bluuebunny/crossref_metadata_2025_split huggingface dataset:
Admission Glucose Levels and Associated Risk for Heart Failure After Myocardial Infarction in Patients Without Diabetes
Authors: Ritsinger Viveca , Hagström Emil , Lagerqvist Bo , Norhammar Anna 
Published: October 2021

Background
Dysglycemia at acute myocardial infarction (AMI) is common and is associated with mortality. Information on other outcomes is less well explored in patients without diabetes in a long‐term perspective. We aimed to explore the relationship between admission glucose level and long‐term outcomes in patients with AMI without diabetes in a nationwide setting.

Methods and Results

Patients without diabetes (n=45 468) with AMI registered in SWEDEHEART (Swedish Web–System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) and admission glucose ≤11 mmol/L (≤198 mg/dL) were followed for outcomes (AMI, heart failure, stroke, renal failure, and death) between 2012 and 2017 (mean follow‐up time 3.3±1.7 years). The association between categorized glucose levels and outcomes was assessed in adjusted Cox proportional hazards regression analyses (glucose levels 4.0–6.0 mmol/L [72–109 mg/dL] as reference). Further nonfatal complications and their associated mortality were explored (patients without events served as a reference). A glucose level of 7.8–11.0 mmol/L (140–198 mg/dL) was associated with hospitalization for heart failure (hazard ratio [HR] 1.40 [95% CI, 1.30–1.51],
P
<0.001), renal failure (1.17; 1.04–1.33,
P
=0.009), and death (1.31; 1.20–1.43,
P
<0.001), but not with recurrent myocardial infarction (0.99; 0.92–1.07,
P
=0.849) or stroke (1.03; 0.88–1.19,
P
=0.742). Renal failure had the strongest association with future mortality (age‐adjusted HR 4.93 [95% CI, 4.34–5.60],
P
<0.001), followed by heart failure (3.71; 3.41–4.04,
P
<0.001), stroke (3.39; 2.94–3.91,
P
<0.001), and myocardial infarction (2.08; 1.88–2.30,
P
<0.001).

Conclusions
Elevated glucose levels at AMI admission identifies patients without diabetes at increased risk of long‐term complications: in particular, hospitalization for heart and renal failure. These results emphasize that glucose levels at admission could be useful in risk assessment after myocardial infarction.
Religious and Secular Coping Strategies of Reappraisal
Authors: Riegel Ulrich , Unser Alexander 
Published: October 2021

Abstract
In times of disaster, religion is said to be a powerful resource of meaning-focused coping. If offers motifs, symbols, and stories to reappraise situations and thereby ascribe meaning to them. Aside from religion, in modern times secular resources are feasible for meaning making during disaster as well. Empirical instruments that assess both religious and secular types of meaning-focused coping, however, are not available. Relevant instruments focus exclusively on either religious or secular coping. This paper addresses this desideratum by supplementing the RCOPE-scales of reappraisal with relevant scales of secular reappraisal. Three scales – Trust in Science, Consequences of Lifestyle, and Reappraisal of Science’s Power – have been constructed and tested on a sample of university students and staff members coping with the Corona pandemic. CFA shows a satisfactory fit for the supplementing instrument when Trust in Science is removed from the analysis. Correlation analysis with scales of religiosity (Centrality of Religiosity and Post-Critical Belief) indicates a good external validity of the new instrument. In consequence, the two supplements of Consequences of Lifestyle and Reappraisal of Science’s Power facilitate assessment of secular meaning-focused coping aside with relevant religious coping, while the Trust in Science Reappraisal scale needs further development.
Reconciled Community
Authors: Paas Stefan , Schaeffer Hans 
Published: October 2021

Abstract
Recent experience suggests that there is insufficient reflection on the ‘why’ of mission among missionary pioneers, that is, on the soteriology that underpins missional practices in the West. This article argues, first, that a social view of salvation is the best way to make theological sense of missional community formation (mcf). Second, this implied soteriology is further developed as an integrative lens on various dimensions of salvation in Christianity. Third, it is argued that this relocation of mcf in this social view of salvation offers rich opportunities for witness, and thus a potential remedy against soteriological embarrassment.
A multivariate modeling method for the prediction of low fetal fraction before noninvasive prenatal testing
Authors: Hu Liang , Pei Yuanyuan , Luo Xiaojin , Wen Lijuan , Xiao Hui , Liu Jinxing , Wu Liping , Li Gaochi , Wei Fengxiang 
Published: November 2021

Objective: To investigate factors associated with fetal fraction and to develop a new predictive method for low fetal fraction before noninvasive prenatal testing. Methods: The study was a retrospective cohort analysis based on the results of noninvasive prenatal testing, complete blood count, thyroxin test, and Down's syndrome screening during the first or second trimester in 14,043 pregnant women. Random forests algorithm was applied to predict the low fetal fraction status (fetal fraction < 4%) through individual information and laboratory records. The performance of the model was evaluated and compared to predictions using maternal weight. Results: Of 14,043 cases, maternal weight, red blood cell, hemoglobin, and free T3 were significantly negatively correlated with fetal fraction while gestation age, free T4, pregnancy-associated plasma protein-A, alpha-fetoprotein, unconjugated estriol, and β-human chorionic gonadotropin were significantly positively correlated with fetal fraction. Compared to predictions using maternal weight as an isolated parameter, the model had a higher area under the curve of receiver operating characteristic and overall accuracy. Conclusions: The comprehensive predictive method based on combined multiple factors was more effective than a single-factor model in low fetal fraction status prediction. This method can provide more pretest quality control for noninvasive prenatal testing.
Gas-containing renal stones: a red flag for renal infection
Authors: Zawaideh Jeries Paolo , Simonato Alchiede , Barbero Stefano , Bertolotto Michele , Cardone Gianpiero , Vota Paolo , Pavlica Piero , Derchi Lorenzo E 
Published: October 2021

BackgroundGas in the renal excretory system is described as a consequence of recent procedures but it can be a sign of severe conditions such as fistulas or infections; however, gas-containing renal stones are only rarely encountered.PurposeTo describe the association of gas-containing renal stones and urinary tract infection.Material and MethodsWe performed a retrospective evaluation of the clinical and imaging findings in a series of six patients with gas-containing renal stones and compared our findings with those of patients with gas-containing renal stones reported in the literature. Urine and stone cultures were used as a diagnostic standard for urinary tract infection.ResultsIncluding the present series, there is a total of 21 patients with gas-containing renal stones in the literature. Based on clinical presentation, urinary tract infection could be suspected in 10 (57%) patients, while urine and/or stone cultures showed infection in 18 of 19 (95%) patients, with only one case with no bacterial growth in both (5%); in the remaining patient the information was not available.ConclusionGas-containing renal stones are a rarely reported entity usually diagnosed with computed tomography. They are a radiological sign often associated with urinary tract infection that can also be encountered in patients with non-specific renal symptoms.
High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt
Authors: Domínguez-Mayoral Ana , Sánchez-Gómez Jesús , Guerrero Patricia , Ferrer Marta , Gutiérrez Carmen , Aguilar María , Fouz-Rosón Natalia , Benítez José María , Pérez-Sánchez Soledad , Gamero-García Miguel Ángel , De Torres-Chacón Reyes , Barragán-Prieto Ana , Algaba Pilar , Ruiz-Bayo Lidia , Montaner Joan 
Published: October 2021

Objective Spain’s so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea–hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain. Methods We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests. Results Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea–hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients. Conclusions The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.
Association between systemic lupus erythematosus and risk of cervical atypia: A meta-analysis
Authors: Chen Yanya , Wu Xuewei , Liu Lu 
Published: October 2021

Background Previous studies showed conflicting results regarding the association between systemic lupus erythematosus (SLE) and risk of cervical atypia. Therefore, the present study aimed to make a meta-analysis to summarize results of studies regarding association between SLE and risk of cervical atypia. Methods We searched for articles published before March 2021 in in the following databases: PubMed, EMBASE, Web of Science, Medline and Google Scholar. Odds ratios (ORs) and relative risks (RRs) with their 95% confidence intervals (CIs) were computed to create a pooled effect size and 95% CI using STATA 12.0 software. Results The present meta-analysis showed that SLE was significantly associated with increased risks of cervical atypia (OR/RR = 2.94, 95% CI 2.22 to 3.89, I2 = 92.1%, p < .001), cervical cancer (OR/RR = 3.13, 95% CI 2.09 to 4.70, I2 = 84.7%, p < .001), squamous intraepithelial lesion (SIL) (OR/RR = 5.00, 95% CI 2.58 to 9.69, I2 = 88.9%, p < .001) and low-grade SIL (OR/RR = 3.14, 95% CI 1.29 to 7.67, I2 = 63.3%, p = .018) with random effects models. Conclusion In summary, findings of this meta-analysis demonstrated that SLE was associated with a higher risk of cervical pre-malignant lesions and carcinoma. It may be necessary for clinicians to remind women with SLE to screen human papillomavirus infection and be vaccinated as soon as possible. However, caution is required when interpreting our findings. Further studies, especially well-designed randomized controlled clinical trials are awaited to confirm the association between SLE and cervical atypia–associated diseases.
Demographic Pattern, Management, and Outcome of Intestinal Atresias Among Neonates in a Tertiary Care Indian Hospital
Authors: Tripathy Prasanta Kumar , Jena Pradeep Kumar 
Published: October 2021

Objectives: To analyze the incidence, management approach, and outcome of intestinal atresias among neonates in our hospital. Design: Retrospective observational study. Settings: Tertiary care pediatric institute located in eastern part of India. Study period: January 2015 to December 2019. Results: Intestinal atresias constituted 54% of neonatal intestinal obstruction cases ( n = 369). Out of 201 cases of intestinal atresias, only 120 patients presented during first week of life and the male to female ratio was 1.3:1. The mean (±SD) weight at presentation was 2.03 (±0.49) kg and newborns below 1.5 kg were associated with significantly higher mortality ( P =.001). Jejunoileal atresias were found to be the most common type of atresia ( n = 116, 58%) followed by duodenal atresias ( n = 67, 33%). Colonic and pyloric atresias were found in 14 (7%) and 4 cases (2%), respectively. The overall mortality in the present study was 18% ( n = 36) and septicemia was the leading cause. Conclusion: Intestinal atresias were the most common cause of intestinal obstruction and surgical emergency in neonates. Although, there is gradual improvement in survival in these newborns, low birth weight, late presentation, and associated comorbidities are high risk factors. Increased awareness about these congenital anomalies, early referral to tertiary care centers, and timely management can improve the outcome.
Acute hemodynamic changes during far infrared treatment of the arteriovenous fistula in hemodialysis patients
Authors: Hansen Emilie K , Lindhard Kristine , Hansen Ditte 
Published: October 2021

Background: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD) treatment and preservation of a stable vascular access is crucial. Long term Far Infrared Radiation (FIR) has been found to increase access flow together with an enhanced maturation and patency of the AVF. The acute effects of FIR on access flow have been sparsely described and the results are contradictory, perhaps due to differences in measurement conditions and other factors of importance for access flow. Methods: Twenty patients in HD with an AVF were included. Each patient was randomized to receive either FIR (FIR group) or no FIR (control group). The acute changes in access flow were investigated in both groups on the second dialysis day of the week and during the first 1.5 h of the dialysis session. Concomitant changes in hemodynamic parameters of importance for access flow were also explored. Results: There was no significant change in access flow in the FIR group compared with the control group (median (Interquartile Range)) (−10 (−413.8; 21.3) ml/min vs −17.5 (−83.8; 76.3) ml/min, p = 0.58). There was no significant difference in any of the hemodynamic parameters between the FIR and the control group; cardiac output (−0.7 (−1.2; −0.2) l/min vs −0.4 (−0.9; 0.1) l/min, p = 0.58), cardiac index (−0.3 (−0.5; −0.1)) l/min/m2 vs −0.3 (−0.4; 0) l/min/m2, p = 0.68), mean arterial pressure (5.5 (−1.8; 8.4) mmHg vs 1.5 (−3; 6.3) mmHg, p = 0.35) and total peripheral resistance (2 (1.8; 3.4) mmHg × min/l vs 1 (−0.3; 3.1) mmHg × min/l, p = 0.12). Conclusion: In this trial, with a highly standardized set-up, one session of FIR did not result in any acute changes in access flow. This was not due to differences in the hemodynamic parameters between the groups.
Formative Usability of the Kidneytime Online Live Donor Kidney Transplant Education Tool Among Transplant Candidates
Authors: Keller Maria M. , Dolph Beth , Cavuoto Lora , Ranahan Molly , Feeley Thomas H. , Kayler Liise K. 
Published: October 2021

Background Web-based education may be a powerful tool to support transplant candidates’ learning and communication about live donor kidney transplantation. Few educational interventions are web-based and have education sharing for living donor transplant as a primary goal. Methods Through user-centered design and iterative usability testing, we developed a web platform, called KidneyTIME, to support an educational intervention for adult transplant candidates. KidneyTIME delivers animated videos to improve candidate knowledge, motivation, and self-efficacy to pursue living donor transplantation and to promote outreach through video sharing. The animated-video educational content was previously produced by the researchers. We conducted a formative usability evaluation of the KidneyTIME web platform to enable users to find, view, and share the previously produced videos. A total of 30 kidney transplant candidates were involved in 4 rounds of testing at one transplant center, with amendments made after each round. Results Transplant candidates were predominantly White non-Hispanic; 47% had incomes <$30 000 and >43% had vision or motor impairment. Readability, navigation, and failure to find videos were the main usability issues identified. Substantial improvements were found in the usability of most functions after implementing certain features, such as enlarging text and buttons, enhancing contrast, and simplifying presentation. Participants reported that the intervention was user friendly and easy to navigate. Conclusion Considering feedback from a wide spectrum of users has improved the usability of KidneyTIME. A salient concern for End stage kidney disease populations is ensuring online accessibility despite vision and motor impairments.
The clinical implications of sinus tachycardia in mild COVID-19 infection: A retrospective cohort study
Authors: Hsieh Jenny Yi Chen , Kan Juliana Yin Li , Mattar Shaikh Abdul Matin , Qin Yan 
Published: October 2021

Objectives: This study aims to estimate the prevalence of sinus tachycardia in hospitalized patients with mild COVID-19 infection and to identify the clinical, radiological, and biological characteristics associated with sinus tachycardia. Methods: A retrospective cohort study was conducted on patients with mild COVID-19 infection and sinus tachycardia during hospitalization. Outcomes measured included incidences of venous thromboembolism, high-dependency/intensive care unit admission, laboratory parameters, and radiological findings. Results: A total of 236 COVID-19 positive patients admitted to Singapore General Hospital isolation general wards from 1 June 2020 to 30 June 2020 were included in this study. Ninety-seven (41.1%) patients had sinus tachycardia on or during their admission. All patients were monitored in general wards and discharged to community quarantine facilities. None required oxygen support or high-dependency/intensive care unit admission. Sinus tachycardia was associated with increased C-reactive protein level (odds ratio = 1.033, 95% confidence interval = 1.002–1.066), abnormal chest X-ray findings (odds ratio = 3.142, 95% confidence interval = 1.390–7.104), and longer hospitalization (odds ratio = 1.117, 95% confidence interval = 1.010–1.236). There was no significant statistical association between sinus tachycardia and incidences of venous thromboembolism. Conclusion: This study suggests that patients with mild COVID-19 infection and concurrent sinus tachycardia are more likely to have higher inflammatory marker levels, abnormal imaging, and prolonged hospitalization. However, no significant association between sinus tachycardia and thromboembolism is identified in mild COVID-19 infection.
Mainstreaming Genetic Testing for Adult Patients With Autosomal Dominant Polycystic Kidney Disease
Authors: Elliott Mark D. , James Leslie C. , Simms Emily L. , Sharma Priyana , Girard Louis P. , Cheema Kim , Elliott Meghan J. , Lauzon Julie L. , Chun Justin 
Published: October 2021

Purpose: Genetic testing results are currently obtained approximately 1 year after referral to a medical genetics team for autosomal dominant polycystic kidney disease (ADPKD). We evaluated a mainstream genetic testing (MGT) pathway whereby the nephrology team provided pre-test counseling and selection of patients with suspected ADPKD for genetic testing prior to direct patient interaction by a medical geneticist. Sources of information: A multidisciplinary team of nephrologists, genetic counselors, and medical geneticists developed an MGT pathway for ADPKD using current testing criteria for adult patient with suspected ADPKD and literature from MGT in oncology. Methods: An MGT pathway was assessed using a prospective cohort and compared to a retrospective cohort of 56 patients with ADPKD who received genetic testing using the standard, traditional pathway prior to implementing the MGT for ADPKD. The mainstream pathway was evaluated using time to diagnosis, diagnostic yield, and a patient survey to assess patient perceptions of the MGT pathway. Key findings: We assessed 26 patients with ADPKD using the MGT and 18 underwent genetic testing with return of results. Of them, 52 patients had data available for analysis in the traditional control cohort. The time for return of results using our MGT pathway was significantly shorter with a median time to results of 6 months compared to 12 months for the traditional pathway. We identified causative variants in 61% of patients, variants of uncertain significance in 28%, and 10% had negative testing which is in line with expectations from the literature. The patient surveys showed high satisfaction rates with the MGT pathway. Limitations: This report is an evaluation of a new genetic testing pathway restricted to a single, publicly funded health care center. The MGT pathway involved a prospective collection of a limited number of patients with ADPKD with comparison to a retrospective cohort of patients with ADPKD evaluated by standard testing. Implications: A MGT pathway using clearly defined criteria and commercially available gene panels for ADPKD can be successfully implemented in a publicly funded health care system to reduce the time required to obtain genetic results.
The Impact of Covid-19 on Diabetes Care in Muscat Governorate: A Retrospective Cohort Study in Primary Care
Authors: Al Harthi Thuraiya , Anwar Huda , Al Lawati Anwaar , Al Shuriqi Fathyia , Al Rashdi Fakhria , Al Mahrouqi Adil , Al Ismaili Mohammed , Al Syiabi Riyadh , Al Azri Hasna , Meah Umme Habiba , Al Ghafri Thamra 
Published: October 2021

Background COVID-19 pandemic has led to health service modification and temporary disruption of the routine care provided to patients with diabetes mellitus (DM) in primary care. This was done to minimize outpatient visits, permit physical distancing, and ensure patients’ and healthcare providers safety. There is no evidence that explored or measured the impact of COVID-19 pandemic on diabetes services and patients’ glycemic outcome in Oman. Aim and Objectives To explore the accessibility of DM services in primary care after COVID-19 pandemic announcement, and measure patients’ glycemic outcome. Methods Before and after, retrospective cohort study using Al-Shifa healthcare database in primary care. One thousand adult patients with diabetes who attended DM clinic before pandemic announcement in 2019 were randomly selected and followed up until end of 2020. Patients aged ≥18 years and had at least 2 visits in 2019 were included. Access to DM services was identified by number of patients received care, frequency of consultations, mode of consultation, and type of intervention given to patients. Patients’ glycated hemoglobin (HbA1c), and other glycemic parameters after pandemic announcement in 2020 were determined and compared with the same parameters before pandemic in 2019. Association between patients’ HbA1c and mode of consultation was measured using multivariable regression analysis. Results A total of 937 patients continued to follow and received DM care after pandemic announcement. Median number of consultations was 2 with interquartile range (IQR): 3-2. 57.4% had face-to-face alone, 32.4% had combined face to face and telephone consultation, and 10% had telephone consultation alone. Mean difference in HbA1c (%) before and after pandemic announcement was 0.2 ± 1.4 (95% CI: 0.1 to 0.3), P = .002. With multivariable linear regression, the mean difference in HbA1c was −0.3 (−2.3 to 1.5), P = .734 for telephone consultation alone, −0.5 (−2.4 to 1.4), P = .613 for face-to-face alone, and −0.5 (−2.4 to 1.3), P = .636 for combined consultations, compared to those who did not receive any formal consultation. Conclusion Despite service modification and disruption of comprehensive care in primary care after COVID-19 pandemic announcement, DM services were accessible as majority of patients maintained follow up. There was an overall increase in mean glycated hemoglobin, however, it was a less than 1 unit increase. After adjusting for multivariable, glycated hemoglobin was reduced among those who received consultation including telephone consultation compared to those who did not, however evidence was unconvincing.