bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unequal Transitions to Adulthood: Widening Disparities in Age at First Union, Sex, and Birth in Many Low‐ and Middle‐Income Countries
Authors: Batyra Ewa , Kohler Hans‐Peter 
Published: September 2022

AbstractResearch on the timing of events during the transition to adulthood, such as first union, sex, and birth in low‐ and middle‐income countries (LMICs), focused predominantly on measures of central tendency, notably median or mean ages. In this report, we adopt a different perspective on this topic by examining disparities in the timing of these events in 46 LMICs spanning four decades. Using Demographic and Health Surveys, we estimate ages at which 25 percent, 50 percent, and 75 percent of women have first union, birth, and sex. We compute interquartile ranges to measure within‐country variation and disparities in the timing of sexual initiation and family formation. Variation in the timing of first union, birth, and sex generally increases as the median ages at these events increase. Disparities in the timing of first union and birth grew in West Africa and Latin America, and women who experience these events relatively early increasingly lag behind women who experience them relatively late. Documenting trends in measures of central tendency is insufficient to capture the complexity of ongoing changes because they mask growing disparities in the timing of family formation across many LMICs. These results are important for assessing progress toward the achievement of sustainable development goals related to the reduction of early marriages and pregnancies and highlight a need for more holistic approaches to measure the timing of family formation.
InstabilitiesEverywhere!Hard Problems in Aero-Engines
Authors: Spakovszky Zoltán S. 
Published: September 2022

AbstractMany of the challenges that limited aero-engine operation in the 1950s, 1960s, 1970s, and 1980s were static in nature: hot components exceeding temperature margins, stresses in the high-speed rotating structure approaching safety limits, and turbomachinery aerodynamic efficiencies missing performance goals. Modeling tools have greatly improved since and have helped enhance jet engine design, largely due to better computers and improved simulations of the fluid flow and supporting structure. The situation is thus different today, where important problems encountered past the design and development phases are dynamic in nature. These can jeopardize engine certification and lead to major delays and increased program costs. A real challenge is the characterization of damping and the related dynamic behavior of rotating and stationary components and assemblies, and of the fluid–structure interactions and coupling. The theme of this lecture is instability in the broadest sense. A number of problems of technological interest in aero-engines are discussed with a focus on dynamical system modeling and identification of the underlying mechanisms. Future perspectives on outstanding seminal problems and grand challenges are also given.
MAN v FAT Soccer: Feasibility Study and Preliminary Efficacy of a Sport-Based Weight-Loss Intervention for Overweight and Obese Men in Australia
Authors: Budden Timothy , Dimmock James A. , Rosenberg Michael , Beauchamp Mark R. , Fitzpatrick Ian , Jackson Ben 
Published: September 2022

MAN v FAT Soccer is a sport-based weight-loss program for overweight and obese men that originated in the United Kingdom (i.e., as MAN v FAT Football) and appears to successfully engage men with weight loss. We sought to explore whether the program would work in an Australian context by (a) establishing a foundation for the implementation of the program on a larger scale and (b) determining how large-scale implementation is most feasible. We conducted a nonrandomized, single intervention group feasibility trial of MAN v FAT Soccer in Australia with 418 male participants with a body mass index greater than 27.50 kg/m2. Results indicate that the program is acceptable, with participants reporting positive perceptions of the various components of the program and a high proportion reporting intentions to recommend the program to others (95.9%). Furthermore, preliminary effectiveness results indicate positive changes in weight (4.6% reduction) and physical activity (88.5% increase) and improvements in psychological outcomes such as depression (17.6% decrease), stress (19.0% decrease), and body appreciation (19.1% increase). Our findings provide general support for the feasibility of MAN v FAT Soccer and the notion that leveraging competition and masculinity may help drive men’s health behavior change.
Occult anterior uveal melanomas presenting as extrascleral extension
Authors: Maheshwari Abhilasha , Finger Paul T , Iacob Codrin E 
Published: September 2022

ObjectiveTo describe the management of patients with occult anterior uveal melanomas presenting with extrascleral extension.Methods and analysisRetrospective case series including five patients with small pigmented nodular mass on the episclera. Each lesion was documented by slit-lamp photography and measured with high-frequency ultrasound imaging (ultrasound biomicroscopy). Diagnosis of uveal melanoma was confirmed by biopsy with lamellar sclerectomy. Immediate scleral patch graft repair was performed. Later, each tumour was treated with palladium-103 ophthalmic plaque brachytherapy. The mean plaque diameter was 12 mm (median, 12; range, 10–14). A mean apex prescription dose of 87 Gy (median, 84.5; range, 82.3–99.2) to a tumour depth of 2 mm from the inner sclera delivered over 7 continuous days. The main outcome measures were best-corrected visual acuity, changes in tumour and scleral characteristics and complications.ResultsDuring each surgery, residual tumour was visualised within an emissary passageway at the deep plane of scleral resection. At a mean of 80 months (median, 57; range, 24–159) follow-up, no patients experienced graft infection, scleromalacia or rejection. Biopsy was required to establish the diagnosis, transillumination failed, and therefore ultrasound measurements were used to determine the plaque size required to treat the relatively occult intraocular component. Despite these challenges, there were no cases of local tumour recurrence, secondary enucleation or metastatic disease. Attributed to cataract surgery, visual acuities improved in three patients and two were stable.ConclusionExtrascleral uveal melanoma extension can occur with undetectable, occult intraocular tumours. In these cases, plaque radiation effectively induced local tumour control, preserved vision and prevented metastasis.
Association of ultra-processed food consumption with colorectal cancer risk among men and women: results from three prospective US cohort studies
Authors: Wang Lu , Du Mengxi , Wang Kai , Khandpur Neha , Rossato Sinara Laurini , Drouin-Chartier Jean-Philippe , Steele Euridice Martínez , Giovannucci Edward , Song Mingyang , Zhang Fang Fang 
Published: September 2022

AbstractObjectiveTo examine the association between consumption of ultra-processed foods and risk of colorectal cancer among men and women from three large prospective cohorts.DesignProspective cohort study with dietary intake assessed every four years using food frequency questionnaires.SettingThree large US cohorts.ParticipantsMen (n= 46 341) from the Health Professionals Follow-up Study (1986-2014) and women (n=159 907) from the Nurses’ Health Study (1986-2014; n=67 425) and the Nurses’ Health Study II (1991-2015; n=92 482) with valid dietary intake measurement and no cancer diagnosis at baseline.Main outcome measureAssociation between ultra-processed food consumption and risk of colorectal cancer, estimated using time varying Cox proportional hazards regression models adjusted for potential confounding factors.Results3216 cases of colorectal cancer (men, n=1294; women, n=1922) were documented during the 24-28 years of follow-up. Compared with those in the lowest fifth of ultra-processed food consumption, men in the highest fifth of consumption had a 29% higher risk of developing colorectal cancer (hazard ratio for highest versus lowest fifth 1.29, 95% confidence interval 1.08 to 1.53; P for trend=0.01), and the positive association was limited to distal colon cancer (72% increased risk; hazard ratio 1.72, 1.24 to 2.37; P for trend<0.001). These associations remained significant after further adjustment for body mass index or indicators of nutritional quality of the diet (that is, western dietary pattern or dietary quality score). No association was observed between overall ultra-processed food consumption and risk of colorectal cancer among women. Among subgroups of ultra-processed foods, higher consumption of meat/poultry/seafood based ready-to-eat products (hazard ratio for highest versus lowest fifth 1.44, 1.20 to 1.73; P for trend<0.001) and sugar sweetened beverages (1.21, 1.01 to 1.44; P for trend=0.013) among men and ready-to-eat/heat mixed dishes among women (1.17, 1.01 to 1.36; P for trend=0.02) was associated with increased risk of colorectal cancer; yogurt and dairy based desserts were negatively associated with the risk of colorectal cancer among women (hazard ratio 0.83, 0.71 to 0.97; P for trend=0.002).ConclusionsIn the three large prospective cohorts, high consumption of total ultra-processed foods in men and certain subgroups of ultra-processed foods in men and women was associated with an increased risk of colorectal cancer. Further studies are needed to better understand the potential attributes of ultra-processed foods that contribute to colorectal carcinogenesis.
Qualitative documentary analysis of guidance on information provision and consent for the introduction of innovative invasive procedures including surgeries within NHS organisations’ policies in England and Wales
Authors: Ochieng Cynthia A , Richards Hollie , Zahra Jesmond , Cousins Sian , Elliott Daisy , Wilson Nicholas , Paramasivan Sangeetha , Avery Kerry N L , Mathews Johnny , Main Barry G , Hinchliffe Robert , Blencowe Natalie S , Blazeby Jane M 
Published: September 2022

ObjectiveTo review guidance, included in written local UK National Health Service (NHS) organisation policies, on information provision and consent for the introduction of new invasive procedures- including surgeries, and devices (IPs/Ds).DesignA qualitative documentary analysis of data on patient information provision and consent extracted from policies for the introduction of IP/Ds from NHS organisations in England and Wales.SettingNHS trusts in England and health boards in Wales, UK.ParticipantsBetween December 2017 and July 2018, 150 acute trusts in England and 7 health boards in Wales were approached for their policies for the introduction of new IP/Ds. In total, 123 policies were received, 11 did not fit the inclusion criteria and a further policy was included from a trust website resulting in 113 policies included for review.ResultsFrom the 113 policies, 22 did not include any statements on informed consent/information provision or lacked guidance on the information to be provided to patients and were hence excluded. Consequently, 91 written local NHS policies were included in the final dataset. Within the guidance obtained, variation existed on disclosure of the procedure’s novelty, potential risks, benefits, uncertainties, alternative treatments and surgeon’s experience. Few policies stated that clinicians should discuss the existing evidence associated with a procedure. Additionally, while the majority of policies referred to patients needing written information, this was often not mandated and few policies specified the information to be included.ConclusionsNearly a fifth of all the policies lacked guidance on information to be provided to patients. There was variability in the policy documents regarding what patients should be told about innovative procedures. Further research is needed to ascertain the information and level of detail appropriate for patients when considering innovative procedures. A core information set including patients’ and clinicians’ views is required to address variability around information provision/consent for innovative procedures.
Haemodynamic effects of a 10-min treatment with a high inspired oxygen concentration in the emergency department: a prospective observational study
Authors: Stolmeijer Renate , van Ieperen Ellen , Lameijer Heleen , van Beest Paul , ter Maaten Jan Cornelis , ter Avest Ewoud 
Published: September 2022

Previous studies show that prolonged exposure to a high inspired oxygen concentration (FiO2) is associated with unfavourable haemodynamic effects. Until now, it is unknown if similar effects also occur after oxygen therapy of limited duration in the emergency department (ED).ObjectivesTo investigate the haemodynamic effects of a high FiO2 administered for a limited duration of time in patients who receive preoxygenation for procedural sedation and analgesia (PSA) in the ED.Design, settings and participantsIn a prospective cohort study, cardiac output (CO), stroke volume (SV) and systemic vascular resistance (SVR) were measured using the Clearsight non-invasive CO monitoring system in patients who received preoxygenation for PSA in the ED. Measurements were performed at baseline, after 5 min of preoxygenation via a non-rebreathing mask at 15 /L min and after 5 min of flush rate oxygen administration.Outcomes measuresThe primary outcome was defined as the change in CO (L/min) from baseline after subsequent preoxygenation with 15 L/min and flush rate.ResultsSixty patients were included. Mean CO at baseline was 6.5 (6.0–6.9) L/min and decreased to 6.3 (5.8–6.8) L/min after 5 min of oxygen administration at a rate of 15 L/min, and to 6.2 (5.7–6.70) L/min after another 5 min at flush rate (p=0.037). Mean SV remained relatively constant during this period, whereas mean SVR increased markedly (from 781 (649–1067), to 1244 (936–1695) to 1337 (988–1738) dyn/s/cm–5, p<0.001. Sixteen (27%) patients experienced a>10% decrease in CO.ConclusionExposure of patients to a high FiO2 for 5–10 min results in a significant drop in CO in one out of four patients. Therefore, even in the ED and in prehospital care, where oxygen is administered for a limited amount of time, FiO2 should be titrated based on deficit whenever this is feasible and high flow oxygen should not be given as a routine treatment.
Development and testing of a reduced carbohydrate intervention for the management of obesity and reduction of gestational diabetes (RECORD): protocol for a feasibility randomised controlled trial
Authors: Michalopoulou Moscho , Jebb Susan A , MacKillop Lucy H , Dyson Pamela , Hirst Jane E , Wire Amy , Astbury Nerys M 
Published: September 2022

IntroductionPrevious trials of dietary interventions to prevent gestational diabetes mellitus (GDM) have yielded only limited success. Low-carbohydrate diets have shown promise for the treatment of type 2 diabetes, but there is no evidence to support their use in pregnancy. The aim of this study is to explore the feasibility of a moderately reduced-carbohydrate dietary intervention delivered from mid-pregnancy alongside routine antenatal care.Methods and analysisThis is a feasibility randomised controlled trial (RCT) with embedded qualitative study. Sixty women who are pregnant <20 weeks’ gestation, with body mass index ≥30 kg/m2 at their antenatal booking appointment, will be randomised 2:1 intervention or control (usual care) and followed up until delivery. The intervention is a moderately reduced-carbohydrate diet (~130–150 g total carbohydrate/day), designed to be delivered alongside routine antenatal appointments. Primary outcomes are measures of adoption of the diet and retention of participants. Secondary outcomes include incidence of GDM, change in markers of glycaemic control, gestational weight gain, total carbohydrate and energy intake. Process outcomes will examine resources and management issues. Exploratory outcomes include further dietary changes, quality of life, maternal and neonatal outcomes, and qualitative measures.Ethics and disseminationThis trial was reviewed and approved by the South-Central Oxford B Research Ethics Committee NHS National Research Ethics Committee and the Health Research Authority (Reference: 20/SC/0442). The study results will inform whether to progress to a full-scale RCT to test the clinical effectiveness of the RECORD programme to prevent GDM in women at high risk. The findings will be published in peer-reviewed journals and presented at conferences.Trial registration numberISRCTN16235884.
Attitudes towards coronavirus (COVID-19) vaccine and sources of information across diverse ethnic groups in the UK: a qualitative study from June to October 2020
Authors: Sides Eirwen , Jones Leah Ffion , Kamal Atiya , Thomas Amy , Syeda Rowshonara , Kaissi Awatif , Lecky Donna M , Patel Mahendra , Nellums Laura , Greenway Jane , Campos-Matos Ines , Shukla Rashmi , Brown Colin S , Pareek Manish , Sollars Loretta , Pawson Emma , McNulty Cliodna 
Published: September 2022

ObjectivesAcross diverse ethnic groups in the UK, explore attitudes and intentions towards COVID-19 vaccination and sources of COVID-19 information.DesignRemote qualitative interviews and focus groups (FGs) conducted June–October 2020 before UK COVID-19 vaccine approval. Data were transcribed and analysed through inductive thematic analysis and mapped to the Theoretical Domains Framework.SettingEngland and Wales.Participants100 participants from 19 self-identified ethnic groups.ResultsMistrust and doubt were reported across ethnic groups. Many participants shared concerns about perceived lack of information about COVID-19 vaccine safety and efficacy. There were differences within each ethnic group, with factors such as occupation and perceived health status influencing intention to accept a vaccine once made available. Across ethnic groups, participants believed that public contact occupations, older adults and vulnerable groups should be prioritised for vaccination. Perceived risk, social influences, occupation, age, comorbidities and engagement with healthcare influenced participants’ intentions to accept vaccination once available. All Jewish FG participants intended to accept, while all Traveller FG participants indicated they probably would not.Facilitators to COVID-19 vaccine uptake across ethnic groups included: desire to return to normality and protect health and well-being; perceived higher risk of infection; evidence of vaccine safety and efficacy; vaccine availability and accessibility.COVID-19 information sources were influenced by social factors and included: friends and family; media and news outlets; research literature; and culture and religion. Participants across most different ethnic groups were concerned about misinformation or had negative attitudes towards the media.ConclusionsDuring vaccination rollout, including boosters, commissioners and providers should provide accurate information, authentic community outreach and use appropriate channels to disseminate information and counter misinformation. Adopting a context-specific approach to vaccine resources, interventions and policies and empowering communities has potential to increase trust in the programme.
Eesophagogastroduodenoscopy in paediatrics: does abiding by the international guidelines lead to appropriate management? A cross-sectional study
Authors: Burayzat Salma , Odeh Mohanad , Altamimi Eyad , Al-Dweik Sarah , El Wahab Khaled , Alanasweh Muntasir , Al-Khraisat Mohammad , Barqawi Mohammad 
Published: September 2022

Objectives Esophagogastroduodenoscopy (EGD) is one of the most practiced procedures in paediatric gastroenterology. As with all other procedures, it is guided and controlled by specific guidelines developed and approved internationally. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are two of the most followed guidelines in paediatric gastroenterology. This study aimed to determine how optimal patient condition management is when following international paediatric gastroenterology guidelines and to correlate the appropriateness of EGD and other variables with positive or negative findings on EGD.DesignA cross-sectional retrospective cohort of all first-time diagnostic upper endoscopies was conducted between 1 January 2016 and 1 February 2020, in Prince Hamzah Hospital in Jordan.ParticipantsPaediatric patients between 9 months and 14 years of age with indications for EGD.ResultsOverall, 529 diagnostic EGDs were performed during the study period. Helicobacter pylori-associated gastritis was the most common final diagnosis in 247 patients (47%). Furthermore, 488 (92%) EGDs were deemed appropriate, while 41 (7.7%) were considered inappropriate. Finally, 74.0% of all biopsies performed had positive contributive findings.ConclusionsAbiding by international guidelines in paediatric gastroenterology can optimise care for paediatric patients. General paediatricians are urged to follow guidelines rigorously when referring patients to minimise inappropriate procedures.
Dynamic accessibility by car to tertiary care emergency services in Cali, Colombia, in 2020: cross-sectional equity analyses using travel time big data from a Google API
Authors: Cuervo Luis Gabriel , Martinez-Herrera Eliana , Osorio Lyda , Hatcher-Roberts Janet , Cuervo Daniel , Bula Maria Olga , Pinilla Luis Fernando , Piquero Felipe , Jaramillo Ciro 
Published: September 2022

ObjectivesTo test a new approach to characterise accessibility to tertiary care emergency health services in urban Cali and assess the links between accessibility and sociodemographic factors relevant to health equity.DesignThe impact of traffic congestion on accessibility to tertiary care emergency departments was studied with an equity perspective, using a web-based digital platform that integrated publicly available digital data, including sociodemographic characteristics of the population and places of residence with travel times.Setting and participantsCali, Colombia (population 2.258 million in 2020) using geographic and sociodemographic data. The study used predicted travel times downloaded for a week in July 2020 and a week in November 2020.Primary and secondary outcomesThe share of the population within a 15 min journey by car from the place of residence to the tertiary care emergency department with the shortest journey (ie, 15 min accessibility rate (15mAR)) at peak-traffic congestion hours. Sociodemographic characteristics were disaggregated for equity analyses. A time-series bivariate analysis explored accessibility rates versus housing stratification.ResultsTraffic congestion sharply reduces accessibility to tertiary emergency care (eg, 15mAR was 36.8% during peak-traffic hours vs 84.4% during free-flow hours for the week of 6–12 July 2020). Traffic congestion sharply reduces accessibility to tertiary emergency care. The greatest impact fell on specific ethnic groups, people with less educational attainment and those living in low-income households or on the periphery of Cali (15mAR: 8.1% peak traffic vs 51% free-flow traffic). These populations face longer average travel times to health services than the average population.ConclusionsThese findings suggest that health services and land use planning should prioritise travel times over travel distance and integrate them into urban planning. Existing technology and data can reveal inequities by integrating sociodemographic data with accurate travel times to health services estimates, providing the basis for valuable indicators.