bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengthening assessment and response to mental health needs for Aboriginal and Torres Strait Islander children and adolescents in primary care settings: study protocol for the Ngalaiya Boorai Gabara Budbut implementation project
Authors: Reilly Rachel , Azzopardi Peter S , Brown Alex , Fisher Jane , Patton George , Rickwood Debra J , Yong Choong-Siew , Pearson Odette , Brown Ngiare 
Published: September 2022

IntroductionOpportunities for improved mental health and wellbeing of Aboriginal and Torres Strait Islander children and young people lie in improving the capability of primary healthcare services to identify mental healthcare needs and respond in timely and appropriate ways. The development of culturally appropriate mental health assessment tools and clinical pathways have been identified as opportunities for strengthening workforce capacity in this area. The Ngalaiya Boorai Gabara Budbut implementation project seeks to pursue these opportunities by developing and validating a psychosocial assessment tool, understanding what services need to better care for your people and developing resources that address those needs.Methods and analysisThe project will be governed by a research governance group comprising Aboriginal service providers, young people, and researchers. It will be implemented in an urban health service in Canberra, and regional services in Moree, Wollongong, and the Illawarra regions of New South Wales Australia. The validation study will follow an argument-based approach, assessing cultural appropriateness and ease of use; test–retest validity; internal consistency, construct validity and the quality of decisions made based on the assessment. Following piloting with a small group of young people and their caregivers (n=10), participants (n=200) will be young people and/or their caregivers, attending one of the partner services. The needs assessment will involve an in-depth exploration of service via an online survey (n=60) and in-depth interviews with service providers (n=16) and young people (n=16). These activities will run concurrently. Service providers, researchers and the governance group will codesign resources that respond to the needs identified and pilot them through the participating services.Ethics and disseminationThe Aboriginal Health and Medical Research Council of NSW Human Research Ethics committee (#1769/21) has approved this project. Informed consent will be obtained from all participants and/or their caregivers (with assent from those aged <16 years) prior to participating in all aspects of the study. Research dissemination will occur through participating health services, academic journal articles and conference presentations.
Effectiveness of public health education on the uptake of iron and folic acid supplements among pregnant women: a stepped wedge cluster randomised trial
Authors: Njiru Haron , Njogu Eunice , Gitahi Mary W , Kabiru Ephantus 
Published: September 2022

IntroductionIron deficiency is the most prevalent micronutrient deficiency in pregnancy globally responsible for nearly 120 000 maternal deaths per year and a fifth of maternal mortality. Over 46% of pregnant women in Africa and 62% of pregnant women in Kenya are anaemic. Anaemia has severe economic and health consequences. Daily iron and folic acid supplementation (IFAS) is an efficacious strategy recommended in pregnancy to reduce the risk of anaemia and improve maternal and neonatal survival. However, most pregnant women do not consume IFAS as recommended. Limited knowledge on IFAS, its benefits and its connection with anaemia, and mitigation of its side effects lead to poor consumption. The main objective of this trial is to determine the effectiveness of public health education on uptake of antenatal IFAS.Methods and analysisA stepped wedge cluster randomised trial with antenatal clinics as units of randomisation. Twelve clusters will be randomised to receive the intervention and levels of IFAS uptake compared with preintervention period. The 9-month trial will enrol 1205 pregnant women. The primary outcome will be the proportion of pregnant women effectively taking up IFAS measured through self-reports, residual pill count and inspection of pill reminder cards. Routine clinical data on haemoglobin counts and fetal growth monitoring will also be used. Descriptive and bivariate analysis will be conducted in Stata using Pearson’s χ2 test for association, and multivariate logistic regression to identify determinants of uptake. The potential public health benefits will be estimated using the number needed to treat and the preventable fraction.Ethics and disseminationEthical approval was granted by Kenyatta University Ethics Review Committee (PKU/2443/11575). The research permit is obtained from Kenya National Commission for Science, Technology and Innovation (NACOSTI/P/22/16168). Findings will be disseminated through peer-reviewed publications and public health conferences.Trial registration numberPACTR202202775997127.
Polymorphisms ofACEand thrombophilic genes: risk for recurrent pregnancy loss
Authors: Miljanović Olivera , Ilić Vesna , Teofilov Slađana , Cikota-Aleksić Bojana , Magić Zvonko 
Published: September 2022

BackgroundRecurrent pregnancy loss (RPL) affects up to 5% of pregnancies, but with no consensus on the definition. Inherited thrombophilia has been postulated as a risk factor for RPL. The aim of this study was to investigate the association of RPL with polymorphisms of five genes that influent the coagulation and fibrinolysis.MethodsThis study was conducted on total of 224 women, 129 women with ≥2 early RPL or ≥1 late pregnancy loss, 95 women with at least two normal life births and no history of pregnancy loss. Five gene polymorphismsF220 210G>A (rs1799963),F51691G>A (rs6025),MTHFR677C>T (rs1801133),SERPINE1 −675 4G/5G (rs1799762) andACEI/D (rs1799752) were genotyped by PCR-based methods.ResultsA significant relationship was found betweenSERPINE14G/4G andACED/D polymorphisms and RPL (p<0.001 both, OR 2.91 and 3.02, respectively). In contrast, no association was found betweenF220 210G>A,F51691G>A andMTHFR677C>T polymorphisms and risk for RPL. A combination of hypofibrinolytic homozygotesSERPINE14G/4G+ACE D/D was observed as a highly associated with RPL (Cochran-Armitage test, p<0.001), and their strong independent association with RPL risk was confirmed by logistic regression analysis (both p values <0.001, OR 3.35 and 3.43, respectively).ConclusionOur data have demonstrated thatSERPINE1andACEgene polymorphisms, individually or in combination, appear to be a significant risk for RPL. This data may be useful in adding to the knowledge on inherited thrombophilia as an important contributor to RPL pathogenesis.
Cerebrovascular pulsatile tinnitus: causes, treatments, and outcomes in 164 patients with neuroangiographic correlation
Authors: Cummins Daniel D , Caton M Travis , Hemphill Kafi , Lamboy Allison , Tu-Chan Adelyn , Meisel Karl , Narsinh Kazim H , Amans Matthew R 
Published: September 2022

BackgroundPulsatile tinnitus (PT) can cause significant detriment to quality of life and may herald a life-threatening condition. Endovascular evaluation is the gold standard for the definitive diagnosis of PT and facilitates treatment. However, no large study has determined the distribution of causes and treatment outcomes of PT evaluated endovascularly.MethodsConsecutive patients evaluated at a multidisciplinary PT clinic from a single academic center were retrospectively reviewed. Patients with a suspected cerebrovascular etiology of PT based on clinical and/or non-invasive imaging, who were evaluated by endovascular techniques (arteriography, venography, manometry, and/or balloon test occlusion), were included in analysis. Baseline clinical features and treatment results by final etiology of PT were compared.ResultsOf 552 patients referred for PT evaluation, 164 patients (29.7%) who underwent endovascular evaluation of PT were included. Mean (±SD) age at first clinical evaluation was 54.3±14.1 years (range 25–89 years); 111 patients (67.7%) were female. PT causes were 75.6% vascular and 24.4% non-vascular. Arteriovenous shunting lesions caused 20.7% of cases, venous etiologies 48.2%, and arterial etiologies 6.7%. Of patients with a shunting lesion treated with endovascular embolization, 96.9% had lasting significant improvement or resolution in PT. Endovascular stenting for venous sinus stenosis gave 84.6% of patients lasting improvement or resolution in PT. Arterial and non-vascular PT had fewer patients treated endovascularly and less improvement in PT symptoms.ConclusionPT with a suspected vascular cause is most often attributable to venous etiologies. PT caused by arteriovenous shunting or venous sinus stenosis may be effectively treated endovascularly.
Nerve stimulation guided bilateral pudendal nerve block versus landmark-based caudal block for hypospadias repair in young children: a prospective, randomized, pragmatic trial
Authors: Choudhry Dinesh K , Heredia Larry , Brenn Bruce Randall , Brown Melinda , Carvalho Norman F , Whaley Milicent C , Shaik Sadiq S , Hagerty Jennifer A , Bani Hani Ahmad 
Published: September 2022

IntroductionCaudal block is frequently performed to provide analgesia for hypospadias repair. Literature suggests that pudendal block provides prolonged postoperative analgesia as compared with caudal block in children between 2 and 5 years. We compared the efficacy of pudendal and caudal blocks in children less than 2 years.Methods60 children scheduled for hypospadias repair received standard general anesthesia along with either pudendal or caudal block (groups of 30 each). Variables collected were demographic data, block time, operating room time, intraoperative pain medication need, pain assessment score and medication need in the recovery room and pain assessment at home.ResultGroups were demographically similar. No differences were observed in the following recorded times (minutes): block procedure (caudal: 9.5±4.0, pudendal: 10.6±4.1, p=0.30), anesthesia (caudal: 17.3±5.3, pudendal: 17.7±4.3, p=0.75), total OR (caudal: 171±35, pudendal: 172±41; p=0.95) and postanesthesia care unit (PACU) stay (caudal: 88±37, pudendal: 86±42; p=0.80). Additionally, no differences were observed in rescue pain medication need in the operating room (caudal: 0, pudendal: 2 (p=0.49), in PACU (caudal: 4, pudendal: 4, p=0.99), pain assessed at home, time to pain level 2 (caudal: 13.93±8.9, pudendal: 15.17±8.7), average pain scores (p=0.67) and total pain free epochs (pain level of zero) (p=0.80) in the first 24 hours.DiscussionIn children less than 2 years, both blocks provide comparable intraoperative and postoperative pain relief in the first 24 hours after hypospadias surgery.Trial registration numberNCT03145415.
Monopoles, exotic states and muon $$g-2$$ in TeV scale trinification
Authors: Raut Digesh , Shafi Qaisar , Thapa Anil 
Published: September 2022

AbstractWe study the low energy implications of a trinification model based on the gauge symmetry $$G= SU(3)_c \times SU(3)_L \times SU(3)_R$$

G
=
S
U

(
3
)

c

×
S
U

(
3
)

L

×
S
U

(
3
)

R

, without imposing gauge coupling unification. A minimal model requires two Higgs multiplets that reside in the bi-fundamental representation of G, and this is shown to be adequate for accommodating the Standard Model (SM) fermion masses and generate, via loop corrections and seesaw mechanism, suitable masses for the heavy neutral leptons as well as the observed SM neutrinos. We estimate a lower bound of around 15 TeV for the masses of the new down- type quarks that are required by the $$SU(3)_L \times SU(3)_R$$

S
U

(
3
)

L

×
S
U

(
3
)

R

symmetry. We examine the resonant production at the LHC of the new gauge bosons, which leads to a lower bound of 16 TeV for the symmetry breaking scale of G. We also show how the muon $$g-2$$

g
-
2

anomaly can be resolved in the presence of these new gauge bosons and the heavy charged leptons present in the model. Finally, the model predicts the presence of a topologically stable monopole carrying three quanta $$(6 \pi /e)$$

(
6
π
/
e
)

of Dirac magnetic charge and mass $$\gtrsim 160$$

≳
160

TeV. If new matter fields lying in the fundamental representations of G are included, the model predicts the presence of exotic leptons, mesons and baryons carrying fractional electric charges such as $$\pm e/3$$

±
e
/
3

and $$\pm 2e/3$$

±
2
e
/
3

, fully compatible with the Dirac quantization condition.
Characterizations of mixed quasi-Einstein spacetimes under Gray’s decomposition
Authors: Hazra Dipankar , De Uday Chand , Sarkar Avijit 
Published: September 2022

In this study, we analyze mixed quasi-Einstein spacetimes endowed with Gray’s decomposition, as well as generalized Robertson–Walker spacetimes. For mixed quasi-Einstein spacetimes, the shape of the Ricci tensor in all [Formula: see text]-invariant subspaces can be identified using Gray’s decomposition of the gradient of the Ricci tensor. In case one, such a spacetime is found to be static; in three cases, the Ricci tensor is found to be in the form of a Â perfect fluid; and in the other three situations, the spacetime becomes a quasi-Einstein spacetime under certain restrictions on the associated vector fields. Finally, it is established that a mixed quasi-Einstein generalized Â Robertson–Walker spacetime is a perfect fluid spacetime.
The Nonproteolytic Intracellular Domain of Membrane-Type 1 Matrix Metalloproteinase Coordinately Modulates Abdominal Aortic Aneurysm and Atherosclerosis in Mice—Brief Report
Authors: Silvestro Michele , Rivera Cristobal F. , Alebrahim Dornazsadat , Vlahos John , Pratama Muhammad Yogi , Lu Cuijie , Tang Claudia , Harpel Zander , Sleiman Tellaoui Rayan , Zias Ariadne L. , Maldonado Delphina J. , Byrd Devon , Attur Mukundan , Mignatti Paolo , Ramkhelawon Bhama 
Published: September 2022

Background:
MT1-MMP (membrane-type 1 matrix metalloproteinase, MMP-14) is a transmembrane-anchored protein with an extracellular proteinase domain and a cytoplasmic tail devoid of proteolytic functions but capable of mediating intracellular signaling that regulates tissue homeostasis. MT1-MMP extracellular proteolytic activity has been shown to regulate pathological remodeling in aortic aneurysm and atherosclerosis. However, the role of the nonproteolytic intracellular domain of MT1-MMP in vascular remodeling in abdominal aortic aneurysms (AAA) is unknown.

Methods:
We generated a mutant mouse that harbors a point mutation (Y573D) in the MT1-MMP cytoplasmic domain that abrogates the MT1-MMP signaling function without affecting its proteolytic activity. These mice and their control wild-type littermates were subjected to experimental AAA modeled by angiotensin II infusion combined with PCSK9 (proprotein convertase subtilisin/kexin type 9) overexpression and high-cholesterol feeding.

Results:
The mutant mice developed more severe AAA than the control mice, with concomitant generation of intraaneurysmal atherosclerotic lesions and dramatically increased macrophage infiltration and elastin degradation. Aortic lesion-associated and bone marrow–derived macrophages from the mutant mice exhibited an enhanced inflammatory state and expressed elevated levels of proinflammatory Netrin-1, a protein previously demonstrated to promote both atherosclerosis and AAA.

Conclusions:
Our findings show that the cytoplasmic domain of MT1-MMP safeguards from AAA and atherosclerotic plaque development through a proteolysis-independent signaling mechanism associated with Netrin-1 expression. This unexpected function of MT1-MMP unveils a novel mechanism of synchronous onset of AAA and atherogenesis and highlights its importance in the control of vascular wall homeostasis.
Disparities in Geographic Access to Cardiac Rehabilitation in Los Angeles County
Authors: Ebinger Joseph E. , Lan Roy , Driver Matthew P. , Rushworth Parker , Luong Eric , Sun Nancy , Nguyen Trevor‐Trung , Sternbach Sarah , Hoang Amy , Diaz Jacqueline , Heath Mallory , Claggett Brian L. , Bairey Merz C. Noel , Cheng Susan 
Published: September 2022

Background
Exercise‐based cardiac rehabilitation (CR) is known to reduce morbidity and mortality for patients with cardiac conditions. Sociodemographic disparities in accessing CR persist and could be related to the distance between where patients live and where CR facilities are located. Our objective is to determine the association between sociodemographic characteristics and geographic proximity to CR facilities.

Methods and Results
We identified actively operating CR facilities across Los Angeles County and used multivariable Poisson regression to examine the association between sociodemographic characteristics of residential proximity to the nearest CR facility. We also calculated the proportion of residents per area lacking geographic proximity to CR facilities across sociodemographic characteristics, from which we calculated prevalence ratios. We found that racial and ethnic minorities, compared with non‐Hispanic White individuals, more frequently live ≥5 miles from a CR facility. The greatest geographic disparity was seen for non‐Hispanic Black individuals, with a 2.73 (95% CI, 2.66–2.79) prevalence ratio of living at least 5 miles from a CR facility. Notably, the municipal region with the largest proportion of census tracts comprising mostly non‐White residents (those identifying as Hispanic or a race other than White), with median annual household income <$60 000, contained no CR facilities despite ranking among the county's highest in population density.

Conclusions
Racial, ethnic, and socioeconomic characteristics are significantly associated with lack of geographic proximity to a CR facility. Interventions targeting geographic as well as nongeographic factors may be needed to reduce disparities in access to exercise‐based CR programs. Such interventions could increase the potential of CR to benefit patients at high risk for developing adverse cardiovascular outcomes.
Sex‐Based Differences in 30‐Day Readmissions After Cardiac Arrest: Analysis of the Nationwide Readmissions Database
Authors: Sobti Navjot Kaur , Yeo Ilhwan , Cheung Jim W. , Feldman Dmitriy N. , Amin Nivee P. , Paul Tracy K. , Ascunce Rebecca R. , Mecklai Alicia , Marcus Julie L. , Subramanyam Pritha , Wong Shing‐Chiu , Kim Luke K. 
Published: September 2022

Background
There are limited data on the sex‐based differences in the outcome of readmission after cardiac arrest.

Methods and Results

Using the Nationwide Readmissions Database, we analyzed patients hospitalized with cardiac arrest between 2010 and 2015. Based on
International Classification of Diseases, Ninth Revision, Clinical Modification
(
ICD‐9‐CM
) codes, we identified comorbidities, therapeutic interventions, and outcomes. Multivariable logistic regression was performed to assess the independent association between sex and outcomes. Of 835 894 patients, 44.4% (n=371 455) were women, of whom 80.7% presented with pulseless electrical activity (PEA)/asystole. Women primarily presented with PEA/asystole (80.7% versus 72.4%) and had a greater comorbidity burden than men, as assessed using the Elixhauser Comorbidity Score. Thirty‐day readmission rates were higher in women than men in both PEA/asystole (20.8% versus 19.6%) and ventricular tachycardia/ventricular fibrillation arrests (19.4% versus 17.1%). Among ventricular tachycardia/ventricular fibrillation arrest survivors, women were more likely than men to be readmitted because of noncardiac causes, predominantly infectious, respiratory, and gastrointestinal illnesses. Among PEA/asystole survivors, women were at higher risk for all‐cause (adjusted odds ratio [aOR], 1.07; [95% CI, 1.03–1.11]), cardiac‐cause (aOR, 1.15; [95% CI, 1.06–1.25]), and noncardiac‐cause (aOR, 1.13; [95% CI, 1.04–1.22]) readmission. During the index hospitalization, women were less likely than men to receive therapeutic procedures, including coronary angiography and targeted therapeutic management. While the crude case fatality rate was higher in women, in both ventricular tachycardia/ventricular fibrillation (51.8% versus 47.4%) and PEA/asystole (69.3% versus 68.5%) arrests, sex was not independently associated with increased crude case fatality after adjusting for differences in baseline characteristics.

Conclusions
Women are at increased risk of readmission following cardiac arrest, independent of comorbidities and therapeutic interventions.
Demographic and Regional Trends in Stroke‐Related Mortality in Young Adults in the United States, 1999 to 2019
Authors: Ariss Robert W. , Minhas Abdul Mannan Khan , Lang Jacob , Ramanathan P. Kasi , Khan Safi U. , Kassi Mahwash , Warraich Haider J. , Kolte Dhaval , Alkhouli Mohamad , Nazir Salik 
Published: September 2022

Background
Despite improvements in the management and prevention of stroke, increasing hospitalizations for stroke and stagnant mortality rates have been described in young adults. However, there is a paucity of contemporary national mortality estimates in young adults.

Methods and Results
Trends in mortality related to stroke in young adults (aged 25–64 years) were assessed using the Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research database. Age‐adjusted mortality rates per 100 000 people with associated annual percentage change were calculated. Joinpoint regression was used to assess the trends in the overall sample and different demographic (sex, race and ethnicity, and age) and geographical (state, urban‐rural, and regional) subgroups. Between 1999 and 2019, a total of 566 916 stroke‐related deaths occurred among young adults. After the initial decline in mortality in the overall population, age‐adjusted mortality rate increased from 2013 to 2019 with an associated annual percentage change of 1.5 (95% CI, 1.1–2.0). Mortality rates were higher in men versus women and in non‐Hispanic Black people versus individuals of other races and ethnicities. Non‐Hispanic American Indian or Alaskan Native people had a marked increase in stroke‐related mortality (annual percentage change 2010–2019: 3.3). Furthermore, rural (nonmetropolitan) counties experienced the greatest increase in mortality (annual percentage change 2012–2019: 3.1) compared with urban (metropolitan) counties.

Conclusions
Following the initial decline in stroke‐related mortality, young adults have experienced increasing mortality rates from 2013 to 2019, with considerable differences across demographic groups and regions.