bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study
Authors: Johannesen Camilla Ditlev Lindhardt , Langsted Anne , Mortensen Martin Bødtker , Nordestgaard Børge Grønne 
Published: December 2020

Abstract

Objective
To determine the association between levels of low density lipoprotein cholesterol (LDL-C) and all cause mortality, and the concentration of LDL-C associated with the lowest risk of all cause mortality in the general population.

Design
Prospective cohort study.

Setting
Denmark; the Copenhagen General Population Study recruited in 2003-15 with a median follow-up of 9.4 years.

Participants
Individuals randomly selected from the national Danish Civil Registration System.

Main outcome measures
Baseline levels of LDL-C associated with risk of mortality were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. Main outcome was all cause mortality. Secondary outcomes were cause specific mortality (cardiovascular, cancer, and other mortality).

Results
Among 108 243 individuals aged 20-100, 11 376 (10.5%) died during the study, at a median age of 81. The association between levels of LDL-C and the risk of all cause mortality was U shaped, with low and high levels associated with an increased risk of all cause mortality. Compared with individuals with concentrations of LDL-C of 3.4-3.9 mmol/L (132-154 mg/dL; 61st-80th centiles), the multivariable adjusted hazard ratio for all cause mortality was 1.25 (95% confidence interval 1.15 to 1.36) for individuals with LDL-C concentrations of less than 1.8 mmol/L (<70 mg/dL; 1st-5th centiles) and 1.15 (1.05 to 1.27) for LDL-C concentrations of more than 4.8 mmol/L (>189 mg/dL; 96th-100th centiles). The concentration of LDL-C associated with the lowest risk of all cause mortality was 3.6 mmol/L (140 mg/dL) in the overall population and in individuals not receiving lipid lowering treatment, compared with 2.3 mmol/L (89 mg/dL) in individuals receiving lipid lowering treatment. Similar results were seen in men and women, across age groups, and for cancer and other mortality, but not for cardiovascular mortality. Any increase in LDL-C levels was associated with an increased risk of myocardial infarction.

Conclusions
In the general population, low and high levels of LDL-C were associated with an increased risk of all cause mortality, and the lowest risk of all cause mortality was found at an LDL-C concentration of 3.6 mmol/L (140 mg/dL).
Comparison of different mobile health applications for intervention in children and adolescent with overweight: a protocol for systematic review with meta-analysis and trial sequential analysis
Authors: Perego Paolo , Rashid Rajeeb , Gluud Christian , Jakobsen Janus C , Andreoni Giuseppe , Lissau Inge 
Published: December 2020

IntroductionOverweight in children is increasing worldwide. Innovative smartphone health applications (mHealth apps) have either sought to deliver single or multi-component interventions for the management of overweight in children. However, the clinical effects of these apps are poorly explored. The objective of the review will be to compare the benefits and harms of different categories of mHealth apps for intervention of overweight in children.Methods and analysisWe will include randomised clinical trials irrespective of publication type, year, status or language. Children and adolescents between 0 to 18 years will be referred to as children in the remaining part of the paper. Children with all degrees of overweight included obesity and morbidly obese in the remaining part of the paper will be referred to as overweight. We plan to classify different apps according to type of intervention, measurement device, coaching and reward system. The following databases will be used: Cochrane Library, Excerpta Medica database (Embase), PsycINFO, PubMed, IEEE Explore and Web of Science, CINAHL and LILACS. Primary outcomes will be body mass index z-score, quality of life and serious adverse event. Secondary outcomes will be body weight, self-efficacy, anxiety, depression and adverse event not considered serious. Study inclusion, data extraction and bias risk assessment will be conducted independently by at least two authors. We will assess the risk of bias through eight domains and control risks of random errors with Trial Sequential Analysis. The quality of the evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE).Ethics and disseminationAs the protocol is for a systematic reviews, we have not included any patient data and we do not require ethical approval. This review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019120266.
Is hard physical work in the early working life associated with back pain later in life? A cross-sectional study among 5700 older workers
Authors: Bláfoss Rúni , Skovlund Sebastian Venge , López‐Bueno Rubén , Calatayud Joaquin , Sundstrup Emil , Andersen Lars L 
Published: December 2020

ObjectivesPhysically demanding work increases the risk of developing musculoskeletal disorders during working life, with low back pain (LBP) as the most prevalent and debilitating musculoskeletal disorder worldwide. However, a lack of knowledge exists about the role of early working years on musculoskeletal health later in life. This study investigated whether an exposure–response association exists between physical demands in early working life and risk of LBP in later working life.DesignCross-sectional study.Setting, participants and outcome measureIn the SeniorWorkingLife study, 5909 wage earners aged ≥50 years with currently sedentary work replied to a questionnaire survey in 2018 about physical work demands during their first working years (exposure) and current LBP (outcome). Associations between physical work demands in the early working years and current LBP were modelled using general linear models controlling for various confounders, combined with model-assisted weights based on national registers.ResultsHard physical work during early working life was associated with more intense LBP later in life among senior workers with currently sedentary jobs. In the fully adjusted model, workers with ‘standing/walking work with lifting/carrying’ and ‘heavy or fast work that is physically strenuous’ during the first years of working life reported higher LBP intensity than those with sedentary work during their first working years (0.2 (95% CI, 0.0 to 0.4) and 0.6 (95% CI, 0.4 to 0.9), respectively).ConclusionWork involving lifting/carrying or work that is physically strenuous in early life is associated with higher intensity of LBP among older workers with currently sedentary employment. These findings suggest that early working life may have an impact on later working years and underscore the necessity for careful introduction and instruction to the working environment for retaining musculoskeletal health and prolonging working life.Trial registration numberNCT03634410.
Adults’ experiences of living with pulmonary hypertension: a thematic synthesis of qualitative studies
Authors: Rawlings Gregg Harry , Beail Nigel , Armstrong Iain , Condliffe Robin , Kiely David G , Sabroe Ian , Thompson Andrew R 
Published: December 2020

ObjectivesPulmonary hypertension is a life-shortening disease that has a considerable impact on quality of life. Improving our understanding of how individuals are affected and cope with the disease will help to improve services and outcomes. This review synthesises the published qualitative research that has listened to adults discuss their experiences of living with the disease.DesignA comprehensive systematic search of four databases was conducted in May 2020: Web of Science, PubMed, PsycINFO and Cochrane Library. Suitable studies were evaluated using the Critical Appraisal Skills programme. Findings from the studies were extracted and subjected to a thematic synthesis.ResultsNineteen articles were identified reflecting the experiences of over 1900 individuals impacted by pulmonary hypertension from Europe, North and South America and Asia. Ten studies did not report participant’s WHO functional class of pulmonary hypertension, which resulted in comparing experiences between different severity difficult. All studies met the majority of the quality assessment items. Six descriptive themes emerged discussing participant’s experiences of diagnosis, treatment, prognosis, healthcare professionals, impact and coping with pulmonary hypertension. Four higher order analytical themes were developed from the descriptive themes, reflecting: (i) uncertainties and anxiety that participants encountered related to pulmonary hypertension; (ii) lack of recognition of the impact of the condition; (iii) frustration at the paucity of awareness of pulmonary hypertension in society and healthcare settings and (iv) participant’s accounts of transitioning through different stages of living with the disease.ConclusionsThese findings form the first synthesis of experiences of life in individuals impacted by pulmonary hypertension and illustrate the multifaceted impact of the condition. The voices of numerous groups are missing from the literature highlighting the need for additional research. The results have implications for clinical practice emphasising the role of educational and psychological therapies to support those with the disease.
Association between person-centred care and healthcare providers’ job satisfaction and work-related health: a scoping review
Authors: van Diepen Cornelia , Fors Andreas , Ekman Inger , Hensing Gunnel 
Published: December 2020

ObjectiveThis scoping review aimed to explore and describe the research on associations between person-centred care (PCC) and healthcare provider outcomes, for example, job satisfaction and work-related health.DesignScoping review.Eligibility criteriaStudies were included if they were empirical studies that analysed associations between PCC measurement tools and healthcare providers outcomes.Search strategySearches in PubMed, CINAHL, Psychinfo and SCOPUS databases were conducted to identify relevant studies published between 2001 and 2019. Two authors independently screened studies for inclusion.ResultsEighteen studies fulfilled the inclusion criteria. Twelve studies were cross-sectional, four quasi-experimental, one longitudinal and one randomised controlled trial. The studies were carried out in Sweden, The Netherlands, the USA, Australia, Norway and Germany in residential care, nursing homes, safety net clinics, a hospital and community care. The healthcare provider outcomes consisted of job satisfaction, burnout, stress of conscience, psychosocial work environment, job strain and intent to leave. The cross-sectional studies found significant associations, whereas the longitudinal studies revealed no significant effects of PCC on healthcare provider outcomes over time.ConclusionMost studies established a positive association between PCC and healthcare provider outcomes. However, due to the methodological variation, a robust conclusion could not be generated. Further research is required to establish the viability of implementing PCC for the improvement of job satisfaction and work-related health outcomes through rigorous and consistent research.
Reduced antibiotic use in extremely preterm infants with an antimicrobial stewardship intervention
Authors: Gustavsson Lars , Lindquist Simon , Elfvin Anders , Hentz Elisabet , Studahl Marie 
Published: December 2020

IntroductionExcessive administration of antibiotics to preterm infants is associated with increased rates of complications. The purpose of the study was to evaluate the effect of an antimicrobial stewardship intervention on antibiotic use in extremely preterm infants.Design, setting, patients and interventionA before and after study of infants born at ≤28 weeks’ gestational age was performed in the neonatal intensive care unit of Queen Silvia’s Children’s Hospital, Gothenburg, Sweden. Retrospective analysis of the baseline period (January–December 2014) guided the development of a limited antimicrobial stewardship intervention. The intervention consisted of updated local guidelines with a focus on shortened and standardised treatment duration plus increased access to infectious disease consultant advice. It was fully implemented during the intervention period (October 2017–September 2018).ObjectivePrimary aim was to compare antibiotic use, defined as antibiotic treatment days per 1000 patient-days, between the two periods, and the secondary aim was to evaluate the number of days with meropenem-based regimens before and after the intervention.ResultsWe included 145 infants with a median birth weight of 870 g and median gestational age of 26 weeks. The baseline period comprised 82 infants and 3478 patient-days, the intervention period comprised 63 infants and 2753 patient-days. Overall antibiotic use (treatment and prophylaxis) was 534 versus 466 days per 1000 patient-days during the baseline and intervention periods, respectively. Antibiotic treatment days decreased from 287 to 197 days per 1000 patient-days. The proportion of meropenem-based regimens was 69% versus 44%, respectively. No increases in mortality or reinitiation of antibiotics were seen.ConclusionsImplementation of a limited antimicrobial stewardship intervention anchored in analysis of previous prescription patterns can contribute to safe decreases in antibiotic use in extremely preterm infants.
Long-term safety of prenatal and neonatal exposure to paracetamol: a protocol for a systematic review
Authors: Samiee-Zafarghandy Samira , Sushko Katelyn , Van Den Anker John 
Published: December 2020

IntroductionA surge in the use of paracetamol in neonates has resulted in growing concerns about its potential long-term adverse events. In this study, we conduct a systematic review of the long-term safety of prenatal and neonatal exposure to paracetamol in newborn infants.Methods and analysisWe will follow the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements to conduct and report this review. We will conduct a systematic search of Embase, MEDLINE, Web of Science and Google Scholar for studies with data on long-term adverse events in neonates that were exposed to paracetamol in the prenatal and/or neonatal period. We will not apply language or design limitations. We will use standardised risk of bias assessment tools to perform a quality assessment of each included article.Ethics and disseminationThis systematic review will only involve access to publicly available data, and therefore ethical approval will not be required. The results of this study will be communicated to the target audience through peer-reviewed publication as well as other knowledge exchange platforms, such as conferences, congresses or symposia.Trial registrationThe protocol for this systematic review is submitted for registration to international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).
Trends in wildfire burn severity across Canada, 1985 to 2015
Authors: Guindon Luc , Gauthier Sylvie , Manka Francis , Parisien Marc-André , Whitman Ellen , Bernier Pierre , Beaudoin André , Villemaire Philippe , Skakun Rob 
Published: December 2020

Burn severity is an important component of the fire regime that has not yet been fully characterized for the forests of Canada. The objectives of this study were to (i) create a Canada-wide geospatial database of burn severity for wildland fires across forested regions of Canada from 1985 to 2015, and (ii) use this database to evaluate seasonal and annual trends in burn severity across Canada and regionally using two different regional units (ecozones and Homogeneous Fire Regime zones). We developed the 30 m resolution geospatial Canadian Landsat Burn Severity (CanLaBS) product from Landsat imagery, using values of pre-fire to post-fire differences in normalized burn ratios (dNBRs) for nearly 60 Mha of area burned across Canada’s forests from 1985 to 2015, complemented with estimates of pre-fire forest composition, crown closure, and biomass. Our results suggest that burn severity is generally lower in spring fires than in summer ones nationally and in almost every regional unit. We found no consistent relationship between burn severity and annual area burned across ecozones. Finally, we observed a small but significant decrease in burn severity from 1985 to 2015 across Canada, although this is regionally variable. The CanLaBS database is publicly available at https://doi.org/10.23687/b1f61b7e-4ba6-4244-bc79-c1174f2f92cd .
Effects of physical exercise on baroreflex sensitivity and renal sympathetic nerve activity in chronic nicotine-treated rats
Authors: Rodríguez-Núñez Iván , Pontes Roberto B. , Romero Fernando , Campos Ruy R. 
Published: December 2020

Chronic nicotine exposure may increase cardiovascular risk by impairing the cardiac autonomic function. Besides, physical exercise (PE) has shown to improve cardiovascular health. Thus, we aimed to investigate the effects of PE on baroreflex sensitivity (BRS), heart rate variability (HRV), and sympathetic nerve activity (SNA) in chronically nicotine-exposed rats. Male Wistar rats were assigned to four independent groups: Control (treated with saline solution), Control+Ex (treated with saline and submitted to treadmill training), Nicotine (treated with Nicotine), and Nicotine+Ex (treated with nicotine and submitted to treadmill training). Nicotine (1 mg·kg−1) was administered daily for 28 consecutive days. PE consisted of running exercise (60%–70% of maximal aerobic capacity) for 45 min, 5 days per week, for 4 weeks. At the end of the protocol, cardiac BRS, HRV, renal SNA (rSNA), and renal BRS were assessed. Nicotine treatment decreased absolute values of HRV indexes, increased low frequency/high frequency ratio of HRV, reduced the bradycardic and sympatho-inhibitory baroreceptor reflex responses, and reduced the rSNA. PE effectively restored time-domain HRV indexes, the bradycardic and sympatho-inhibitory reflex responses, and the rSNA in chronic nicotine-treated rats. PE was effective in preventing the deterioration of time-domain parameters of HRV, arterial baroreceptor dysfunction, and the rSNA after nicotine treatment.
A review of present-day deformation of active volcanoes in China between 1970 and 2013
Authors: Ji Lingyun , Xu Jiandong , Liu Lei , Zhang Wenting 
Published: December 2020

Abstract

China has numerous active volcanoes, and more than 10 erupted in the Quaternary. Although a modern eruption event has not occurred in China, the potential risk from volcanic hazards should be noted. With the development of geodetic technologies including the Global Positioning System (GPS), levelling and interferometric synthetic aperture radar (InSAR), volcanologists can now detect the present-day deformation state of China's active volcanoes. In this paper, we summarize the present-day deformation patterns, magma sources and magma plumbing systems of China's active volcanoes between 1970 and 2013. The results show that the most active volcano in China is the Changbaishan volcano; it showed significant inflation from 2002–03, with the deformation becoming gradually weaker after 2003, indicating that it had been experiencing a magma process during 2000–10. A point source at a depth of
c.
10 km was responsible for the observed deformation. The Leiqiong volcanic field showed a trough pattern deformation during 2007–10, which was interpreted as a dyke intrusion model. Fluctuant deformation patterns were shown in the Tengchong volcanic field. The Longgang volcanic field had experienced a volcano-wide uplift during the 1970s and 1990s. Deformation was observed in the Tatun volcanic field from 2006–13, and two shallow sources account for the observed deformation. These volcanoes merit further monitoring given possible evidence of deformation. No obvious deformation related to volcanic activity was observed at the Ashikule volcanic field from 2003–11. The results provide a basic introduction to the deformation state of China's active volcanoes, and may be helpful for evaluating the activity levels of China's volcanoes and mitigating the risks of future volcanic hazards.
Positive Clinical Benefit on Patient Care, Quality of Life, and Symptoms After Contact Force–Guided Radiofrequency Ablation in Persistent Atrial Fibrillation
Authors: Natale Andrea , Calkins Hugh , Osorio Jose , Pollak Scott J. , Melby Daniel , Marchlinski Francis E. , Athill Charles A. , Delaughter Craig , Patel Anshul M. , Gentlesk Philip J. , DeVille Brian , Macle Laurent , Ellenbogen Kenneth A. , Dukkipati Srinivas R. , Reddy Vivek Y. , Mansour Moussa ,   on behalf of the PRECEPT Investigators
Published: December 2020

Background:
There is limited evidence on the long-term clinical benefits of catheter ablation in patients with persistent atrial fibrillation.

Methods:
PRECEPT was a prospective, multicenter, single-arm Food and Drug Administration–regulated investigational device exemption clinical study. Patients were followed up to 15 months after ablation. Outcomes included use of antiarrhythmic drugs, rate of cardioversions and cardiovascular hospitalization, Atrial Fibrillation Effect on Quality-of-Life score, and Canadian Cardiovascular Society Severity of Atrial Fibrillation score.

Results:
A total of 333 enrolled persistent atrial fibrillation patients underwent ablation. The cardioversion rate decreased by 83% at the 9- to 15-month follow-up. Antiarrhythmic drug utilization decreased by 69% at 12 to 15 months post-ablation. The Kaplan-Meier estimate of freedom from cardiovascular hospitalization was 84.2% (95% CI, 80.2%–88.2%) at 15 months. Consistent improvements in mean Atrial Fibrillation Effect on Quality-of-Life composite (+50.0) were seen at 6 months, sustained at 15 months, and exceeded the minimum clinically important difference. Improvements in Atrial Fibrillation Effect on Quality-of-Life scores were significantly better among participants without documented atrial arrhythmia recurrences. By Canadian Cardiovascular Society Severity of Atrial Fibrillation symptom classification, >80% of patients were asymptomatic (class 0) at 15 months post-ablation compared with only 0.7% at baseline.

Conclusions:
Contact force–guided radiofrequency ablation of persistent atrial fibrillation was associated with a significant decrease in antiarrhythmic drug use, cardioversion rate, and hospitalization. Clinically meaningful improvements in quality of life were observed in all patients. The majority of the patients (>80%) were asymptomatic at 15 months post-ablation. The positive clinical impact of improved quality of life and reduced health care utilization may help with shared decision-making in persistent atrial fibrillation treatment.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02817776.