bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender differences and determinants of prevalence, awareness, treatment and control of hypertension among adults in China and Sweden
Authors: Santosa Ailiana , Zhang Yue , Weinehall Lars , Zhao Genming , Wang Na , Zhao Qi , Wang Weibing , Ng Nawi 
Published: November 2020

Abstract
Background
Failure to promote early detection and better management of hypertension will contribute to the increasing burden of cardiovascular diseases. This study aims to assess the gender differences in the prevalence, awareness, treatment and control of hypertension, together with its associated factors, in China and Sweden.

Methods
We used data from two cross-sectional studies: the Västerbotten Intervention Program in northern Sweden (n = 25,511) and the Shanghai survey in eastern China (n = 25,356). We employed multivariable logistic regression to examine the socio-demographics, lifestyle behaviours, and biological factors associated with the prevalence, awareness, treatment and control of hypertension.

Results
Men had a higher prevalence of hypertension (43% in Sweden, 39% in China) than their female counterparts (29 and 36%, respectively). In Sweden, men were less aware of, less treated for, and had less control over their hypertension than women. Chinese men were more aware of, had similar levels of treatment for, and had less control over their hypertension compared to women. Awareness and control of hypertension was lower in China compared to Sweden. Only 33 and 38% of hypertensive Chinese men and women who were treated reached the treatment goals, compared with a respective 48 and 59% in Sweden. Old age, impaired glucose tolerance or diabetes, a family history of hypertension or cardiovascular diseases, low physical activity and overweight or obesity were found to increase the odds of hypertension and its diagnosis.

Conclusions
This study shows the age and gender differences in the prevalence, awareness, treatment and control of hypertension among adults in China and Sweden. Multisectoral intervention should be developed to address the increasing burden of sedentary lifestyle, overweight and obesity and diabetes, all of which are linked to the prevention and control of hypertension. Development and implementation of the gender- and context-specific intervention for the prevention and control of hypertension facilitates understanding with regard to the implementation barriers and facilitators.
A qualitative exploration of the factors associated with initiation to methamphetamine use in Iran
Authors: Shahbazi Sighaldeh Shirin , Zarghami Fatemeh , Shahryari Ali , Mohammadinia Ali , Ebrahimi Mohsen , Jorjani Teimoor , Hamrah Mohammad Shoaib , Charkazi Abdurrahman 
Published: November 2020

Abstract
Background
Crystal (methamphetamine) is a strong stimulant of addictive substances that affects the central nervous system. The consumption of this substance is increasing among teenagers and adult young people in the country. In this matter, one of the practical and important ways to its control is to identify the factors leading to its first use. Thus this paper, explores the factors related to the first crystal use in Golestan province, Iran.

Methods
In a qualitative study, 19 crystal users were recruited in the study conducted in Golestan province by snowball sampling from DIC (Drop-In Center) in addiction treatment centers. The interviews were mostly carried out individually with the participants; only one interview was conducted in an addiction treatment camp in the form of a group-focused discussion. Data analysis was implemented through content analysis in MAXQDA 10 software.

Results
The mean age of the participants was 35.05 ± 6.06 years with a range of 23–46 years. Meanwhile, the mean of crystal use period was 7.42 (SD: 3.61) and a range of 1–14 years. Based on the obtained data, the reasons for first crystal use could be categorized in six; 1: “crystal use to other drugs rehabilitation”; 2: “Lack of awareness of the addictive nature of crystal”; 3: “stimulating curiosity in public with crystal-use friends”, 4: affordable and convenient use”, 5: “anti-sleeping effects and increasing work efficiency”, and 6: “therapeutic and other misconceptions”“.

Conclusions
The results indicated that crystal is mostly abused to opium rehabilitation. The lack of awareness and misconceptions about this substance can lead people to crystal use. Therefore, designing public health interventions to increase awareness about negative consequences of crystal use is fundamental to prevent people from abusing it. We suggest designing public health program to promote awareness about health risks of crystal and modifying related misconceptions. Finally, the government can establish policies to mandate sale tax for crystal producers and reduce easy access to crystal especially among youth.
Surgical findings in cryptorchidism in children with Zika-related microcephaly: a case series
Authors: de Vasconcelos Rômulo A. L. , Ximenes Ricardo A. A. , Calado Adriano A. , Martelli Celina M. T. , Gonçalves Andreia V. , Brickley Elizabeth B. , de Araújo Thalia V. B. , Rocha Maria A. W. , Miranda-Filho Demócrito de B. 
Published: November 2020

Abstract
Background
Complications in the urinary tract related to congenital Zika syndrome have recently been reported. One complication, cryptorchidism, has been reported by the Microcephaly Epidemic Research Group/MERG, in Pernambuco/Brazil. The present article describes for the first time the surgical findings in a case series of boys with Zika-related microcephaly and cryptorchidism, who underwent surgical testicular exploration as a contribution to better understand the possible mechanisms involved in gonads formation and descent.

Methods
A total of 7 children (11 testicular units), aged 3 to 4 years, were submitted to inguinal or scrotal orchidopexy for the treatment of palpable cryptorchidism between August 2019 and January 2020. Characteristics of the gonads and its annexes related to appendixes, testis-epididymis dissociation, gubernacular insertion, and associated hydroceles and/or hernias were described. Measures in centimetres were taken for volume calculate.

Results
We found a low prevalence of testicular and epididymal appendix (66.7%), a high prevalence of testis-epididymis dissociation (55.6%), low mean testicular volume for their ages (lower for older boys) and ectopic gubernacular insertion in all cases. There was no evidence of associated hydroceles and/or hernias in any case. No surgical complication was registered or reported, and all explored gonads were properly placed in the scrotal sac.

Conclusions
We herein describe the surgical findings of these children's orchidopexies and discuss the possible mechanisms of viral action in embryogenesis and postnatal growth and development of the testes and annexes. These children need to be followed over time due to the higher risk of testicular atrophy and malignancy. Surgical timing seems to be relevant to avoid loss of testicular volume.
High body fat percentage is associated with primary aldosteronism: a cross-sectional study
Authors: Manosroi Worapaka , Atthakomol Pichitchai 
Published: November 2020

Abstract
Background
Excess aldosterone has been shown to be associated with obesity; however, there is currently a lack of data regarding the relationship between percentage of body fat and primary aldosteronism (PA), particularly pertaining to Asian populations. Furthermore, essential hypertension may mimic the condition of PA and there needs to be differentiation between the two. This study aimed to assess the association between percentage of body fat and PA.

Methods
A cross-sectional study was conducted in the outpatient department of the Endocrine and Metabolism Unit of the tertiary care medical center in Thailand. Data was obtained from 79 patients who had been screened for PA due to hypertension in young-onset, hypokalemia, adrenal incidentaloma or resistance hypertension. Essential hypertension was defined as patients who had high blood pressure and were negative for PA screening. Body fat percentage was assessed by bioelectrical impedance analysis. The relationship between percentage of body fat and a diagnosis of PA was assessed using logistic regression analysis, including adjustment for confounding factors.

Results
The participants were divided into a PA group (n = 41) and an essential hypertension group (n = 38). After controlling for confounding variables (age, sex, body mass index, cholesterol and insulin resistance status), the odds ratio of having PA in males with a percentage of body fat > 25% and females with percentage > 30% was 1.82 (95%CI = 1.79–1.86, p < 0.001).

Conclusion
A higher percentage of body fat is associated with an increased risk of PA. Further studies need to be conducted to confirm the relationship between body fat percentage and PA.
Women’s experiences of living with increased inter-recti distance after childbirth: an interview study
Authors: Eriksson Crommert Martin , Petrov Fieril Karolina , Gustavsson Catharina 
Published: November 2020

Abstract
Background
Although an increased inter-recti distance, also known as diastasis recti, is common after pregnancy, evidence-based knowledge about the condition is relatively limited. In particular, little is known about the consequences as perceived by the women. The objective of the present study was to describe how postpartum women with increased inter-recti distance experience the condition as well as the contacts they have had with healthcare providers regarding their symptoms.

Methods
A purposeful sampling approach was used to recruit 19 participants from an existing study cohort of 144 women. All participants had an inter-recti distance of at least two finger widths and at least one child, with the youngest child between the ages of 1 and 6 years. Individual interviews based on a semi-structured interview guide were performed and subsequently analysed using qualitative content analysis.

Results
Four categories emerged from the interviews: the body’s function and ability has changed; the body does not look like it used to; uncomprehending attitudes and treatment in their surroundings; and trying to acquire an understanding of and strategies to cope with the diastasis. The findings reveal that women with increased inter-recti distance might experience fear of movement and engage in avoidance behaviour. In combination with feelings of physical instability in the midsection of their bodies and body dissatisfaction, many of the women restrict their everyday lives and physical activities.

Conclusions
The findings indicate that increased inter-recti distance is a complex phenomenon that affects the women in a multitude of ways, highlighting the importance of considering the condition for each individual in her own context from a biopsychosocial perspective.
Current status and future perspective of external herbal dispensaries preparing traditional herbal medicine in South Korea: the first National-Wide Survey results
Authors: Sung Soo-Hyun , Han Ji-Eun , Ryu Ji-Yeon , Sung Angela Dong-Min , Park Jung-Youn , Ha In-Hyuk , Kim Kyeong Han , Park Jang-Kyung , Shin Byung-Cheul 
Published: November 2020

Abstract
Background
An external herbal dispensary (EHD) is a type of pharmacy that provides various types of personalized herbal medicines (PHMs) to other traditional Korean medicine (TKM) institutions. Such dispensaries were legalized by the Ministry of Health and Welfare (MoHW) in 2008 in South Korea. The purpose of this study is to understand the current status of the EHD facilities and their quality controls and compare them with the good manufacture practice (GMP) guidelines to contribute to the establishment of the safety and quality control criteria for PHMs.

Methods
We contacted 107 EHD representatives or people in charge of the preparation of PHMs (TKM pharmacists) and invited them to complete a survey questionnaire; of the total, 81 responded. The survey questionnaire was developed in 3 stages: drafting, revision by external experts, and final editing. It consisted of 20 questions covering 3 sections: basic characteristics of EHDs, facility, and quality control. The survey was hosted online from December 2017 to January 2018 as guided by the MoHW.

Results
The completion rate was 75.7% (n = 81). In terms of facilities, the five facilities (water supply, manufacture, pest control, hygiene management and warehousing) that corresponded to the legal requirements of EHD were mostly equipped, but the types of facilities and equipment differed. Two facilities (sterilization and cross-contamination that were not legally required for EHD were found to have mostly pharmacopuncture-EHD (P-EHD), but hardly any herbal medicine-EHD (H-EHD). In our findings regarding quality control of non-medicinal herbs, sensory evaluation that included checks for foreign bodies and deterioration were conducted. In terms of the quality control of herbal medicines, residual pesticides and heavy metals tests were performed and for pharmacopuncture, pH, salinity, sterility, and endotoxin tests along with gross examination were performed. In the end, we found that 6 of the 38 standard items as required by the Korea GMP were suitable.

Conclusions
In this study, detailed information for each existing EHD law was determined through a nationwide questionnaire. Moreover, the basis for its reflection in additional legal standards should be introduced so that safe herbal medicine can be prepared in EHDs.
Cardioprotective potential of polyphenols rich Thraatchathi Chooranam against isoproterenol induced myocardial necrosis in experimental rats
Authors: Ganapathy Ramakrishnan , Ramachandran Anita , Shivalingaiah Sushmitha Basavapattana , Bishir Muhammed , Bhojaraj Saravanan , Sridhar Shivashree , Mohan Surapaneni Krishna , Veeraraghavan Vishnu Priya , Chidambaram Saravana Babu , Essa Musthafa Mohamed , Qoronfleh M. Walid 
Published: November 2020

AbstractBackgroundThe present study establishes the cardioprotective role of Thraatchathi Chooranam (TC), a polyherbal traditional Siddha medicine, in terms of membrane stabilizing and antioxidant properties in isoproterenol (ISO) induced myocardial necrosis model in rats.MethodsAnimals were divided into six groups (n = 6), normal (received vehicle 0.5% CMC, p.o.), ISO control (received 0.5% CMC + ISO 120 mg/kg, b.w. s.c. twice at an interval of 48 h), standard control (received Vit-E 100 mg/kg, p.o.) + ISO, TC low and high dose (50 and 100 mg/kg p.o., respectively) + ISO, and drug control (received TC at 100 mg/kg, p.o.). At the end of experimental period, blood samples collected and plasma cardiac troponin-I (CTn-I) was measured by ELISA. Cardiac tissues were isolated, levels of membrane stabilizing enzymes, antioxidants and inflammatory markers were estimated. Gene expression of Bax, Bcl2, Caspase 3, HIF-α, TNF-α, iNOS, TRX1 and TrxR were performed by RT-PCR. Histopathological studies on cardiac tissues were conducted using hematoxylin and eosin (H&E) stain. Statistical analyses were performed by one-way ANOVA followed by Tukey’s multiple comparison as post-hoc test.ResultsAdministration of ISO resulted in a significant increase in plasma CTn-I, decrease in superoxide dismutase, glutathione and glutathione peroxidase; it also significantly altered membrane stabilizing enzymes like Na+/K+-ATPase, Mg2+-ATPase Ca2+-ATPase and Cathepsin D. Pretreatment with TC (50 mg/kg and 100 mg/kg) decreased CTn-I, and improved membrane stabilizing and endogenous antioxidant enzymes and decreased cathespin D level in a dose dependent manner. Histopathological examination revealed that TC improves cellular membrane integrity and decreases inflammatory cell infiltration and necrotic death.ConclusionThe present study provided a strong evidence on the protective effects of TC against ISO-induced myocardial necrosis in rats.
Aqueous extract of Arctium lappa L. root (burdock) enhances chondrogenesis in human bone marrow-derived mesenchymal stem cells
Authors: Wu King-Chuen , Weng Hung-Kai , Hsu Yun-Shang , Huang Pin-Jia , Wang Yang-Kao 
Published: November 2020

AbstractBackgroundArctium lappa L.root (burdock root) has long been recommended for the treatment of different diseases in traditional Chinese medicine. Burdock root possesses anti-oxidative, anti-inflammatory, anti-cancer, and anti-microbial activities. The aim of the study was to elucidate whether aqueous extract of burdock root regulates mesenchymal stem cell proliferation and differentiation.MethodsHuman bone marrow-derived mesenchymal stem cells in 2D high density culture and in 3D micromass pellets were treated with chondrogenic induction medium and chondral basal medium in the absence or presence of aqueous extract of burdock root. The chondrogenic differentiation was accessed by staining glucosaminoglycans, immunostaining SOX9 and type II collagen and immuonblotting of SOX9, aggrecan and type II collagen.ResultsTreatment of aqueous extract of burdock root increased the cell proliferation of hMSCs. It did not have significant effect on osteogenic and adipogenic differentiation, but significantly enhanced chondrogenic induction medium-induced chondrogenesis. The increment was dose dependent, as examined by staining glucosaminoglycans, SOX9, and type II collagen and immunobloting of SOX9, aggrecan and type II collagen in 2D and 3D cultures. In the presence of supplemental materials, burdock root aqueous extract showed equivalent chondrogenic induction capability to that of TGF-β.ConclusionsThe results demonstrate that aqueous extract ofArctium lappa L.root promotes chondrogenic medium-induced chondrogenic differentiation. The aqueous extract of burdock root can even be used alone to stimulate chondrogenic differentiation. The study suggests that the aqueous extract of burdock root can be used as an alternative strategy for treatment purposes.
Association between training experience and readiness for advance care planning among healthcare professionals: a cross-sectional study
Authors: Chan Helen Yue-lai , Kwok Annie Oi-ling , Yuen Kwok-keung , Au Derrick Kit-sing , Yuen Jacqueline Kwan-yuk 
Published: November 2020

Abstract
Background
Training has been found effective in improving healthcare professionals’ knowledge, confidence, and skills in conducting advance care planning (ACP). However, the association between training and its actual practice in the clinical setting has not been well demonstrated. To fill this gap, this paper examines the association between their readiness for ACP, in terms of perceived relevancy of ACP with their clinical work, attitudes toward and confidence and willingness to perform it, based on the Theory Planned Behavior and relevant training experiences.

Methods
An online survey about experiences about ACP of healthcare professionals, including physicians, nurses, social workers, and allied healthcare professionals, currently working in hospital and community care in Hong Kong was conducted.

Results
Of 250 respondents, approximately half (52.0%) had received ACP-related training. Those with relevant training reported significantly more positive in the perceived clinical relevance, willingness, and confidence in conducting ACP and different levels of agreement with 19 out of the 25 statements in a questionnaire about attitudes toward ACP than those without (ps ≤ 0.001–0.05). Respondents who received training only in a didactic format reported a significantly lower level of confidence in conducting ACP than did others who received a blended mode of learning (p = 0.012). Notwithstanding significant differences between respondents with and without relevant training, respondents generally acknowledged their roles in initiating conversations and appreciated ACP in preventing decisional conflict in surrogate decision-making regardless of their training experience.

Conclusions
This paper revealed the association between training and higher level of readiness toward ACP among healthcare professionals. The findings showed that training is a predictor of their readiness for ACP in terms of perceived relevancy, willingness, and confidence. Those who had received training were less likely to consider commonly reported barriers such as time constraints, cultural taboos, and avoidance among patients and family members as hindrances to ACP implementation.
What can we expect from medical graduates? Empirical survey on the performance of Core EPAs in the first days of residency
Authors: Holzhausen Ylva , Maaz Asja , Roa-Romero Yadira , Peters Harm 
Published: November 2020

AbstractBackgroundCore Entrustable Professional Activities (EPAs) have been defined to specify the performance expectations for entering residents worldwide. The content of these EPAs was elaborated and validated primarily via medical expert consent approaches. The present study aims to collect empirical information on the actual task performance and supervision level of entering residents as a complementary methodological approach to enhance the content validity of a set of institutional EPAs.MethodsIn the summers of 2017 and 2018, Charité medical graduates (n = 720) received a post-graduation survey by mail. The questionnaire covered the performance of Core EPAs, Core procedures and more advanced EPAs. Graduates were asked how frequently they had performed the respective EPAs since the start of residency and under what level of supervision. We expected the large majority of graduates (> 75%) to have performed the Core EPAs and procedures under at least indirect supervision.ResultsIn total, 215 graduates (30%) returned the questionnaire, and 131 (18%) surveys could be included in the data analysis. The majority of participants were female (63%) and worked in hospitals (50%) or in university medical centres (30%) across various medical disciplines. Among the Core EPAs, 10 out of 11 tasks had been performed by more than 75% of graduates since the start of residency, 9 under indirect supervision. Regarding the Core procedures, only 3 out of 13 procedures had been performed by the large majority of graduates under indirect supervision, and 10 procedures had not been carried out by at least one-third of participants. Among the 5 advanced EPAs, none of 5 had been performed by more than 75% of the participants since the start of residency, and 4 had been carried out by 50% under indirect supervision.ConclusionsThe results of this study largely and complementarily confirm the validity of the defined Core EPAs representing realistic expectations for entry into residence at our institution. The low actual performance rate of Core procedures serves to stimulate an institutional discussion on their adjustment to better match the workplace reality.