pilot study has revealed evident biomechanical differences between elderly people and young adults during the transition from level walking to stair ascent. Additionally, it has shown that the VSS may accentuate the features of the transition movement of the elderly and regulate joint kinetics. The results of the present pilot study can provide a base for further research and understanding of movement, which can be utilized in designing assistance aids for the elderly.

Trial registration
CRIS, KCT0005434, Registered 25 September 2020, Retrospectively registered.
Evaluating willingness for surgery using the SMART Choice (Knee) patient prognostic tool for total knee arthroplasty: study protocol for a pragmatic randomised controlled trial
Authors: Zhou Yuxuan , Weeden Claire , Patten Lauren , Dowsey Michelle , Bunzli Samantha , Choong Peter , Schilling Chris 
Published: February 2022

Abstract
Background
Approximately 1 in 5 patients feel unsatisfied after total knee arthroplasty (TKA). Prognostic tools may aid in the patient selection process and reduce the proportion of patients who experience unsatisfactory surgery. This study uses the prognostic tool SMART Choice (Patient Prognostic Tool for Total Knee Arthroplasty) to predict patient improvement after TKA. The tool aims to be used by the patient without clinician input and does not require clinical data such as X-ray findings or blood results. The objective of this study is to evaluate the SMART Choice tool on patient decision making, particularly willingness for surgery. We hypothesise that the use of the SMART Choice tool will influence willingness to undergo surgery, especially when used earlier in the patient TKA journey.

Methods
This is a multicentred, pragmatic, randomised controlled trial conducted in Melbourne, Australia. Participants will be recruited from the St. Vincent’s Hospital, Melbourne (SVHM) Orthopaedic Clinic, and the client base of HCF, Australia (private health insurance company). Patients over 45 years of age who have been diagnosed with knee osteoarthritis and considering TKA are eligible for participation. Participants will be randomised to either use the SMART Choice tool or treatment as usual. The SMART Choice tool provides users with a prediction for improvement or deterioration / no change after surgery based on utility score change calculated from the Veterans-RAND 12 (VR-12) survey. The primary outcome of the study is patient willingness for TKA surgery. The secondary outcomes include evaluating the optimal timing for tool use and using decision quality questionnaires to understand the patient experience when using the tool. Participants will be followed up for 6 months from the time of recruitment.

Discussion
The SMART Choice tool has the potential to improve patient decision making for TKA. Although many prognostic tools have been developed for other areas of surgery, most are confined within academic bodies of work. This study will be one of the first to evaluate the impact of a prognostic tool on patient decision making using a prospective clinical trial, an important step in transitioning the tool for use in clinical practice.

Trial registration
Australia and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12622000072718. Prospectively registered – 21 January 2022.
Clinical application of the C2 pars screw technique in the treatment of ossification of the posterior longitudinal ligament
Authors: Wang Zheng , Chang Heng-Rui , Liu Zhen , Wang Zhi-Wei , Ding Wen-Yuan , Yang Da-Long 
Published: February 2022

Abstract
Background
Our research was designed to decide whether the application of C2 pars screws is an alternative choice for patients with OPLL involving the C2 segment.

Methods
A total of 40 patients who underwent cervical laminectomy with fusion (LF) from C2 to C6 for OPLL were reviewed. Among them, C2 pedicle screws were placed in 23 patients, who were the pedicle group, and C2 pars screws were placed in 17 patients, who were the pars group. The screw placement and vertebral artery (VA) anatomy presented by standard CT. General clinical characteristics and health-related outcomes were evaluated and compared preoperatively and during the follow-up period.

Results
The Pars group tended to have a shorter operation duration and less blood loss than the pedicle group (operation time: 115.29 ± 28.75 vs 133.48 ± 26.22, p = 0.044; blood loss: 383.53 ± 116.19 vs 457.83 ± 145.45, p = 0.039). Operation time and blood loss were both independently related to the pars group (operation time: OR = 0.966, p = 0.021; blood loss: OR = 0.993, p = 0.046). The idealization and acceptability of C2 screws in the pars group exceeded those in the pedicle group (100% vs 91.3%). However, no statistically obvious variation in the included complications or health-related outcomes between the pedicle and pars groups was observed.

Conclusion
In the treatment of patients with OPLL involving the C2 segment, the application of C2 pars screws is an alternative choice, which is not only safer but also reduces the amount of blood loss, shortens the operation time and obtains a more ideal screw placement.