bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction
Authors: Caughey Melissa C. , Vaduganathan Muthiah , Arora Sameer , Qamar Arman , Mentz Robert J. , Chang Patricia P. , Yancy Clyde W. , Russell Stuart D. , Shah Sanjiv J. , Rosamond Wayne D. , Pandey Ambarish 
Published: January 2021

BACKGROUND/OBJECTIVESObesity increases with age, is disproportionately prevalent in black populations, and is associated with heart failure with preserved ejection fraction (HFpEF). An “obesity paradox,” or improved survival with obesity, has been reported in patients with HFpEF. The aim of this study was to examine whether racial differences exist in the temporal trends and outcomes associated with obesity among older patients with HFpEF.DESIGNCommunity surveillance of acute decompensated heart failure (ADHF) hospitalizations, sampled by stratified design from 2005 to 2014.SETTINGAtherosclerosis Risk in Communities Study (NC, MS, MD, MN).PARTICIPANTSA total of 10,147 weighted hospitalizations for ADHF (64% female, 74% white, mean age 77 years), with ejection fraction ≥50%.MEASUREMENTSADHF classified by physician review, HFpEF defined by ejection fraction ≥50%. Body mass index (BMI) calculated from weight at hospital discharge. Obesity defined by BMI ≥30 kg/m2, class III obesity by BMI ≥40 kg/m2.RESULTSWhen aggregated across 2005–2014, the mean BMI was higher for black compared to white patients (34 vs 30 kg/m2; P < .0001), as was prevalence of obesity (56% vs 43%; P < .0001) and class III obesity (24% vs 13%; P < .0001). Over time, the annual mean BMI and prevalence of class III obesity remained stable for black patients, but steadily increased for white patients, with annual rates statistically differing by race (P‐interaction = .04 and P = .03, respectively). For both races, a U‐shaped adjusted mortality risk was observed across BMI categories, with the highest risk among patients with a BMI ≥40 kg/m2.CONCLUSIONBlack patients were disproportionately burdened by obesity in this decade‐long community surveillance of older hospitalized patients with HFpEF. However, temporal increases in mean BMI and class III obesity prevalence among white patients narrowed the racial difference in recent years. For both races, the worst survival was observed with class III obesity. Effective strategies are needed to manage obesity in patients with HFpEF.
Low placental growth factor levels and high soluble endoglin levels at 26–31 weeks of gestation precede light placenta with and without relatively heavy infant, respectively: A retrospective cohort study
Authors: Hirashima Chikako , Ohkuchi Akihide , Sasaki Kemal , Takahashi Kayo , Suzuki Hirotada , Matsubara Shigeki , Matsuda Yoshio 
Published: January 2021

AbstractAimOur aim was to examine whether serum levels of placental growth factor (PlGF) and soluble endoglin (sEng) at 19–25 and 26–31 weeks of gestation were associated with the occurrence of the 9‐block categorization of placenta weight (PW) and fetal/placenta ratio (F/P ratio).MethodsWe performed a retrospective cohort study in 1391 women with singleton pregnancy. Serum levels of PlGF and sEng were measured by enzyme immunosorbent assay. A light placenta was defined as PW ZS < −1.28 SD. Based on the PW (light, normal, and heavy) and F/P ratio (relatively heavy, balanced growth, and relatively small), 9‐block categorization were performed. Multivariable logistic regression analyses were performed.ResultsLow PlGF at 26–31 weeks was an independent risk factor for the birth of infants belonging to Block A (light placenta and relatively heavy infant), after adjusting for prepregnancy body mass index and serum levels of sEng. High sEng at 26–31 weeks was an independent risk factor for the birth of infants belonging to Block D (light placenta and balanced growth of infant), after adjusting for past history of either preeclampsia or gestational hypertension, high pulsatility index of uterine artery flow velocity waveforms in the second trimester, and serum level of PlGF.ConclusionsLow PlGF levels at 26–31 weeks of gestation may precede a light placenta and relatively heavy infant (Block A), and high sEng levels at 26–31 weeks of gestation may precede a light placenta and balanced growth of infant (Block D).
Outcome and prognosis for canine appendicular osteosarcoma treated with stereotactic body radiation therapy in 123 dogs
Authors: Martin Tiffany Wormhoudt , Griffin Lynn , Custis James , Ryan Stewart D. , Lafferty Mary , Boss Mary‐Keara , Regan Daniel , Rao Sangeeta , Leary Del , Withrow Stephen J. , LaRue Susan M. 
Published: January 2021

AbstractCanine appendicular osteosarcoma is commonly treated with limb amputation; however, limb‐sparing options are frequently desired or necessary for a subset of patients. We evaluated 123 patients and 130 sites treated with stereotactic body radiation therapy (SBRT). Eighty‐two out of 98 dogs (84%) had maximum lameness improvement at a median of 3 weeks for a median of 6 months duration. Histopathologic evaluation of available samples from amputation or necropsy revealed >80% tumor necrosis in 50% of limbs consistent with local disease control. Of evaluable patients, 41% fractured and 21% pursued an amputation after treatment. Fine needle aspirate (n = 52) and needle core biopsy (n = 28) did not result in increased fracture risk compared to those without tumor sampling (n = 50). Median survival time (MST) was 233 days and time to first event was 143 days. Gross tumor volume and planned target volume were significantly inversely associated with survival and tumor location was significantly associated with survival. Dogs with salvage amputation had a significantly longer MST compared to those without (346 vs 202 days; P = .04). The presence of metastatic disease at the time of treatment in 15 dogs did not significantly impact survival time (200 vs 237 days without metastasis; P = .58). Skin side effects correlated significantly with dose with 33% of patients with acute grade 3 effects developing consequential late grade 3 effects. While SBRT improves lameness in most patients, further investigation is needed to identify candidates with minimal early fracture risk prior to initiating therapy.
Fibro‐Osseous Lesions Of The Craniofacial Complex In Horses: 30 Cases (2001‐2019)
Authors: Nottle Bridget F. , Tatarniuk Dane M. , Caldwell Fred J. , Bell Chris D. , Caston Stephanie S. , Merkatoris Paul T. , Gillen Alex M. , Katzman Scott A. 
Published: January 2021

AbstractObjectiveTo describe the presentation, diagnosis, treatment, and outcome for horses with fibro‐osseous lesions of the craniofacial complex.Study designRetrospective multicenter case series.AnimalsThirty horses evaluated for fibro‐osseous lesions of the skull from January 1, 2001 through December 31, 2019 in four centers.MethodsMedical records were reviewed for signalment, clinical presentation, histological and diagnostic imaging findings, treatment instituted, and outcome. Long‐term outcome information was obtained by owner questionnaire or the medical record.ResultsDiagnoses included ossifying fibroma in 20 of 30 horses, osteoma in eight of 30 horses, and fibrous dysplasia in two of 30 horses. Twelve of 30 lesions were diagnosed in horses <1 year old, and 20 of 30 lesions originated from the rostral mandible. The most common treatment was rostral mandibulectomy. Recurrence was not reported after complete excision. Incomplete excision was confirmed in eight horses (four ossifying fibromas, three osteomas, and one fibrous dysplasia), and follow‐up information was available for seven horses. Recurrence occurred in one horse, while six horses had long‐term resolution of clinical signs. Prognosis for survival and return to use was excellent in 23 horses with long‐term follow‐up.ConclusionFibro‐osseous lesions were uncommon in this multicenter study; they were most commonly diagnosed in young animals and most frequently affected the rostral mandible. Long‐term survival was excellent.Clinical significanceThe definitive diagnosis of fibro‐osseous lesions of the craniofacial complex in horses is made from results of histopathology and cannot be determined on the basis of clinical presentation alone. Surgical excision is indicated, and prognosis can be favorable even when complete surgical margins are not obtained.
Towards an appropriate ethics framework for Health and Demographic Surveillance Systems (HDSS): learning from issues faced in diverse HDSS in sub-Saharan Africa
Authors: Hinga Alex Nginyo , Molyneux Sassy , Marsh Vicki 
Published: January 2021

IntroductionHealth and Demographic Surveillance Systems (HDSS) collect data on births, deaths and migration from relatively small, geographically defined populations primarily in Africa and Asia. HDSS occupy a grey area between research, healthcare and public health practice and it is unclear how ethics guidance that rely on a research-practice distinction apply to HDSS. This topic has received little attention in the literature. In this paper, based on empirical research across sub-Saharan Africa, we map out key ethical issues for HDSS and assess the relevance of current ethics guidance in relation to these findings.MethodsWe conducted a qualitative study across seven HDSS sites in sub-Saharan Africa, including individual in-depth interviews and informal discussions with 68 research staff, document reviews and non-participant observations of surveillance activities. Qualitative data analysis drew on a framework approach led by a priori and emergent themes, drawing on the wider ethics and social science literature.ResultsThere were diverse views on core ethical issues in HDSS, including regarding the strengths and challenges of community engagement, informed consent and data sharing processes. A key emerging issue was unfairness in the overall balance of benefits and burdens for residents and front-line staff when compared with other stakeholders, particularly given the socioeconomic contexts in which HDSS are generally conducted.ConclusionWe argue that HDSS operate as non-traditional epidemiologic research projects but are often governed using ethics guidance developed for traditional forms of health research. There is a need for specific ethics guidance for HDSS which prioritises considerations around fairness, cost-effectiveness, ancillary care responsibilities, longitudinality and obligations of the global community to HDSS residents.
Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations
Authors: Vu Duong Hoang , Cashin Jennifer , Gribble Karleen , Marinelli Kathleen , Mathisen Roger 
Published: January 2021

IntroductionRecommendations for the clinical management of new mothers with suspected or confirmed COVID-19 and their infants are required. Guidance must weigh the risk posed by transmission of SARS-CoV-2 against the protection that maternal proximity and breastfeeding provide infants. Our aim was to review international COVID-19 guidance for maternal and newborn care, assessing alignment with WHO recommendations and the extent to which policy supported or undermined breastfeeding.MethodsGuidance documents from 33 countries on the care of infants whose mothers were suspected or confirmed as having COVID-19 were assessed for alignment with WHO recommendations regarding: (1) skin-to-skin contact; (2) early initiation of breastfeeding; (3); rooming-in; (4) direct breastfeeding; (5) provision of expressed breastmilk; (6) provision of donor human milk; (7) wet nursing; (8) provision of breastmilk substitutes; (9) psychological support for separated mothers; and (10) psychological support for separated infants.ResultsConsiderable inconsistency in recommendations were found. Recommendations against practices supportive of breastfeeding were common, even in countries with high infant mortality rates. None of the guidance documents reviewed recommended all aspects of WHO guidance. The presence of influential guidance conflicting with WHO recommendations and an undervaluing of the importance of maternal proximity and breastfeeding to infant health appeared to contribute to this poor alignment.ConclusionThose developing guidance in the COVID-19 pandemic and other infectious disease outbreaks need to appropriately consider the importance of skin-to-skin contact, early initiation of breastfeeding, rooming-in and breastfeeding to maternal and infant physical and psychological health. In weighing the value of recommendations of others in future guidance development, countries should consider past reliability and value placed on breastfeeding. Recommendations against maternal proximity and breastfeeding should not be made without compelling evidence that they are necessary, and less harmful than maintaining dyad integrity.
Choice between implants in knee replacement: protocol for a Bayesian network meta-analysis, analysis of joint registries and economic decision model to determine the effectiveness and cost-effectiveness of knee implants for NHS patients—The KNee Implant Prostheses Study (KNIPS)
Authors: Marques Elsa M R , Dennis Jane , Beswick Andrew D , Higgins Julian , Thom Howard , Welton Nicky , Burston Amanda , Hunt Linda , Whitehouse Michael R , Blom Ashley W 
Published: January 2021

IntroductionKnee replacements are highly successful for many people, but if a knee replacement fails, revision surgery is generally required. Surgeons and patients may choose from a range of implant components and combinations that make up knee replacement constructs, all with potential implications for how long a knee replacement will last. To inform surgeon and patient decisions, a comprehensive synthesis of data from randomised controlled trials is needed to evaluate the effects of different knee replacement implants on overall construct survival. Due to limited follow-up in trials, joint registry analyses are also needed to assess the long-term survival of constructs. Finally, economic modelling can identify cost-effective knee replacement constructs for different patient groups.Methods and analysisIn this protocol, we describe systematic reviews and network meta-analyses to synthesise evidence on the effectiveness of knee replacement constructs used in total and unicompartmental knee replacement and analyses of two national joint registries to assess long-term outcomes. Knee replacement constructs are defined by bearing materials and mobility, constraint, fixation and patella resurfacing. For men and women in different age groups, we will compare the lifetime cost-effectiveness of knee replacement constructs.Ethics and disseminationSystematic reviews are secondary analyses of published data with no ethical approval required. We will design a common joint registry analysis plan and provide registry representatives with information for submission to research or ethics committees. The project has been assessed by the National Health Service (NHS) REC committee and does not require ethical review.Study findings will be disseminated to clinicians, researchers and administrators through open access articles, presentations and websites. Specific UK-based groups will be informed of results including National Institute for Health Research and National Institute for Health and Care Excellence, as well as international orthopaedic associations and charities. Effective dissemination to patients will be guided by our patient–public involvement group and include written lay summaries and infographics.PROSPERO registration numberCRD42019134059 and CRD42019138015.
Patient experiences and perspectives on hypertension at a major referral hospital in rural southwestern Uganda: a qualitative analysis
Authors: Herbst Austin Gregory , Olds Peter , Nuwagaba Gabriel , Okello Samson , Haberer Jessica 
Published: January 2021

ObjectivesNovel care models are needed to address the large burden of hypertension globally. We aimed to explore how patients in rural Uganda experience and perceive hypertension in order to understand factors that may inform development of a patient-centred care model for hypertension management in this setting.DesignWe conducted one-time, in-depth qualitative interviews focusing on participants’ experiences and perceptions of the meaning and management of hypertension.SettingOutpatient clinic at Mbarara Regional Referral Hospital in Uganda.ParticipantsWe enrolled patients who had hypertension and had used antihypertensive medication for at least 1 month. We used purposive sampling to recruit 30 participants with similar representation by gender and by absence or presence of comorbid conditions.ResultsParticipants had been diagnosed and initiated care at various clinical stages of hypertension, which impacted their understanding of hypertension. Several participants saw hypertension as a chronic disease that can lead to complications if not controlled, while others attributed symptoms typically associated with other diseases to hypertension. Participants described inconsistent access to antihypertensive medications and difficulty with transport to the clinic (time needed and expense) as the major barriers to access to care. Initiation and maintenance of care were facilitated by family support and ready access to health facilities. Many participants identified an understanding of the important lifestyle and dietary changes required to control hypertension.ConclusionsPatients with hypertension in rural Uganda demonstrated a varied understanding and experience with hypertension. Interventions leveraging family support may help with patient education and clinical management. Integration of patient perspectives into the care model, patient-centred care, may serve as a successful model for hypertension and potentially delivery of care for other non-communicable diseases in Uganda and other similar resource-limited settings.
Excess mortality in adults with documented diabetes in Germany: routine data analysis of all insurance claims in Germany 2013–2014
Authors: Schmidt Christian , Reitzle Lukas , Heidemann Christin , Paprott Rebecca , Ziese Thomas , Scheidt-Nave Christa , Baumert Jens 
Published: January 2021

ObjectivesLittle is known about the age-specific excess mortality pattern of people with diagnosed diabetes in Germany. Thus, our goal was to determine the excess mortality in diagnosed diabetes overall and stratified by age and sex based on claims data.DesignRoutine data analysis using a claims dataset from all statutory health-insured persons in Germany in 2013, which accounts for about 90% of the population.ParticipantsWe included persons who lived in Germany, were insured at least 360 days, were not self-paying any health services and were aged 30 years or older leading to a total number of 47.3 million insured persons for analyses.ExposureDiabetes was determined by the International Classification of Diseases-10 codes E10–E14, which were documented in 2013 in at least two-quarters on an outpatient setting or at least once on an inpatient setting.Outcome measuresThe vital status in the study population was drawn from the claims dataset for the year 2014. We derived the excess mortality estimated as an age-adjusted mortality rate ratio (MRR) by sex and for age groups using a Poisson model.Main resultsWe found age-adjusted MRRs (95% CI) for diabetes of 1.52 (1.51 to 1.52) for women and 1.56 (1.56 to 1.56) for men. These figures declined with increasing age and were highest for ages 30–34 years with 6.76 (4.99 to 9.15) for women and 6.87 (5.46 to 8.64) for men, and lowest for age 95 years and older with 1.13 (1.10 to 1.15) for women and 1.11 (1.05 to 1.17) for men.ConclusionsWe derived deeply age-stratified figures on excess mortality in diabetes for Germany. Establishing a sustainable analysis of excess mortality is aimed at within the framework of diabetes surveillance.
Identifying indicators sensitive to primary healthcare nurse practitioner practice: a review of systematic reviews protocol
Authors: Kilpatrick Kelley , Tchouaket Eric Nguemeleu , Chouinard Maud-Christine , Savard Isabelle , Bouabdillah Naima , Houle Julie , St-Louis Geneviève , Jabbour Mira , Atallah Renee 
Published: January 2021

IntroductionPrimary healthcare nurse practitioners (PHCNPs) practice in a wide range of clinical settings and with diverse patient populations. Several systematic reviews have examined outcomes of PHCNP roles. However, there is a lack of consistency in the definitions used for the PHCNP role across the reviews. The identification of indicators sensitive to PHCNP practice from the perspective of patients, providers and the healthcare system will allow researchers, clinicians and decision-makers to understand how these providers contribute to outcomes of care.Methods and analysisA review of systematic reviews is proposed to describe the current state of knowledge about indicators sensitive to PHCNP practice using recognised role definitions. Outcomes of interest include any outcome indicator measuring the effectiveness of PHCNPs. We will limit our search to 2010 onwards to capture the most up-to-date trends. The following electronic databases will be searched: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, EMBASE, Global Health, Health Economics Evaluation Database, Health Evidence, HealthStar, Health Systems Evidence, Joanna Briggs Institute, Medline, PDQ-Evidence, PubMed and Web of Science. The search strategies will be reviewed by an academic librarian. Reference lists of all relevant publications will be reviewed. Grey literature will be searched from 2010 onwards, and will include: CADTH Information Services, CADTH’s Grey Matters tool, OpenGrey, Organisation for Economic Co-operation and Development, ProQuest Dissertation and Theses and WHO. The PROSPERO International Prospective Register of Systematic Reviews will be searched to identify registered review protocols. The review protocol was developed using Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A narrative synthesis will be used to summarise study findings.Ethics and disseminationNo ethical approval is required for the study. The data used in the study will be abstracted from published systematic reviews. Dissemination strategies will include peer-reviewed publication, conference presentations and presentations to key stakeholders.PROSPERO registration numberCRD42020198182.