bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heterogeneity in the association between youth unemployment and mental health later in life: a quantile regression analysis of longitudinal data from English schoolchildren
Authors: Wright Liam , Head Jenny , Jivraj Stephen 
Published: July 2021

ObjectivesAn association between youth unemployment and poorer mental health later in life has been found in several countries. Little is known about whether this association is consistent across individuals or differs in strength. We adopt a quantile regression approach to explore heterogeneity in the association between youth unemployment and later mental health along the mental health distribution.DesignProspective longitudinal cohort of secondary schoolchildren in England followed from age 13/14 in 2004 to age 25 in 2015.SettingEngland, UK.Participants7707 participants interviewed at age 25.Primary and secondary outcome measures12-Item General Health Questionnaire (GHQ) Likert score, a measure of minor psychiatric morbidity.ResultsYouth unemployment was related to worse mental health at age 25. The association was several times stronger at deciles of GHQ representing the poorest levels of mental health. This association was only partly attenuated when adjusting for confounding variables and for current employment status. In fully adjusted models not including current employment status, marginal effects at the 50th percentile were 0.73 (95% CI −0.05 to 1.54, b=0.11) points, while marginal effects at the 90th percentile were 3.76 (95% CI 1.82 to 5.83; b=0.58) points. The results were robust to different combinations of control variables.ConclusionsThere is heterogeneity in the longitudinal association between youth unemployment and mental health, with associations more pronounced at higher levels of psychological ill health. Youth unemployment may signal clinically relevant future psychological problems among some individuals.
Development and validation of the Health-Friendly Activity Index: an assessment tool to comprehensively measure health-friendly activities of corporations or organisations
Authors: Yun Young Ho , Oh Si Nae , Sim Jin-Ah , Lee Sujee , Sohn Eun-Jung 
Published: July 2021

ObjectivesWe developed the Health-Friendly Activity Index (HFAI) to comprehensively measure the health-friendly activities of corporations or organisations. We validated the developed tool and reported on its use as an assessment tool to improve consumers’ health-related outcomes.DesignThis was a cross-sectional study.SettingDevelopment of the HFAI questionnaire followed a three-phase process: item generation, item construction and validation with field testing. Using relevance and feasibility criteria, we developed a 105-item questionnaire with six domains (Governance and Infrastructure, Needs Assessment, Planning, Implementation, Monitoring and Feedback, and Outcomes).ParticipantsTo assess the sensitivity and validity of the questionnaire, the HFAI and Contribution Assessment Tool for Consumer’s Health (CATCH) were administered to 302 participants (151 employers and 151 employees) from 151 Korean companies.Primary outcome measuresThe CATCH measured the contribution of each company to the physical, mental, social and spiritual health of its consumers. To estimate the reliability and validity of all six HFAI domains and their respective scales, Cronbach’s α coefficients and correlation coefficients were used.ResultsEach domain and scale of the HFAI exhibited a Cronbach’s α coefficient between 0.80 and 0.98 for the employers and employees. The overall HFAI and its six domains correlated significantly and positively with all health outcomes such as physical, mental, social and spiritual status scores evaluated using the CATCH (Spearman’s correlation range: 0.37–0.68).ConclusionThe HFAI, a unique assessment tool with acceptable psychometric properties, can help corporate managers assess their health-friendly activities.
Acceptability of patient reported outcome measures (PROMs) in a cystic fibrosis data registry
Authors: Ratnayake Irushi , Ahern Susannah , Ruseckaite Rasa 
Published: July 2021

IntroductionImprovements in the treatment of cystic fibrosis (CF) have resulted in longer survival and an increased focus on optimising daily functioning with the condition. Patient-reported outcome measures (PROMs) are valuable tools in evaluating the health-related quality of life of persons with chronic diseases. PROMs may be incorporated into clinical registries to assess and provide feedback regarding the health-related quality of life of the affected population. This study uses qualitative methodology to describe the views of patients with CF, caregivers and clinicians on the usefulness and practicality of incorporating a PROM in the Australian Cystic Fibrosis Data Registry (ACFDR).MethodsWe conducted semistructured interviews with a convenience sample of patients with CF (n=5), caregivers (n=7) and clinicians (n=13) on their opinions on incorporating the Cystic Fibrosis Questionnaire-Revised or the Cystic Fibrosis Quality of Life Questionnaire into the ACFDR. We analysed data into topics and subtopics using conventional content analysis.ResultsParticipants believed that PROMs could generate useful aggregate health-related quality of life data to support better understanding of the experiences of the modern CF population. Participants emphasised that implementation must be supported by processes to feedback data to patients and clinicians. Most participants preferred electronic PROMs administration for easy integration into existing systems and the potential to support feedback.ConclusionPatients, caregivers and clinicians in this study generally supported the usefulness and practicality of PROM implementation in the ACFDR.
Among respiratory symptoms, wheeze associates most strongly with impaired lung function in adults with asthma: a long-term prospective cohort study
Authors: Bermúdez Barón Nicolás , Lindberg Anne , Stridsman Caroline , Andersson Martin , Hedman Linnea , Vikjord Sigrid Anna , Kankaanranta Hannu , Lundbäck Bo , Rönmark Eva , Backman Helena 
Published: July 2021

BackgroundAsthma is a common disease and a major public health concern. Respiratory symptoms are related to its prognosis, which in turn associates with lung function. Still this association on a long-term basis is not entirely understood.AimTo study the association of the type and number of respiratory symptoms with FEV1and FEV1decline in women and men with asthma.MethodA population-based cohort of adults with asthma was examined at study entry between 1986 and 2001 and at follow-up between 2012 and 2014, and n=977 had valid measurements of FEV1on both occasions. Data regarding respiratory symptoms at study entry (recurrent wheeze, dyspnoea, longstanding cough and productive cough) were analysed in relation to FEV1and annual decline in FEV1, both unadjusted and adjusted for other potentially associated factors by linear regression.ResultsFor both sexes recurrent wheeze and dyspnoea were associated with lower FEV1at study entry and follow-up, while productive cough was associated with lower FEV1only at follow-up. No associations were found between the type of symptoms and annual decline in FEV1. In adjusted analyses, the association between recurrent wheeze and lower FEV1both at study entry and follow-up remained significant among women. Also, the association between a higher number of symptoms with lower FEV1both at study entry and follow-up were present for both sexes and remained after adjustment.ConclusionsParticularly recurrent wheeze and a higher number of respiratory symptoms may predict lower lung function also in the long run among women and men with asthma.
COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study
Authors: Belli Luca Saverio , Duvoux Christophe , Cortesi Paolo Angelo , Facchetti Rita , Iacob Speranta , Perricone Giovanni , Radenne Sylvie , Conti Sara , Patrono Damiano , Berlakovich Gabriela , Hann Angus , Pasulo Luisa , Castells Lluis , Faitot Francois , Detry Olivier , Invernizzi Federica , Magini Giulia , De Simone Paolo , Kounis Ilias , Morelli Maria Cristina , Díaz Fontenla Fernando , Ericzon Bo-Göran , Loinaz Carmelo , Johnston Chris , Gheorghe Liliana , Lesurtel Mickael , Romagnoli Renato , Kollmann Dagmar , Perera M Thamara PR , Fagiuoli Stefano , Mirza Darius , Coilly Audrey , Toso Christian , Zieniewicz Krzysztof , Elkrief Laure , Karam Vincent , Adam Rene , den Hoed Caroline , Merli Marco , Puoti Massimo , De Carlis Luciano , Oniscu Gabriel C , Piano Salvatore , Angeli Paolo , Fondevila Constantino , Polak Wojciech G 
Published: July 2021

ObjectiveExplore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course.DesignData from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed.ResultsFrom 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10–30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15–19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44–102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31–170).ConclusionsIncreased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).
Beneficial haemodynamic effects of insulin in chronic heart failure
Authors: Parsonage W A , Hetmanski D , Cowley A J 
Published: July 2021

OBJECTIVETo characterise the central and regional haemodynamic effects of insulin in patients with chronic heart failure.DESIGNSingle blind, placebo controlled study.SETTINGUniversity teaching hospital.PATIENTSTen patients with stable chronic heart failure.INTERVENTIONSHyperinsulinaemic euglycaemic clamp and non-invasive haemodynamic measurements.MAIN OUTCOME MEASURESChange in resting heart rate, blood pressure, cardiac output, and regional splanchnic and skeletal muscle blood flow.RESULTSInsulin infusion led to a dose dependent increase in skeletal muscle blood flow of 0.36 (0.13) and 0.73 (0.14) ml/dl/min during low and high dose insulin infusions (p < 0.05 and p < 0.005 v placebo, respectively). Low and high dose insulin infusions led to a fall in heart rate of 4.6 (1.4) and 5.1 (1.3) beats/min (p < 0.05 and p < 0.005 v placebo, respectively) and a modest increase in cardiac output. There was no significant change in superior mesenteric artery blood flow.CONCLUSIONIn patients with chronic heart failure insulin is a selective skeletal muscle vasodilator that leads to increased muscle perfusion primarily through redistribution of regional blood flow rather than by increased cardiac output. These results provide a rational haemodynamic explanation for the apparent beneficial effects of insulin infusion in the setting of heart failure.
Clinical outcome following coronary angioplasty in dialysis patients: a case–control study in the era of coronary stenting
Authors: Le Feuvre C , Dambrin G , Helft G , Beygui F , Touam M , Grünfeld J P , Vacheron A , Metzger J P 
Published: July 2021

BACKGROUNDBalloon coronary angioplasty has been reported to be ineffective in patients treated for end stage renal disease because of a high restenosis rate.OBJECTIVETo compare the clinical outcome following coronary angioplasty with provisional stenting in dialysis versus non-dialysis patients.DESIGNA case–control study.PATIENTSOf 1428 consecutive patients who underwent coronary angioplasty, 100 (7%) were being treated for end stage renal disease. These were compared with 100 control patients matched for age, sex, coronary lesions, presence of diabetes mellitus, and rate of coronary stenting (40%).MAIN OUTCOME MEASURESIn-hospital and one year clinical outcome.RESULTSThe rates of procedural success (90% v 93%), in-hospital mortality (1% v 0%), stent thrombosis (0%v 0%), and Q wave myocardial infarction (0% v 1%) were similar in dialysis and non-dialysis patients. One year clinical outcome after coronary angioplasty was similar in the two groups in terms of clinical restenosis (31% v 28%) and myocardial infarction (6% v 2%), but cardiac death was more common in dialysed patients (11% v2%, p < 0.03).CONCLUSIONSDialysis does not increase the risk of clinical restenosis after coronary angioplasty with provisional stenting. Coronary angioplasty is a safe and effective therapeutic procedure in selected dialysis patients with culprit lesions accessible to stenting. However, the one year survival is reduced in this high risk population.
Increased brain and atrial natriuretic peptides in patients with chronic right ventricular pressure overload: correlation between plasma neurohormones and right ventricular dysfunction
Authors: Tulevski I I , Groenink M , van der Wall E E , van Veldhuisen D J , Boomsma F , Stoker J , Hirsch A , Lemkes J S , Mulder B J M 
Published: July 2021

OBJECTIVETo evaluate the role of plasma neurohormones in the diagnosis of asymptomatic or minimally symptomatic right ventricular dysfunction.SETTINGTertiary cardiovascular referral centre.METHODSPlasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) concentrations were measured in 21 asymptomatic or minimally symptomatic patients with chronic right ventricular pressure overload caused by congenital heart disease, and in seven healthy volunteers. Right ventricular ejection fraction was determined using magnetic resonance imaging.RESULTSRight ventricular ejection fraction in the volunteers was higher than in the patients (69.0 (8.2)% v 58.0(12.0)%, respectively; p < 0.006). Left ventricular ejection fraction was 72.3(7.8)% in volunteers and 68.1(11.0)% in patients (NS). There was a significant difference between patients and volunteers in the plasma concentrations of BNP (5.3 (3.5) v 2.3 (1.7) pmol/l, respectively; p < 0.009) and ANP (7.3 (4.5)v 3.6 (1.4) pmol/l; p < 0.05). In both patients and volunteers, mean plasma ANP was higher than mean plasma BNP. Right ventricular ejection fraction was inversely correlated with BNP and ANP (respectively, r = 0.65; p < 0.0002 and r = 0.61; p < 0.002). There was no correlation between left ventricular ejection fraction and BNP (r = 0.2; NS) or ANP (r = 0.52; NS). Similarly, no correlation was shown between the level of right ventricular systolic pressure and either plasma BNP (r = 0.20) or plasma ANP (r = 0.07).CONCLUSIONSThere was a significant inverse correlation between right ventricular ejection fraction and the plasma neurohormones BNP and ANP in asymptomatic or minimally symptomatic patients with right ventricular pressure overload and congenital heart disease. Monitoring changes in BNP and ANP may provide quantitative follow up of right ventricular dysfunction in these patients.
Long term results of mechanical prostheses for treatment of active infective endocarditis
Authors: Guerra J M , Tornos M P , Permanyer-Miralda G , Almirante B , Murtra M , Soler-Soler J 
Published: July 2021

OBJECTIVETo analyse the long term results of mechanical prostheses for treating active infective endocarditis.DESIGNProspective cohort study of a consecutive series of patients diagnosed with infective endocarditis and operated on in the active phase of the infection for insertion of a mechanical prosthesis.SETTINGTertiary referral centre in a metropolitan area.RESULTSBetween 1975 and 1997, 637 cases of infective endocarditis were diagnosed in the centre. Of these, 436 were left sided (with overall mortality of 20.3%). Surgical treatment in the active phase of the infection was needed in 141 patients (72% native, 28% prosthetic infective endocarditis). Mechanical prostheses were used in 131 patients. Operative mortality was 30.5% (40 patients). Ninety one survivors were followed up prospectively for (mean (SD)) 5.4 (4.5) years. Thirteen patients developed prosthetic valve dysfunction. Nine patients suffered reinfection: four of these (4%) were early and five were late. The median time from surgery for late reinfection was 1.4 years. During follow up, 12 patients died. Excluding operative mortality, actuarial survival was 86.6% at five years and 83.7% at 10 years; actuarial survival free from death, reoperation, and reinfection was 73.1% at five years and 59.8% at 10 years.CONCLUSIONSIn patients surviving acute infective endocarditis and receiving mechanical prostheses, the rate of early reinfection compares well with reported results of homografts. In addition, prosthesis dysfunction rate is low and long term survival is good. These data should prove useful for comparison with long term studies, when available, using other types of valve surgery in active infective endocarditis.
What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education
Authors: Moons P , De Volder E , Budts W , De Geest S , Elen J , Waeytens K , Gewillig M 
Published: July 2021

OBJECTIVETo assess how much adults with congenital heart disease understand about their heart defect, its treatment, and the preventive measures necessary to avoid complications.DESIGNDescriptive, cross sectional study.SETTINGAdult congenital heart disease programme in one tertiary care centre in Belgium.PATIENTS62 adults with congenital heart disease (47 men; 15 women), median age 23 years.MAIN OUTCOME MEASURESPatients' knowledge was assessed during an outpatient visit using the Leuven knowledge questionnaire for congenital heart diseases, a 33 item instrument developed for this study.RESULTSPatients had adequate knowledge (> 80% correct answers) about their treatment, frequency of follow up, dental practices, occupational choices, appropriateness of oral contraceptives, and the risks of pregnancy. Knowledge about the name and anatomy of the heart defect, the possibility of recurrent episodes of endocarditis during their lifetime, and the appropriateness of different physical activities was moderate (50–80% correct answers). There was poor understanding (< 50% correct answers) about the reasons for follow up, the symptoms of deterioration of the heart disease, the definition, characteristics, and risk factors of endocarditis, the impact of smoking and alcohol on the heart disease, the hereditary nature of the condition, and the suitability of intrauterine devices as contraceptives.CONCLUSIONSAdults with congenital heart disease have important gaps in their knowledge about their condition. The results of this study can be used as a basis for developing or optimising structured educational interventions to enhance patients' health behaviour.
Raised urinary glucocorticoid and adrenal androgen precursors in the urine of young hypertensive patients: possible evidence for partial glucocorticoid resistance
Authors: Shamim W , Yousufuddin M , Francis D P , Gualdiero P , Honour J W , Anker S D , Coats A J S 
Published: July 2021

OBJECTIVETo evaluate urinary glucocorticoid excretion profiles in a cohort of recently diagnosed young hypertensive patients.METHODSAfter excluding patients with secondary causes, 60 individuals with premature hypertension were recruited (diagnosed by ambulatory blood pressure monitoring before the age of 36 years). In addition, 30 older hypertensive controls (age of onset > 36 years, “middle aged hypertensive controls”), and 30 normal controls (age matched to the young hypertensive group) were studied. All provided 24 hour urine collections for mass spectrometry for total cortisol metabolites and total androgen metabolites by gas chromatography.RESULTSAmong male patients, those with premature hypertension had higher total urinary excretion of cortisol metabolites (mean (SD), 13 332 (6472) μg/day) than age matched normal controls (7270 (1788) μg/day; p = 0.00001) or middle aged hypertensive controls (8315 (3565) μg/day; p = 0.002). A similar increase was seen among the female patients, although the absolute concentrations were lower. There was no significant difference between middle aged hypertensive patients and normal controls. Urinary total androgen excretion profiles in female patients also showed an unusual increase in the premature hypertension group (2958 (1672) μg/day) compared with the other groups (middle aged hypertensive controls, 1373 (748) μg/day, p = 0.0003; normal controls, 1687 (636) μg/day, p = 0.002). In all subjects, serum sodium and creatinine concentrations were within the normal range; serum potassium concentrations were found to be low before the start of treatment.CONCLUSIONSIndividuals presenting with premature hypertension have an abnormally high excretion of glucocorticoid metabolites in the urine. While the mechanism remains uncertain, these findings are compatible with partial resistance of the glucocorticoid receptors, with a compensatory increase in cortisol and androgen metabolites. The mineralocorticoid effects of the latter (sodium and water retention) may contribute to an abnormally high blood pressure and may have implications for targeted selection of first line treatment in young hypertensive patients.