bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health literacy as a key to improving weight status among Palestinian adolescents living in chronic conflict conditions: a cross-sectional study
Authors: Sarhan Mohammed B A , Fujiya Rika , Shibanuma Akira , Giacaman Rita , Kiriya Junko , Kitamura Akiko , Jimba Masamine 
Published: September 2022

ObjectiveTo examine the moderating role of health literacy in the association between direct exposure to violence and weight status among Palestinian adolescents.DesignA household cross-sectional study conducted in 2017.SettingA Palestinian district of the West Bank.ParticipantsPalestinian adolescents aged 11–16 years.ResultsAfter excluding underweight adolescents from the 1200 who were initially recruited, the data of 1173 adolescents were analysed. A high proportion (62%) of adolescents were directly exposed to violence. The prevalence of obesity and overweight was 6.5% and 17.1%, respectively. The odds of obesity and overweight were 2.8 and 1.8 times higher among adolescents who were not exposed to domestic and school violence when they had low health literacy in the communication subscale. The odds of obesity were 62% and 57% lower among adolescents with high functional health literacy when exposed to domestic and school violence and to any form of violence, respectively. Among adolescents who were not exposed to any form of violence, those who had high health literacy in the communication subscale were 72% less likely to be obese compared with those who had low health literacy.ConclusionsHealth literacy moderated the association between direct exposure to violence and weight status. When health literacy levels were higher, lower obesity rates were observed among adolescents who were directly exposed to any form of violence or exposed either to political violence only or domestic and school violence only. The results warrant further investigation of the role of health literacy in adolescent health. It is recommended that policy-makers integrate the health literacy concept into both education and health systems.
The Australian Temperament Project Generation 3 study: a population-based multigenerational prospective cohort study of socioemotional health and development
Authors: Olsson Craig A , Letcher Primrose , Greenwood Christopher J , McIntosh Jennifer E , Barker Sophie , Olsson Catherine M , Macdonald Jacqui A , Spry Elizabeth A , Hutchinson Delyse , Ryan Joanne , Edwards Benjamin , McGee Rob , Patton George C , Sanson Ann V 
Published: September 2022

PurposeThe Australian Temperament Project Generation 3 Study (ATPG3) was established to examine the extent to which offspring social and emotional development is shaped in the decades prior to conception, in parent and grandparent histories of psychosocial adjustment (eg, emotional regulation, relationship quality and prosociality) and maladjustment (eg, depressive symptoms, substance use and antisociality).ParticipantsThe Australian Temperament Project (ATP) commenced in 1983 as a population representative survey of the social and emotional health of 2443 young Australians (Generation 2: 4–8 months old) and their parents (Generation 1). Since then, families have been followed from infancy to young adulthood (16 waves). Between 2012 and 2018, the cohort was screened biannually for pregnancies (Generation 3), with assessments conducted in the third trimester of pregnancy, and at 8 weeks and 1 year postpartum.Findings to dateA total of 1167 offspring (607 female) born to 703 Generation 2 parents (400 mothers) were recruited into the ATPG3 Study. Findings to date highlight: (1) strong continuities in depressive symptoms and substance use from adolescence through to becoming a parent; (2) a role for persistent preconception mental health problems in risk for parent–child bonding difficulties, as well as infant emotional reactivity and behaviour problems; (3) the importance of secure attachments in adolescence in reducing long-term risk for postpartum mental health problems; and (4) the protective nature of perceived social support, both preconception and postpartum, in strengthening relationship quality and social support during the COVID-19 pandemic.Future plansAssessments of ATPG3 families in preschool and middle childhood are currently funded and underway. We intend to maintain the offspring cohort through childhood, adolescence, young adulthood and into parenthood. Data will be used to map preconception determinants of emotional health, and enhance approaches to population monitoring and targeted intervention over the life course and across generations.
Predictors of response rates of safety culture questionnaires in healthcare: a systematic review and analysis
Authors: Ellis Louise A , Pomare Chiara , Churruca Kate , Carrigan Ann , Meulenbroeks Isabelle , Saba Maree , Braithwaite Jeffrey 
Published: September 2022

ObjectivesSafety culture questionnaires are widely used in healthcare to understand how staff feel at work, their attitudes and views, and the influence this has on safe and high-quality patient care. A known challenge of safety culture questionnaires is achieving high response rates to enhance reliability and validity. This review examines predictors of response rates, explores reasons provided for low response rates and identifies strategies to improve those rates.MethodsFour bibliometric databases were searched for studies assessing safety culture in hospitals from January 2008 to May 2022. Data were extracted from 893 studies that included a safety culture questionnaire conducted in the hospital setting. Regression was used to predict response rate based on recruitment and data collection methods (incentives, reminders, method of survey administration) and country income classification. Reasons for low response were thematically analysed and used to identify strategies to improve response rates.ResultsOf the 893 studies that used a questionnaire to assess safety culture in hospitals, 75.6% reported a response rate. Response rates varied from 4.2% to 100%, with a mean response rate of 66.5% (SD=21.0). Regression analyses showed that safety culture questionnaires conducted in low-income and middle-income countries were significantly more likely to yield a higher response rate compared with high-income countries. Mode of administration, questionnaire length and timing of administration were identified as key factors. Remote methods of questionnaire data collection (electronic and by post) were significantly less likely to result in a higher response rate. Reasons provided for low response included: survey fatigue, time constraints, and lack of resources.ConclusionThis review presents strategies for researchers and hospital staff to implement when conducting safety culture questionnaires: principally, distribute questionnaires in-person, during meetings or team training sessions; use a local champion; and consider the appropriate time of distribution to manage survey fatigue.
Medical, behavioural and social preconception and interconception risk factors among pregnancy planning and recently pregnant Canadian women
Authors: Dennis Cindy-Lee , Prioreschi Alessandra , Brown Hilary K , Brennenstuhl Sarah , Bell Rhonda C , Atkinson Stephanie , Misita Dragana , Marini Flavia , Carsley Sarah , Jiwani-Ebrahim Nilusha , Birken Catherine 
Published: September 2022

ObjectivesThe objective of this study is to describe the clustering of medical, behavioural and social preconception and interconception health risk factors and determine demographic factors associated with these risk clusters among Canadian women.DesignCross-sectional data were collected via an online questionnaire assessing a range of preconception risk factors. Prevalence of each risk factor and the total number of risk factors present was calculated. Multivariable logistic regression models determined which demographic factors were associated with having greater than the mean number of risk factors. Exploratory factor analysis determined how risk factors clustered, and Spearman’s r determined how demographic characteristics related to risk factors within each cluster.SettingCanada.ParticipantsParticipants were recruited via advertisements on public health websites, social media, parenting webpages and referrals from ongoing studies or existing research datasets. Women were eligible to participate if they could read and understand English, were able to access a telephone or the internet, and were either planning a first pregnancy (preconception) or had ≥1 child in the past 5 years and were thus in the interconception period.ResultsMost women (n=1080) were 34 or older, and were in the interconception period (98%). Most reported risks in only one of the 12 possible risk factor categories (55%), but women reported on average 4 risks each. Common risks were a history of caesarean section (33.1%), miscarriage (27.2%) and high birth weight (13.5%). Just over 40% had fair or poor eating habits, and nearly half were not getting enough physical activity. Three-quarters had a body mass index indicating overweight or obesity. Those without a postsecondary degree (OR 2.35; 95% CI 1.74 to 3.17) and single women (OR 2.22, 95% CI 1.25 to 3.96) had over twice the odds of having more risk factors. Those with two children or more had 60% lower odds of having more risk factors (OR 0.68, 95% CI 0.52 to 0.86). Low education and being born outside Canada were correlated with the greatest number of risk clusters.ConclusionsMany of the common risk factors were behavioural and thus preventable. Understanding which groups of women are prone to certain risk behaviours provides opportunities for researchers and policy-makers to target interventions more efficiently and effectively.
HSP90α induces immunosuppressive myeloid cells in melanoma via TLR4 signaling
Authors: Arkhypov Ihor , Özbay Kurt Feyza Gül , Bitsch Rebekka , Novak Daniel , Petrova Vera , Lasser Samantha , Hielscher Thomas , Groth Christopher , Lepper Alisa , Hu Xiaoying , Li Wei , Utikal Jochen , Altevogt Peter , Umansky Viktor 
Published: September 2022

BackgroundTumor cells modulate host immunity by secreting extracellular vesicles (EV) and soluble factors. Their interactions with myeloid cells lead to the generation of myeloid-derived suppressor cells (MDSC), which inhibit the antitumor function of T and NK cells. We demonstrated previously that EV derived from mouse and human melanoma cells induced immunosuppressive activity via increased expression of programmed cell death ligand 1 (PD-L1) on myeloid cells that was dependent on the heat-shock protein 90α (HSP90α) in EV. Here, we investigated whether soluble HSP90α could convert monocytes into MDSC.MethodsCD14 monocytes were isolated from the peripheral blood of healthy donors, incubated with human recombinant HSP90α (rHSP90α) alone or in the presence of inhibitors of TLR4 signaling and analyzed by flow cytometry. Inhibition of T cell proliferation assay was applied to assess the immunosuppressive function of rHSP90α-treated monocytes. HSP90α levels were measured by ELISA in plasma of patients with advanced melanoma and correlated with clinical outcome.ResultsWe found that the incubation of monocytes with rHSP90α resulted in a strong upregulation of PD-L1 expression, whereas reactive oxygen species (ROS) and nitric oxide (NO) production as well as the expression of arginase-1, ectoenzymes CD39 and CD73 remained unchanged. The PD-L1 upregulation was blocked by anti-TLR4 antibodies and a nuclear factor-κB inhibitor. rHSP90α-treated monocytes displayed the downregulation of HLA-DR expression and acquired the resistance to apoptosis. Moreover, these monocytes were converted into MDSC as indicated by their capacity to inhibit T cell proliferation, which was mediated by TLR4 signaling as well as PD-L1 and indoleamine 2,3-dioxygenase (IDO) 1 expression. Higher levels of HSP90α in plasma of patients with melanoma correlated with augmented PD-L1 expression on circulating monocytic (M)-MDSC. Patients with melanoma with high levels of HSP90α displayed shorter progression-free survival (PFS) on the treatment with immune checkpoint inhibitors (ICIs).ConclusionOur findings demonstrated that soluble rHSP90α increased the resistance of normal human monocytes to apoptosis and converted them into immunosuppressive MDSC via TLR4 signaling that stimulated PD-L1 and IDO-1 expression. Furthermore, patients with melanoma with high concentrations of HSP90α displayed increased PD-L1 expression on M-MDSC and reduced PFS after ICI therapy, suggesting HSP90α as a promising therapeutic target for overcoming immunosuppression in melanoma.
Mode of anesthesia is not associated with outcomes following emergency hip fracture surgery: a population-level cohort study
Authors: Mohammad Ismail Ahmad , Forssten Maximilian Peter , Bass Gary Alan , Trivedi Dhanisha Jayesh , Ekestubbe Lovisa , Ioannidis Ioannis , Duffy Caoimhe C , Peden Carol J , Mohseni Shahin 
Published: September 2022

BackgroundHip fractures often occur in frail patients with several comorbidities. In those undergoing emergency surgery, determining the optimal anesthesia modality may be challenging, with equipoise concerning outcomes following either spinal or general anesthesia. In this study, we investigated the association between mode of anesthesia and postoperative morbidity and mortality with subgroup analyses.MethodsThis is a retrospective study using all consecutive adult patients who underwent emergency hip fracture surgery in Orebro County, Sweden, between 2013 and 2017. Patients were extracted from the Swedish National Hip Fracture Registry, and their electronic medical records were reviewed. The association between the type of anesthesia and 30-day and 90-day postoperative mortality, as well as in-hospital severe complications (Clavien-Dindo classification ≥3a), was analyzed using Poisson regression models with robust SEs, while the association with 1-year mortality was analyzed using Cox proportional hazards models. All analyses were adjusted for potential confounders.ResultsA total of 2437 hip fracture cases were included in the study, of whom 60% received spinal anesthesia. There was no statistically significant difference in the risk of 30-day postoperative mortality (adjusted incident rate ratio (IRR) (95% CI): 0.99 (0.72 to 1.36), p=0.952), 90-day postoperative mortality (adjusted IRR (95% CI): 0.88 (0.70 to 1.11), p=0.281), 1-year postoperative mortality (adjusted HR (95% CI): 0.98 (0.83 to 1.15), p=0.773), or in-hospital severe complications (adjusted IRR (95% CI): 1.24 (0.85 to 1.82), p=0.273), when comparing general and spinal anesthesia.ConclusionsMode of anesthesia during emergency hip fracture surgery was not associated with an increased risk of postoperative mortality or in-hospital severe complications in the study population or any of the investigated subgroups.Level of evidence: Therapeutic/Care Management, level III
Anisotropic solution for polytropic stars in 4D Einstein–Gauss–Bonnet gravity
Authors: Singh Ksh. Newton , Maurya S. K. , Bhar Piyali , Nag Riju 
Published: September 2022

AbstractIn the present work we have investigated a new anisotropic solution for polytropic stars in the framework of 4D Einstein–Gauss–Bonnet (EGB) gravity. The possibility of determining the masses and radii of compact stars which puts some limitations on equation of state (EoS) above the nuclear saturation density. For this purpose, the 4D EGB field equations are solved by taking a generalized polytropic equation of state (EoS) with Finch–Skea ansatz. The generalized solution for anisotropic model has been tested for different values of Gauss–Bonnet constant $$\alpha $$
α
which satisfies all the physical criteria including causality with static stability via mass vs central mass density ($$M-\rho _c$$

M
-

ρ
c

), Bondi and Abreu criterion. The adiabatic index shows a minor influence of the GB coupling constant whereas the central and surface redshifts in the EGB gravity always remain lower than the GR. We present the possibility of fitting the mass and radius for some known compact star via $$M-R$$

M
-
R

curve which satisfies the recent gravitational wave observations from GW 170817 event.
When low-order expansions fail and all higher-order contributions matter—basic example of the mean squared displacement for Brownian motion
Authors: Menzel Andreas M. 
Published: September 2022

AbstractHardly any theoretically formulated realistic problem can be solved exactly. Therefore, as a standard, we resort to approximations. In this context, expansions play a major role. We are used to relying on lowest-order expansions and confining our point of view accordingly. However, one should always bear in mind that such considerations may fail at some point. Here, we address a very common example situation, namely, the motion of a Brownian particle. We know that the associated mean-squared displacement in the long term increases linearly in time. Yet, when we take the Fokker–Planck approach in combination with a low-order expansion, the direct route towards this result fails. That is, in the expansion the term linear in time vanishes. Instead, the treatment requires consideration ofallhigher-order contributions. Together, they restore the linear increase in time. In this way, we stress that care is always mandatory when resorting to low-order expansions, and we present in a traceable way a route to solving the considered problem.
Prognostic Value of Measuring Fractional Flow Reserve After Percutaneous Coronary Intervention in Patients With Complex Coronary Artery Disease: Insights From the FAME 3 Trial
Authors: Piroth Zsolt , Otsuki Hisao , Zimmermann Frederik M. , Ferenci Tamás , Keulards Danielle C.J. , Yeung Alan C. , Pijls Nico H.J. , De Bruyne Bernard , Fearon William F. ,   on behalf of the FAME 3 Investigators
Published: September 2022

Background:
We evaluate the prognostic value of measuring fractional flow reserve (FFR) after percutaneous coronary intervention (post-PCI FFR) and intravascular imaging in patients undergoing PCI for 3-vessel coronary artery disease in the FAME 3 trial (Fractional Flow Reserve versus Angiography for Multivessel Evaluation).

Methods:
The FAME 3 trial is a multicenter, international, randomized study comparing FFR-guided PCI with coronary artery bypass grafting in patients with multivessel coronary artery disease. PCI was not noninferior with respect to the primary end point of death, myocardial infarction, stroke, or repeat revascularization at 1 year. Post-PCI FFR data were acquired on a patient and vessel-related basis. Intravascular imaging guidance was tracked. The primary end point is a comparison of target vessel failure (TVF) defined as a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization at 1 year based on post-PCI FFR values. Cox regression with robust SEs was used for analysis.

Results:

Of the 757 patients randomized to PCI, 461 (61%) had post-PCI FFR measurement and 11.1% had intravascular imaging performed. The median post-PCI FFR was 0.89 [IQR‚ 0.85–0.94]. On a vessel-level, post-PCI FFR was found to be a significant predictor of TVF univariately (hazard ratio=0.67 [95% CI‚ 0.48–0.93] for 0.1 unit increase,
P
=0.0165). On a patient-level, the single lowest post-PCI FFR value was also found to be a significant predictor of TVF univariately (hazard ratio=0.65 [95% CI‚ 0.48–0.89] for 0.1 unit increase,
P
=0.0074). Post-PCI FFR was an independent predictor of TVF in multivariable analysis adjusted for key clinical parameters. Outcomes were similar between patients who had intravascular imaging guidance and those who did not.

Conclusions:
Post-PCI FFR measurement was a significant predictor of TVF on a vessel and patient level and an independent predictor of outcomes in a population with complex 3-vessel coronary artery disease eligible for coronary artery bypass grafting. The limited use of intravascular imaging did not affect outcomes.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02100722.
Transcriptional and Immune Landscape of Cardiac Sarcoidosis
Authors: Liu Jing , Ma Pan , Lai Lulu , Villanueva Ana , Koenig Andrew , Bean Gregory R. , Bowles Dawn E. , Glass Carolyn , Watson Michael , Lavine Kory J. , Lin Chieh-Yu 
Published: September 2022

Background:
Cardiac involvement is an important determinant of mortality among sarcoidosis patients. Although granulomatous inflammation is a hallmark finding in cardiac sarcoidosis, the precise immune cell populations that comprise the granuloma remain unresolved. Furthermore, it is unclear how the cellular and transcriptomic landscape of cardiac sarcoidosis differs from other inflammatory heart diseases.

Methods:

We leveraged spatial transcriptomics (GeoMx digital spatial profiler) and single-nucleus RNA sequencing to elucidate the cellular and transcriptional landscape of cardiac sarcoidosis. Using GeoMX digital spatial profiler technology, we compared the transcriptomal profile of CD68
+
rich immune cell infiltrates in human cardiac sarcoidosis, giant cell myocarditis, and lymphocytic myocarditis. We performed single-nucleus RNA sequencing of human cardiac sarcoidosis to identify immune cell types and examined their transcriptomic landscape and regulation. Using multichannel immunofluorescence staining, we validated immune cell populations identified by single-nucleus RNA sequencing, determined their spatial relationship, and devised an immunostaining approach to distinguish cardiac sarcoidosis from other inflammatory heart diseases.

Results:

Despite overlapping histological features, spatial transcriptomics identified transcriptional signatures and associated pathways that robustly differentiated cardiac sarcoidosis from giant cell myocarditis and lymphocytic myocarditis. Single-nucleus RNA sequencing revealed the presence of diverse populations of myeloid cells in cardiac sarcoidosis with distinct molecular features. We identified GPNMB (transmembrane glycoprotein NMB) as a novel marker of multinucleated giant cells and predicted that the MITF (microphthalmia-associated transcription factor) family of transcription factors regulated this cell type. We also detected additional macrophage populations in cardiac sarcoidosis including HLA-DR (human leukocyte antigen-DR)
+
macrophages, SYTL3 (synaptotagmin-like protein 3)
+
macrophages and CD163
+
resident macrophages. HLA-DR
+
macrophages were found immediately adjacent to GPMMB
+
giant cells, a distinct feature compared with other inflammatory cardiac diseases. SYTL3
+
macrophages were located scattered throughout the granuloma and CD163
+
macrophages, CD1c
+
dendritic cells, nonclassical monocytes, and T cells were located at the periphery and outside of the granuloma. Finally, we demonstrate mTOR (mammalian target of rapamycin) pathway activation is associated with proliferation and is selectively found in HLA-DR
+
and SYLT3
+
macrophages.

Conclusions:
In this study, we identified diverse populations of immune cells with distinct molecular signatures that comprise the sarcoid granuloma. These findings provide new insights into the pathology of cardiac sarcoidosis and highlight opportunities to improve diagnostic testing.