bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies
Authors: Iso Hiroyasu , Cui Renzhe , Takamoto Iseki , Kiyama Masahiko , Saito Isao , Okamura Tomonori , Miyamoto Yoshihiro , Higashiyama Aya , Kiyohara Yutaka , Ninomiya Toshiharu , Yamada Michiko , Nakagawa Hideaki , Sakurai Masaru , Shimabukuro Michio , Higa Moritake , Shimamoto Kazuaki , Saito Shigeyuki , Daimon Makoto , Kayama Takamasa , Noda Mitsuhiko , Ito Sadayoshi , Yokote Koutaro , Ito Chikako , Nakao Kazuwa , Yamauchi Toshimasa , Kadowaki Takashi 
Published: November 2021

Background
It is uncertain whether risk classification under the nationwide program on screening and lifestyle modification for metabolic syndrome captures well high‐risk individuals who could benefit from lifestyle interventions. We examined the validity of risk classification by linking the incidence of cardiovascular disease (CVD).

Methods and Results
Individual‐level data of 29 288 Japanese individuals aged 40 to 74 years without a history of CVD from 10 prospective cohort studies were used. Metabolic syndrome was defined as the presence of high abdominal obesity and/or overweight plus risk factors such as high blood pressure, high triglyceride or low high‐density lipoprotein cholesterol levels, and high blood glucose levels. The risk categories for lifestyle intervention were information supply only, motivation‐support intervention, and intensive support intervention. Sex‐ and age‐specific hazard ratios and population attributable fractions of CVD, which were also further adjusted to consider non–high density lipoprotein cholesterol levels, were estimated with reference to nonobese/overweight individuals, using Cox proportional hazard regression. Since the reference category included those with risk factors, we set a supernormal group (nonobese/overweight with no risk factor) as another reference. We documented 1023 incident CVD cases (565 men and 458 women). The adjusted CVD risk was 60% to 70% higher in men and women aged 40 to 64 years receiving an intensive support intervention, and 30% higher in women aged 65 to 74 years receiving a motivation‐support intervention, compared with nonobese/overweight individuals. The population attributable fractions in men and women aged 40 to 64 years receiving an intensive support intervention were 17.7% and 6.6%, respectively, while that in women aged 65 to 74 years receiving a motivation‐support intervention was 9.4%. Compared with the supernormal group, nonobese/overweight individuals with risk factors had similar hazard ratios and population attributable fractions as individuals with metabolic syndrome.

Conclusions
Similar CVD excess and attributable risks among individuals with metabolic syndrome components in the absence and presence of obesity/overweight imply the need for lifestyle modification in both high‐risk groups.
Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis
Authors: Yu Shandong , Zhang Heping , Li Hongwei 
Published: November 2021

Background
Transesophageal echocardiography (TEE) has been considered the gold standard for left atrial appendage (LAA) thrombus detection. Nevertheless, TEE may sometimes induce discomfort and cause complications. Cardiac computed tomography has been studied extensively for LAA thrombus detection. We performed this systemic review and meta‐analysis to assess the diagnostic accuracy of cardiac computed tomography for LAA thrombus detection compared with TEE.

Methods and Results

A systemic search was conducted in the PubMed, Embase, and Cochrane Library databases from January 1977 to February 2021. Studies performed for assessment diagnostic accuracy of cardiac computed tomography on LAA thrombus compared with TEE were included. Summary sensitivity, specificity, and posterior probability of LAA thrombus was calculated by using bivariate random‐effects model. The Quality Assessment of Diagnostic Accuracy Studies‐2 tool was used for the quality assessment. A total of 27 studies involving 6960 patients were included in our study. The summary sensitivity of early imaging studies was 0.95 (95% CI, 0.79–0.99), and the specificity was 0.89 (95% CI, 0.85–0.92). The positive posterior probability was 19.11%, and the negative posterior probability was 0.16%. The summary sensitivity of delayed imaging studies was 0.98 (95% CI, 0.92–1.00), and the specificity was 1.00 (95% CI, 0.98–1.00). The positive posterior probability was 95.76%, and the negative posterior probability was 0.12%. The delayed imaging method significantly improved the specificity (1.00 versus 0.89;
P
<0.05) and positive posterior probability (95.76% versus 19.11%;
P
<0.05).

Conclusions
Cardiac computed tomography with a delayed imaging is a reliable alternative to TEE. It may save the patient and health care from an excess TEE.

Registration

URL:
https://www.crd.york.ac.uk/PROSPERO
; Unique identifier: CRD42021236352.
Variations of body mass and thermogenesis properties in Eothenomys olitor during cold acclimatization
Authors: Yang Ya-zuo , Han Chun-yan , Jia Ting , Wang Zheng-kun , Zhu Wan-long , Zhang Hao 
Published: November 2021

Abstract
The set-point hypothesis states that there is a biological control method in mammals that actively regulates weight toward a predetermined set weight for each individual, which may occur by regulation of energy intake or energy expenditure. In order to investigate the effects of low temperature on body mass regulation in Eothenomys olitor, body mass, body fat mass, food intake, resting metabolic rate (RMR), non-shivering thermogenesis (NST), serum leptin levels, morphology, biochemical indexes of liver and brown adipose tissue (BAT) and hypothalamic neuropeptide genes expression were measured during cold acclimatization. The results showed that there was no significant difference in body mass, but food intake, RMR and NST increased during cold acclimatization. Cytochrome c oxidase (COX) and α-glycerophosphate oxidase (α-GPO) activities in liver and BAT were significantly enhanced during cold acclimatization, and triiodothyronine (T3) and thyroxine (T4) levels in serum were significantly higher than those in the control group. Serum leptin levels decreased after cold acclimatization. Low temperature significantly increased the expression of neuropeptide Y (NPY) and agouti-related peptide (AgRP), while it decreased cocaine- and amphetamine-regulated transcript peptide (CART) and pro-opiomelanocortin (POMC) expressions. All of the above results suggested that body mass in E. olitor can remain relatively stable at low temperature, which conforms to the ‘set-point hypothesis’. However, the species showed differences with sympatric species, such as E. miletus, Apodemus chevrieri and Tupaia belangeri. Moreover, E. olitor can cope with low temperature by increasing its metabolic rate and thermogenesis properties.
Cubans Mobilize Due to the Blockade and the Pandemic
Authors: Tamayo Manuel Salgado 
Published: November 2021

Abstract
The article analyzes the protests in Cuba in the context of the economic blockade and the health crisis as a consequence of the covid 19 pandemic. The current policy of the United States with President Joe Biden and the distances with the diplomacy of Barack Obama and the events after the more than two hundred measures adopted by Donald Trump, who adopted more than 240 additional measures to deepen the blockade. Additionally, the policy of the United States is detailed historically with Cuba and the milestones of the influence of the Cuban Revolution in Latin America are detailed.
Analysis of the Political Situation of the Protests: Cuba, between Disenchantment and Deprivation
Authors: Cahuasquí Cevallos Santiago 
Published: November 2021

Abstract
This article seeks to provide a brief reflection on the causes of the recent social protests in Cuba that took place in July 2021, addressing in a special way the deprivation of services and rights as the main trigger for satiety and claims. As in 1994 protests were marked by the “special period”, in 2021 protests were set by the covid-19 pandemic and the unilateral coercive sanctions of the United States with an impact on three fundamental areas: tourism, remits and fuel supply.
Optimal frequency of whole body vibration training for improving balance and physical performance in the older people with chronic stroke: A randomized controlled trial
Authors: Wei Ning , Cai Mengying 
Published: November 2021

Objective To explore the optimal frequency of whole-body vibration training for improving the balance and physical performance in older people with chronic stroke. Design a single-blind randomized controlled trial. Setting Two rehabilitation units in the Wuhan Brain Hospital in China. Participants A total of 78 seniors with chronic stroke. Interventions Low-frequency group (13 Hz), high-frequency group (26 Hz), and zero-frequency group (Standing on the vibration platform with 0 Hz) for 10 sessions of side-alternating WBV training. Main measures The timed-up-and-go test, five-repetition sit-to-stand test, 10-metre walking test, and Berg balance scale were assessed pre- and post-intervention. Results Significant time × group interaction effects in five-repetition sit-to-stand test (p = 0.014) and timed-up-and-go test at self-preferred speed (p = 0.028) were observed. The high-frequency group outperformed the zero-frequency group in both five-repetition sit-to-stand test (p = 0.039) and timed-up-and-go test at self-preferred speed (p = 0.024) after 10-sessions training. The low-frequency group displayed only a significant improvement in five-repetition sit-to-stand test after training (p = 0.028). No significant within- or between-group changes were observed in the Berg balance scale and walking speed (p > 0.05). No significant group-difference were found between low-frequency and high-frequency groups. No adverse events were reported during study. Conclusions Compared with 13 Hz, 26 Hz had no more benefits on balance and physical performance in older people with chronic stroke.
Demographic and Clinical Presentations of Youth using Enhanced Mental Health Services in Six Indigenous Communities from the ACCESS Open Minds Network
Authors: Boksa Patricia , Hutt-MacLeod Daphne , Clair Lacey , Brass Gregory , Bighead Shirley , MacKinnon Aileen , Etter Meghan , Gould Hayley , Sock Eva , Matoush Julie , Rabbitskin Norma , Ballantyne Clifford , Goose Annie , Rudderham Heather , Plourde Vickie , Gordon Maria , Gilbert Lorna , Ramsden Vivian R. , Noel Valerie , Malla Ashok , Iyer Srividya N. 
Published: November 2021

Objective In many Indigenous communities, youth mental health services are inadequate. Six Indigenous communities participating in the ACCESS Open Minds (AOM) network implemented strategies to transform their youth mental health services. This report documents the demographic and clinical presentations of youth accessing AOM services at these Indigenous sites. Methods Four First Nations and two Inuit communities contributed to this study. Youth presenting for mental health services responded to a customized sociodemographic questionnaire and presenting concerns checklist, and scales assessing distress, self-rated health and mental health, and suicidal thoughts and behaviors. Results Combined data from the First Nations sites indicated that youth across the range of 11–29 years accessed services. More girls/women than boys/men accessed services; 17% identified as LBGTQ+. Most (83%) youth indicated having access to at least one reliable adult and getting along well with the people living with them. Twenty-five percent of youth reported difficulty meeting basic expenses. Kessler (K10) distress scores indicated that half likely had a moderate mental health problem and a fourth had severe problems. Fifty-five percent of youth rated their mental health as fair or poor, while 50% reported suicidal thoughts in the last month. Anxiety, stress, depression and sleep issues were the most common presenting problems. Fifty-one percent of youth either accessed services themselves or were referred by family members. AOM was the first mental health service accessed that year for 68% of youth. Conclusions This report is the first to present a demographic and clinical portrait of youth presenting at mental health services in multiple Indigenous settings in Canada. It illustrates the acceptability and feasibility of transforming youth mental health services using core principles tailored to meet communities’ unique needs, resources, and cultures, and evaluating these using a common protocol. Data obtained can be valuable in evaluating services and guiding future service design. Trial registration name and number at Clinicaltrials.gov: ACCESS Open Minds/ACCESS Esprits ouverts, ISRCTN23349893
Suicidal Risk and Adverse Social Outcomes in Adulthood Associated with Child and Adolescent Mental Disorders
Authors: Chartier Mariette J. , Bolton James M. , Ekuma Okechukwu , Mota Natalie , Hensel Jennifer M. , Nie Yao , McDougall Chelsey 
Published: November 2021

Objective The life course of children and adolescents with mental disorders is an important area of investigation, yet it remains understudied. This study provides a first-ever comprehensive examination of the relationship between child and adolescent mental disorders and subsequent suicidal and adverse social outcomes in early adulthood using population-based data. Methods De-identified administrative databases were used to create a birth cohort of 60,838 residents of Manitoba born between April 1980 to March 1985 who were followed until March 2015. Unadjusted and adjusted hazard ratios (aHRs) and odds ratios (aORs) were calculated to determine associations between physician-diagnosed mental disorders in childhood or adolescence and a range of adverse early adulthood (ages 18 to 35) outcomes. Results Diagnoses of mood/anxiety disorders, attention-deficit hyperactivity disorder, substance use disorder, conduct disorder, psychotic disorder, personality disorders in childhood or adolescence were associated with having the same diagnoses in adulthood. These mental disorder diagnoses in childhood/adolescence were strongly associated with an increased risk of suicidal behaviors and adverse adult social outcomes in adulthood. Similarly, suicide attempts in adolescence conferred an increased risk in adulthood of suicide death (aHR: 3.6; 95% confidence interval [CI]: 1.9-6.9), suicide attempts (aHR: 6.2; CI: 5.0–7.6), social housing use (aHR: 1.7; CI 1.4–2.1), income assistance (aHR: 1.8; CI 1.6–2.1), criminal accusation (aHR: 2.2; CI 2.0–2.5), criminal victimization (aHR:2.5; CI 2.2–2.7), and not completing high school (aOR: 3.1; CI: 2.5–3.9). Conclusion Mental disorders diagnosed in childhood and adolescence are important risk factors not only for mental disorders in adulthood but also for a range of early adult adversity. These findings provide an evidence-based prognosis of children's long-term well-being and a rationale for ensuring timely access to mental health services. Better population-level mental health promotion and early intervention for children and adolescents with mental disorders are promising for improving future adult outcomes.
Potential added value of combined DPYD/DPD genotyping and phenotyping to prevent severe toxicity in patients with a DPYD variant and decreased dihydropyrimidine dehydrogenase enzyme activity
Authors: Ockeloen Charlotte W , Raaijmakers Aron , Hijmans-van der Vegt Manon , Bierau Jörgen , de Vos-Geelen Judith , Willemsen Annelieke ECAB , van den Bosch Bianca JC , Coenen Marieke JH 
Published: November 2021

Decreased dihydropyrimidine dehydrogenase enzyme activity is associated with severe fluoropyrimidine-associated toxicity. Four clinically relevant variants in the DPYD gene are associated with decreased dihydropyrimidine dehydrogenase activity. However, only ∼25% of DPYD variant carriers show a decreased dihydropyrimidine dehydrogenase activity in peripheral blood mononuclear cells. Objective To investigate if dihydropyrimidine dehydrogenase phenotyping has added value when combined with DPYD genotyping in predicting fluoropyrimidine-related toxicity. Methods Retrospective cohort study in which treatment and toxicity data were collected of 228 patients genotyped for four DPYD variants and phenotyped using an ex vivo peripheral blood mononuclear cell assay. Results Severe toxicity occurred in 25% of patients with a variant and normal dihydropyrimidine dehydrogenase activity, in 21% of patients without a variant and with decreased dihydropyrimidine dehydrogenase activity, and in 29% of patients without a variant and with normal dihydropyrimidine dehydrogenase activity (controls). The majority of patients with a variant or a decreased dihydropyrimidine dehydrogenase activity received an initial dose reduction (68% and 53% vs 19% in controls) and had a lower mean dose intensity (75% and 81% vs 91% in controls). Fifty percent of patients with a variant and decreased enzyme activity experienced severe toxicity, despite the lowest initial dose and whole treatment dose intensity. They also experienced more grade 4/5 toxicities. Conclusions Our results indicate that a combined genotype–phenotype approach could be useful to identify patients at increased risk for fluoropyrimidine-associated toxicity (e.g. patients with a variant and decreased dihydropyrimidine dehydrogenase activity). Because the group sizes are too small to demonstrate statistically significant differences, this warrants further research in a prospective study in a larger cohort.
Men’s Weight Loss Outcomes, Behaviors, and Perceptions in a Self-Directed Commercial Mobile Program: Retrospective Analysis
Authors: Behr Heather , Ho Annabell Suh , Yang Qiuchen , Mitchell Ellen Siobhan , DeLuca Laura , Greenstein Noa , Michaelides Andreas 
Published: November 2021

Background There is little understanding of men’s weight loss outcomes and behaviors in self-directed contexts, such as digital commercial mobile weight management programs. This is an especially pressing question given that men often express disinterest in weight management programs and it is unknown how that manifests in self-directed environments. Aims. Two studies fill this gap by retrospectively observing how men lose weight and engage in weight loss behaviors (Study 1) and their perceptions of improvements and gained knowledge (Study 2) when participating in the full length of a commercial mobile behavior change program called Noom. Method In Study 1, repeated-measures linear mixed modeling was used to examine whether weight loss was statistically significant from baseline to 16 weeks and how engagement behaviors predicted weight in a sample of 7,495 male Noom users. In Study 2, 971 male Noom users completed an exploratory survey on the impact of the behavior change education in the program. Results In Study 1, men who remained in the full length of the program lost statistically significant weight from baseline to 16 weeks. 63% achieved clinically meaningful (5% or more) weight loss. Engagement in weight loss behaviors on the program predicted the amount of weight lost. In Study 2, men reported learning most about practical application and psychological aspects relating to food and psychology. Discussion and Conclusion This is the first study to observe men’s weight loss outcomes, behaviors, and perceptions of what they learned in a self-directed behavior change program. Our findings have important implications for more effective health promotion for the many men who choose to self-direct their weight loss.
Ghost infarct core following endovascular reperfusion: A risk for computed tomography perfusion misguided selection in stroke
Authors: Rodrigues Gabriel M , Mohammaden Mahmoud H , Haussen Diogo C , Bouslama Mehdi , Ravindran Krishnan , Pisani Leonardo , Prater Adam , Frankel Michael R , Nogueira Raul G 
Published: November 2021

Background Computed tomography perfusion (CTP) has been increasingly used for patient selection in mechanical thrombectomy for stroke. However, previous studies suggested that CTP might overestimate the infarct size. The term ghost infarct core (GIC) has been used to describe an overestimation of the final infarct volumes by pre-treatment CTP of >10 ml. Aim We sought to study the frequency and predictors of GIC. Methods A prospectively collected mechanical thrombectomy database at a comprehensive stroke center between September 2010 and August 2020 was reviewed. Patients were included if they had a successful reperfusion (mTICI2b-3), a pre-procedure CTP, and final infarct volume measured on follow-up magnetic resonance imaging. Uni- and multivariable analyses were performed to identify predictors of GIC. Results Among 923 eligible patients (median [IQR] age, 64 [55–75] years; NIHSS, 16 [11–21]; onset to reperfusion time, 436.5 [286–744.5] min), GIC was identified in 77 (8.3%) of the overall patients and in 14% (47/335) of those reperfused within 6 h of symptom onset. The median overestimation volume was 23.2 [16.4–38.3] mL. GIC was associated with higher NIHSS score, larger areas of infarct core and tissue at risk on CTP, unfavorable collateral scores, and shorter times from onset to image acquisition and to reperfusion as compared to non-GIC. Patients with GIC had smaller median final infarct volumes (10.7 vs. 27.1 ml, p < 0.001), higher chances of functional independence (76.2% vs. 55.5%, adjusted odds ratio (aOR) 3.829, 95% CI [1.505–9.737], p = 0.005), lower disability (one-point-mRS improvement, aOR 1.761, 95% CI [1.044–2.981], p = 0.03), and lower mortality (6.3% vs. 15%, aOR 0.119, 95% CI [0.014–0.984], p = 0.048) at 90 days. On multivariable analysis, time from onset to reperfusion ≤6 h (OR 3.184, 95% CI [1.743–5.815], p < 0.001), poor collaterals (OR 2.688, 95% CI [1.466–4.931], p = 0.001), and higher NIHSS score (OR 1.060, 95% CI [1.010–1.113], p = 0.018) were independent predictors of GIC. Conclusion GIC is a relatively common entity, particularly in patients with poor collateral status, higher baseline NIHSS score, and early presentation, and is associated with more favorable outcomes. Patients should not be excluded from reperfusion therapies on the sole basis of CTP findings, especially in the early window.