bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-reported periodontal health and incident hypertension: longitudinal evidence from the NutriNet-Santé e-cohort
Authors: Carra Maria Clotilde , Fessi Sabrine , Detzen Laurent , Darnaud Christelle , Julia Chantal , Hercberg Serge , Touvier Mathilde , Andreeva Valentina A. , Bouchard Philippe 
Published: July 2021

Objective:
An association between periodontitis and arterial hypertension has been suggested recently. This study aimed at investigating the hypothesis that periodontal health is linked to incident arterial hypertension.

Methods:
We analyzed data from the French population-based e-cohort NutriNet-Santé, selecting participants who had completed two oral health questionnaires in 2011–2012. Pregnant women, participants with diabetes, cancer, arterial hypertension and cardiovascular diseases at inclusion were excluded. Incident cases of arterial hypertension were self-reported and/or based on the use of antihypertensive therapy. Periodontal health was evaluated by estimating the modified and validated PEriodontal Screening Score (mPESS), with mPESS at least 5 corresponding to a high probability of severe periodontitis. Descriptive statistics and Cox proportional hazards regression models, taking into account sociodemographic and lifestyle confounders, were used.

Results:
The study population consisted of 32 285 participants (mean age: 45.79 ± 13.87 years); 78.5% were women. Two thousand one hundred and sixteen incident cases of arterial hypertension were identified during a median follow-up of 8 years (April 2012--December 2019). In the fully adjusted model, an mPESS at least 5 [hazard ratio: 1.84; 95% confidence interval (CI): 1.66–2.03] and the presence of nonreplaced missing teeth (hazard ratio: 1.13; 95% CI: 1.03–1.23) were significantly associated with a greater risk of incident arterial hypertension, whereas a regular annual visit to the dentist was associated with a lower risk (hazard ratio: 0.88; 95% CI: 0.80–0.97).

Conclusion:
Self-reported assessed periodontitis was associated with incident arterial hypertension over an 8-year period. The present results highlight the importance of considering periodontal health when assessing an individual's risk of arterial hypertension.

Trial registration:
# NCT03335644
Prenatal X-ray Exposure and the Risk of Developing Pediatric Cancer—A Systematic Review of Risk Markers and a Comparison of International Guidelines
Authors: Wit Fleur , Vroonland Colinda C.J.J. , Bijwaard Harmen 
Published: July 2021

Abstract
Since the first Oxford Survey of Childhood Cancer’s results were published, people have become more aware of the risks associated with prenatal exposure from diagnostic x rays. As a result, it has since been the subject of many studies. In this review, the results of recent epidemiological studies are summarized. The current international guidelines for diagnostic x-ray examinations were compared to the review. All epidemiological studies starting from 2007 and all relevant international guidelines were included. Apart from one study that involved rhabdomyosarcoma, no statistically significant associations were found between prenatal exposure to x rays and the development of cancer during 2007–2020. Most of the studies were constrained in their design due to too small a cohort or number of cases, minimal x-ray exposure, and/or data obtained from the exposed mothers instead of medical reports. In one of the studies, computed tomography exposure was also included, and this requires more and longer follow-up in successive studies. Most international guidelines are comparable, provide risk coefficients that are quite conservative, and discourage abdominal examinations of pregnant women.
Evaluation of Migration Radiological Equivalence for Dual Component Nuclear Waste in a Deep Geological Repository
Authors: Ivanov V. K. , Spirin E. V. , Menyajlo A. N. , Chekin S. Y. , Lovachev S. S. , Korelo A. M. , Tumanov K. A. , Solomatin V. M. 
Published: July 2021

Abstract
The paper is concerned with the issue of achieving the radiological equivalence (the equivalence of radiation risks) of radioactive waste of nuclear reactors and corresponding mass of natural uranium, taking into account the different migration ability of radionuclides in geological formations and soil. This migration radiological equivalence is being investigated for the deep burial of radioactive waste in the case of the development of a two-component nuclear power system with the concurrent use of thermal neutron reactors and fast neutron reactors. Calculations were performed of radiation doses and radiation risks of cancer death arising from consumption of drinking water from a well above a disposal site. The radiation risk relating to a two-component nuclear power system is lower than that from natural uranium; i.e., after reaching the radiological equivalence (100 y of storage) over the timescale of 109 y, the principle of migration radiological equivalence is satisfied. It would take 106 y after radioactive waste disposal to reach the migration radiological equivalence if only thermal reactors were operated. As regards consumption of well drinking water, the radiation risk does not exceed 10−5 y−1 for a two-component nuclear power system, while being 10−3 y−1 (socially unacceptable level) for a power system using only thermal reactors. Radionuclides 241Am, 239Pu, and 240Pu in drinking water make the main contribution to the doses and radiation risks of people for 104 y after the disposal of radioactive waste.
Era of “Dr. YouTube”: Evaluation of YouTube Videos as a Valid Source for Patient Education on Keratoconus
Authors: Ozdemir Zeydanli E. , Alkan Abdurrahman A. 
Published: July 2021

Objective:
To evaluate the content, quality, and reliability of keratoconus-related YouTube videos as sources for patient education.

Methods:
YouTube was queried using the keywords “keratoconus,” “contact lenses for keratoconus,” “corneal cross-linking,” and “corneal transplant surgery for keratoconus.” Two ophthalmologists independently classified videos as useful, misleading, or patient testimonials and rated them using the DISCERN score (range, 16–75), Journal of the American Medical Association score (JAMAS; range, 0–4), Global Quality Score (GQS; range, 1–5), and Keratoconus-Specific Score (KSS; range, 0–32). Interrater agreement was analyzed using intraclass correlation coefficients. Multivariate linear regression models were fitted to identify factors associated with quality and popularity indices.

Results:
Of the 300 videos screened, 201 were included in the study, 58% were classified as useful, 13% as misleading, and 29% as patient views. Overall video quality was poor, with an average DISCERN score of 22, JAMAS of 1.2, GQS of 1.8, and KSS of 4.5. Misleading videos scored significantly lower than average but had higher popularity compared with useful videos. Video length inversely correlated with popularity index. Television shows were more likely to share misleading information than other uploaders, whereas all videos uploaded by university channels provided useful information but constituted only 12% of all videos.

Conclusions:
Videos rated the best source of information were not the ones most popular. YouTube has great potential to change the attitude of individuals both for and against the right choice. Therefore, health professionals should act to use this potential in favor of effective and reliable health communication.
Pregnancy and the eye
Authors: Khong Edmund W.C. , Chan Helen H.L. , Watson Stephanie L. , Lim Lyndell L. 
Published: July 2021

Purpose of review
The aim of this study was to summarize common eye changes that may occur during pregnancy, and how pregnancy may affect preexisting eye conditions such as glaucoma and diabetic retinopathy. Challenges and complexities surrounding the treatment of these eye conditions during pregnancy are also highlighted.

Recent findings
Refractive changes are common and may persist in the postpartum in patients with keratoconus. Although new medical and surgical glaucoma treatments are available, their safety in pregnancy is unknown. Limited use of topical and systemic glaucoma therapies is recommended, with a preference for selective laser trabeculoplasty as first line treatment in appropriate cases. The impact of pregnancy on diabetic retinopathy remains unclear. Although anti-vascular endothelial growth factor agents are first-line treatment for sight-threatening diabetic retinopathy, their effect on the developing foetus remains unknown and are therefore best avoided in the first and second trimesters. Noninfectious uveitis tends to become less active during pregnancy, allowing the potential tapering of systemic therapy and the use of local topical or injected corticosteroid treatment for active disease as required.

Summary
Significant changes can occur to the eye during pregnancy, wherein the optimal treatment for many ocular conditions remains uncertain, highlighting the need for further research to develop clear recommendations that best balance the need to preserve the mother's sight, and the health of the developing foetus. The need for preconception planning, and collaborative multidisciplinary care between the obstetrician, physician, ophthalmologist and paediatrician is paramount.
Roles and mechanisms of circulating CEACAM1 in the cirrhosis-related intestinal hyperpermeability: in vitro approach
Authors: Hsu Chien-Fu , Lin Ming-Wei , Huang Chia-Chang , Li Tzu-Hao , Liu Chih-Wei , Huang Shiang-Fen , Yang Ying-Ying , Huang Yi-Hsiang , Hou Ming-Chih , Lin Han-Chieh 
Published: July 2021

Background:
Cirrhosis-related intestinal hyperpermeability and endotoxemia are characterized by intestinal epithelial cell apoptosis, impaired restitution (proliferation and migration), decreased tight junction protein levels, and subsequent barrier dysfunction. In addition to endotoxin and tumor necrosis factor-α (TNFα), carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) plays crucial roles in the regulation of apoptosis, restitution, tight junction protein-maintained barrier function of intestinal epithelial cells.

Methods:
This study aims to explore the roles and underlying mechanisms of CEACAM1 in cirrhosis-related intestinal hyperpermeability through in vitro approach.

Results:
In cirrhotic patients, high serum levels of intestinal hyperpermeability (zonulin and endotoxin) markers were accompanied by elevated serum levels of TNFα and soluble CEACAM1. In in vitro experiments, we evaluated the individual and interacted roles of TNFα and human recombinant CEACAM1 (hrCEACAM1) in LC-sera (sera of cirrhotic patients)-induced intestinal hyperpermeability-related pathogenic signals. In the cell Line human from human colon (Caucasian colon adenocarcinoma) (Caco-2) cell culture, LC-sera, TNFα, and hrCEACAM1 increased apoptosis (measured by Terminal deoxynucleotidyl transferase [TdT] dUTP nick end labeling+/annexin-5+propidium iodide+ cells and caspase-3 activity), decreased restitution capacity (proliferation and migration), and disrupted tight junction protein-maintained barrier function in Caco-2 cells. The pathogenic changes mentioned above were accompanied by an increase in intracellular reactive oxygen species (ROS) levels, lactate dehydrogenase release, and endoplasmic reticulum stress-related signals in the LC-sera or TNFα-pretreated Caco-2 cells. Concomitant incubation of Caco-2 cells with anti-CEACAM1 suppressed these LC-sera or TNFα-induced negative effects on restitution, barrier function, and cell viability.

Conclusion:
This study demonstrated that sera from cirrhotic patients contain soluble CEACAM1, which is involved in the pathogenesis of intestinal hyperpermeability. Accordingly, it is noteworthy to explore the potential use of anti-CEACAM1 treatment for cirrhosis-related intestinal hyperpermeability and endotoxemia.
Treatment of hyperprolactinemia: A single-institute experience
Authors: Chen Tse-Yu , Lee Chung-Hsin , Yang Meng-Yin , Shen Chiung-Chyi , Yang Yin-Ping , Chien Yueh , Huang Yu-Fen , Lai Chih-Ming , Cheng Wen-Yu 
Published: July 2021

Background:
Dopamine agonists such as bromocriptine and cabergoline have been found to be an effective treatment for hyperprolactinemia, not only inducing adenoma shrinkage but also lowering serum prolactin levels. Among known dopamine agonists, cabergoline is the drug of choice due to its enhanced tolerability compared with bromocriptine. This study aimed to evaluate cabergoline’s effectiveness, along with transsphenoidal surgery, in the treatment of hyperprolactinemia.

Methods:
We retrieved all patients with a diagnosis of prolactinoma who were treated in our hospital during 2000–2018. A total of 208 patients were enrolled in the analysis after applying exclusion criteria. Patients were divided into four groups according to the treatments received. The demographic data, dosage and duration of cabergoline, and serum prolactin levels at different time points were collected for analysis.

Results:
Normalization was achieved in 59 patients (83.10%) within a short median duration of 2.80 months among those treated with cabergoline only. Although cabergoline alone was effective and well-tolerated, our data showed that long-term remission rates were more favorable when surgery was involved. The long-term remission rate of all patients enrolled was 53.8% (112 patients among 208 patients). The long-term remission rates for the different treatment groups were 17.8% (8 of 45 patients) in Group 1 (Operation→Drug), 83.3% (5 of 6 patients) in Group 2 (Drug→Operation), 79.0% (68 of 86 patients) in Group 3 (Operation only), and 43.7% (31 of 71 patients) in Group 4 (Drug only).

Conclusion:
Cabergoline has been demonstrated to be effective and should be considered as a first-line treatment for hyperprolactinemia. In our study, transsphenoidal surgery was also demonstrated to achieve good results compared with medical treatment. Surgical intervention may resurface as an alternative first-line treatment. When used in combination with cabergoline, surgery offers a higher disease remission rate than either drug or operation alone.
Effect of Colchicine in Reducing Inflammatory Biomarkers and Cardiovascular Risk in Coronary Artery Disease: A Meta-analysis of Clinical Trials
Authors: Sethuramalingam Sujitha , Maiti Rituparna , Hota Debasish , Srinivasan Anand 
Published: July 2021

Background:
Colchicine's role in reducing inflammation and cardiovascular adverse events despite standard care in coronary artery disease (CAD) is controversial.

Study Question:
Can colchicine reduce inflammation [high-sensitivity C-reactive protein (hs-CRP)] in CAD?

Data Sources:
PubMed, Cochrane Library, and Trial registries.

Study Design:
The meta-analysis included 15 studies using add-on colchicine in patients with CAD. The outcomes evaluated were hs-CRP, white blood cell and neutrophil count, a composite end point of major cardiovascular events, myocardial infarction (MI), cardiovascular and all-cause mortality, and gastrointestinal adverse events. The analysis was performed using a random-effects model to calculate pooled mean difference and odds ratio (OR).

Results:
The meta-analysis revealed a mean reduction of 0.36 mg/L in hs-CRP levels [95% confidence interval (CI): −0.51 to −0.20] with add-on colchicine. The mean white blood cell reduction of 371.75 per µL (95% CI: −544.27 to −199.24) and the mean neutrophil reduction also favored the add-on colchicine group. There was a reduction in composite end point of major cardiovascular events [OR, 0.65 (95% CI: 0.51–0.83)] and MI [OR, 0.77 (95% CI: 0.63–0.95)] with add-on colchicine therapy. There was no reduction in cardiovascular/overall mortality. Gastrointestinal adverse events were less with low-dose colchicine than those with high dose.

Conclusion:
Add-on colchicine has reduced the inflammation in CAD as implicated by a decrease in inflammatory markers. It has also lowered the incidence of MI but not mortality. With this present trend, the authors recommend further trials to validate the effectiveness of add-on colchicine in the secondary prevention of CAD.
Toolkit to Increase Provider Knowledge, Comfort, and Adoption of POLST
Authors: Gedney-Lose Amalia , Hand Linda Liu , McCarthy Ann Marie 
Published: July 2021

Background:
POLST—Portable Medical Orders—abbreviated as POLST, is a nationwide initiative to help providers document and meet a patient's end-of-life wishes.

Problem:
Provider completion of POLST documents in primary care can promote continuity and implementation of patient preferences at the end of life in community-dwelling adults. Educating and providing a clinical process to support POLST use may improve implementation.

Approach:
A POLST toolkit was developed for primary care providers with measurement of knowledge, comfort, and likelihood of use with pre- and postsurvey data collection. The POLST toolkit was used to engage primary care providers in an educational session to enhance understanding and increased utilization.

Outcomes:
Providers reported increased knowledge, self-reported comfort, and likelihood of using POLST documents.

Conclusions:
Utilization of a POLST toolkit, with an educational component, improved provider interest in POLST implementation.
Specific Elements of Team-Based Learning Used in Nursing Education
Authors: Considine Julie , Berry Debra , Allen Joshua , Hewitt Nicky , Oldland Elizabeth , Sprogis Stephanie K. , Currey Judy 
Published: July 2021

Background
Team-based learning (TBL) is an evidence-based, highly structured teaching strategy.

Purpose
The purpose of this review was to explore the specific TBL structure and process design elements reported in nursing education studies.

Methods
A scoping review was undertaken according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Databases were searched on February 15, 2021, using search terms related to nursing, education, and TBL.

Results
Of 226 potentially relevant citations, 45 studies were included. The specific TBL design elements reported were team size (n = 41), team formation (n = 24), readiness assurance process (n = 45), immediate feedback (n = 42), activity sequencing (n = 42), 4S application design (n = 13), incentive structure(s) (n = 22), and peer evaluation (n = 13).

Conclusions
There was variability in the reporting of TBL design elements. Preclass preparation and individual and team Readiness Assurance Tests were well reported. Application exercise design and approach to peer evaluation were gaps in the included studies.
The Future Capacity of the Nursing Workforce
Authors: Mannino Jennifer Emilie , Watters Pamela , Cotter Elizabeth , Armstrong Normadeane , Moore Geraldine A. , Bongiorno Anne Watson , Kelley Randy 
Published: July 2021

Background
Nurses are concerned for their safety and conflicted about their career, because their duty to care for patients during the pandemic involved competing ethical obligations, including their own personal safety.

Purpose
The aim was to explore the impact of COVID-19 on new nurses and nursing students in terms of safety and interest in nursing specifically related to self-efficacy, geographic region case density, and frontline experience in health care.

Methods
New nurses and nursing students (N = 472) responded to an online survey examining self-efficacy, sense of safety, and interest in nursing. The survey included an open-ended question to support response interpretation.

Results
Researchers identified significant differences among new nurses and students from contrasting case-dense regions in terms of safety and interest in nursing.

Conclusion
Concerns about personal safety and the safety of others were apparent. Over time, this may lead to a decrease in willingness to enter or remain in the nursing profession.
Barriers to Care and Root Cause Analysis of LGBTQ+ Patients’ Experiences
Authors: Nair Julie McCulloh , Waad Alex , Byam Stacey , Maher Madeline 
Published: July 2021

Background
LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, and others) people face a unique set of barriers to receiving quality healthcare. Very little exists in nursing literature that addresses these barriers.

Objective
This study aimed to analyze patient experience data to better understand the context of barriers to care that LGBTQ+ patients experience, in addition to institutional responses.

Methods
Documentary analysis was employed to review four LGBTQ+ patient experiences that resulted in formal feedback provided to the Office of Patient Relations. Each case was analyzed for content, process, and outcomes.

Results
Through the outlined analysis, the study team found three primary themes and five secondary themes across the four cases. The overarching themes identified through the study’s case review include (a) lack of provider knowledge, (b) lack of patient-centered care, and (c) lack of institutional infrastructures associated with the provision of affirming care to LGBTQ+ individuals.

Discussion
Findings suggest the need for a multipronged approach when addressing the care of LGBTQ+ communities. A combination of provider-level education and institutional capacity building to treat diverse patient populations is necessary for addressing the issues demonstrated within the data. Moreover, further research is needed to identify unique needs of transgender and nonbinary patients and determine efficacy of institutional efforts to build capacity for caring and studying the health needs of LGBTQ+ communities.
Evaluation of Clinical, Gram Stain, and Microbiological Cure Outcomes in Men Receiving Azithromycin for Acute Nongonococcal Urethritis: Discordant Cures Are Associated With Mycoplasma genitalium Infection
Authors: Toh Evelyn , Gao Xiang , Williams James A. , Batteiger Teresa A. , Coss Lisa A. , LaPradd Michelle , Ren Jie , Geisler William M. , Xing Yue , Dong Qunfeng , Nelson David E. , Jordan Stephen J. 
Published: July 2021

Background
In men with nongonococcal urethritis (NGU), clinicians and patients rely on clinical cure to guide the need for additional testing/treatment and when to resume sex, respectively; however, discordant clinical and microbiological cure outcomes do occur. How accurately clinical cure reflects microbiological cure in specific sexually transmitted infections (STIs) is unclear.

Methods
Men with NGU were tested for Neisseria gonorrhoeae, Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis, urethrotropic Neisseria meningitidis ST-11 clade strains, and Ureaplasma urealyticum (UU). Men received azithromycin 1 g and returned for a 1-month test-of-cure visit. In MG infections, we evaluated for the presence of macrolide resistance-mediating mutations (MRMs) and investigated alternate hypotheses for microbiological treatment failure using in situ shotgun metagenomic sequencing, phylogenetic analysis, multilocus sequence typing analyses, and quantitative PCR.

Results
Of 280 men with NGU, 121 were included in this analysis. In the monoinfection group, 52 had CT, 16 had MG, 7 had UU, 10 had mixed infection, and 36 men had idiopathic NGU. Clinical cure rates were 85% for CT, 100% for UU, 50% for MG, and 67% for idiopathic NGU. Clinical cure accurately predicted microbiological cure for all STIs, except MG. Discordant results were significantly associated with MG-NGU and predominantly reflected microbiological failure in men with clinical cure. Mycoplasma genitalium MRMs, but not MG load or strain, were strongly associated with microbiological failure.

Conclusions
In azithromycin-treated NGU, clinical cure predicts microbiological cure for all STIs, except MG. Nongonococcal urethritis management should include MG testing and confirmation of microbiological cure in azithromycin-treated MG-NGU when MRM testing is unavailable.