bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPERURICEMIA IN PATIENTS WITH HYPERTENSION AND OBESITY: PREVALENCE AND CORRELATIONS WITH METABOLIC SYNDROME
Authors: Faria Nathalia , Cardoso Bruna , Duenhas-Berger Ana Luíse , Bortolotto Luiz Aparecido 
Published: April 2021

Objective:
Describe hyperuricemia prevalence in people diagnosed with hypertension and obesity attended in a Hypertension ambulatory and co-related the metabolic syndrome with hyperuricemia.

Design and method:
A retrospective cross-sectional study in which data comes from patients’ electronic medical records watched between January 2018 to December 2019 in a Cardiovascular Hospital in Sao Paulo, Brazil. Sex, age, arterial systolic and diastolic blood pressure, abdominal circumference, uric acid, fasting glycemia, HDL-c, and triglycerides were collected from the latest result during that period. The National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) as a reference to metabolic syndrome definition. Pearson and Spearman correlation test to describe the correlation between uric acid and metabolic syndrome requirements, according to p < 0.05 as a statistical significance.

Results:
31 patients watched with 54 ± 11 years old; most were women (64,5% n = 20). In addition, 45,2% (n = 14) shows hypertension diagnostics and all had metabolic syndrome. It was observed linear positive correlation between uric acid values and abdominal circumference (r = 0,493; p = 0,005), triglycerides (r = 0,467; p = 0,008). It was not found correlation between glycemia (r = 0,202; p = 0,276), SBP (r = 0,295; p = 0,107), DBP (r = 0,273; p = 0,335) and HDL-c (r = 0,194; p = 0,295).

Conclusions:
Hyperuricemia is prevalent between individuals’ diagnostics with hypertension and obesity, and also shows relation with metabolic syndrome, introducing the importance of the nutritional actions to prevent and minimize hypertension and obesity-associated, including the acid uric diet control.
STUDY ON THE DISTRIBUTION OF FAT FREE MASS OF SCHOOL-AGED CHILDREN AND ADOLESCENTS IN YINCHUAN CITY
Authors: Dong Yangyang , Cai Rongrong , Ma Ping , Yang Qingmei , Jia Leina , Ding Wenqing 
Published: April 2021

Objective:
To understand the changing trend of fat free mass distribution with age and gender differences among school-age children and adolescents in Yinchuan city, China, and to provide scientific basis for healthy development and prevention of chronic diseases of children and adolescents and formulation of intervention measures

Design and method:
Using the method of convenient cluster sampling, 1175 school-age children and adolescents aged 10 to 20 years in Yinchuan, China were randomly selected for questionnaire survey and physical examination, and their body composition was measured by bioelectrical impedance analysis(BIA).

Results:
At the age of 12 to 18 years old, the fat free mass (FFM) and fat free mass percentage (FFMP) of boys increased with age (39.78 to 52.63 kg, 77.51% to 83.80%, respectively), the age trends of body parts FFM and FFMP were the same as the general trend, and were significantly higher than those of girls (all P < 0.05). In girls, the FFM reached the peak of 40.96 kilogram at 15 years old and decreased slightly at 15 to 18 years old, the age trend of body parts FFM were the same as the general trend; the FFMP and FFMP of left and right legs decreased with the increase of age, while the FFMP of left and right arms increased with age; the FFMP of trunk reached a minimum of 29.93% at 15 years old and increased at 15 to 18 years old (all P < 0.05).

Conclusions:
For school-age children and adolescents aged 12 to 18 years old in Yinchuan city, China, the fat free mass changed with age and gender differences, which accorded with the characteristics of their growth and development.
CLINICAL CHARACTERISTICS OF PEDIATRIC HYPERTENSION BASED ON THE HOSPITAL RECORDS: A MULTICENTER RETROSPECTIVE STUDY
Authors: Chen Yijun , Dong Hongbo , Mi Jie 
Published: April 2021

Objective:
To understand the clinical characteristics and causes of HTN among pediatric inpatients in China.

Design and method:
Medical records were collected from 10 medical centers during 2016 to 2018 in China. Hypertensive inpatients were defined as patients who were under 18 years old and discharged with HTN diagnosis. For patients with multiple admissions during the study period, first admission records were included for analysis.

Results:
A total of 3,875 hypertensive discharge records were extracted from the 10 centers. After excluding multiple admission records, 2,394 hypertensive inpatients were included for analysis. The proportion of primary HTN, secondary HTN and unclear types of HTN were 24.4%, 46.5%, and 29.2%, respectively. Male patients accounted for a higher proportion than females among the three types of HTN. Compared with primary hypertensives, children with secondary HTN and unclear types were younger (0∼5 ages), especially for inpatients with unclear HTN, 41.0% were under 3 years old. In addition, most of patients with primary or secondary HTN were distributed in the eastern and developed regions (74.3% and 65.0%), while those with unclear HTN were mostly distributed in the western and undeveloped areas (74.6%). In patients with secondary HTN, renal diseases were the leading causes (54.5%), followed by rheumatic autoimmune diseases (15.5%).

Conclusions:
Secondary HTN was the most common type in Chinese hypertensive children. However, due to the high proportion of inpatients with unclear types, careful examinations should be mandatory in children with underlying disease for differential diagnosis.
THE IMPACT OF COVID-19 PANDEMIC LOCKDOWN ON HYPERTENSIVE INDIVIDUALS WITH COMORBIDITIES OF A LONGITUDINAL COHORT IN INDIA
Authors: Chakraborty Kaushik , Chakraborty Nilanjana , Mitra Ramendra Nath , Mitra Dipra 
Published: April 2021

Objective:
The study objectives are to assess the challenges faced, individual awareness of pandemic, attitudes, and compliance of guidelines during lockdown.

Design and method:
This telephonic survey of 404 adult individuals were administered among hypertensive population with and without comorbidities of a longitudinal cohort in Barrackpore, West Bengal, India in Aug-Sept’2020. Comorbidities comprised with cardiovascular diseases, diabetes, asthma, OSA, BMI, epilepsy, stroke, arthritis, and cancer. Convenience sampling was considered to outline socio-demographics; chronic illness status; knowledge, attitude and practices; mood changes; and difficulties faced during lockdown. Association between variables have been conformed through multivariate logistic regression.

Results:
A total of 404 respondents, lone hypertensive 6.4%, hypertensive with other comorbidities 93.6%. Overall mean score of knowledge was 18.4 ± 5.2 (Range 1–23), practices 6.1 ± 1.1 (Range 2–8). Direct impacts on income 25.7%. Compliance of prescribed handwashing 93.3%, frequently hand sanitization 82.9%, using mask appropriately 91.1%, physical distancing 95.1%. Awareness of pandemic being contagious respiratory virus infection 97.8%, dispersion from human-to-human close contact 97.2%, curable 13.6%, could be fatal 4.5%, regarding symptoms 94.6%.
Adverse impact due to the non-availability of medicine at home 4.5%, in pharmacy 2.2%; absence of doctors 9.4%; procured medicine at higher cost 6.2%; inaccessibility of transport 2.7%. On 3 or more drugs 33.2%, stored drugs 34.7%. Required and received medical advice due to polypharmacy 2.5%.
Inadequate knowledge regarding 14-days isolation 4.5%; isolation and treatment reduce spread 2.7%; Lockdown was not an effective measure 11.4%; unconcerned regarding family members protection 34.2%; vaccine available in market 12.4%; and non-compliance of personal hygiene 6.2%. Pandemic still uncontrolled 14.4%.
Multiple physical and sedentary activities less among hypertensive with comorbidities compared to lone hypertensives (AOR = 0.96, CI: 0.95, 0.97, p < .0001). Hypertensives with comorbidities expressed better knowledge and practices compared to lone hypertensives.

Conclusions:
Short term impact during lockdown on hypertensive with or without comorbidities individuals was not significant.
For effective control of the pandemic each and every individual of the cohort needs fully to comply with the prescribed isolation regime, personal protective measures and physical distancing beside real understanding of preventive function of safe-effective vaccine for everyone when available.
EFFECT OF MAT PILATES ON RESPONSES OF BLOOD PRESSURE REACTIVITY IN NORMOTENSE AND HYPERTENSIVE POST MENOPAUSE SUBMITTED TO PSYCHOLOGICAL STRESS
Authors: Carrijo Victor Hugo Vila , Conçalves Ludimila Ferreira , Batista Jaqueline Pontes , Tavares Júlia Buiatte , Mariano Igor Moraes , Souza Tállita Cristina Ferreira de , Amaral Ana Luiza , Puga Guilherme Morais 
Published: April 2021

Objective:
To analyze the effect of Mat Pilates training on blood pressure reactivity responses during psychological stress and resting blood pressure in normotensive (NT) and hypertensive (HT) postmenopausal women.

Design and method:
Forty-seven postmenopausal women participated in the study (24 normotensive and 23 hypertensive) (age: NT = 57.8 ± 4.4 years, HT = 58.9 ± 5.2 years). The intervention was carried out with Mat Pilates training three times a week for 12 weeks. Blood pressure reactivity was measured three times during the Stroop color stress test, using the auscultatory method. Resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) was measured using the OMRON HEM-7113 automatic monitor, after 15 minutes of rest in a sitting position. Statistics performed with normality test by Shapiro-Wilk and Levene's homogeneity. The analysis of variance was performed using the ANOVA test (two way), for variables in relation to time (T), group (G) and time and group interaction (I), and the Newman Keuls post hoc test. The level of significance was set at p < 0.05.

Results:
After 12 weeks of Mat pilates, the results show that in BP reactivity I (p = 0.036) was found in the PAS variation, but there were no differences in T (p = 0.378) and G (p = 0.784), in the variation of PAS PAD results show significant differences in T (p = 0.003) and I (p = 0.001), but not in G (p = 0.264), in the variation of PAM the results show T (p = <0.001) and I (p = <0.001) and G (p = 0.709). For resting SBP there was a significant difference in variable T (p = <0.001) and resting DBP, difference in T (p = <0.001). However, in mean arterial pressure (MBP) there were significant differences in T (p = <0.001), and there were no differences in G (p = 0.075) and I (p = 0.434).

Conclusions:
Training with 12 weeks of Mat Pilates was able to generate positive responses in blood pressure reactivity during psychological stress and in resting blood pressure. Hypertensive women had better results than normotensive women.
EFFECTS OF MAT PILATES TRAINING ON BODY COMPOSITION AND CARDIOMETABOLIC MARKERS IN POSTMENOPAUSAL WOMEN WITH MULTIMORBIDITY
Authors: Amaral Ana Luiza , Batista Jaqueline , Goncalves Ludimila , Tavares Julia , Souza Tallita Cristina , Mariano Igor , Rodrigues Mateus , Junior Jair Cunha , Araujo Karine , Ribeiro Paula , Puga Guilherme 
Published: April 2021

Objective:
The aim of this study was to evaluate the effects of Mat Pilates training on body composition, resting blood pressure, and lipids, glucose, and adiponectin levels in postmenopausal women with cardiometabolic multimorbidities.

Design and method:
Forty-seven postmenopausal women between 50 and 70 years were allocated into two groups based on the number of comorbidities: no more than 1 (COM n = 23) and at least 2 comorbidities (MULT n = 24). Both groups performed Mat Pilates three times a week for 12 weeks. Before and after the intervention, resting blood pressure, body composition, and blood samples (lipidogram, adiponectin, glucose, glycated hemoglobin, and uric acid) were evaluated. A two-factor Generalized Estimated Equation was used to compare groups, time, and their interaction (groups∗time).

Results:
Women in MULT presented higher body mass, body mass index, fat mass, and abdominal circumference than COM (p < 0.01). Blood pressure was reduced (p < 0.05) in both groups. Triglycerides decreased (p < 0.05) in COM and increases in MULT (p < 0.05) over time with no changes in total cholesterol, HDL, or LDL. Uric acid increases (p < 0.01) over time in both groups. Adiponectin had higher (p < 0.01) levels in the COM group and glycated hemoglobin decrease (p < 0.05) over time in both groups without changes in blood glucose. No interaction was found in any analyzed variable.

Conclusions:
These results suggest that 12 weeks of Mat Pilates training can improve blood pressure and glycated hemoglobin independent of the number of morbidities of cardiometabolic disease, but may not change body composition, lipids, glucose, or adiponectin levels in postmenopausal women.
ASSOCIATION BETWEEN THE DIFFERENCE OF BILATERAL BRACHIAL-ANKLE PULSE WAVE AND CARDIOVASCULAR EVENTS, ALL-CAUSE MORTALITY
Authors: Zheng Mengyi , Zhang Xinyuan , Wu Shouling 
Published: April 2021

Aims:
To assess whether an elevated bilateral pulse wave velocity difference (BPWVD) is associated with a higher risk of cardiovascular disease (CVD) and allcause mortality.

Methods and Results:
We included 38512 participants from the community-based longitudinal Kailuan Cohort. These participants underwent measurements of the brachial-ankle pulse wave velocity (baPWV) from 2010 to 2011, and were followed to 2018 for CVD outcome and to 2019 for mortality. During a mean followup of 4.30 years of CVD and 5.23 years of all -cause mortality, 815 CVD cases (cerebral infarction, n = 556; intracerebral hemorrhage, n = 70; myocardial infarction, n = 179) and 952 mortalities were identifi ed. The mean BPWVD was 63.0?8.8 cm/s (median:43 cm/s; inter-quartile range:19,80 cm/s), and 9,708 (25.2%) participants were categorized as the high BPWVD group with a BPWVD in the highest quartile (≥80 cm/s). In the multivariable Cox proportional hazard model, compared with the normal BPWVD group, the high BPWVD group had a signifi cantly higher risk of myocardial infarction and all-cause mortality, with adjusted HRs (95%CI) 1.43 (95% CI: 1.04–1.96) and 1.18 (95%CI: 1.03–1.35), respectively. A higher BPWVD by one standard deviation was associated with HRs of 1.06 (95% CI: 1.02–1.10) for incident CVD, 1.10 (95% CI: 1.02–1.17) for incident myocardial infarction and of 1.07 (95% CI: 1.04–1.10) for all-cause mortality.

Conclusion:
Higher BPWVD was positively associated with the risks of CVD and all-cause mortality. Our fi ndings emphasize the importance of assessing BPWVD to identify high-risk individuals for CVD and mortality.
Individual-Level and Neighborhood-Level Risk Factors for Severe Maternal Morbidity
Authors: Meeker Jessica R. , Canelón Silvia P. , Bai Ray , Levine Lisa D. , Boland Mary Regina 
Published: April 2021

OBJECTIVE:
To investigate the association between individual-level and neighborhood-level risk factors and severe maternal morbidity.

METHODS:
This was a retrospective cohort study of all pregnancies delivered between 2010 and 2017 in the University of Pennsylvania Health System. International Classification of Diseases codes classified severe maternal morbidity according to the Centers for Disease Control and Prevention guidelines. Logistic regression modeling evaluated individual-level risk factors for severe maternal morbidity, such as maternal age and preeclampsia diagnosis. Additionally, we used spatial autoregressive modeling to assess Census-tract, neighborhood-level risk factors for severe maternal morbidity such as violent crime and poverty.

RESULTS:
Overall, 63,334 pregnancies were included, with a severe maternal morbidity rate of 2.73%, or 272 deliveries with severe maternal morbidity per 10,000 delivery hospitalizations. In our multivariable model assessing individual-level risk factors for severe maternal morbidity, the magnitude of risk was highest for patients with a cesarean delivery (adjusted odds ratio [aOR] 3.50, 95% CI 3.15–3.89), stillbirth (aOR 4.60, 95% CI 3.31–6.24), and preeclampsia diagnosis (aOR 2.71, 95% CI 2.41–3.03). Identifying as White was associated with lower odds of severe maternal morbidity at delivery (aOR 0.73, 95% CI 0.61–0.87). In our final multivariable model assessing neighborhood-level risk factors for severe maternal morbidity, the rate of severe maternal morbidity increased by 2.4% (95% CI 0.37–4.4%) with every 10% increase in the percentage of individuals in a Census tract who identified as Black or African American when accounting for the number of violent crimes and percentage of people identifying as White.

CONCLUSION:
Both individual-level and neighborhood-level risk factors were associated with severe maternal morbidity. These factors may contribute to rising severe maternal morbidity rates in the United States. Better characterization of risk factors for severe maternal morbidity is imperative for the design of clinical and public health interventions seeking to lower rates of severe maternal morbidity and maternal mortality.
Association of Patient Sex and Pregnancy Status With Naloxone Administration During Emergency Department Visits
Authors: Forbes Lauren A. , Canner Joseph K. , Milio Lorraine , Halscott Torre , Vaught Arthur Jason 
Published: April 2021

OBJECTIVE:
To evaluate the association of sex and pregnancy status with rates of naloxone administration during opioid overdose–related emergency department (ED) visits by using the Nationwide Emergency Department Sample.

METHODS:
A retrospective cohort study was conducted using the Nationwide Emergency Department Sample 2016 and 2017 data sets. Eligible records included men and women, 15–49 years of age, with an opioid overdose–related ED visit; records for women were stratified by pregnancy status (International Classification of Diseases, Tenth Revision O codes). A multivariable logistic regression model was used to assess the primary outcome of naloxone administration (Current Procedural Terminology code: J2310). Secondary outcomes included subsequent admission and mortality. A subgroup analysis compared pregnant women who did receive naloxone compared with those who did not receive naloxone.

RESULTS:
Records from 443,714 men, 304,364 nonpregnant women, and 25,056 pregnant women were included. Nonpregnant women had lower odds for naloxone administration (1.70% vs 2.10%; adjusted odds ratio [aOR] 0.86 [95% CI 0.83–0.89]) and mortality (2.21% vs 2.99%; aOR 0.71 [95% CI 0.69–0.73]) but higher odds of subsequent admission (30.22% vs 27.18%; aOR 1.04 [95% CI 1.03–1.06]) compared with men. Pregnant women had lower odds for naloxone administration (0.27% vs 1.70%; aOR 0.16 [95% CI 0.13–0.21]) and mortality (0.41% vs 2.21%; aOR 0.28 [95% CI 0.23–0.35]) but higher odds of subsequent admission (40.50% vs 30.22%; aOR 2.04 [95% CI 2.00–2.10]) compared with nonpregnant women. Pregnant women who received naloxone had higher odds of mortality (14% vs 0.39%; aOR 6.30 [95% CI 2.11–18.78]) compared with pregnant women who did not receive naloxone. Pregnant women who did not receive naloxone were more likely to have Medicaid as their expected insurance payer, be in the lowest quartile of median household income for residence ZIP codes, and have a concurrent mental health diagnosis compared with pregnant women who did receive naloxone.

CONCLUSION:
Reproductive-aged women who are nonpregnant and pregnant were less likely to receive naloxone during opioid overdose–related ED visits compared with reproductive-aged men. Naloxone administration for reproductive-aged women should be prioritized in the efforts to reduce opioid- and pregnancy-related morbidity and mortality in the United States.
“Shared Decision-Making” in Athletes With Known Cardiac Disease: Interpretation and Implementation in the Real World
Authors: Phelan Dermot , Farokhrani Amin , Retallick Rachel , Day Carly 
Published: April 2021

Objective:
Recommendations for addressing sporting eligibility and disqualification in athletes with heart disease have traditionally used a paternalistic approach with cardiologists making a binary “yes-no” decision. This paradigm has recently evolved to a shared decision-making model recognizing and respecting the autonomy of the athlete while instituting safeguards to mitigate risk where possible. How well this paradigm is understood or has been integrated into the athletic trainer (AT) community is unknown.

Design:
Athletic trainers from the Ohio High School Athletic Association were surveyed.

Results:
Of 107 ATs who responded, we found that the majority had not heard of the term “shared decision-making” in the context of sporting participation [62.6%, confidence interval (CI) 0.53-0.72 vs 37.4%, CI 0.28-0.47]. Furthermore, we found large discrepancies as to how ATs would interpret and implement recommendations from cardiologists.

Conclusions:
This study highlights the need to educate and improve communication between AT, sports medicine physicians, and sports cardiologists if shared decision-making strategies are to become widely implemented.
Vaccinating in the Emergency Department, a Model to Overcome Influenza Vaccine Hesitancy
Authors: Baumer-Mouradian Shannon H. , Servi Ashley , Kleinschmidt Abigail , Nimmer Mark , Lazarevic Kimberly , Hanson Thomas , Jastrow Jena , Jaworski Brian , Kopetsky Matthew , Drendel Amy L. 
Published: April 2021

Introduction:
Vaccine hesitancy and delays in vaccine administration time have limited the success of prior influenza vaccination initiatives in the pediatric emergency department (ED). In 2018–2019, season 1, this ED implemented mandatory vaccine screening and offered the vaccine to all eligible patients; however, only 9% of the eligible population received the vaccine. In 2019–2020, season 2, the team sought to improve influenza vaccination rates from 9% to 15% and administer over 2,000 vaccines to eligible ED patients.

Methods:
Key drivers included: identifying vaccine hesitancy, providing counseling, reducing administration delays, and developing reminders for vaccine administration. We tested interventions using plan-do-study-act cycles. We included discharged ED patients, age 6 months–18 years old, emergency severity index score 2–5, and no prior vaccine this season. Process measures included percent of patients screened, eligible, accepting the vaccine, and leaving before vaccination. Outcome measures were the percent of eligible patients vaccinated and the total number of vaccines administered. Vaccination time was the balancing measure.

Results:
We included 57,804 children in this study. Comparing season 1 to 2, screening rates (84%) and eligibility rates (58%) were similar. Vaccine acceptance rates improved from 13% to 22%, the proportion of patients leaving before vaccination decreased from 32% to 17%, and vaccination rates improved from 9% to 20%. Total vaccines administered increased from 1,309 to 3,180, and vaccination time was 5 minutes faster in season 2.

Conclusions:
This ED influenza vaccination process provides a model to overcome vaccine hesitancy and can be adapted and replicated for any vaccine-preventable illness.