bluuebunny/crossref_metadata_2025_split huggingface dataset:
Above and Beyond Age: Prediction of Major Postoperative Adverse Events in Head and Neck Surgery
Authors: Mascarella Marco A. , Muthukrishnan Nikesh , Maleki Farhad , Kergoat Marie-Jeanne , Richardson Keith , Mlynarek Alex , Forest Veronique-Isabelle , Reinhold Caroline , Martin Diego R. , Hier Michael , Sadeghi Nader , Forghani Reza 
Published: August 2021

Objective: Major postoperative adverse events (MPAEs) following head and neck surgery are not infrequent and lead to significant morbidity. The objective of this study was to ascertain which factors are most predictive of MPAEs in patients undergoing head and neck surgery. Methods: A cohort study was carried out based on data from patients registered in the National Surgical Quality Improvement Program (NSQIP) from 2006 to 2018. All patients undergoing non-ambulatory head and neck surgery based on Current Procedural Terminology codes were included. Perioperative factors were evaluated to predict MPAEs within 30-days of surgery. Age was classified as both a continuous and categorical variable. Retained factors were classified by attributable fraction and C-statistic. Multivariate regression and supervised machine learning models were used to quantify the contribution of age as a predictor of MPAEs. Results: A total of 43 701 operations were analyzed with 5106 (11.7%) MPAEs. The results of supervised machine learning indicated that prolonged surgeries, anemia, free tissue transfer, weight loss, wound classification, hypoalbuminemia, wound infection, tracheotomy (concurrent with index head and neck surgery), American Society of Anesthesia (ASA) class, and sex as most predictive of MPAEs. On multivariate regression, ASA class (21.3%), hypertension on medication (15.8%), prolonged operative time (15.3%), sex (13.1%), preoperative anemia (12.8%), and free tissue transfer (9%) had the largest attributable fractions associated with MPAEs. Age was independently associated with MPAEs with an attributable fraction ranging from 0.6% to 4.3% with poor predictive ability (C-statistic 0.60). Conclusion: Surgical, comorbid, and frailty-related factors were most predictive of short-term MPAEs following head and neck surgery. Age alone contributed a small attributable fraction and poor prediction of MPAEs. Level of evidence: 3
Mortality in dementia is predicted by older age of onset and cognitive presentation
Authors: Loi Samantha M , Tsoukra Paraskevi , Chen Zhiben , Wibawa Pierre , Mijuskovic Tamara , Eratne Dhamidhu , Di Biase Maria A , Evans Andrew , Farrand Sarah , Kelso Wendy , Goh Anita MY , Walterfang Mark , Velakoulis Dennis 
Published: August 2021

Objectives: Survival information in dementia is important for future planning and service provision. There have been limited Australian data investigating survival duration and risk factors associated with mortality in younger-onset dementia. Methods: This was a cross-sectional retrospective study investigating survival in inpatients with a diagnosis of dementia admitted to a tertiary neuropsychiatry service from 1991 to 2014. The Australian Institute of Health and Welfare National Death Index was used to obtain mortality information. Results: A total of 468 inpatients were identified, of which 75% had symptom onset at ⩽65 years of age (defined as younger-onset dementia). Dementia was categorised into four subtypes, Alzheimer’s dementia, frontotemporal dementia, vascular dementia and other dementias; 72% of the patients had died. Overall median survival duration was 10.6 years with no significant differences in duration within the dementia subtypes ( p = 0.174). Survival in older-onset dementia (symptom onset at >65 years of age) was about half of that in younger-onset dementia (median survival 6.3 years compared to 12.7 years, respectively). Independent predictors of mortality were having older-onset dementia (hazard ratio: 3.2) and having initial presenting symptoms being cognitive in nature (hazard ratio: 1.5). Females with an older-onset dementia had longer survival compared to males with an older-onset dementia, and this was reversed for younger-onset dementia. Older-onset dementia and younger-onset dementia conferred 3 and 6 times, respectively, increased risk of death compared to the general population. Conclusion: This is the largest Australian study to date investigating survival and risk factors to mortality in dementia. We report important clinical information to patients with dementia and their families about prognosis which will assist with future planning. Our findings suggest that for both older-onset dementia and younger-onset dementia, ‘new onset’ psychiatric symptoms precede the cognitive symptoms of a neurodegenerative process. This, and sex differences in survival depending on the age of onset of the dementia warrant further investigation.
Unusual presentation of extranodal diffuse large B-cell lymphoma in a solid-organ recipient during long-term immunosuppressive treatment
Authors: Camerini Chiara , Sant’Antonio Emanuela , Ginori Alessandro , Pellegri Marco , De Gaudio Cataldo , Banti Elena , Ciliberti Vincenzo , Parrini Manuela , Bozzoli Laura , Simonetti Federico , Capochiani Enrico 
Published: August 2021

Introduction: Posttransplant lymphoproliferative disorders (PTLDs) refer to a group of diseases, including diffuse large B-cell lymphoma (DLBCL), that develop after solid organ transplantation or hematopoietic stem cell transplantation. Extranodal involvement in PTLDs is common. Reports about exclusive bone marrow involvement are rare. Case description: A 70-year-old woman, who had undergone kidney transplantation in 2018, was diagnosed with exclusively extranodal, Epstein-Barr virus–negative DLBCL, with bone marrow and spleen involvement, during long-term immunosuppression. She achieved complete remission with combined immunochemotherapy and temporary hold of immunosuppression. Conclusions: This case shows an uncommon clinical presentation of DLBCL, which was challenging to diagnose, being entirely extranodal. The favorable clinical course relied on timely diagnosis and a multidisciplinary approach. Long-term consequences of posttransplant immunosuppression require a high level of suspicion for an appropriate management, aimed at preserving the graft while eradicating the lymphoproliferative disorder.
Retirement? Other Ways Out of the Labour Market Are Far More Worrying for Health: Results from a Matching Approach Study
Authors: Pirani Elena , De Santis Gustavo , Zanasi Francesca 
Published: August 2021

Objective Despite a growing body of research, the effects of retirement on health are not clear. The study explores the role played by the path out of the labour market (formal retirement vs. unemployment or family reasons), accounting for individual heterogeneity. Methods: Propensity score matching approach is employed on longitudinal data from the Survey of Health, Ageing and Retirement in Europe (2004–2015). Results: While health does not change significantly for those who formally retire, it worsens considerably for those who leave the labour market for other reasons. Moreover, health outcomes turn out to be highly heterogeneous, depending on individual socio-economic and job-related characteristics. Discussion: Leaving the labour market in one’s mature years is a complex transition. Future research should focus on understanding and combating the causes of premature exit from the labour market, a relevant concern both in economic terms and on health grounds, in the light of our results.
Hong Kong Poison Information Centre: Annual report 2019
Authors: Chow Tin Yat Anthony , Chan Chi Keung , Ng Sze Hong , Tse Man Li 
Published: August 2021

Background:The Hong Kong Poison Information Centre (HKPIC) provides consultation service to health care professionals and collect epidemiological data on poisoning in Hong Kong since 2005.Objective:To report and analyse the data of Hong Kong Poison Information Centre on poisoning in 2019.Methods:This was a retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2019.Results:A total of 4016 poisoned cases were analysed, which involved 1698 men (42.3%), 2312 women (57.6%) and 6 sex‐unspecified patients (0.1%). Majority of cases (77.3%) were between 13 and 69 years of age, and 10.5% were teenagers 13–19 years of age. Self‐harm/suicidal attempt (42.1%), unintentional exposure (18.1%) and abusive substance use (11.1%) were common reasons of poisoning. Excluding ethanol, which was the common co‐ingestant, the five most common types of poison were benzodiazepines, paracetamol, household products, zopiclone and Chinese herbal medicine. While most patients were managed with supportive treatment, 16.5% and 16.8% of the consultation cases were treated with decontamination and antidotes, respectively. Majority of cases recovered uneventfully, but 1.0% died and 4.7% had a major outcome. A total of six interesting cases and two outbreaks were discussed in this report.Conclusion:This 14th annual report provided updated epidemiological information on the pattern of poisoning in Hong Kong and highlighted a number of important changes compared with our previous reports.
A randomized non‐inferiority pilot study on the use of methoxyflurane (Penthrox®) for pain control in the emergency department
Authors: Wong Ka Ying , Lau James Siu Ki , Siu Axel Yuet Chung , Kan Pui Gay 
Published: August 2021

Background:Patients commonly visit the emergency department for pain after musculoskeletal injury, but the problem of oligoanalgesia is prevalent. Methoxyflurane (Penthrox®) is an inhalational analgesic for moderate to severe trauma‐associated pain in stable and conscious patients. It is a fast‐acting, effective analgesic that can be readily administered via a non‐invasive route, making it an attractive agent for managing acute pain in the emergency departments.Objectives:The aim was to assess the analgesic efficacy of methoxyflurane in patients with acute traumatic pain by comparing it to ketorolac, a standard analgesic treatment for moderate pain in emergency departments in Hong Kong.Methods:This was a single‐center, open‐label, randomized controlled, parallel‐group, non‐inferiority pilot study that enrolled adult patients with moderate trauma‐associated pain in an emergency department in Hong Kong. Patients were randomized 1:1 to the methoxyflurane group or the ketorolac group. The primary outcome was the change in pain intensity measured by visual analogue scale from baseline to 5, 15, 30, and 60 min after drug administration.Results:Twenty patients received methoxyflurane, and twenty patients received ketorolac. There were significant reductions in pain score over 60 min in both groups. The pain reduction at 5 min was significantly greater for the methoxyflurane group (−13.912 mm; 95% confidence interval = −20.008 to −7.817) than for the ketorolac group (−4.888 mm; 95% confidence interval = −10.983 to 1.208), with the treatment effect (−9.025 mm; 95% confidence interval = −17.656 to −0.393; p = 0.041) demonstrating superiority of methoxyflurane. The treatment effect at 15 and 30 min demonstrated non‐inferiority of methoxyflurane versus ketorolac.Conclusion:Methoxyflurane provided non‐inferior analgesia in the first 30 min with a faster onset of action when compared with ketorolac in moderate traumatic pain. It can be considered a non‐invasive, rapid‐acting, and effective first‐line alternative to currently available analgesics for traumatic pain in emergency settings.
Repeatability of Weightbearing Computed Tomography Measurement of First Metatarsal Alignment and Rotation
Authors: Najefi Ali-Asgar , Alsafi Mohammad Khalid , Malhotra Karan , Patel Shelain , Cullen Nicholas , Welck Matthew 
Published: August 2021

Background: Weightbearing computed tomography (WBCT) can be used to assess alignment and rotation of the first metatarsal. It is unknown whether these measures remain consistent on sequential WBCTs in the same patient when a patient’s standing position may be different. The aim of this study was to establish the repeatability (test-retest) of measurements of first metatarsal alignment and rotation in patients without forefoot pathology on WBCT. Methods: We retrospectively identified 42 feet in 26 patients with sequential WBCT studies less than 12 months apart. Patients with surgery between scans, previous forefoot surgery or hallux rigidus were excluded. Hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured using digitally reconstructed radiographs. Two methods of calculating metatarsal rotation (metatarsal pronation angle [MPA] and alpha angle) were measured on standardized coronal CT slices. Interobserver agreement and test-retest repeatability were assessed using intraclass correlation coefficients (ICCs). Standard error of measurement (SEM) and minimally detectable change (MDC95) were calculated. Results: Interobserver agreement was excellent for HVA and IMA (ICC 0.96 and 0.90, respectively) and was good for MPA and alpha angle (ICC 0.81 and 0.80, respectively). There was excellent test-retest repeatability for HVA (ICC=0.90) and good test-retest repeatability for IMA (ICC=0.77). There was excellent test-retest repeatability for MPA (ICC=0.91) and good test-retest repeatability for alpha angle (ICC=0.87). The MDC95 was 4.6 degrees for MPA and 6.1 degrees for alpha angle. Five percent of patients had a difference outside of the MDC95 for the alpha angle, compared with 2% for the MPA. Conclusion: Measurements of first metatarsal alignment and rotation are reliable between assessors and repeatable between sequential WBCTs in patients without forefoot pathology. Subtle differences in patient positioning during image acquisition do not significantly affect measurements, supporting the validity of this method of assessment in longitudinal patient care. Level of Evidence: Level IV, retrospective case series.
Work ability and psychological distress in a working population: results from the Stockholm Public Health Cohort
Authors: Onell Clara , Holm Lena W. , Bohman Tony , Magnusson Cecilia , Lekander Mats , Skillgate Eva 
Published: August 2021

Aims: Psychological distress is a global public health concern with individual and societal implications causing work-related disability and loss of productivity. It is less known how much work ability contributes to the development of psychological distress. This study aimed to assess the association between self-perceived physical and mental work ability in relation to job demands, and the incidence of psychological distress in a Swedish working population. Methods: Data were obtained from three subsamples of the Stockholm Public Health Cohort with baseline in 2010 and follow-up in 2014, based on a working population in Stockholm County aged 18–60 years, with no or mild psychological distress at baseline ( n=29,882). Self-perceived physical and mental work ability in relation to job demands were assessed at baseline with a subscale from the Work Ability Index. Study participants scoring 4 or more on the General Health Questionnaire 12 at follow-up were classified as having developed psychological distress during the study period. Poisson log linear regression was used to calculate crude and adjusted rate ratios with 95% confidence intervals. Results: At follow-up, 2543 participants (12%) had developed psychological distress. Reporting poor physical and/or poor mental work ability in relation to job demands at baseline was associated with an almost doubled rate ratio of psychological distress at follow-up, compared to reporting good work ability (rate ratio 1.8; 95% confidence interval 1.6–2.0). Conclusions: Poor work ability is associated with a higher incidence of future psychological distress compared to good work ability.
The rate of child restraint system use among children aged under six years in China
Authors: Zheng Xiaoguo , Li Ruili , Yang Huimin , Yin Delu , Yin Tao , Wang Lihong , Chen Bowen 
Published: August 2021

Aims: The child restraint system (CRS) for vehicles is designed to provide specialized protection for children in the event of a crash. The aim of the study was to investigate the rate of CRS use and analyze the factors associated with CRS use among children aged under six years in China, and to provide further insight into developing strategies for promoting public health education. Methods: This is a cross-sectional study. The study sites were 36 primary healthcare institutions in 12 provinces across China, and the participants were 34,503 guardians of children aged 0–6 years. Guardians who owned private cars were included and completed surveys about their experience using CRS. Odds ratios and 95% confidence intervals were calculated using multivariate logistic regression models. Results: The overall rate of CRS use among children aged under six years in China was 17.3%. Multivariate logistic regression analysis revealed that living in an urban area, low age of the child, guardians having higher education and being looked after by parents had a significant positive association with CRS use among children aged under six years. Conclusions: This study confirms that there is a low rate of CRS use among children aged under six years in China, highlighting the considerable need for CRS use education, advocacy and promotion of increasing use.
Overweight and obesity among children in rural areas: The importance of culture
Authors: Heggem Reidun , Zahl-Thanem Alexander 
Published: August 2021

Aims: This paper focuses on how social inequality is associated with overweight and obesity in children. There is a lack of research with a focus on an important distinction in social inequality, namely geography. The aim of this study was to reduce this knowledge gap by looking closely at the links between rurality and overweight. Methods: The findings in this paper are based on in-depth interviews with school nurses and teachers in rural Norway. The focus was on their experiences with and knowledge about overweight and obesity numbers in rural versus urban areas. Results: We used Bourdieu’s terminology to address the challenges related to urban–rural differences, and found that cultural factors connected to tradition, identity and courtesy play an important role in the rural overweight and obesity discourse. Conclusions: Actors and ‘experts’ working with overweight and obesity and national guidelines need to understand rural contexts and customs and address problems of the countryside on rural, not exclusively urban, premises. Different contexts imply different needs when it comes to reducing the inequalities between rural and urban areas regarding overweight and obesity.
The belts are set out: The batizado as a symbolic welcome to capoeira culture
Authors: Delamont Sara , Stephens Neil 
Published: August 2021

In contemporary capoeira groups, newcomers are symbolically ‘baptised’ into the community at a public ceremony called their Batizado (literally baptism) held during a festival. Novices play a game with a guest expert, get their first belt and thereafter they are members of their teacher’s group. Drawing on a long term, two-handed ethnography of diasporic capoeira contemporanea in the UK, including observation of 53 such festivals, their ceremonial features are analysed. At all the stages of the ‘welcome’, before, during and after the batizado, the topic of gender in capoeira contemporanea is explored. In the last 40 years, women have become enthusiastic participants and are core members of the groups we have studied. The article compares the sociological (symbolic interactionist) and anthropological approaches to ceremonies and rituals such as the capoeira batizado, drawing on Glaser, Strauss and Katz compared to van Gennep, Turner and MacAloon.
Culturally Relevant Online Cancer Education Supports Tribal Primary Care Providers to Reduce Their Cancer Risk and Share Information About Cancer
Authors: Cueva Katie , Cueva Melany , Revels Laura , Hensel Michelle , Dignan Mark 
Published: August 2021

Background Culturally relevant education is an opportunity to reduce health disparities, and online learning is an emerging avenue for health promotion. In 2014–2019, a team based at the Alaska Native Tribal Health Consortium developed, implemented, and evaluated culturally relevant online cancer education modules with, and for, Alaska’s tribal primary care providers. The project was guided by Indigenous Ways of Knowing and the principles of community-based participatory action research and was evaluated in alignment with empowerment theory. About 265 unique learners completed 1,898 end-of-module evaluation surveys between March 2015 and August 2019, and 13 people completed a follow-up survey up to 28 months post module completion. Key Findings Learners described the modules as culturally respectful and informative and reported feeling more knowledgeable and comfortable talking about cancer as a result of the modules. About 98% of the learners planned to reduce their cancer risk because of the modules, and all follow-up survey respondents had reduced their risk, including by quitting smoking, getting screened for cancer, eating healthier, and exercising more. About 98% of the learners planned to share information with their patients, families, friends, and community members because of the modules, with all follow-up survey respondents indicating that they had shared information about cancer from the modules. Implications for Practice and Further Research Culturally relevant online modules have the capacity for positive behavioral change and relatively high correlations between intent and behavior change. Future research could determine which aspects of the modules catalyzed reduced cancer risk and increased dissemination of cancer information.
Early and midterm outcomes of hybrid first line treatment in patients with chronic limb threatening ischemia
Authors: Mezzetto Luca , Mastrorilli Davide , Scorsone Lorenzo , Macrì Marco , Criscenti Paolo , Bruno Salvatore , Veraldi Edoardo , Veraldi Gian Franco 
Published: August 2021

Objective The aim of the study was to evaluate the outcome of first line hybrid treatment in patients with chronic limb threatening ischemia (CLTI) and to evaluate possible predictors of primary patency (PP) loss and limb clinical improvement (LCI). Methods This was a retrospective non-randomized study. All patients underwent one-stage hybrid common femoral artery (CFA) endarterectomy combined with an inflow and/or outflow endovascular revascularization procedure. Demographic, clinical, and lesion characteristics for each patient were reported. Primary patency analysis was performed using Kaplan–Meier life tables, and univariate and multivariate analysis was used to assess possible predictors of PP loss and clinical improvement. Results Complete data were obtained from 132 patients. Patients were divided into two groups according to their Rutherford’s category (RC), group 1 (Rutherford 4) and group 2 (Rutherford 5 and 6). Technical success was 98%. The overall surgical peri-operative complication rate was 8%. At a mean follow-up of 32 ± 23 months, the rate of major adverse limb events (MALE) was 30%; only the rate of major amputation between two groups was significant statistically different ( p = .006). Group 1 had significantly lower amputation rate at 36 months ( p = .01). The presence of high iliac peripheral artery calcium scoring system (PACCS) grade (HR 9.43, 95% CI 2.40–36.9, p = .001), the poor run-off of leg vessels (HR 0.15, 95% CI 0.02–0.92, p = .04), and undergoing CFA endarterectomy combined with outflow endovascular revascularization procedure (HR 4.25, 95% CI 1.07–16.89, p = .04) were independent predictors of PP loss, while severe iliac artery stenosis (OR 0.09, 95% CI 0.02–0.32, p = <.001) and the presence of pre-operative patent leg vessels (OR 8.03, 95% CI 2015–29.95, p = .002) were the significant independent predictors of LCI. Conclusion The use of hybrid first line approach in patients with CLTI is a safe and feasible technique. From the analysis of the current study, it is clear that any effort should be made to achieve as many patency leg vessels as possible in order to obtain better and longer lasting clinical outcomes.