bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States– and Foreign‐Born Adults in the National Health Interview Survey
Authors: Mannoh Ivy , Turkson‐Ocran Ruth‐Alma , Mensah Jasmine , Mensah Danielle , Yi Stella S. , Michos Erin D. , Commodore‐Mensah Yvonne 
Published: November 2021

Background
Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality.

Methods and Results
We analyzed cross‐sectional data from the 2014 and 2017 National Health Interview Surveys on US‐ and foreign‐born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing “call 9‐1‐1” as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US‐born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign‐born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017.

Conclusions
These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.
Prediction of Lifetime Risk of Cardiovascular Disease Deaths Stratified by Sex in the Japanese Population
Authors: Imai Yukiko , Mizuno Tanaka Sachiko , Satoh Michihiro , Hirata Takumi , Murakami Yoshitaka , Miura Katsuyuki , Waki Takashi , Hirata Aya , Sairenchi Toshimi , Irie Fujiko , Sata Mizuki , Ninomiya Toshiharu , Ohkubo Takayoshi , Ishikawa Shizukiyo , Miyamoto Yoshihiro , Ohnishi Hirofumi , Saitoh Shigeyuki , Tamakoshi Akiko , Yamada Michiko , Kiyama Masahiko , Iso Hiroyasu , Sakata Kiyomi , Nakagawa Hideaki , Okayama Akira , Ueshima Hirotsugu , Okamura Tomonori , Imai Yutaka , Kitamura Akihiko , Kiyohara Yutaka , Harada Akiko , Sakurai Masaru , Nakayama Takeo , Tsuji Ichiro , Kokubo Yoshihiro , Yatsuya Hiroshi , Okamura Tomonori 
Published: November 2021

Background
Lifetime risk is an informative estimate for driving lifestyle and behavioral changes especially for young adults. The impact of composite risk factors for cardiovascular disease on lifetime risk stratified by sex has not been investigated in the Japanese population, which has a much lower mortality of coronary heart disease compared with the Western population. We aimed to estimate lifetime risk of death from cardiovascular disease attributable to traditional risk factors.

Methods and Results
We analyzed pooled individual data from the Evidence for Cardiovascular Prevention from Observational Cohorts in a Japanese cohort study. A modified Kaplan–Meier approach was used to estimate the remaining lifetime risk of cardiovascular death. In total, 41 002 Japanese men and women with 537 126 person‐years of follow‐up were included. The lifetime risk at the index‐age of 45 years for those with optimal risk factors (total cholesterol <4.65 mmol/L, systolic blood pressure <120 mm Hg, diastolic blood pressure <80 mm Hg, absence of diabetes, and absence of smoking habit) was lower compared with the highest risk profile of ≥2 risk factors (6.8% [95% CI, 0%–11.9%] versus 19.4% [16.7%–21.4%] for men and 6.9% [1.2%–11.5%] versus 15.4% [12.6%–18.1%] for women).

Conclusions
The magnitude and the number of risk factors were progressively associated with increased lifetime risk even in individuals in early adulthood who tend to have low short‐term risk. The degree of established cardiovascular risk factors can be converted into lifetime risk. Our findings may be useful for risk communication in the early detection of future cardiovascular disease risk.
Sex‐, Race‐ and Ethnicity‐Based Differences in Thromboembolic Events Among Adults Hospitalized With COVID‐19
Authors: Ilyas Sadia , Henkin Stanislav , Martinez‐Camblor Pablo , Suckow Bjoern D. , Beach Jocelyn M. , Stone David H. , Goodney Philip P. , Ebinger Joseph E. , Creager Mark A. , Columbo Jesse A. 
Published: November 2021

Background
Patients hospitalized with COVID‐19 have an increased risk of thromboembolic events. Whether sex, race or ethnicity impacts these events is unknown. We studied the association between sex, race, and ethnicity and venous and arterial thromboembolic events among adults hospitalized with COVID‐19.

Methods and Results

We used the American Heart Association Cardiovascular Disease COVID‐19 registry. Primary exposures were sex and race and ethnicity, as defined by the registry. Primary outcomes were venous thromboembolic events and arterial thromboembolic events. We used logistic regression for risk adjustment. We studied 21 528 adults hospitalized with COVID‐19 across 107 centers (54.1% men; 38.1% non‐Hispanic White, 25.4% Hispanic, 25.7% non‐Hispanic Black, 0.5% Native American, 4.0% Asian, 0.4% Pacific Islander, and 5.9% other race and ethnicity). The rate of venous thromboembolic events was 3.7% and was more common in men (4.2%) than women (3.2%;
P
<0.001), and in non‐Hispanic Black patients (4.9%) than other races and ethnicities (range, 1.3%–3.8%;
P
<0.001). The rate of arterial thromboembolic events was 3.9% and was more common in men (4.3%) than women (3.5%;
P
=0.002), and in non‐Hispanic Black patients (5.0%) than other races and ethnicities (range, 2.3%–4.7%;
P
<0.001). Compared with men, women were less likely to experience venous thromboembolic events (adjusted odds ratio [OR], 0.71; 95% CI, 0.61–0.83) and arterial thromboembolic events (adjusted OR, 0.76; 95% CI, 0.66–0.89). Compared with non‐Hispanic White patients, non‐Hispanic Black patients had the highest likelihood of venous thromboembolic events (adjusted OR, 1.27; 95% CI, 1.04–1.54) and arterial thromboembolic events (adjusted OR, 1.35; 95% CI, 1.11–1.65).

Conclusions
Men and non‐Hispanic Black adults hospitalized with COVID‐19 are more likely to have venous and arterial thromboembolic events. These subgroups may represent at‐risk patients more susceptible to thromboembolic COVID‐19 complications.
Effect of Moderate and Severe Persistent Hyperglycemia on Outcomes in Patients With Intracerebral Hemorrhage
Authors: Qureshi Adnan I. , Huang Wei , Lobanova Iryna , Chandrasekaran Premkumar N. , Hanley Daniel F. , Hsu Chung Y. , Martin Renee H. , Steiner Thorsten , Suarez Jose I. , Yamamoto Haruko , Toyoda Kazunori 
Published: November 2021

Background:
We evaluated the effect of persistent hyperglycemia on outcomes in 1000 patients with intracerebral hemorrhage enrolled within 4.5 hours of symptom onset.

Methods:
We defined moderate and severe hyperglycemia based on serum glucose levels ≥140 mg/dL—<180 and ≥180 mg/dL, respectively, measured at baseline, 24, 48, and 72 hours. Persistent hyperglycemia was defined by 2 consecutive (24 hours apart) serum glucose levels. We evaluated the relationship between moderate and severe hyperglycemia and death or disability (defined by modified Rankin Scale score of 4–6) at 90 days in the overall cohort and in groups defined by preexisting diabetes.

Results:

In the multivariate analysis, both moderate (odds ratio, 1.8 [95% CI, 1.1–2.8]) and severe (odds ratio, 1.8 [95% CI, 1.2–2.7]) hyperglycemia were associated with higher 90-day death or disability after adjusting for Glasgow Coma Scale score, hematoma volume, presence or absence of intraventricular hemorrhage, hyperlipidemia, cigarette smoking, and hypertension (no interaction between hyperglycemia and preexisting diabetes,
P
=0.996). Among the patients without preexisting diabetes, both moderate (odds ratio, 1.8 [95% CI, 1.0–3.2]) and severe (odds ratio, 2.0 [95% CI, 1.1–3.7]) hyperglycemia were associated with 90-day death or disability after adjusting for above mentioned potential confounders. Among the patients with preexisting diabetes, moderate and severe hyperglycemia were not associated with 90-day death or disability.

Conclusions:
Persistent hyperglycemia, either moderate or severe, increased the risk of death or disability in nondiabetic patients with intracerebral hemorrhage.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01176565.
The Resource Costs of Maintaining Learner Utilization of a Simulation Center During the COVID-19 Pandemic
Authors: Mitsakos Anastasios T. , Xanthoudakis Eftechios , Irish William , Robey Walter C. , Gilbird Rebecca M. , Cringan Jessica , Haisch Carl E. 
Published: December 2021

Background Despite advances in online education during the COVID-19 pandemic, its impact on surgical simulation remains unclear. The aim of this study was to compare the costs and resources required to maintain simulation training in the pandemic and to evaluate how it affected exposure of medical students to simulation during their surgical clerkship. Methods The number of learners, contact hours, staff hours, and costs were collected from a multi-departmental simulation center of a single academic institution in a retrospective fashion. Utilization and expenditure metrics were compared between the first quarter of academic years 2018-2020. Statistical analysis was performed to evaluate potential differences between overall resource utilization before and during the pandemic, and subgroup analysis was performed for the resources required for the training of the third-year medical students. Results The overall number of learners and contact hours decreased during the first quarter of the academic year 2020 in comparison with 2019 and 2018. However, the staff hours increased. In addition, the costs for PPE increased for the same periods of time. In the subgroup analysis of the third-year medical students, there was an increase in the number of learners, as well as in the staff hours and in the space required to perform the simulation training. Discussion Despite an increase in costs and resources spent on surgical simulation during the pandemic, the utilization by academic entities has remained unaffected. Further studies are required to identify potential solutions to lower simulation resources without a negative impact on the quality of surgical simulation.
Availability and Utilization of the WHO-Recommended Lifesaving Medicines for Under-Five Children at University of Gondar Comprehensive Specialized Hospital, Amhara Region, Ethiopia
Authors: Woldeyohanins Alem Endeshaw , Kasahun Asmamaw Emagn , Demeke Chilot Abiyu , Kifle Zemene Demelash 
Published: November 2021

According to the World Health Organization report, 5.4 million under-five children died, which is similar to under-five mortality rate of 39 deaths per 1000 live births. This rate is higher in sub-Saharan Africa with 76 deaths per 1000 live births. More than 1 out of every 2 deaths is because of diseases that can be managed with drug of low-cost and high quality. Institutional-based cross-sectional survey was conducted from January to February 2021, at the University of Gondar Comprehensive Specialized Hospital. Statistical Package for the Social Sciences software version 24 was used for data analysis. The results were presented using Figures, tables, and texts according to the nature of the data. The overall average availability of priority medicines was 75% on the day of visit and the average stock-out duration in the last 6 months was 23.85 days. Availability and utilization of priority medicines for the management of antiretroviral infections, Vitamin A deficiency, malaria, and diarrheal cases were high, whereas availability and utilization of suggested medication for neonatal sepsis were very low. A significant proportion of priority diseases was managed by non-priority medications. Medicines supply sources of the country, ministry of health, policymakers as well as facility managers should work in collaboration toward ensuring sustainable and consistent availability of priority medicines through the country. Continues in-service training of healthcare professionals is also mandatory to update themselves with newly developed guidelines, standards, and recommendations.
Hazards and Management of Wire Bristle ingestions: A Systematic Review
Authors: Miller Nathaniel , Noller Michael , Leon Matthew , Moreh Yonatan , Watson Nora L. , Costello Justin , Hong Steven 
Published: November 2021

ObjectiveInadvertently ingested grill brush bristles can lodge in various locations and lead to a variety of injuries. They can also be difficult to identify and remove. Our primary objective was to perform a systematic review of cases reported in the literature, with analysis of trends in clinical presentation and success of diagnostic modalities and treatment approaches.Data SourcesCases of reported grill brush bristle ingestion reported in PubMed, PubMed Central, and Google Scholar databases through April 30, 2021.Review MethodsDatabases were searched for the following terms: (“ingestion” OR “injury” OR “barbeque” OR “BBQ” OR “grill” OR “foreign body” OR “brush” AND “wire” OR “bristle”). Data were collected on patient demographics, clinical presentation, and treatment course. Statistical analysis was performed on characteristics with low risk of confounding.ResultsAn overall 57 studies involving 91 patients were included. Grill brush bristles presented most commonly in the upper aerodigestive tract (48/91), followed by the abdomen (26/91) and deep neck (17/91). Computed tomography was the most accurate imaging modality for initial diagnosis, identifying 92.8% of bristles. Less invasive or adjunctive techniques such as endoscopy, intraoperative imaging, or minimally invasive surgery may be useful particularly for bristles located in the head and neck given the low rate of success of transoral surgery (66.7%).ConclusionAlthough this review of retained bristle may be biased toward complex cases, retained grill brush bristles represent an underrecognized and difficult‐to‐manage hazard. When cases are suspected, clinicians should obtain computed tomography imaging based on presentation and tailor management appropriately.
Explanatory Models of Depression in a Rural Community of Coastal Karnataka, India: A Cross-Sectional Survey
Authors: Hegde Sameeksha , Karkal Ravichandra 
Published: December 2021

Background: Depression is a major public health problem but there is a huge treatment gap in India. Cultural beliefs influence conception of illness, personal meaning, help-seeking behaviors, and adherence to treatment. Research on explanatory models of depression attempt to explore these unique characteristics in an individual and the community. We set out to examine explanatory models of depression in a rural community of coastal Karnataka and explore the association between sociodemographic variables and explanatory models of depression. Methods: A cross-sectional household survey in the rural community of Harekala village, Mangaluru taluk, Dakshina Kannada district, Karnataka, was done using Kish tables. A total of 200 individuals were interviewed with an adaptation of the Short Explanatory Model Interview in a local language using a case vignette of depression. Results: Around 40% of the individuals perceived the problem as tension/stress/excessive worrying and did not perceive it as mental illness. A scant 10% of the participants recognized some mental illness. Around one-fifth of the individuals attributed the problem to evil spirits and black magic; female participants were more likely to endorse consulting a doctor (P = 0.003**) or a psychiatrist (P = 0.012*). In addition, participants belonging to Islam were less likely to consult a doctor (P = 0.028*) and psychiatrist (P = 0.021*). Also, participants belonging to lower social class were less likely to endorse psychiatric consultation (P = 0.018*) Conclusions: A vast majority of the study subjects failed to identify depression as an illness or acknowledge biomedical causation. Gender, religion, and socioeconomic class may influence help-seeking behavior.
Association between obesity and the aggravation of limited range of ankle mobility in chronic venous disease
Authors: Belczak Sergio Q , Neves Ramos Rubiana , Pereira de Godoy Jose Maria 
Published: November 2021

Aim The aim of the present study was to show that an increase in weight leads to the aggravation of limited joint mobility. Method One hundred sixteen patients with varicose veins of the lower limbs and body mass index (BMI) higher than 30 kg/m2 were evaluated at the Belczak Clinic in Maringá, Brazil. All patients were evaluated by the same physician, and the goniometric readings were performed on all patients by a physiotherapist. The participants were then divided into three groups based on BMI: Group I—BMI between 30 and 40. Group II—BMI between 40 and 50, and Group III—BMI > 50. Results There is a significant difference between the groups detected. Conclusion The present findings show that an increased BMI in obese individuals with chronic venous disease is associated with a progressive limitation of ankle mobility.
A pilot study of the association between leukoaraiosis and cerebral atherosclerosis using synthetic magnetic resonance imaging
Authors: Yang Jingdong , Song Yan , Huang Juan , Qu Jianxun , Jiao Sheng , Wu Puyeh , Chen Min 
Published: December 2021

Background Leukoaraiosis is a type of lesion characterized by tissue rarefaction or myelin pallor resulting from axons loss and gliosis. Synthetic magnetic resonance imaging (MRI) could yield quantitative T1, T2, proton density (PD) values of leukoaraiosis in addition to information on the volume of the lesion. Purpose To investigate the feasibility of quantifying leukoaraiosis using synthetic MRI and to explore the association between leukoaraiosis and cerebral small vascular diseases and cerebral atherosclerosis. Material and Methods Patients with acute ischemic stroke were enrolled in this study. All participants underwent a conventional T2-weighted image, brain volume, CUBE fluid attenuated inversion recovery, and synthetic MRI acquisition using a 3.0-T MR system. A time-of-flight magnetic resonance angiography was also obtained. We evaluated the T1, T2, PD values and leukoaraiosis volume. Results Analysis of the leukoaraiosis volume ratios demonstrated a positive association with T2 values, a negative association with T1 values, and no association with PD values. Leukoaraiosis volume ratios were independently correlated with age ( P < 0.001), lacunes ( P = 0.022), and cerebral microbleeds ( P = 0.010). A statistical association was found between both age ( P < 0.001) and lacunes ( P = 0.047) and leukoaraiosis T2 values. Conclusion Synthetic MRI may enhance the evaluation of leukoaraiosis, in addition to providing information on its volume. Leukoaraiosis may represent a type of cerebral small vascular disease rather than cerebral atherosclerosis and may share the same pathological mechanism as lacunes and cerebral microbleeds.
Mutation analysis of a 10-gene panel for colorectal cancer in Huizhou, Guangdong Province of China
Authors: Li Jun , Sun Aihua , Zhong Guofang , He Ying , Xiong Hailin , Yuan Xia 
Published: December 2021

Objective This study aimed to investigate the type and frequency of mutations in 10 genes in 85 colorectal cancer (CRC) patients in Huizhou and the guiding significance of targeted drug use. Methods The 10-gene panel next-generation sequencing (NGS) was used to assess genetic variants in 85 CRC patients from the Huizhou area combined with clinical information for a comprehensive analysis. Results Upon initial mutation testing, 68% (58/85) were positive. The mutation frequencies of these genes, including KRAS, PIK3CA, NRAS, ERBB2, BRAF, EGFR, and PDGFRA, were 51%, 20%, 5%, 4%, 4%, 1%, and 1%, respectively. Overall, 29 mutation types were detected from seven genes. More mutations were detected in more advanced cancers. There were three samples with multiple mutations of a single gene, including KRAS (n = 2) and ERBB2 (n = 2), 12 samples with multiple mutations of double genes, including KRAS/PIK3CA (n = 10), BRAF/PIK3CA (n = 1), and NRAS/PIK3CA (n = 1), and one sample with multiple mutations of three genes, including ERBB2/KRAS/PIK3CA (n = 1). Theoretically, 27 patients could receive targeted treatment. During the actual treatment, 10 patients received bevacizumab, cetuximab, or fruquintinib with no progression ranging from 12 to 24 months. Conclusion Gene mutations detected by a 10-gene panel were useful for targeting therapy of CRC in Huizhou.
Near-Fatal Self-Harm Among Canadian Adolescents
Authors: Mitchell Rachel HB , Ani Cornelius , Cyr Claude , Irvine James , Joffe Ari R , Skinner Robin , Wong Sam , Stang Antonia S , Laffin Melanie , Korczak Daphne J 
Published: November 2021

Objective To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm. Methods 2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the Canadian Paediatric Surveillance Program to ascertain data from eligible cases. Results Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ2 = 7.8 (1), p = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ2 = 3.9 (1), p = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ2 = 4.1 (1), p = .06), a previous suicide attempt (55.9% vs. 29.4%, χ2 = 3.8 (1), p = .05), and prior use of mental health service (69.7% vs. 27.8%, χ2 = 10.4 (1), p = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm. Conclusions Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.