bluuebunny/crossref_metadata_2025_split huggingface dataset:
A favorable lifestyle lowers the risk of coronary artery disease consistently across strata of non-modifiable risk factors in a population-based cohort
Authors: Dimovski Kristian , Orho-Melander Marju , Drake Isabel 
Published: November 2019

Abstract
Background
A healthy lifestyle has been shown to reduce the risk of coronary artery disease (CAD). The extent to which lifestyle influences the risk of CAD for people with pre-existing non-modifiable risk factors is less studied. We therefore examined the associations between a favorable lifestyle and incidence of CAD in population subgroups based on gender, age, educational level, and parental history of myocardial infarction.

Methods
A total of 26,323 men and women from the Malmö Diet and Cancer study were prospectively followed-up for 18 years. A favorable lifestyle was determined using a four-component lifestyle score based on data collected at baseline: no smoking, no obesity, regular physical activity, and a healthy diet. Cox proportional hazards regression models were used to estimate the relative risk of CAD during follow-up and cumulative risk during a 10-year interval.

Results
A favorable lifestyle was associated with a 44% (95% confidence interval, 38–48%) lower risk of CAD compared to an unfavorable lifestyle. The relative risk was similarly reduced among subjects subdivided by gender, age group, educational level, and parental history of myocardial infarction. These findings corresponded with a reduced standardized 10-year incidence of CAD of around 40% in each subgroup.

Conclusion
In this population-based cohort, a favorable lifestyle was associated with a significant reduction of CAD across strata of non-modifiable risk factors. These findings provide support for lifestyle modification as a means for risk reduction in a range of subgroups within a general healthy population.
Systematically testing the effects of promotion techniques on children’s fruit and vegetables intake on the long term: a protocol study of a multicenter randomized controlled trial
Authors: Folkvord Frans 
Published: November 2019

AbstractBackgroundEating a diet rich in fruit and vegetables is essential for healthy development, protects against chronicle diseases, and increases mental well-being. Numerous studies have consistently shown that children do not consume enough fruit and vegetables, especially among children from low socioeconomic status, while foods high in fat, sugar and salt are over-consumed. In order to improve children’s eating behavior, there is an urgent need to systematically test novel and effective methods to make fruit and vegetables more appealing and increase the intake among children. Therefore, the main aim of the proposed project is to test if food promotion techniques increase children’s fruit and vegetable intake, both on the short- and long-term.MethodsThree studies will be conducted. First, to develop the vlogs in co-creation, multiple focus groups will be held with (1) children (N = 25, between 8 and 13 years), (2) parents (N = 10), (3) vloggers (N = 5), and (4) fruit and vegetable producers and marketers (N = 5). Second, a multicenter randomized clinical trial will be conducted among 10 primary schools. A mixed repeated measure design with three different conditions will be used: (1) control, (2) a vlog unboxing fruit and vegetables (preparing and tasting), and (3) a vlog doing a challenge with the fruit and vegetables (e.g., contests, tricks, games). Children between 7 and 13 will participate in the experiments (N = 350). Third, after 6 and 12 months follow-up measurements will take place.DiscussionHFSS foods have higher intrinsically rewarding properties that make them more “wanted” and “liked” than fruit and vegetables, thereby inducing unhealthy eating behavior among children. Additionally, promotion for HFSS foods is omnipresent and increases the rewarding value of these foods. Moreover, some studies showed that the promotion of fruit and vegetables affects the intake, although a recent systematic review shows that evidence is inconclusive and a theoretical understanding for the underlying mechanism is missing. The current study aims to improve the existing knowledge by experimentally testing a newly developed theoretical model.Trial registrationNetherlands Trial registration:NL8077, received on 12 October 2019.
High positive end expiratory pressure levels affect hemodynamics in elderly patients with hypertension admitted to the intensive care unit: a prospective cohort study
Authors: Zhou Lili , Cai Guoen , Xu Zhihui , Weng Qinyong , Ye Qinyong , Chen Cunrong 
Published: November 2019

Abstract
Background
To study the effects of different positive end expiratory pressure (PEEP) on blood pressure and heart function in elderly patients with hypertension.

Methods
Forty elderly patients above 65 years of age treated with mechanical ventilation were divided into two groups: a control group of non-hypertensive subjects (n = 18) and a hypertension group (n = 22) patients with essential hypertension. Changes in blood pressure, central venous pressure (CVP), central venous oxygen saturation (ScvO2), heart rate, and airway pressure were determined in response to different selected PEEP levels of 0, 2, 4, 6, 8, 10 and 12 cm H2O under SIMV(PC) + PSV mode throughout the study.

Results
In both groups, the increase in PEEP led to an increase in CVP and airway pressure. When PEEP was above 4 cm H2O in the hypertension group, a decrease in blood pressure and ScvO2, and an increase of heart rate were observed. These results indicated that cardiac output significantly decreased.

Conclusion
High levels of PEEP can significantly influence changes in blood pressure and heart function in elderly patients with hypertension.

Trial registration
This trial was retrospectively registered, The Chinese trial registration number is ChiCTR-ROC-17012873. The date of registration is 10-2-2017.
Baseline characteristics and comorbidities in the CAnadian REgistry for Pulmonary Fibrosis
Authors: Fisher J. H. , Kolb M. , Algamdi M. , Morisset J. , Johannson K. A. , Shapera S. , Wilcox P. , To T. , Sadatsafavi M. , Manganas H. , Khalil N. , Hambly N. , Halayko A. J. , Gershon A. S. , Fell C. D. , Cox G. , Ryerson C. J. 
Published: November 2019

Abstract
Background
The CAnadian REgistry for Pulmonary Fibrosis (CARE-PF) is a multi-center, prospective registry designed to study the natural history of fibrotic interstitial lung disease (ILD) in adults. The aim of this cross-sectional sub-study was to describe the baseline characteristics, risk factors, and comorbidities of patients enrolled in CARE-PF to date.

Methods
Patients completed study questionnaires and clinical measurements at enrollment and each follow-up visit. Environmental exposures were assessed by patient self-report and comorbidities by the Charlson Comorbidity Index (CCI). Baseline characteristics, exposures, and comorbidities were described for the overall study population and for incident cases, and were compared across ILD subtypes.

Results
The full cohort included 1285 patients with ILD (961 incident cases (74.8%)). Diagnoses included connective tissue disease-associated ILD (33.3%), idiopathic pulmonary fibrosis (IPF) (24.7%), unclassifiable ILD (22.3%), chronic hypersensitivity pneumonitis (HP) (7.5%), sarcoidosis (3.2%), non-IPF idiopathic interstitial pneumonias (3.0%, including idiopathic nonspecific interstitial pneumonia (NSIP) in 0.9%), and other ILDs (6.0%). Patient-reported exposures were most frequent amongst chronic HP, but common across all ILD subtypes. The CCI was ≤2 in 81% of patients, with a narrow distribution and range of values.

Conclusions
CTD-ILD, IPF, and unclassifiable ILD made up 80% of ILD diagnoses at ILD referral centers in Canada, while idiopathic NSIP was rare when adhering to recommended diagnostic criteria. CCI had a very narrow distribution across our cohort suggesting it may be a poor discriminator in assessing the impact of comorbidities on patients with ILD.
The economic burden of systemic sclerosis related pulmonary arterial hypertension in Australia
Authors: Morrisroe Kathleen , Stevens Wendy , Sahhar Joanne , Ngian Gene-Siew , Ferdowsi Nava , Hansen Dylan , Patel Shreeya , Hill Catherine L. , Roddy Janet , Walker Jennifer , Proudman Susanna , Nikpour Mandana 
Published: November 2019

Abstract
Background
To quantify the financial cost of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc).

Methods
Healthcare use was captured through data linkage, wherein clinical data for SSc patients enrolled in the Australian Scleroderma Cohort Study were linked with hospital, emergency department (ED) and ambulatory care databases (MBS) for the period 2008–2015. PAH was diagnosed on right heart catheter according to international criteria. Determinants of healthcare cost were estimated using logistic regression.

Results
Total median (25th–75th) healthcare cost per patient (including hospital, ED and MBS cost but excluding medication cost) for our cohort during 2008–2015 was AUD$37,685 (18,144-78,811) with an annual per patient healthcare cost of AUD$7506 (5273-10,654). Total healthcare cost was higher for SSc-PAH patients compared with those without PAH with a total cost per patient of AUD$70,034 (37,222-110,814) vs AUD$34,325 (16,093 – 69,957), p < 0.001 respectively with an annual excess healthcare cost per PAH patient of AUD$2463 (1973-1885), p < 0.001. The cost of SSc-PAH occurs early post PAH diagnosis with 89.4% utilizing a healthcare service within the first 12 months post PAH diagnosis with an associated cost per patient of AUD$4125 (0–15,666). PAH severity was the main significant determinant of increased healthcare cost (OR 2.5, p = 0.03) in our PAH cohort.

Conclusions
Despite SSc-PAH being a low prevalence disease, it is associated with significant healthcare resource utilization and associated economic burden, predominantly driven by the severity of PAH.
Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review
Authors: Xu Bang Yu , Yan Shi , Low Lian Leng , Vasanwala Farhad Fakhrudin , Low Sher Guan 
Published: November 2019

AbstractBackgroundHip fracture is an important and prevalent medical condition associated with adverse outcomes. The aim of this article is to systematically review and summarise the predictors of poor functional outcomes and mortality for patients with hip fractures.MethodsWe conducted a systemic literature search using PubMed, EMBASE and Cochrane Library. We included English peer-reviewed cohort studies that examined predictors of poor functional outcomes (such as independence in Activities of Daily Living) and mortality for patients with hip fracture published in the past 15 years (from 1 Jan 2004 up to 30 May 2019). Two independent researchers evaluated the articles for eligibility. Consensus on the eligibility was sought and a third researcher was involved if there was disagreement. A standardised form was used to extract relevant data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies.ResultsWe retrieved 4339 and included 81 articles. We identified two emerging predictors of poor functional outcomes and mortality for patients with hip fractures: low hand grip strength and frailty in line with an emerging concept of “physical performance”. The predictors identified in this systematic review can be grouped into 1) medical factors, such as presence of co-morbidities, high American Society of Anesthesiologists (ASA) grade, sarcopenia, 2) surgical factors including delay in operation (e.g. > 48 h), type of fracture s, 3) socio-economic factors which include age, gender, ethnicity, and 4) system factors including lower case-volume centers.ConclusionsThis systematic review identified multiple significant predictors of poor functional outcomes and mortality, with the hand grip strength and frailty being important emerging predictors in the most recent literature. These predictors would further inform healthcare providers of their patients’ health status and allow for early intervention for modifiable predictors.
Effects of soft tissue surgery on transverse kinematics in patients with cerebral palsy
Authors: Park Byeong-Seop , Chung Chin Youb , Park Moon Seok , Lee Kyoung Min , Cho Seong Hee , Sung Ki Hyuk 
Published: November 2019

Abstract
Background
Gait disturbances, including flexed knee gait, stiff knee gait, and tip-toeing gait, are common in patients with cerebral palsy (CP). There has been no reports regarding kinematic changes in the transverse plane after soft tissue surgeries, such as distal hamstring lengthening (DHL), rectus femoris transfer (RFT), and tendo-Achilles lengthening (TAL). This study aimed to evaluate changes in the transverse plane after soft tissue surgery in patients with CP by assessing the effects of the DHL, RFT, and TAL.

Methods
The study enrolled 156 consecutive patients (mean age, 8.4 years; range, 4.4 to 20.9), representing 213 operated limbs, who underwent soft tissue surgery including DHL with semitendinosus transfer, RFT, and TAL. All patients were assessed by preoperative and 1-year postoperative three-dimensional gait analysis. Changes in transverse plane kinematics after soft tissue surgery and affecting factors were analyzed.

Results
Sagittal kinematics including knee flexion at initial contact, ankle dorsiflexion at initial contact, and mean ankle dorsiflexion in the stance phase were significantly improved after single event multilevel surgery (all p < 0.001). Transverse kinematics, including mean tibial rotation and foot progression angle, were significantly improved to a more external angle after soft tissue surgeries (− 2.9°, p = 0.004 and − 9.5°, p < 0.001). The mean hip rotation was significantly improved to a more external angle by RFT (− 4.7°, p = 0.010) and the foot progression angle was significantly improved to a more external angle by TAL (− 3.9°, p = 0.028).

Conclusions
This study found that the transverse kinematics were improved to a more external angle after soft tissue surgery in patients with CP. Therefore, clinicians should consider that soft tissue surgery can affect the transverse plane kinematics in patients with CP. To confirm our findings, further research regarding the natural history of femoral and tibial torsion in children with CP is needed.
Optical puncture combined with balloon dilation PCNL vs. conventional puncture dilation PCNL for kidney stones without hydronephrosis: a retrospective study
Authors: Zhou Mi , He Xiang , Zhang Yuelong , Yu Weiwen 
Published: November 2019

AbstractBackgroundAccurate puncture and dilation of the target kidney calices for percutaneous nephrolithotomy (PCNL) can be difficult. This study aimed to investigate the advantages of PCNL using optical puncture (i.e. the puncture is visualized on a screen as seen through the needle) combined with balloon dilation vs. conventional puncture methods.MethodsThis was a retrospective study of 58 consecutive patients with kidney stones without hydronephrosis and treated at the Minimally Invasive Urology Center of Zhejiang Provincial People’s Hospital between 10/2016 and 12/2017. Twenty-one patients underwent optical puncture combined with balloon dilation PCNL. Thirty-seven patients underwent conventional puncture instrument dilation PCNL (controls). Success rate, tubeless rate, blood loss, pain, and complications were compared between the two groups.ResultsThe one-time puncture success rate (95.2% [20/21] vs. 67.6% [25/37],P = 0.02) and the postoperative tubeless rate (81.0% [17/21] vs. 54.1% [20/37],P = 0.04) were higher in the optical puncture group compared with controls. The average postoperative hemoglobin reduction was smaller (1.13 ± 0.63 vs. 1.56 ± 0.59 g/dL,P = 0.01), the postoperative VAS score was lower (1.6 ± 0.9 vs. 2.5 ± 1.2,P = 0.004), the rate of postoperative analgesic use was lower (14.3% [3/21] vs. 40.5% [15/37],P = 0.04), and the postoperative mean hospitalization days was shorter (3.7 ± 0.9 vs. 4.4 ± 0.8,P = 0.005) in the optical puncture group vs. controls. There was no case of urinary sepsis, blood transfusion, perirenal hematoma, pleural injury, and visceral organ damage.ConclusionsOptical puncture combined with balloon dilation PCNL could be associated with good therapeutic effect and low frequency of complications for the treatment of kidney stones without hydronephrosis.
Assemblages of certain benthic molluscs along the southwestern Atlantic: from subtidal to deep sea
Authors: Teso Valeria , Urteaga Diego , Pastorino Guido 
Published: November 2019

AbstractBackgroundWe analyse the distribution of Gastropods and Chitons from shallow to deep waters along the southwestern Atlantic Ocean off Argentina and discuss possible factors determining the observed biogeographic patterns.ResultsThree major biogeographic groups are defined on the basis of Gastropod and Chiton species associations, i.e., continental shelf (< 350 m), upper continental slope (> 350–2000 m) and lower continental slope (2000–3000 m). Bathymetry appears as the main factor modifying large-scale distribution of the fauna at a. In this scenario, species associations are determined by marine currents that clearly occur at a particular and well defined depth. No arrangement of species by geographic location was found in assemblages from the continental shelf and upper continental slope.ConclusionsWe hypothesize that depth and marine currents are the main factor affecting the distribution of Gastropods and Chitons along the SW Atlantic between 200 and 3000 m depth.
Association between malocclusion, caries and oral hygiene in children 6 to 12 years old resident in suburban Nigeria
Authors: Kolawole Kikelomo Adebanke , Folayan Morenike Oluwatoyin 
Published: November 2019

Abstract
Background
There are conflicting opinions about the contribution of malocclusions to the development of dental caries and periodontal disease. This study’s aim was to determine the association between specific malocclusion traits, caries, oral hygiene and periodontal health for children 6 to 12 years old.

Methods
The study was a household survey. The presence of malocclusion traits was assessed in 495 participants. The caries status and severity were assessed with the decayed, missing, and filled teeth (dmft/DMFT) index and the pulpal involvement, ulceration, fistula and abscess (pufa/PUFA) index. The Simplified Oral Hygiene Index (OHI-S) and Gingival Index (GI) were used to assess periodontal health. The association between malocclusion traits, the presence of caries, poor oral hygiene, and poor gingival health were determined with chi square and logistic regression analyses. Statistical significance was inferred at p < 0.05.

Results
Seventy-four (14.9%) study participants had caries, with mean (SD) dmft/DMFT scores of 0.27 (0.82) and 0.07 (0.39), respectively, and mean (SD) pufa/PUFA index scores of 0.09 (0.43) and 0.02 (0.20), respectively. The mean (SD) OHI-S score was 1.56 (0.74) and mean (SD) GI score was 0.90 (0.43). Dental Aesthetic Index scores ranged from 13 to 48 with a mean (SD) score of 20.7 (4.57). Significantly greater proportions of participants with crowding (p = 0.026) and buccal crossbite (p = 0.009) had caries. Significantly more children with increased overjet (p = 0.003) and anterior open bite (p = 0.008) had moderate to severe gingivitis. Poor oral hygiene (OR: 1.83; CI: 1.05–3.18 p = 0.033), crowding (OR: 1.97; CI: 1.01–3.49; p = 0.021) and buccal crossbite (OR: 6.57; CI: 1.51–28.51 p = 0.012) significantly increased the odds of having caries. Poor oral hygiene (p < 0.001), increased overjet (p = 0.003), and anterior open bite (p = 0.014) were the only significant traits associated with gingivitis.

Conclusions
Crowding and buccal cross bite were associated with caries, whereas increased overjet and anterior open bite were associated with gingivitis. These findings justify the recommendation of orthodontic treatment to improve oral health.
Refugee women’s experience of the resettlement process: a qualitative study
Authors: Mangrio Elisabeth , Zdravkovic Slobodan , Carlson Elisabeth 
Published: November 2019

Abstract
Background
Resettlement can be particularly challenging for women as having a lower socioeconomic status and language barriers, may impede women’s access to education, employment opportunities, health-care services, as well as the cultural, social, material and resilience factors that facilitate adjustment and adaption. Thus, the aim of this study is to further explore the perception of refugee women in Sweden concerning their situation during active participation in the resettlement process in the country.

Methods
Qualitative interview study with 11 recently arrived refugee women who had received their residence permits and were enrolled in the resettlement process. The interviews were conducted in Swedish with the support of an authorized Arabic translator present by telephone.

Results
Refugee women suffered from being separated from their loved ones and felt compelled to achieve something of value in the host country. All experienced both physical and mental anguish.

Conclusions
Stakeholders in societies that receive refugee women should stress the importance of finding opportunities for and fast entrance into employment in the host countries. This would be beneficial for the integration and well-being of refugee women after migration.
Primary malignant melanoma arising from ruptured ovarian mature cystic teratoma with elevated serum CA 19–9: a case report and review of literature
Authors: Choi Won Ku , Lee Dong Hyun , Cho Dong Hyu , Jang Kyu Yun , Kim Kyoung Min 
Published: November 2019

Abstract
Background
Ovarian mature cystic teratomas comprise tissues derived from all three germ layers. In rare incidences, malignant tumors may arise from ovarian mature cystic teratoma, which occurs in 0.2–1.8% of cases. A variety of tumors can arise within mature cystic teratoma, among which malignant melanoma is exceedingly rare.

Case presentation
A 42-year-old woman presented with abdominal pain. Transvaginal ultrasonography showed mixed echogenic cystic masses in both ovaries. Her serum cancer antigen (CA19–9) level was elevated at 29,770 U/ml. Surgical excision was performed. Histologic examination showed infiltrating nests of pleomorphic cells with prominent nucleoli and black pigments in the background of a mature cystic teratoma. These pleomorphic cells showed strong immunoreactivity for Melan-A and HMB-45. The patient was re-evaluated and the possibility of a melanoma at any other site was ruled out. Based on these findings, we concluded that the malignant melanoma originated from the ovarian mature cystic teratoma.

Conclusion
We report a rare case of primary malignant melanoma derived from an ovarian mature cystic teratoma.