bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in the Risk of Adverse Outcomes After Incident Diabetic
Foot Hospitalization: A Population Cohort Study
Authors: Seghieri Giuseppe , Policardo Laura , Gualdani Elisa , Francesconi Paolo 
Published: August 2021

Background:
Diabetic Foot Disease (DFD) is more prevalent among males and is associated
with an excess risk of cardiovascular events or mortality.

Aims:
This study aimed at exploring the risk of cardiovascular events, renal failure, and all-cause
mortality after incident DFD hospitalizations, separately in males and females, to detect any gender
difference in a cohort of 322,140 people with diabetes retrospectively followed up through administrative
data sources in Tuscany, Italy, over the years 2011-2018.

Methods:
The Hazard Ratio (HR) for incident adverse outcomes after first hospitalizations for
DFD, categorized as major/minor amputations (No.=449;3.89%), lower limbs’ revascularizations
(LLR: No.=2854;24.75%), and lower-extremity-arterial-disease (LEAD) with no procedures
(LEAD-no proc: No.=6282;54.49%), was compared to the risk of patients having a background of
DFD (ulcers, infections, Charcot-neuroarthropathy: No.=1,944;16.86%).

Results:
DFD incidence rate was higher among males compared to females (1.57(95%
CI:1.54-1.61) vs. 0.97(0.94-1.00)/100,000p-years]. After DFD, the overall risk of coronary artery
disease was significantly associated with the male gender and of stroke with the female gender.
LEAD-no proc and LLR were associated with the risk of stroke only in females, whereas they were
found to be associated with the risk of coronary artery disease among females to a significantly
greater extent compared to males. The incident of renal failure was not associated with any DFD
category. Amputations and LEAD-no proc significantly predicted high mortality risk only in females,
while LLR showed reduced risk in both genders. Moreover, females had a greater risk of
composite outcomes (death or cardiovascular events). Compared to the background of DFD, the
risk was found to be 34% higher after amputations (HR: 1.34(1.04-1.72)) and 10% higher after
LEAD-no proc (HR:1.10(1.03-1.18)), confirming that after incident DFD associated with vascular
pathogenesis, females are at an increased risk of adverse events.

Conclusions:
After incident DFD hospitalizations, females with DFD associated with amputations
or arterial disease are at a greater risk of subsequent adverse cardiovascular events than those with
a DFD background.
Cardiovascular Autonomic Reflex Tests and 7 Heart Rate Variability Indices for Early Diagnosis of Cardiovascular Autonomic Neuropathy in Type 2 Diabetes Individuals
Authors: Atala Yeelen Ballesteros , De Matos Mozânia Reis , Correa-Giannella Maria Lucia , Ribeiro Parisi Maria Cândida , Zantut-Wittmann Denise Engelbrecht , Castillo Alejandro Rosell , Santos-Bezerra Daniele P 
Published: August 2021

Background:Cardiovascular autonomic neuropathy (CAN) is a common complication of type 2 Diabetes mellitus (T2D), and prevalence varies according to the methodology used. CAN should be diagnosed in the subclinical stage when an intensive treatment of T2D could avoid the progression to irreversible phases.Objective:Determine the prevalence of early involvement (EI) of CAN in T2D individuals comparing two methodologies.Methods:This was a cross-sectional study that included 183 T2D individuals who were monitored in a Tertiary centre. The diagnosis of CAN was based on the results of four cardiovascular autonomic reflex tests (CARTs: expiration-inspiration index, Valsalva maneuver, orthostatic test, and changes in blood pressure after standing) and of seven heart rate variability (7HRV) indices (CARTs plus the spectral analysis). The findings were validated in an independent cohort comprised of 562 T2D individuals followed in a Primary care setting.Results:With the use of 7HRV, 30.6% and 77.8% of individuals in the Tertiary and in the Primary centers, respectively, were classified as without CAN; 25.1% and 15.3% as EI and 44.3% and 6.9% as definitive CAN, respectively. The use of CARTs decreased the proportion of individuals without CAN in both centers (7.1% and 47%) and increased the frequency of EI (30.6% and 36.6%) and definitive CAN (62.3% and 16.4%), respectively. The concordance between both evaluated methodologies was weak.Conclusion:Higher proportions of T2D individuals were diagnosed with EI and with definitive CAN with the use of CARTs.
The Role of CO-RADS Scoring System in the Diagnosis of COVID-19
Infection and its Correlation with Clinical Signs
Authors: Çomoğlu Şenol , Öztürk Sinan , Topçu Ahmet , Kulalı Fatma , Kant Aydın , Sobay Resul , Arslan Mustafa , Ülgür Hanife Şeyda , Kostakoğlu Uğur , Küçük Eyüp Veli , Karakoç Hanife Nur , Çağlar Merve , Uzuğ Gülsüm , Bağcı Ulaş , Özkan Ömer Faruk , Yılmaz Gürdal 
Published: August 2021

Background:
Computed tomography (CT) evaluation systematics has become necessary
to eliminate the difference of opinion among radiologists in evaluating COVID-19 CT findings.

Introduction:
The objectives of this study were to evaluate the efficiency of CO-RADS scoring
system in our patients with COVID-19 as well as to examine its correlation with clinical and laboratory
findings.

Method:
The CO-RADS category of all patients included in the study was determined by a radiologist
who did not know the rtRT-PCR test result of the patients, according to the Covid-19 reporting
and data system of Mathias Prokop et al.

Results:
A total of 1338 patients were included. CT findings were positive in 66.3%, with a mean
CO-RADS score of 3,4 ± 1,7. 444 (33.1%) of the patients were in the CO-RADS 1-2, 894 (66.9%)
were in the CO-RADS 3-5 group. There were positive correlations between CO-RADS score and
age, CMI, hypertension, diabetes mellitus, chronic pulmonary diseases presence of symptoms,
symptom duration, presence of cough, shortness of breath, malaise, CRP, and LDH, while CORADS
score was negatively correlated with lymphocyte count. The results of the ROC analysis
suggested that those with age ≥40 years, symptom duration >2 days, CMI score >1 and/or comorbid
conditions were more likely to have a CO-RADS score of 3-5.

Conclusion:
The CO-RADS classification system is a CT findings assessment system that can be
used to diagnose COVID-19 in patients with symptoms of cough, shortness of breath, myalgia and
fatigue for more than two days.
Facemask Detection Based on Double Convolutional Neural Networks
Authors: Chen Guoqiang , Bai Bingxin , Zhou Hongpeng , Liu Mengchao , Yi Huailong 
Published: August 2021

Background:
The study on facemask detection is of great significance because facemask
detection is difficult, and the workload is heavy in places with a large number of people during the
COVID-19 outbreak.

Objective:
The study aims to explore new deep learning networks that can accurately detect facemasks
and improve the network's ability to extract multi-level features and contextual information.
In addition, the proposed network effectively avoids the interference of objects like masks. The new
network could eventually detect masks wearers in the crowd.

Method:
A Multi-stage Feature Fusion Block (MFFB) and a Detector Cascade Block (DCB) are
proposed and connected to the deep learning network for facemask detection. The network's ability
to obtain information improves. The network proposed in the study is Double Convolutional Neural
Networks (CNN) called DCNN, which can fuse mask features and face position information. During
facemask detection, the network extracts the featural information of the object and then inputs it into
the data fusion layer.

Results:
The experiment results show that the proposed network can detect masks and faces in a
complex environment and dense crowd. The detection accuracy of the network improves effectively.
At the same time, the real-time performance of the detection model is excellent.

Conclusion:
The two branch networks of the DCNN can effectively obtain the feature and position
information of facemasks. The network overcomes the disadvantage that a single CNN is susceptible
to the interference of the suspected mask objects. The verification shows that the MFFB and the
DCB can improve the network's ability to obtain object information, and the proposed DCNN can
achieve excellent detection performance.
Bio-guided Studies of Lotus maritimus Aerial Parts and Investigation of
their Antioxidant, Tyrosinase and Elastase Inhibitory Activities
Authors: Schmitt Marie , Magid Abdulmagid Alabdul , Etique Nicolas , Hubert Jane , Duca Laurent , Nuzillard Jean-Marc , Voutquenne-Nazabadioko Laurence 
Published: August 2021

Background:
Lotus maritimus L. (Fabaceae) is a perennial herb species with yellow
flowers, growing in Europe, Asia, Middle East and Maghreb. Some flavones and flavonols have
been identified in their leaves and flowers. Their leaf extract was used as a cellulolytic and antiaging
cosmetic ingredient.

Objective:
The aim of this work was to perform antioxidant, anti-tyrosinase and anti-elastase properties
of L. maritimus aerial parts and their chemical profile.

Methods:
A 13C NMR-based dereplication method combined with a bio-guided purification was
used for metabolite identification. Chemical structures were determined by NMR and ESI-MS spectroscopic
methods. The antioxidant properties of the fractions and purified compounds were measured
using CUPRAC, DPPH and hydroxyl radical scavenging assays. Their inhibitory activities
against the fungal tyrosinase and human neutrophil elastase enzymes were also evaluated.

Results:
EtOAc and n-BF fractions were characterized as the most active parts. Twenty-two compounds
were identified from these fractions by using a 13C NMR-based dereplication method. This
process was completed by the purification of minor compounds in the n-BuOH fraction. Eight
known compounds were isolated, including many mono-glycosylated flavonoids with variable substitutions
on the B-ring, allowing structure-activity relationships.

Conclusion:
Twenty-two compounds, including phenolic acids, flavonoids and glycoside derivatives,
were firstly described in L. maritimus. Three quercetin and myricetin-type flavonoids exhibited
good antioxidant activities and all flavonoids tested have moderate effects on elastase inhibition.
Financial Incentives for Healthy Living for Patients With Cardiac Disease From the Perspective of Health Care Professionals: Interview Study
Authors: de Buisonjé David , Van der Geer Jessica , Keesman Mike , Van der Vaart Roos , Reijnders Thomas , Wentzel Jobke , Kemps Hareld , Kraaijenhagen Roderik , Janssen Veronica , Evers Andrea 
Published: August 2021

Background
A promising new approach to support lifestyle changes in patients with cardiovascular disease (CVD) is the use of financial incentives. Although financial incentives have proven to be effective, their implementation remains controversial, and ethical objections have been raised. It is unknown whether health care professionals (HCPs) involved in CVD care find it acceptable to provide financial incentives to patients with CVD as support for lifestyle change.

Objective
This study aims to investigate HCPs’ perspectives on using financial incentives to support healthy living for patients with CVD. More specifically, we aim to provide insight into attitudes toward using financial incentives as well as obstacles and facilitators of implementing financial incentives in current CVD care.

Methods
A total of 16 semistructured, in-depth, face-to-face interviews were conducted with Dutch HCPs involved in supporting patients with CVD with lifestyle changes. The topics discussed were attitudes toward an incentive system, obstacles to using an incentive system, and possible solutions to facilitate the use of an incentive system.

Results
HCPs perceived an incentive system for healthy living for patients with CVD as possibly effective and showed generally high acceptance. However, there were concerns related to focusing too much on the extrinsic aspects of lifestyle change, disengagement when rewards are insignificant, paternalization and threatening autonomy, and low digital literacy in the target group. According to HCPs, solutions to mitigate these concerns included emphasizing intrinsic aspects of healthy living while giving extrinsic rewards, integrating social aspects to increase engagement, supporting autonomy by allowing freedom of choice in rewards, and aiming for a target group that can work with the necessary technology.

Conclusions
This study mapped perspectives of Dutch HCPs and showed that attitudes are predominantly positive, provided that contextual factors, design, and target groups are accurately considered. Concerns about digital literacy in the target group are novel findings that warrant further investigation. Follow-up research is needed to validate these insights among patients with CVD.
Gamification and Game-Based Strategies for Dermatology Education: Narrative Review
Authors: Szeto Mindy D , Strock Daniel , Anderson Jarett , Sivesind Torunn E , Vorwald Victoria M , Rietcheck Hope R , Weintraub Gil S , Dellavalle Robert P 
Published: August 2021

Background
Game-based approaches, or gamification, are popular learning strategies in medical education for health care providers and patients alike. Gamification has taken the form of serious educational games and simulations to enable learners to rehearse skills and knowledge in a safe environment. Dermatology learners in particular may benefit from gamification methods, given the visual and procedural nature of the field.

Objective
This narrative review surveys current applications of gamification within general medical training, in the education of dermatology students, and in dermatology patient outreach.

Methods
A literature search was performed using PubMed, Google Scholar, and ResearchGate to access and review relevant medical education- and dermatology-related gamification studies published in peer-reviewed journals. Two independent researchers with education and experience in dermatology screened publications to select studies featuring a diversity of gamification approaches and study subjects for in-depth examination.

Results
A total of 6 general medical education–related and 7 dermatology-specific gamification studies were selected. Gamification generally increased motivation and engagement, improved reinforcement of learning objectives, and contributed to more enjoyable and positive educational experiences compared to traditional modes of instruction. Enhancing examination scores, building confidence, and developing stronger team dynamics were additional benefits for medical trainees. Despite the abundance of gamification studies in general medical education, comparatively few instances were specific to dermatology learning, although large organizations such as the American Academy of Dermatology have begun to implement these strategies nationally. Gamification may also a provide promising alternative means of diversifying patient education and outreach methods, especially for self-identification of malignant melanoma.

Conclusions
Serious games and simulations in general medical education have successfully increased learner motivation, enjoyment, and performance. In limited preliminary studies, gamified approaches to dermatology-specific medical education enhanced diagnostic accuracy and interest in the field. Game-based interventions in patient-focused educational pilot studies surrounding melanoma detection demonstrated similar efficacy and knowledge benefits. However, small study participant numbers and large variability in outcome measures may indicate decreased generalizability of findings regarding the current impact of gamification approaches, and further investigation in this area is warranted. Additionally, some relevant studies may have been omitted by the simplified literature search strategy of this narrative review. This could be expanded upon in a secondary systematic review of gamified educational platforms.
Infección por Trypanosoma Cruzi en donantes de un banco de sangre del departamento Boyacá, Colombia
Authors: Suescún Carrero Sandra Helena , Medina Alfonso Mabel Idaliana , Murcia García Nubia Alexandra , Forero Pulido Sandra Marina 
Published: August 2021

Introducción: La Enfermedad de Chagas también conocida como Tripanosomiasis americana es un problema de salud pública. Se calcula que en el mundo hay entre 6 y 7 millones de personas infectadas por Trypanosoma cruzi, la mayoría de ellas en América Latina.
Objetivo: Identificar la prevalencia de infección por Trypanosoma cruzi en donantes de un banco de sangre del departamento de Boyacá 2016-2018.
Materiales y métodos: Estudio descriptivo retrospectivo realizado en 25.920 donantes de sangre del departamento de Boyacá. La fuente de información fue secundaria. Se determinó la prevalencia de la infección por Trypanosoma cruzi y se compararon según sexo, grupo etario y tipo de donante a través de análisis de frecuencias.
Resultados: Se evaluaron 9187 donantes durante el año 2016; 8517 en el 2017 y 8216 en el 2018, de los cuales 56,1% eran de sexo femenino y 43,9% masculino. La prevalencia de la infección por Trypanosoma cruzi fue 0,17 % en la tamización y 0,08 % con las pruebas confirmatorias de las cuales el 70,0% eran mujeres, el 85,0% donantes voluntarios por primera vez, el rango de edad en el que se presentó mayor prevalencia de este marcador serológico fue de 41 a 50 y de 51 a 65 años con un 35,0% cada uno . La prevalencia de la infección de Chagas presentó asociación estadísticamente significativa con la edad (p < 0,05).
Conclusiones: Los bancos de sangre resultan ser una de las fuentes de información disponibles para monitorear el comportamiento de la enfermedad de Chagas y evaluar la toma de decisiones en salud pública, teniendo en cuenta que la enfermedad se caracteriza de manera asintomática y sin compromiso clínico en la mayoría de los casos.
Descripción Manejo de la hiperglicemia en un hospital de primer nivel de atención
Authors: Castrillon Spitia Juan Daniel , Londoño Montes Juliana , Jaramillo Patiño Juliana , Garrido Hernández Carolina , Bermúdez Cardona Diana Carolina , Machado Alba Jorge Enrique 
Published: August 2021

Objetivo: Describir el tratamiento en un hospital de primer nivel de pacientes que consultaron el servicio de urgencias por hiperglucemia, el manejo previo y su probable relación con nuevas hiperglucemias.
Materiales y métodos: Estudio observacional de corte transversal con seguimiento de un año en pacientes mayores de 18 años con hiperglucemia que consultaron en el servicio de urgencias entre septiembre-2016 y agosto-2017. Se revisaron las historias clínicas y se establecieron variables sociodemográficas, clínicas, y farmacológicas. Se empleó estadística descriptiva, X2 y modelos de regresión logística binaria (P<0.05).

Resultados: Se presentaron 86 pacientes con hiperglucemia (edad media de 52.1±14.93 años). Se encontró que en el 58,1% de casos había un diagnóstico previo de diabetes mellitus; 87,2% fueron tratados con insulina cristalina y el 47,0% de los pacientes consultaron nuevamente por una crisis de hiperglucemia en los seis meses posteriores al egreso.

Conclusión: Existe alta proporción de pacientes con hiperglucemias no cetónicas, no hiperosmolares que desconocían presentar diabetes mellitus. Además, casi la mitad de los pacientes consultan nuevamente por crisis de hiperglucemia en los siguientes seis meses después del alta.
Hipotensión Permisiva en Trauma
Authors: Estrada Berrío Yamileth , Barco S´ánchez Alejandro , Ballén Ramírez Sthefanía , Salazar Bartolo Jeimmy Lorena , Ocampo Rincón John Jairo 
Published: August 2021

Introducción: El shock hemorrágico es una de las causas más comunes de muerte en pacientes con trauma debido a que pone en marcha un círculo vicioso de mecanismos que incluyen hipotermia, acidosis y coagulopatía. Para mitigar estos efectos, se han propuesto estrategias de control de daños, incluido el aporte controlado de líquidos con hipotensión permisiva contemplando metas en la presión arterial sistólica para mantener una adecuada perfusión de los tejidos.
Objetivo: Conocer información actualizada acerca del manejo de la hipotensión permisiva en pacientes con trauma.
Metodología: Se buscó información en las bases de datos Web-of-Science y Scopus de los últimos cinco años. El resultado arrojó un total de 118 artículos de los cuales se tomaron 30, según los criterios de inclusión y exclusión.
Resultados: Todos los artículos consideran el uso de la hipotensión permisiva como una buena opción para el manejo de los pacientes con trauma e hipotensión, sin embargo, difieren en qué momento es adecuado utilizarlo y en qué condiciones se debe realizar.
Conclusiones: Si bien la hipotensión permisiva se ha convertido en uno de los pilares fundamentales en el manejo prehospitalario del paciente con trauma, se requieren estudios investigativos en humanos para soportar cuándo y cómo debe utilizarse.
Psicodrama como terapia en trauma y estrés postraumático
Authors: Gutiérrez Segura Julio César , Ocampo Serna Sabina 
Published: August 2021

Objetivo: Evaluar la evidencia disponible de la eficacia del psicodrama como terapia para el manejo del trauma psicológico, trastorno por estrés agudo y postraumático.
Método: Se realizó una búsqueda sistemática de la literatura en MEDLINE, EMBASE, Cochrane Central, Scopus, LILACS y Ovid hasta abril de 2019. Se incluyeron los términos: (1)Psychodrama, (2)Role-playing, (3)Stress disorders, Acute, posttraumatic, y (4)Psychological trauma (MeSH). Se seleccionaron revisiones sistemáticas de la literatura, metaanálisis, ensayos clínicos aleatorios, cuasi aleatorios y estudios observacionales en inglés y español. Se seleccionaron los trabajos que incluyeran una descripción de las intervenciones con técnicas del psicodrama.
Resultados: 14 trabajos cumplieron criterios de inclusión.
Conclusión: No se encontró una asociación fuerte de la eficacia del psicodrama ante los síntomas de estrés postraumático. Se requieren más investigaciones con diseño metodológico ajustado para este tipo de intervenciones.
Enfermedad, eutanasia y aborto: una reflexión desde la bioética
Authors: Picón Jaimes Yelson Alejandro , Orozco Chinome Javier Esteban , Lozada Martínez Iván David , Moscote Salazar Luis Rafael 
Published: August 2021

El objetivo de este manuscrito es reflexionar sobre la enfermedad, la eutanasia y el aborto desde la bioética, considerando las implicaciones legales en Colombia y la visión al respecto de profesionales dedicados a las ciencias de la salud en diferentes lugares del mundo. Las enfermedades crónicas son causa importante de limitación funcional, sufrimiento y mortalidad; algunas patologías comprometen tanto el estado de conciencia en las personas que afectan la capacidad de decidir, por lo cual, es importante buscar alternativas para garantizar la autonomía de los pacientes. La eutanasia es aceptada solo en algunos países, pero cuenta con dificultades para el acceso, debido a trámites burocráticos o falta de reglamentación. Finalmente, el aborto es un procedimiento altamente cuestionado por colectivos sociales y religiosos, lo cual ha llevado a la estigmatización de las mujeres que desean acceder a él.