bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration of Finnish adults’ successful weight management over the life course: a qualitative study
Authors: Joki Anu , Mäkelä Johanna , Konttinen Hanna , Fogelholm Mikael 
Published: January 2020

Abstract
Background
Despite the current obesogenic environment creating challenges weight management, some people succeed in maintaining a normal weight. This study explored lifelong weight management from the life course perspective. We aimed to gain an insight into the issues related to the pathways of individuals of normal weight from childhood to adulthood, and how their experiences and social connections influence their weight management.

Methods
We approached the research topic using qualitative methods. Two age groups (30–45; 55–70 years, men and women), forming a total of 39 individuals, participated in theme interviews. Thematic analysis resulted in two main categories, namely (1) adoption of lifestyle and (2) maintenance of lifestyle.

Results
Childhood family played a central role in the formation of lifestyle: food-upbringing created the basis for the interviewees’ current diet, and their lives had always been characterized by an active lifestyle. High perceived self-efficacy was vital in weight management. The interviewees were confident about their routines and trusted their abilities to recognize and handle situations that threatened their lifestyles. They possessed skills for adjusting their lifestyle to altered environments, and showed a high level of coping self-efficacy. The interviewees also highlighted the importance of habits for weight management. They had improved their adopted lifestyle through constant learning. New routines had become more internalized through active repetition, finally turning into habitual practices, which simplified weight management.

Conclusions
Based on our interviews, we conclude that childhood was important in the development of the health-promoting lifestyle of our interviewees. However, weight management was described as a journey over the life course, and success also encouraged skills of identifying risks and adjusting actions to cope with challenging situations.
Socioeconomic status of patients in a Swedish national self-management program for osteoarthritis compared with the general population—a descriptive observational study
Authors: Gustafsson Kristin , Kvist Joanna , Eriksson Marit , Dahlberg Leif E. , Rolfson Ola 
Published: January 2020

Abstract
Background
First-line treatment for hip and knee osteoarthritis (OA) including education and supervised exercises, delivered as a self-management program, is considered one of the mainstays in OA treatment. However, the socioeconomic profile of the population that utilizes first-line treatment for hip and knee OA is unclear. The aim of this study was to describe the socioeconomic status (SES) of a population referred to a self-management program for OA, in comparison with that of the general Swedish population.

Methods
This is a cross-sectional study including 72,069 patients with hip or knee OA enrolled in the National Quality Register for Better management of patients with Osteoarthritis (BOA) between 2008 and 2016, and registered before participation in a structured OA self-management program. A reference cohort (n = 216,207) was selected from the general Swedish population by one-to-three matching by year of birth, sex and residence. Residential municipality, country of birth, marital status, family type, educational level, employment, occupation, disposable income and sick leave were analyzed.

Results
The BOA population had higher educational level than the reference group, both regarding patients with hip OA (77.5% vs 70% with ≥10 years of education), and with knee OA (77% vs 72% with ≥10 years of education). Their average disposable income was higher (median [IQR] in Euro (€), for hip €17,442 [10,478] vs €15,998 [10,659], for knee €17,794 [10,574] vs €16,578 [11,221]). Of those who worked, 46% of patients with hip OA and 45% of the reference group had a blue-collar occupation. The corresponding numbers for knee OA were 51 and 44% respectively. Sick leave was higher among those with hip and knee OA (26%) than those in the reference groups (13% vs 12%).

Conclusions
The consistently higher SES in the BOA population compared with the general population indicates that this self-management program for OA may not reach the more socioeconomically disadvantaged groups, who are often those with a higher disease burden.
Understanding the impact of five major determinants of health (genetics, biology, behavior, psychology, society/environment) on type 2 diabetes in U.S. Hispanic/Latino families: Mil Familias - a cohort study
Authors: Morales Jessikah , Glantz Namino , Larez Arianna , Bevier Wendy , Conneely Mary , Fan Ludi , Reed Beverly , Alatorre Carlos , Paczkowski Rosirene , Ahmed Tamim , Mackenzie Andrew , Duncan Ian , Kerr David 
Published: January 2020

Abstract
Background
In the United States (U.S.), the prevalence of both diagnosed and undiagnosed type 2 diabetes (T2D) is nearly twice as high among Mexican-origin Hispanic/Latino adults compared to non-Hispanic Whites. Rates of diabetes-related complications, e.g., acute stroke and end-stage renal disease, are also higher among Hispanic/Latino adults compared to their non-Hispanic/Latino White counterparts. Beyond genetic and biological factors, it is now recognized that sociocultural influences are also important factors in determining risk for T2D and the associated complications. These influences include ethnicity, acculturation, residence, education, and economic status. The primary objective of this study is to determine the influence of the 5 major determinants of human health (genetics, biology, behavior, psychology, society/environment) on the burden of T2D for Latino families. To achieve this objective, Mil Familias (www.milfamilias.sansum.org/) is establishing an observational cohort of 1000 Latino families, with at least one family member living with T2D.

Methods
Specially trained, bilingual Latino/a community health workers (Especialistas) recruit participant families and conduct research activities. Each individual family member will contribute data annually on over 100 different variables relating to their genetics, biology, psychology, behavior, and society/environment, creating a Latino-focused biobank (“Living Information Bank”). This observational cohort study is cross-sectional and longitudinal. Participants are divided into 4 groups: adults age ≥ 18 years with and without T2D, and children age ≥ 7 and < 18 years with and without T2D. Study activities take place through encounters between families and their Especialista. Encounters include screening/enrollment, informed consent, health promotion assessment, laboratory tests, questionnaires, physical activity monitoring, and reflection.

Discussion
By creating and providing the framework for the Cohort Establishment study, we intend to inform new approaches regarding equity and excellence in diabetes research and care. We will examine the complex set of factors that contribute to the burden of diabetes in Latino families and assess if cardio-metabolic disease risks go beyond the traditional biological and genetic factors. Breaking the code on the interplay of cardio-metabolic risk factors may help not only this fast growing segment of the U.S. population, but also other high-risk populations.

Trial registration
Study retrospectively registered at ClinicalTrials.gov (NCT03830840), 2/5/2019 (enrollment began 2/1/2019).
Adaptation and validation of the PEDSQL™ oral health scale for toddlers in Chilean population
Authors: Atala-Acevedo Claudia , Zaror Carlos , Espinoza-Espinoza Gerardo , Muñoz-Millán Patricia , Muñoz Sergio , Martínez-Zapata María José , Ferrer Montse 
Published: January 2020

Abstract
Background
The Pediatric Quality of Life Inventory™ (PedsQL™) Oral Health Scale was developed to measure oral health-related quality of life (OHRQoL). The aim of this study was to cross-culturally adapt the parent-reported version for toddlers of PedsQL™ Oral Health Scale into Spanish and to assess the acceptability, reliability and validity of this version in Chilean preschool population.

Methods
The PedsQL™ Oral Health Scale for toddlers was cross-culturally adapted for the Spanish language using the recommended standards. To assess metric properties, a cross-sectional study was carried out with 301 children aged 2 to 5 years in Carahue, Chile. Chilean versions of the PedsQL™ Oral Health Scale, PedsQL™ 4.0 Generic Core Scales, and Early Childhood Oral Health Impact Scale (ECOHIS) were completed by the children’s parents. Dental caries, malocclusion and dental trauma were examined by trained dentists. The PedsQL™ Oral Health Scale was administrated a second time 14–21 days after. The reliability of the scale was verified by analysis of internal consistency (Cronbach’s alpha) and reproducibility (Intraclass correlation coefficient – ICC). The validity of the construct was assessed by confirmatory factor analysis and known groups method. The convergent validity was assessed by calculating the Spearman’s correlation with the ECOHIS questionnaire.

Results
The PedsQL™ Oral Health Scale demonstrated good reliability, with Cronbach’s alpha coefficient of 0.79 and ICC of 0.85. A moderate-to-strong correlation was found between the PedsQL™ Oral Health Scale and the ECOHIS questionnaire (− 0.64); the PedsQL™ Oral Health Scale score was lower in children with poor than those with excellent/very good oral health (median 100 vs 85, p < 0.001); it also was lower in children with caries than in those caries-free (median 100 vs 90, p < 0.001). No statistically significant differences were found among groups according to malocclusion and traumatic dental injuries.

Conclusions
The PedsQL™ Oral Health Scale for toddlers in Spanish showed to be equivalent to the original version, and its psychometric properties were satisfactory for application in a Chilean pre-school population.
Prevalence of primary dysmenorrhea, its intensity, impact and associated factors among female students’ at Gondar town preparatory school, Northwest Ethiopia
Authors: Azagew Abere Woretaw , Kassie Destaye Guadie , Walle Tarkie Abebe 
Published: January 2020

Abstract
Background
Primary dysmenorrhea is defined as a crampy pain in the lower abdomen before or during the menstrual period in the absence of any pelvic pathology. It is the leading motherhood problem worldwide but there is limited evidence on the prevalence of primary dysmenorrhea in the study area as well in Ethiopia. Researching primary dysmenorrhea helps to focus on the treatment plan. The study aimed to assess the prevalence, intensity, impact, and associated factors of primary dysmenorrhea among female students at Gondar town preparatory school.

Methods
A cross-sectional study design conducted among female students at Gondar town Preparatory School from May 1–10/2017. A total of 459 study participants were used. A simple random sampling technique was used to select study participants. A self-administered structured questionnaire was employed. Epi Info version 7 and SPSS version 20 were used for data entry and analysis respectively. A binary logistic regression model was computed. Variables having a p-value < 0.05 in the multivariate logistic regression model were considered as statistically significant.

Results
A total of 459 female students participated in the study with a response rate of 96.29%. The prevalence of primary dysmenorrhea among female students was found to be 64.7% (95% CI; 60.2–69.2%). Around 61% reported moderate intensity of menstrual pain and 50.7% complain about lower abdominal pain. Sixty-five percent of study participants reported that absenteeism from school was the impact of menstrual pain. Having irregular monthly menstrual cycle (AOR = 1.70, 95% CI; 1.02, 2.84) and positive family history of dysmenorrhea (AOR = 5.19, 95% CI: 3.21, 8.37) were significantly associated with primary dysmenorrhea.

Conclusions
The prevalence of primary dysmenorrhea was found to be high. Having an irregular monthly menstrual cycle and a positive family history of dysmenorrhea were determinants of primary dysmenorrhea.
Adverse drug reactions in primary care: a scoping review
Authors: Khalil H. , Huang C. 
Published: January 2020

Abstract
Background
Medication-related adverse events, or adverse drug reactions (ADRs) are harmful events caused by medication. ADRs could have profound effects on the patients’ quality of life, as well as creating an increased burden on the healthcare system. ADRs are one of the rising causes of morbidity and mortality internationally, and will continue to be a significant public health issue with the increased complexity in medication, to treat various diseases in an aging society. This scoping review aims to provide a detailed map of the most common adverse drug reactions experienced in primary healthcare setting, the drug classes that are most commonly associated with different levels/types of adverse drug reactions, causes of ADRs, their prevalence and consequences of experiencing ADRs.

Methods
We systematically reviewed electronic databases Ovid MEDLINE, Embase, CINAHL Plus, Cochrane Central Register of Controlled Trials, PsycINFO and Scopus. In addition, the National Patient Safety Foundation Bibliography and the Agency for Health Care Research and Quality and Patient Safety Net Bibliography were searched. Studies published from 1990 onwards until December 7, 2018 were included as the incidence of reporting drug reactions were not prevalent before 1990. We only include studies published in English.

Results
The final search yielded a total of 19 citations for inclusion published over a 15-year period that primarily focused on investigating the different types of adverse drug reactions in primary healthcare. The most causes of adverse events were related to drug related and allergies. Idiosyncratic adverse reactions were not very commonly reported. The most common adverse drug reactions reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with adverse events.

Conclusion
This scoping review identified that the most causes of ADRs were drug related and due to allergies. Idiosyncratic adverse reactions were not very commonly reported in the literature. This is mainly because it is hard to predict and these reactions are not associated with drug doses or routes of administration. The most common ADRs reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with ADRs.
Barriers and facilitators to healthcare access for children with disabilities in low and middle income sub-Saharan African countries: a scoping review
Authors: Adugna Molalign B. , Nabbouh Fatima , Shehata Selvia , Ghahari Setareh 
Published: January 2020

Abstract
Background
Children with disabilities (CwDs) make up around 150 million of the billion people with disabilities in the world. The Sub-Saharan African countries have a large number of CwDs who have limited access to healthcare and rehabilitation care. This, combined with chronic poverty, low education, and inadequately trained healthcare professionals, substantially lowers these children’s quality of life. The main objective of this scoping review was to discover the barriers and facilitators to healthcare access for CwDs in selected low to middle income Sub-Saharan African countries. As African countries significantly vary in socioeconomic status, we only focused on countries in Sub-Saharan Africa who allocated less than $50/person to healthcare.

Methods
A broad and iterative search strategy using multiple sources and databases including CINAHL, Medline, Global Health, and Embase were utilized. Using a comprehensive search strategy, 704 articles were generated. After removal of the duplicates, 466 of them were screened based on the study inclusion and exclusion criteria. After iterative reading and screening of these articles, a final 15 articles were included in this review.

Results
This scoping review shows that CwDs in the selected Sub-Saharan African countries face major barriers including stigma and negative attitudes, poverty and insufficient resources, inadequate policy implementations, physical inaccessibility, lack of transportation, lack of privacy, and inadequately trained healthcare professionals to deal with disability. Emotional and social support, including peer support for CwDs and caregivers, were identified as facilitators for better access to health services.

Conclusions
There is limited access to healthcare services in the low and middle income Sub-Saharan African countries due to poverty, low education, inadequate healthcare systems, and shortage of healthcare professionals. It is evident that there are socioeconomic, cultural, and physical related impediments that affect CwDs’ and their caregivers’ access to the required healthcare services. Policy development, improved physical accessibility, public disability awareness, and parental support are some of the key facilitators to access healthcare services. The study highlights the importance of revisions to childhood disability and healthcare provisions policy and practice as well as sustainable rehabilitation programs. Further research is required to explore ways to improve experience of accessing health services.
Use of antibiotics and asthma medication for acute lower respiratory tract infections in people with and without asthma: retrospective cohort study
Authors: Denholm Rachel , van der Werf Esther T. , Hay Alastair D. 
Published: January 2020

Abstract
Background
Antibiotics are overused in patients with acute lower respiratory tract infections (ALRTIs), but less is known about their use in patients with asthma, or the use of asthma medication for ALRTI in patients without asthma. Our aim was to describe the frequency, variation and drivers in antibiotic and asthma medication prescribing for ALRTI in adults with and without asthma in primary care.

Methods
A retrospective cohort analysis of patients aged ≥12 years, diagnosed with an ALRTI in primary care in 2014–15 was conducted using data from the Clinical Practice Research Datalink. Current asthma status, asthma medication and oral antibiotic use within 3 days of ALRTI infection was determined. Treatment frequency was calculated by asthma status. Mixed-effect regression models were used to explore between-practice variation and treatment determinants.

Results
There were 127,976 ALRTIs reported among 110,418 patients during the study period, of whom 17,952 (16%) had asthma. Respectively, 81 and 79% of patients with and without asthma received antibiotics, and 41 and 15% asthma medication. There were significant differences in between-practice prescribing for all treatments, with greatest differences seen for oral steroids (odds ratio (OR) 18; 95% CI 7–82 and OR = 94; 33–363, with and without asthma) and asthma medication only (OR 7; 4–18 and OR = 17; 10–33, with and without asthma).
Independent predictors of antibiotic prescribing among patients with asthma included fewer previous ALRTI presentations (≥2 vs. 0 previous ALRTI: OR = 0.25; 0.16–0.39), higher practice (OR = 1.47; 1.35–1.60 per SD) and prior antibiotic prescribing (3+ vs. 1 prescriptions OR = 1.28; 1.04–1.57) and concurrent asthma medication (OR = 1.44; 1.32–1.57). Independent predictors of asthma medication in patients without asthma included higher prior asthma medication prescribing (≥7 vs. 0 prescriptions OR = 2.31; 1.83–2.91) and concurrent antibiotic prescribing (OR = 3.59; 3.22–4.01).

Conclusion
Findings from the study indicate that antibiotics are over-used for ALRTI, irrespective of asthma status, and asthma medication is over-used in patients without asthma, with between-practice variation suggesting considerable clinical uncertainty. Further research is urgently needed to clarify the role of these medications for ALRTI.
The Operative management in Bariatric Acute abdomen (OBA) Survey: long-term complications of bariatric surgery and the emergency surgeon’s point of view
Authors:   the OBA trial supporters, De Simone Belinda , Ansaloni Luca , Sartelli Massimo , Kluger Yoram , Abu-Zidan Fikri M. , Biffl Walter L. , Heyer Arianna , Coccolini Federico , Baiocchi Gian Luca , Catena Fausto 
Published: January 2020

Abstract
Background
The number of bariatric procedures is increasing worldwide. No consensus or guidelines about the emergency management of long-term complications following bariatric surgery are currently available. The aim of this study is to investigate by a web survey how an emergency surgeon approaches this unique group of patients in an emergency medical scenario and to report their personal experience.

Method
An international web survey was sent to 197 emergency surgeons with the aim to collect data about emergency surgeons’ experience in the management of patients admitted in the emergency department for acute abdominal pain after bariatric surgery. The survey was conceived as a questionnaire composed by 26 (multiple choice and open) questions and approved by a steering committee.

Results
One hundred seventeen international emergency surgeons decided to join the project and answered to the web survey with a response rate of 59.39%.

Conclusions
The aim of this WSES web survey was to highlight the current management of patients previously submitted to bariatric surgical procedures by ES.
Emergency surgeons must be mindful of postoperative bariatric surgery complications. CT scan with oral intestinal opacification may be useful in making a diagnosis if carefully interpreted by the radiologist and the surgeon.
In case of inconclusive clinical and radiological findings, when symptoms fail to improve, surgical exploration for bariatric patients presenting acute abdominal pain, by laparoscopy if expertise is available, is mandatory in the first 12–24 h, to have good outcomes and decrease morbidity rate.
Increased neutrophil extracellular traps promote metastasis potential of hepatocellular carcinoma via provoking tumorous inflammatory response
Authors: Yang Lu-Yu , Luo Qin , Lu Lu , Zhu Wen-Wei , Sun Hao-Ting , Wei Ran , Lin Zhi-Fei , Wang Xiang-Yu , Wang Chao-Qun , Lu Ming , Jia Hu-Liang , Chen Jin-Hong , Zhang Ju-Bo , Qin Lun-Xiu 
Published: January 2020

Abstract
Background
The propensity of the activated neutrophils to form extracellular traps (NETs) is demonstrated in multiple inflammatory conditions. In this study, we investigated the roles of NETs in metastasis of hepatocellular carcinoma (HCC) and further explored the underlying mechanism of how NETs affect metastasis as well as the therapeutic value.

Methods
The neutrophils were isolated from the blood of human HCC patients and used to evaluate the formation of NETs. The expression of NET markers was detected in tumor specimens. A LPS-induced NET model was used to investigate the role of NETs on HCC metastasis. RNA-seq was performed to identify the key molecular event triggered by NETs, and their underlying mechanism and therapeutic significance were explored using both in vitro and in vivo assays.

Results
NET formation was enhanced in neutrophils derived from HCC patients, especially those with metastatic HCCs. NETs trapped HCC cells and subsequently induced cell-death resistance and enhanced invasiveness to trigger their metastatic potential, which was mediated by internalization of NETs into trapped HCC cells and activation of Toll-like receptors TLR4/9-COX2 signaling. Inhibition of TLR4/9-COX2 signaling abrogated the NET-aroused metastatic potential. A combination of DNase 1 directly wrecking NETs with anti-inflammation drugs aspirin/hydroxychloroquine effectively reduced HCC metastasis in mice model.

Conclusions
NETs trigger tumorous inflammatory response and fuel HCC metastasis. Targeting NETs rather than neutrophils themselves can be a practice strategy against HCC metastasis.