bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality and years of life lost of colorectal cancer in China, 2005–2020: findings from the national mortality surveillance system
Authors: Wang Wei , Yin Peng , Liu Yun-Ning , Liu Jiang-Mei , Wang Li-Jun , Qi Jin-Lei , You Jin-Ling , Lin Lin , Meng Shi-Di , Wang Fei-Xue , Zhou Mai-Geng 
Published: July 2021

Abstract

Background:
Colorectal cancer (CRC) is the fourth cause of cancer death in China. We aimed to provide national and subnational estimates and changes of CRC premature mortality burden during 2005–2020.

Methods:
Data from multi-source on the basis of the national surveillance mortality system were used to estimate mortality and years of life lost (YLL) of CRC in the Chinese population during 2005–2020. Estimates were generated and compared for 31 provincial-level administrative divisions in China.

Results:
Estimated CRC deaths increased from 111.41 thousand in 2005 to 178.02 thousand in 2020; age-standardized mortality rate decreased from 10.01 per 100,000 in 2005 to 9.68 per 100,000 in 2020. Substantial reduction in CRC premature mortality burden, as measured by age-standardized YLL rate, was observed with a reduction of 10.20% nationwide. Marked differences were observed in the geographical patterns of provincial units, and they appeared to be obvious in areas with higher economic development. Population aging was the dominant driver which contributed to the increase in CRC deaths, followed by population growth and age-specific mortality change.

Conclusions:
Substantial discrepancies were observed in the premature mortality burden of CRC across China. Targeted considerations were needed to promote a healthy lifestyle, expand cost-effective CRC early screening and diagnosis, and improve medical treatment to reduce CRC mortality among high-risk populations and regions with inadequate healthcare resources.
Sodium–glucose cotransporter-2 Inhibitors in Heart Failure: An Updated Systematic Review and Meta-analysis of 13 Randomized Clinical Trials Including 14,618 Patients With Heart Failure
Authors: Shrestha Dhan Bahadur , Budhathoki Pravash , Sedhai Yub Raj , Karki Parag , Gurung Suja , Raut Sumit , Damonte Juan Ignacio , Del Buono Marco Giuseppe , Mojadidi Mohammad Khalid , Elgendy Islam Y. , Patel Toralben , Patel Nimesh K. 
Published: July 2021

Abstract:
Sodium–glucose cotransporter-2 (SGLT-2) inhibitors showed benefit in patients with heart failure. In this updated meta-analysis, we evaluate the therapeutic efficacy and safety of SGLT-2 inhibitors in patients with heart failure. Different electronic databases were searched to find relevant articles. RevMan 5.4 was used for pooling data using a random/fixed-effects model, complemented by several sensitivity and subgroup analyses. A total of 13 randomized clinical trials including 14,618 patients with heart failure were included in analysis among 6797 studies screened. The overall mortality rate was 12.45% in the SGLT-2 group and 14.67% in the placebo group with 18% lower odds of overall mortality [odds ratio (OR), 0.82; confidence interval (CI), 0.75–0.91] in the SGLT-2 group. Odds of cardiovascular mortality was 18% lower (OR, 0.82; CI, 0.74–0.92) in the SGLT-2 group. The odds of hospitalization for heart failure (HHF) was 38% lower during the study period (OR, 0.62; CI, 0.56–0.68) in the SGLT-2 group. In addition, a benefit was seen for composite outcome HHF or mortality and considering subgrouping based on diabetes status, gender, and age groups. Although genital infection was significantly higher in the SGLT-2 group, the occurrence of severe adverse events, hypoglycemia, urinary tract infection, bone fracture, volume depletion, and other renal events did not differ between the 2 groups. Thus, SGLT-2 inhibitors improved cardiovascular outcomes among patients with heart failure with no significant difference in adverse events. Clinical benefit was comparable in diabetic and nondiabetic individuals, males and females, people in younger and older age groups with underlying heart failure, and HF with reduced ejection fraction.
Individual changes of central blood pressure in response to upright posture: different hemodynamic phenotypes
Authors: Suojanen Lauri J. , Koskela Jenni K. , Wilenius Matias , Choudhary Manoj Kumar , Hautaniemi Elina J. , Viik Jari , Mustonen Jukka T. , Pörsti Ilkka H. 
Published: July 2021

Objectives:
Most studies about upright regulation of blood pressure have focused on orthostatic hypotension despite the diverse hemodynamic changes induced by orthostatic challenge. We investigated the effect of passive head-up tilt on aortic blood pressure.

Methods:
Noninvasive peripheral and central hemodynamics in 613 volunteers without cardiovascular morbidities or medications were examined using pulse wave analysis, whole-body impedance cardiography and heart rate variability analysis.

Results:
In all participants, mean aortic SBP decreased by −4 (−5 to −3) mmHg [mean (95% confidence intervals)] and DBP increased by 6 (5--6) mmHg in response to upright posture. When divided into tertiles according to the supine-to-upright change in aortic SBP, two tertiles presented with a decrease [−15 (−14 to −16) and −4 (−3 to −4) mmHg, respectively] whereas one tertile presented with an increase [+7 (7-- 8) mmHg] in aortic SBP. There were no major differences in demographic characteristics between the tertiles. In regression analysis, the strongest explanatory factors for upright changes in aortic SBP were the supine values of, and upright changes in systemic vascular resistance and cardiac output, and supine aortic SBP.

Conclusion:
In participants without cardiovascular disease, the changes in central SBP during orthostatic challenge are not uniform. One-third presented with higher upright than supine aortic SBP with underlying differences in the regulation of systemic vascular resistance and cardiac output. These findings emphasize that resting blood pressure measurements give only limited information about the blood pressure status.
IMAGE ANALYSIS OF OPTICAL COHERENCE TOMOGRAPHY SCANS TO EXPLORE ESTABLISHED AND NOVEL CHOROIDAL FEATURES IN PATIENTS WITH CENTRAL SEROUS CHORIORETINOPATHY
Authors: Aslam Tariq M. , Chhabra Ramandeep , Agrawal Rupesh , Beg Amaad , Kasbia Shakti , Boonarpha Nattapon , Ali Zaria , Hoyle David C. 
Published: July 2021

Purpose:To explore the characteristics of choroidal tissue in patients with and without central serous chorioretinopathy (CSC) using an automated system of image analysis to determine known and novel metrics.Methods:This was a retrospective case–control analysis of optical coherence tomography scans of patients seen at Manchester Royal Eye Hospital, UK, comparing patients with active CSC to an age-matched and gender-matched group with no CSC using a purpose-built automated system of image analysis. The expert system segments and measures established and novel features of choroid using a combination of thresholding, noise removal, and morphological techniques.Results:A total of 72 patients were included in this study, with 40 included in the group with CSC and 32 patient controls with no CSC. There were significant increases from normal to CSC of median choroidal vascularity index, 54.7(median absolute deviation = 9.8) to 61.2(4.3), and all choroidal thickness indices including maximum depth, from 249.0(90.1)µm to 372.3(80.3)µm. For novel measures, there was a significant increase in tissue entropy from 6.68(0.28) to 6.95(0.17) and area of the largest five vessels from 6.28(3.04) mm2to 9.10(3.49) mm2. The ratio of vessel lumen to stromal tissue intensity was conversely significantly reduced from 0.674(0.11) in normal patients to 0.59(0.06) in CSC.Conclusion:The automated system of choroidal analysis expands on the utility of known measures and introduces novel metrics. These findings contribute pathophysiological insights and metrics for further assessment and research on conditions affecting choroidal tissue.
Work-Related Behavior and Experience Patterns Among Ambulance Service Personnel of Different Organizational Structures in Urban and Rural Regions
Authors: Thielmann Beatrice , Böckelmann Irina , Schumann Heiko 
Published: July 2021

Objective:
The aim of this study was to identify work-related experience and behavior patterns among rescue workers in different urban and rural organizational structures.

Methods:
The subjects included 276 paramedics from Germany (average age 39.3 ± 8.04 years) in three groups (professional fire department, aid organization in urban or rural regions). Work-related behavior and experience patterns (AVEM) were examined. Influences of age, gender, professional qualifications, frequency of operation, and organization were analyzed.

Results:
AVEM risk patterns were detectable in 44.3% of professional fire department personnel and in 20% of both aid organization groups. There were differences in the various AVEM dimensions. Age had a strong influence on the AVEM dimension work-related ambition.

Conclusions:
There is a need for workplace health promotion and prevention measures, which are especially useful for employees in professional fire departments. Aid organizations in urban and rural regions should also attend to these measures.
Blood pressure and heart rate monitoring in children and adolescent with Still’s vibratory murmur
Authors: Dursun Hasan , Türkmenoğlu Yelda , Aygun Tuğçe Sibel , Kacar Alper , Umman Nazli , Irdem Ahmet 
Published: July 2021

Background
Innocent heart murmur is common in healthy infants, children and adolescents. Although most cases are not pathologic, a murmur may be the manifestation of cardiovascular disease. It may also cause or be an indicator of blood pressure (BP) and heart rate (HR) changes.

Objective
This study aimed to document changes in BP and HR in children with Still’s vibratory murmur (SVM).

Methods
This study included 226 children with SVM, and the control group included 138 healthy children that were age-, height- and weight-balanced. Patient files and our hospital registry system were retrospectively investigated for laboratory findings and electrocardiography and echocardiography results. In addition, we prospectively performed 24-h ambulatory BP monitoring in both groups.

Results
There were no statistically significant differences in 24-h, daytime and nighttime systolic BP, 24-h and nighttime diastolic BP and nighttime HR between the patient and control groups (P = ns). However, daytime diastolic BP, mean HR and daytime HR were significantly higher in patient group (P = 0.009, 0.039 and 0007, respectively).

Conclusions
We believe that in the presence of a higher HR and a higher aortic diastolic BP, which may induce hemodynamic changes in the left ventricle, flow turbulence through the aortic valve may increase, increasing the probability of hearing a murmur. ambulatory BP monitoring could be useful to obtain a better picture of these parameters during the 24-h period.
Waist circumference was associated with 2-year blood pressure change in community dwelling adults independently of BMI
Authors: Tebar William R. , Ritti-Dias Raphael M. , Silva Kelly Samara da , Mielke Gregore Iven , Canhin Daniel S. , Scarabottolo Catarina C. , Mota Jorge , Christofaro Diego G.D. 
Published: July 2021

ObjectiveThe present study aimed to analyze the association of 2-year changes in BMI and waist circumference with changes in blood pressure (BP) in a randomized sample of community-dwelling adults.MethodsA sample of 331 middle-aged and older adults (mean age of 59.6 ± 17.3 years) was randomly selected. Measurements of SBP and DBP, BMI, and waist circumference were collected at baseline and after 2-year follow-up. Chronological age, sex, socioeconomic status, ethnicity, and self-reported medical diagnosis and use of medication for hypertension, diabetes, and high low-density lipoprotein-cholesterol were covariates. Multiple linear regression models were adopted for statistical analysis.ResultsSBP was positively associated with BMI (β = 0.48,P = 0.013) and waist circumference (β = 0.21,P = 0.005) at baseline and only with waist circumference at follow-up (β = 0.20,P = 0.007). DBP was positively associated with BMI (β = 0.31,P = 0.009) and waist circumference (β = 0.12,P = 0.006) values at baseline and at follow-up (BMIβ = 0.42,P = 0.001; waist circumferenceβ = 0.18,P = 0.001). Only the 2-year changes in waist circumference were associated to changes in SBP (β = 0.33,P = 0.013), regardless of confounding factors and BMI.ConclusionIt is suggested that waist circumference is the main factor for control over the time in strategies focused on BP management in adult population.
Mobility speed predicts new-onset hypertension: a longitudinal study
Authors: Chen Yaoxin , Liu Yuewen , Han PeiPei , Zhang Hui , Mei Yan , Wang Yiwen , Wang Jiayou , Zhao Jinxuan , Sha Rui , Wang Wei , Guo Qi , Wang Hong 
Published: July 2021

Objective
The aim of this study was to investigate whether declining mobility and muscle strength predict new-onset hypertension in suburban-dwelling elderly individuals.

Methods
This study was designed as a longitudinal prospective cohort study. It was comprised of 362 individuals (mean age = 67.8 ± 6.2; 157 men) without hypertension at baseline. At baseline, all participants completed health questionnaires and underwent measurements of mobility [the Timed Up and Go test (TUGT) and 4-m walking test] and muscle strength (grip strength). At 1-year follow-up, we determined the number of participants who had developed new-onset hypertension. We then evaluated the relationship between above metrics and the development of hypertension.

Results
In the present study, 94 (26.0%) participants developed hypertension after 1 year. After adjusting for mixed factors, the TUGT scores [hazard ratio = 1.15; 95% confidence interval (CI), 1.10–1.31; P = 0.030] were positively associated with the development of hypertension, while the 4-m walking test scores (hazard ratio = 0.07; 95% CI, 0.01–0.47; P = 0.007) showed an inverse relationship with hypertension incidence. Grip strength (hazard ratio = 1.03; 95% CI, 0.99–1.06; P = 0.098) was not significantly associated with hypertension incidence.

Conclusion
Our results indicate that people with declining mobility are significantly more likely to develop hypertension. Hence, improving mobility could be protective against hypertension for elderly individuals.
Evaluation of arterial hypertension by ambulatory blood pressure monitoring in pediatric liver transplant recipients
Authors: Arikanoğlu Emrullah , Tabel Yilmaz , Selimoğlu Ayşe 
Published: July 2021

Objective
Many cardiovascular complications, including hypertension, are seen in pediatric liver transplantation. The purpose of this study was to analyze the frequency of arterial hypertension of pediatric liver transplant recipients and also to determine the related risk factors.

Methods
Thirty-six pediatric liver transplant recipients aged 8–17 years were prospectively studied by manual and ambulatory blood pressure measurement (ABPM) technique.

Results
The mean age of patients was 12.42 ± 2.74 years and the mean ABPM measurement time after transplantation was 2 years (3 months–5.9 years). Only one (2.7%) patient was detected as hypertensive by casual measurement, but 17 (47.2%) patients were found to be hypertensive when measured through ABPM. Of children that were found to be hypertensive as a result of ABPM, 64.7% were observed to have a nondipper pattern. Considering the time passed after the transplantation, patients were found to be more hypertensive in the first 2 years posttransplant although it was not found statistically significant.

Conclusions
In this study, it has been shown that it is possible to diagnose hypertension at an earlier period of transplantation using ABPM in pediatric liver transplant patients. ABPM is needed to detect masked hypertension that may develop following liver transplantation.
The Cost of Guideline Adherence
Authors: Azab Mohamed M. , Kahl Ryan , Lin Emily , Kam Kelli , Balagoni Harika , Pham Jonathan , Oh Nathan , Piper Marc S. , Wright Andrew P. 
Published: July 2021

Goal:
The goal of this study was to determine the financial impact of adopting the US Multi-Society Task Force (USMSTF) polypectomy guidelines on physician reimbursement and disposable equipment costs for gastroenterologists in the academic medical center and community practice settings.

Background:
In 2020, USMSTF guidelines on polypectomy were introduced with a strong recommendation for cold snare rather than cold forceps technique for removing diminutive and small polyps. Polypectomy with snare technique reimburses physicians at a higher rate compared with cold forceps and also requires different disposable equipment. The financial implications of adopting these guidelines is unknown.

Materials and Methods:
Patients that underwent screening colonoscopy where polypectomy was performed at an academic medical center (Loma Linda University Medical Center) and community practice medical center (Ascension Providence Hospital) between July 2018 and July 2019 were identified. The polypectomy technique performed during each procedure was determined (forceps alone, snare alone, forceps plus snare) along with the number and size of polyps as well as disposable equipment. Actual and projected provider reimbursement and disposable equipment costs were determined based on applying the new polypectomy guidelines.

Results:
A total of 1167 patients underwent colonoscopy with polypectomy. Adhering to new guidelines would increase estimated physician reimbursement by 5.6% and 12.5% at academic and community practice sites, respectively. The mean increase in physician reimbursement per procedure was significantly higher at community practice compared with the academic setting ($29.50 vs. $14.13, P<0.00001). The mean increase in disposable equipment cost per procedure was significantly higher at the community practice setting ($6.11 vs. $1.97, P<0.00001).

Conclusion:
Adopting new polypectomy guidelines will increase physician reimbursement and equipment costs when colonoscopy with polypectomy is performed.
The Manchester Triage System in a Pediatric Emergency Department of an Austrian University Hospital
Authors: Beck Nikolas , Michel Miriam , Binder Elisabeth , Kapelari Klaus , Maurer Michael , Lamina Claudia , Müller Thomas , Karall Daniela , Scholl-Bürgi Sabine 
Published: July 2021

Objectives
The Manchester Triage System (MTS) has entered widespread international use in emergency departments (EDs). This retrospective study analyzes urgency of patient visits (PV) at the ED of the Clinic for Pediatrics at the Medical University of Innsbruck.

Methods
We collected demographic and outcome information, including PV urgency levels (UL) according to the MTS, for 3 years (2015–2018), separating PV during regular office hours (ROH; 8:00 am to 5:00 pm) from PV during afternoon and night hours (5:00 pm to 8:00 am), and PV on weekdays from PV on weekends and bank holidays (WE).

Results
A total of 56,088 PV were registered with a UL. Most (68.4%) PV were classified as nonurgent. During ROH, more PV per hour (PV/h) were recorded than during afternoon and night hours (3.0 PV/h vs 1.6 PV/h), with a higher proportion of less urgent cases during ROH. On WE, the amount of PV/h was higher than on weekdays (3.6 PV/h vs 2.8 PV/h), with a higher proportion of nonurgent cases (74.6% vs 68.6%). Likelihoods of inpatient admission and hospital stay lengths increased in step with UL.

Conclusions
The MTS proved useful for delineating UL distributions. The MTS analyses may be of value in managing EDs. Prompted by the results of our study, a general practice pediatric care unit was established to support the ED during WE.
Infraorbital Subcutaneous Intravascular Lobular Capillary Hemangioma After Rhinoplasty
Authors: Kaiser Benedict , Chijioke Obinna , Bruder Elisabeth , Takes Martin , Haug Martin , Mende Konrad 
Published: July 2021

Background
Lobular capillary hemangioma (LCH; also referred to as pyogenic granuloma) is a common benign vascular tumor that is characterized by proliferation of capillaries with a lobular architecture. Lobular capillary hemangioma can involve superficial cutaneous, mucosal, or subcutaneous structures; the subcutaneous and intravascular variant is very rare.

Methods
A 26-year-old female patient presented with a small infraorbital mass that was slowly growing within the last 6 months. She reported no pain but an uncomfortable feeling of pressure in this area. Six months before symptom onset, the patient had undergone a closed rhinoplasty with osteotomies without any reported complication.

Results
An excisional biopsy was performed via a transconjunctival approach, and the histopathological findings were characteristic for a subcutaneous intravascular LCH. At the 3-month follow-up, the patient was asymptomatic with no evidence of a recurrent lesion.

Conclusion
To our knowledge, this is the first report of a subcutaneous intravascular LCH after rhinoplasty. We would like to draw the attention of stakeholders to this rare condition and raise awareness among clinicians to what seems to be a late finding after rhinosurgery.
The Ideal Nasal Tip Projection and Rotation Angles in Chinese: A Preference Analysis of the General Population
Authors: Sun Sijie , Liang Xuebing , Wang Chunhu , Li Jie , Ma Jiguang , Wang Keming 
Published: July 2021

Abstract
Rhinoplasty to reshape the nasal tip is increasingly popular among Chinese women. Aesthetic standards vary across different ethnic groups and it is key to identify preferences for the ideal nasal tip in China to set surgical goals. Therefore, we administered an online survey to plastic surgeons and the public through social media to rank nasal tip images by aesthetic preference. Images were created from a single photograph to show various dimensions of nasal tip projection to nasal dorsum length ratio (NTP/NDL) and nasal labial angle (NLA). Preferences were compared by age, sex, living area, ethnic background, occupation, and history of plastic procedures on respondents’ preferences. Overall, there were 703 respondents, including 441 (63%) women and 50 plastic surgeons. Nasal tip projection to nasal dorsum length ratio of 0.63 was ranked highest by all demographic groups, including women (47%), men (50%), and plastic surgeons (66%). Nasal labial angle of 106° was first choice overall and preferred by 34%, 34%, and 52%, respectively. Preferences followed a bell curve for NTP/NDL and NLA, with lower rates of preference as parameters diverged further from the first choice. The preference for NTP/NDL of 0.63 and NLA of 106° was conserved across surgeons, lay people, and all demographic groups. The authors suggest that these proportions could be used as reference for preoperative design in rhinoplasty.