bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in Patients With Suspected Cardiac Sarcoidosis Assessed by Cardiovascular Magnetic Resonance Imaging
Authors: Kalra Rajat , Malik Shray , Chen Ko-Hsuan Amy , Ogugua Fredrick , Athwal Pal Satyajit Singh , Elton Andrew C. , Velangi Pratik S. , Ismail Mohamed F. , Chhikara Sanya , Markowitz Jeremy S. , Nijjar Prabhjot S. , von Wald Lisa , Roukoz Henri , Bhargava Maneesh , Perlman David , Shenoy Chetan 
Published: September 2021

Background:
There are few data on sex differences in suspected cardiac sarcoidosis.

Methods:
Consecutive patients with histologically proven sarcoidosis and suspected cardiac involvement were studied. We investigated sex differences in presenting features, cardiac involvement, and the long-term incidence of a primary composite end point of all-cause death or significant ventricular arrhythmia and secondary end points of all-cause death and significant ventricular arrhythmia.

Results:

Among 324 patients, 163 (50.3%) were female and 161 (49.7%) were male patients. Female patients had a greater prevalence of chest pain (37.4% versus 23.6%;
P
=0.010) and palpitations (39.3% versus 26.1%;
P
=0.016) than male patients but not dyspnea, presyncope, syncope, or arrhythmias at presentation. Female patients had a lower prevalence of late gadolinium enhancement on cardiovascular magnetic resonance imaging (20.2% versus 35.4%;
P
=0.003) and less often met criteria for a clinical diagnosis of cardiac sarcoidosis (Heart Rhythm Society consensus criteria, 22.7% versus 36.0%;
P
=0.012 and 2016 Japanese Circulation Society guideline criteria, 8.0% versus 19.3%;
P
=0.005), indicating lesser cardiac involvement. However, the long-term incidence of all-cause death or significant ventricular arrhythmia was not different between female and male patients (23.2% versus 23.2%;
P
=0.46). Among the secondary end points, the incidence of all-cause death was not different between female and male patients (20.7% versus 14.3%;
P
=0.51), while female patients had a lower incidence of significant ventricular arrhythmia compared with male patients (4.3% versus 13.0%;
P
=0.022). On multivariable analyses, sex was not associated with the primary end point (hazard ratio for female patients, 1.36 [95% CI, 0.77–2.43];
P
=0.29).

Conclusions:
We observed distinct sex differences in patients with suspected cardiac sarcoidosis. A paradox was identified wherein female patients had a greater prevalence of chest pain and palpitations than male patients, but lesser cardiac involvement, and a similar long-term incidence of all-cause death or significant ventricular arrhythmia.
Stress and Coping Among Family Caregivers of Patients With a Destination Therapy Left Ventricular Assist Device: A Multicenter Mixed Methods Study
Authors: McIlvennan Colleen K. , Jones Jacqueline , Makic Marybeth , Meek Paula M. , Chaussee Erin , Thompson Jocelyn S. , Matlock Daniel D. , Allen Larry A. 
Published: September 2021

Background:
Family caregivers of patients with a destination therapy left ventricular assist device play a central and formalized role in postimplant care. We aimed to characterize longitudinal stress, predictors and correlates of stress, and coping processes among left ventricular assist device caregivers.

Methods:
We performed a sequential, exploratory, mixed-methods study from 6 diverse left ventricular assist device programs. The primary outcome for the quantitative analysis was the Perceived Stress Scale-10 at 6 months (0–40). Based on the quantitative findings and guided by the Transactional Model of Stress and Coping, semistructured interviews explored causes of stress and coping processes. Integration was performed during the qualitative and interpretation phase.

Results:
A total of 96 caregivers met inclusion criteria for quantitative analysis. Mean (SD) Perceived Stress Scale score was 14.3 (5.5) preimplant and 11.8 (6.9) at 6 months. Preimplant, only decreased preparedness for caregiving was associated with higher Perceived Stress Scale score at 6 months. At 6 months, increased caregiver depressive symptoms, decreased caregiver preparedness for caregiving, and lower patient quality of life were associated with higher Perceived Stress Scale score. Qualitative analysis of 25 caregivers revealed the causes of stress coalesced around 3 themes: (1) lack of preparedness to be a caregiver, (2) uniqueness of stress for the caregiver and patient situation, and (3) caregiving responsibilities physically and emotionally impacting caregivers. To cope with stress, most caregivers employed emotion-focused coping.

Conclusions:
In family caregivers of patients with a left ventricular assist device, higher perceived stress was associated with lower caregiver preparedness, higher caregiver depressive symptoms, and lower patient quality of life. Emotion-focused coping strategies were common for caregivers. Future work should better prepare caregivers for this role and support them through the caregiving experience.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02344576.
Cardiac Hypertrophy Is Associated With Advanced Brain Aging in the General Population
Authors: Frenzel Stefan , Wittfeld Katharina , Bülow Robin , Völzke Henry , Friedrich Nele , Habes Mohamad , Felix Stephan B. , Dörr Marcus , Grabe Hans J. , Bahls Martin 
Published: September 2021

Background
Hypertrophy of the left ventricle (LV) has recently been associated with adverse changes of brain structure in older adults, notably increased burden of white matter hyperintensities (WMHs). Whether greater LV size or mass is also related to WMH burden in middle‐aged adults is currently unclear. In addition, its relation with alterations in cortical thickness (CT) has not been studied to date.

Methods and Results
Data from 1602 participants of the population‐based SHIP (Study of Health in Pomerania) with LV ejection fraction >40% and no history of myocardial infarction were included (aged 21–82 years; median age, 49 years; 53% women). Participants underwent both echocardiography and magnetic resonance imaging of the head. Imaging markers of brain aging (ie, CT and WMH volume) were determined from magnetic resonance imaging scans. LV mass and diameter were associated with lower global CT and greater WMH volume, while adjusting for age, sex, body height, fat‐free body mass, and intracranial volume. Moreover, thicknesses of the interventricular septum and posterior wall were also associated with lower global CT. These associations could not be explained by cardiovascular risk factors (including hypertension), inflammatory markers, or sociodemographic factors. Regional analyses showed distinct spatial patterns of lower CT in association with LV diameter and posterior wall thickness.

Conclusions
LV diameter and mass are associated with lower global and regional CT as well as greater WMH burden in the general population. These findings highlight the brain structural underpinnings of the associations of LV hypertrophy with cognitive decline and dementia.
Forced Self-Reliance: The Kamakura Bakufu Defense against the Mongol Invasion of Japan
Authors: Choi Lyong , Yi Sang Hun 
Published: September 2021

Abstract
When faced with the threat of invasion by the Mongol Empire and Goreyo, its vassal state, Kamakura Japan could have followed a diplomatic course with the Mongols or formed an alliance with anti-Mongol forces on the continent. Authorities in Japan, however, rejected both options, choosing instead to fight the Mongols alone on their own soil. International-relations models fail adequately to explain Kamakura Japan’s preference for self-reliance. By contrast, Asuka Japan, when faced with a similar invasion from Tang–Silla forces in an earlier era, opted to form an alliance with Baekjae, which culminated in a battle on the continent. Despite the copious scholarly treatment of the Mongol invasion, an important question about the Mongol–Japan War remains unanswered: How and why did Kamakura Japan’s governmental structure incline it to choose defensive self-reliance rather than diplomacy or military alliance?
Favorable Early Outcomes With Thyroid Lobectomy for Low-Risk Papillary Thyroid Cancer: The Mayo Clinic Experience
Authors: Merten Michele M. , Foster Trenton , Lyden Melanie , Henry Michael , Regina Castro M. 
Published: September 2021

Background Until 2015, standard of care for low-risk papillary thyroid cancer (PTC) >1 cm was a total or near-total thyroidectomy. Despite changes in guidelines and surgical management of low-risk PTC since 2015, little data are available regarding the effect on the need for additional surgery or risk for development of lymph node metastases. Our aim was to determine outcomes in patients who underwent initial thyroid lobectomy for low-risk PTC at a high-volume tertiary care institution. Methods Retrospective review of patients ≥18 years old with biopsy proven low-risk PTC 1-4 cm who underwent partial thyroidectomy (eg, lobectomy/isthmusectomy) at Mayo Clinic, Rochester, MN, between March 2016 and June 30, 2019. Results From 1481 thyroidectomies performed during study period, 940 contained PTC on final pathology. Of these, 87 (of 123) patients who had an initial thyroid lobectomy met inclusion criteria. Five (6%) of these patients proceeded to completion thyroidectomy (CT), with 3 requiring CT and radioactive iodine in the first postoperative year and 2 undergoing only CT in the second postoperative year. No postoperative complications were reported. No patient in this cohort required additional surgery or treatment for newly discovered lymph node metastases during the follow-up period. 43 (of 72, 60%) patients not on thyroxine therapy preoperatively were started on thyroxine therapy postoperatively. Conclusions Early outcomes for those undergoing thyroid lobectomy for low-risk PTC at our institution have been favorable. These results support the 2015 American Thyroid Association guidelines to offer lobectomy for those with low-risk PTC 1-4 cm.
Characterizing Medicare Reimbursements and Clinical Activity Among Female Otolaryngologists
Authors: Panth Neelima , Torabi Sina J. , Kasle David A. , Savoca Emily L. , Zogg Cheryl K. , O’Brien Erin K. , Manes R. Peter 
Published: September 2021

Objective: To evaluate geographic and temporal trends in Medicare fee-for-service (FFS) billing and reimbursements across female otolaryngologists (ORL). Methods: We performed a cross-sectional, retrospective analysis of the 2017 Medicare Physician and Other Suppliers Aggregate File. We analyzed differences in the number of services, patients, reimbursements, unique Current Procedural Terminology (CPT) codes used, and services billed per patient among female ORLs. Results: Female ORLs accounted for 15.2% of the 8453 Medicare-reimbursed ORLs. Female ORLs who graduated between 2000 and 2010 were reimbursed a median of $58 031.9 (IQR: $32 286.5-$91 512.2) and performed a median of 702 (IQR: 359.5-1221.5) services, significantly less than those who graduated between 1990 and 1999 (median: $67 508.9; IQR: 37 018.0-110 471.5; P < .001; median: 1055.5; IQR: 497.3-1944; P < .001). Female ORLs who graduated between 2000 and 2010 saw a median of 232 patients (IQR: 130.5-368), significantly less than those who graduated between 1990 and 1999 (median: 308; IQR: 168.3-496; P < .001) patients, significantly more than those. Female ORLs in urban settings performed a median of 795 (IQR: 364-1494.3) services and billed for a median of 42 (IQR: 28-58) unique codes, significantly fewer than their counterparts in rural settings (median: 1096; IQR: 600-2192.5; P = .002; median: 54; IQR: 31.5-64.5; P = .001). Conclusions: Medicare reimbursements and billing patterns across female ORLs varied by graduation decade and geography. Female ORLs further along in their careers may be reimbursed more with greater clinical volume and productivity. Those practicing in urban settings may have practices with decreased procedural diversity and lower clinical volume compared to their counterparts in rural areas.
Sport and Recreational Causes of Nasal Bone Fractures
Authors: Xiao Christopher C. , Kshirsagar Rijul S. , Hoerter Jacob E. , Rivero Alexander 
Published: September 2021

Objective: Nasal bone fractures are the most common facial bone fractures. However, there is limited literature on the etiology of these fractures, particularly distribution across sports and other recreational activities. Methods: The Nationwide Electronic Injury Surveillance System (NEISS) national injury database was queried for emergency department visits involving the diagnosis of nasal or nose fractures associated with sports and recreation activities over the most recent 10 year span available. Demographic, disposition, and weighted incidence were analyzed. Results: Total incidence of nasal fractures across 10 years was 158 979. The mean age of nasal bone fractures was 20.4 years old. Nasal fractures were more common in males (74.6%) and white patients (54.1%). National estimated incidence of nasal fractures decreased from 21 028 in 2009 to 11 108 in 2018, a reduction of 47.2%. The most common causes among all patients were basketball (23.2%), baseball (17.1%), softball (9.8%), soccer (7.4%), and football (7%). In pediatric patients, the most common cause was baseball (25.1%). The majority (98.1%) of patients were discharged from the emergency department, while 0.9% of patients were admitted. Conclusion: The most common recreational causes of nasal fractures are sports, with the most common being non-contact sports like basketball and baseball. However, the incidence of nasal bone fractures due to recreational causes nationwide has decreased significantly over the past 10 years. This may reflect improved safety protocols among athletes.
Analyzing the Drivers of Household Dietary Diversity: Evidence from Burkina Faso
Authors: Bandyopadhyay Arkadeep , Haile Beliyou , Azzarri Carlo , Somé Jérôme 
Published: September 2021

Background: The diets of millions of poor individuals lack adequate amount of essential nutrients. Objective: To examine the determinants of household dietary diversity in Burkina Faso and assess whether the choice of a diversity metric matters. Methods: Using survey data from 2014, we construct 3 metrics—Household Dietary Diversity Score (HDDS), Berry Index (BI), and Healthy Food Diversity Index (HFDI). Unlike the oft-used HDDS, the BI captures the quantity distribution of food items while the HFDI captures all 3 aspects of a healthy diet—count, quantity distribution, and health value. We fit linear (for BI and HFDI) and Poisson (for HDDS) models controlling for several socioeconomic and climatic covariates. Results: Some parameter estimates are sensitive to the diversity metric with fewer significant covariates observed in the HFDI model. Overall, diets are more diverse for households in urban areas, with female or better educated heads, with higher asset-based wealth and with more diverse on-farm production, while remoteness reduces dietary diversity. Higher precipitation seems to reduce diversity, potentially driven by the spatial heterogeneity in precipitation and on-farm production diversity. Conclusions: The sensitivity of estimates to the metric used underscores potentially more complex interactions that determine the quantity distribution of food items consumed. Policies that enhance on-farm production diversity, market access, and women’s empowerment may help improve dietary diversity and subsequent nutritional benefits. Efforts should be made to compile health value data that are relevant to developing countries facing nutrition transition.
Costs of Implementing an Integrated Package of Maternal and Pediatric Interventions Including SQ-LNS in Rural Niger
Authors: Hiebert Lindsey , Phelan Kevin , Kinda Moumouni , Dan-Bouzoua Nafissa , Kyungu Maurice , Bounameaux Thomas , Sayadi Sani , Maidadji Oumarou , Hecht Robert 
Published: September 2021

Background: In January 2015, the Alliance for International Medical Action and Bien Être de la Femme et de l’Enfant au Niger launched the 1000 Days Program in Mirriah District, Niger, to provide an integrated package of maternal and pediatric preventive and curative interventions. A new component of the package was the provision of small-quantity lipid-based nutritional supplements (SQ-LNS) for children 6 to 23 months. Objective: The objective of this study was to estimate the costs associated with providing the 1000 days package. Methods: Activity-based costing was used to estimate the total costs of the 10 activities included in the 1000 days package and also the incremental costs of new interventions, those beyond the standard of care. Results: The total cost of the 1000 Days Program was US$2.31 million for 9000 mother–child pairs. The average cost per pair was US$257 or US$103 per year. Incremental costs for new interventions accounted for 56% of program costs. Small-quantity lipid-based nutritional supplement represented 30% of incremental costs. A combination of efficiency measures could lower program costs by 15%. Conclusions: This study is the first to estimate the costs of an integrated, preventative–curative package of maternal–child health interventions with SQ-LNS. Implementing the 1000 days package across Niger will be challenging with only the country’s domestic health resources. Efficiency measures and creative financing arrangements, including support from external partners, should be explored. The approach and results described can inform future resource mobilization, financing, and budgeting efforts to scale the 1000 days or similar programs.
Cross-Sectional Design: Link Between Parkinson’s Pain and Restless Leg Syndrome
Authors: Paul Dion A. , Qureshi Abdul Rehman , Jamal Muhammad K. , Rana Abdul Qayyum 
Published: September 2021

Objective: Prior research suggests that restless leg syndrome (RLS) is prevalent in Parkinson’s disease (PD) with insufficient evidence to support the relationship between RLS, PD, and pain. This study explored the relationship between pain in PD patients and its association with the prevalence and severity of RLS. Method: 127 PD patients were assessed for PD and RLS using the U.K. Brain bank Criteria and the Restless Leg Syndrome diagnostic criteria, respectively. These patients were also assessed for pain perception and interference using the Brief Pain Inventory. Results: The results demonstrated Parkinson’s disease patients who reported pain scored 23 more Restless Leg Syndrome prevalence points ( p < 0.05), and 8.5 counts higher for Restless Leg Syndrome severity ( p < 0.05) compared to the group of Parkinson’s disease patients denying pain. Discussion: The presence of pain in PD patients indicated a higher RLS prevalence and an increased RLS severity. This finding suggests patients suffering from pain interference may experience more severe RLS symptoms. This demonstrates an inextricable link and association between pain in PD patients and RLS. Further robust investigations are required to elucidate any potential causative links, which can inform more holistic treatment principles.
Effects of Shenfu injection on myocardial adenosine receptors in rats with myocardial ischemia-reperfusion postconditioning
Authors: Wang Jie , Wang Xiaohuan , Wan Weiping , Guo Yuanying , Cui Yanfang , Liu Wenbo , Guo Fangming 
Published: September 2021

Objective Shenfu injection (SFI) has been reported to have a protection against myocardial ischemia-reperfusion (MI/R) injury. However, the changes of adenosine receptors in MI/R postconditioning when pretreated with SFI are unclear. Methods Forty-five rats were randomly divided into sham group (sham), MI/R postconditioning group (MI/R-post), low-dose SFI group (1 mL/kg), middle-dose SFI group (2.5 mL/kg), and high-dose SFI group (5 mL/kg). In SFI groups, SFI was intravenously injected before reperfusion, and rats were treated with ischemic postconditioning after ischemia for 30 min. After 24 h of reperfusion, the levels of Ca2+ and cAMP in blood platelets were analyzed. Myocardial infarct volume and myocardial pathology were observed. The levels of adenosine receptor subtypes A1, A2b, and A3 in myocardium were analyzed using immunohistochemistry and Western blot. The oxidative stress–related indicators were also observed. Results Compared with the MI/R-post group, SFI ameliorated the MI/R injury by decreasing the myocardial infarct area, oxidative stress, and concentration of Ca2+ and cAMP ( p < 0.01). Pretreatment with SFI enhanced the expression of adenosine receptors A1 and A2b in a dose manner compared with the MI/R-post group. In contrast, the levels of adenosine receptor A3 were increased after MI/R postconditioning compared with the sham group, and its expression continued to increase with the increase of SFI. Furthermore, the oxidative stress reduced with the concentrations of SFI. Conclusion These results demonstrated that pretreatment with SFI might regulate the expression of adenosine receptors to improve the MI/R postconditioning.
Are autoimmune diseases autoinflammatory: Is it time to change the paradigm?
Authors: Albert Daniel 
Published: September 2021

The paradigm that autoimmune diseases are abberations in the adaptive immune system is over 50 years old, but recent data suggest a multitude of abnormalities in the innate immune system in lupus and other autoimmune diseases. This viewpoint elaborates the reasons that I think it is time to reexamine this paradigm and shift our research focus to the innate immune system in lupus and other prototypic autoimmune diseases.
Vector-Borne Diseases and Associated Factors in the Rural Communities of Northwest Ethiopia: A Community-Based Cross-Sectional Study
Authors: Nigusie Adane , Gizaw Zemichael , Gebrehiwot Mulat , Destaw Bikes 
Published: September 2021

Background: Human illnesses caused by parasites, viruses, and bacteria that are transmitted by vectors are called vector-borne diseases. Vector-borne diseases usually affect the poorest populations, particularly where there is a lack of access to adequate housing, safe drinking water, and sanitation. This community-based cross-sectional study was, conducted to assess the prevalence of self-reported vector-borne diseases and associated factors in the rural communities of northwest Ethiopia. Methods: A community-based cross-sectional study design with structured observation was conducted among 1191 randomly selected rural households in northwest Ethiopia from April to June 2017. Data were collected by using a structured questionnaire; and observation checklist. Multivariable binary logistic regression analysis was used to identify variables associated with the prevalence of self-reported vector-borne diseases on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P-values <.05. Results: In the current study, 216 (18.1%) of the rural households reported one or more vector-borne diseases. Scabies (9.5%) were the most reported vector-borne disease followed by Malaria (6.9%). The prevalence of self-reported vector-borne diseases was statistically associated with the head of the family (mother) (AOR = 0.13, 95% CI = 0.02-0.72), regular cleaning of the living environment (AOR = 0.51, 95% CI = 0.36-0.74), poor cleanness of the living rooms (AOR = 1.77, 95% CI = 1.03-3.03), and moderate cleanness of the floor (AOR = 1.64, 95% CI = 1.06-2.52). Conclusion: The prevalence of self-reported vector-borne diseases was high in the rural communities of northwest Ethiopia. The low prevalence was associated with family head; regular cleaning of living environment and cleanness of the floor. Designing and strengthening an intervention strategy for environmental sanitation, regular cleaning of living house, and keeping personal hygiene shall be considered.