bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardio-metabolic outcomes in South Asians compared to White Europeans in the United Kingdom: a matched controlled population-based cohort study
Authors: Almulhem Munerah , Chandan Joht Singh , Gokhale Krishna , Adderley Nicola J. , Thayakaran Rasiah , Khunti Kamlesh , Tahrani Abd A. , Hanif Wasim , Nirantharakumar Krishnarajah 
Published: June 2021

Abstract
Background
There appears to be an inequality in the risk of cardio-metabolic disease between those from a South Asian (SA) background when compared to those of White Europeans (WE) descendance, however, this association has not been explored in a large European cohort. This population-based open retrospective cohort explores the incidence of cardio-metabolic disease in those without pre-existing cardiometabolic disease taken from a large UK primary care database from 1st January 2007 to 31st December 2017.

Methods
A retrospective open cohort matched population-based study using The Health Improvement Network (THIN) database. The outcomes of this study were the incidences of cardio-metabolic events (type 2 diabetes mellitus, hypertension, ischemic heart disease, stroke, heart failure, and atrial fibrillation).

Results
A total of 94,870 SA patients were matched with 189,740 WE patients. SA were at an increased risk of developing: T2DM (adjusted hazard ratio (aHR) 3.1; 95% CI 2.97–3.23); HTN (1.34; 95% CI: 1.29–1.39); ischaemic heart disease (IHD) (1.81; 95% CI: 1.68–1.93) and heart failure (HF) (1.11; 95% CI: 1.003–1.24). However, they were at a lower risk of atrial fibrillation (AF) (0.53; 95% CI: 0.48–0.59) when compared to WE. Of those of SA origin, the Bangladeshi community were at the greatest risk of T2DM, HTN, IHD and HF, but were at the lowest risk of AF in when compared to Indians and Pakistanis.

Conclusion
Considering the high risk of cardio-metabolic diseases in the SA cohort, differential public health measures should be considered in these patients to reduce their risk of disease, which may be furthered tailored depending on their country of origin.
Primary care consultations on emotional distress – a part of the acculturation process in patients with refugee backgrounds: a grounded theory approach
Authors: Rothlind Erica , Fors Uno , Salminen Helena , Wändell Per , Ekblad Solvig 
Published: June 2021

Abstract
Background
Considering the global refugee crisis, there is an increasing demand on primary care physicians to be able to adequately assess and address the health care needs of individual refugees, including both the somatic and psychiatric spectra. Meanwhile, intercultural consultations are often described as challenging, and studies exploring physician–patient communication focusing on emotional distress are lacking. Therefore, the aim was to explore physician–patient communication, with focus on cultural aspects of emotional distress in intercultural primary care consultations, using a grounded theory approach, considering both the physician’s and the patient’s perspective.

Methods
The study was set in Region Stockholm, Sweden. In total, 23 individual interviews and 3 focus groups were conducted. Resident physicians in family medicine and patients with refugee backgrounds, originating from Somalia, Syria, Afghanistan and Iraq, were included. Data was analysed using a grounded theory approach.

Results
Over time, primary care patients with refugee backgrounds seemed to adopt a culturally congruent model of emotional distress. Gradual acceptance of psychiatric diagnoses as explanatory models for distress and suffering was noted, which is in line with current tendencies in Sweden. This acculturation might be influenced by the physician. Three possible approaches used by residents in intercultural consultations were identified: “biomedical”, “didactic” and “compensatory”. They all indicated that diagnoses are culturally valid models to explain various forms of distress and may thus contribute to shifting patient perceptions of psychiatric diagnoses.

Conclusions
Physicians working in Swedish primary care may influence patients’ acculturation process by inadvertently shifting their perceptions of psychiatric diagnoses. Residents expressed concerns, rather than confidence, in dealing with these issues. Focusing part of their training on how to address emotional distress in an intercultural context would likely be beneficial for all parties concerned.
Development of a multivariable prognostic PREdiction model for 1-year risk of FALLing in a cohort of community-dwelling older adults aged 75 years and above (PREFALL)
Authors: Gade Gustav Valentin , Jørgensen Martin G. , Ryg Jesper , Masud Tahir , Jakobsen Lasse Hjort , Andersen Stig 
Published: June 2021

Abstract
Background
Falls are the leading cause of fatal and non-fatal injuries in older adults, and attention to falls prevention is imperative. Prognostic models identifying high-risk individuals could guide fall-preventive interventions in the rapidly growing older population. We aimed to develop a prognostic prediction model on falls rate in community-dwelling older adults.

Methods
Design: prospective cohort study with 12 months follow-up and participants recruited from June 14, 2018, to July 18, 2019.
Setting: general population.
Subjects: community-dwelling older adults aged 75+ years, without dementia or acute illness, and able to stand unsupported for one minute.
Outcome: fall rate for 12 months.
Statistical methods: candidate predictors were physical and cognitive tests along with self-report questionnaires. We developed a Poisson model using least absolute shrinkage and selection operator penalization, leave-one-out cross-validation, and bootstrap resampling with 1000 iterations.

Results
Sample size at study start and end was 241 and 198 (82%), respectively. The number of fallers was 87 (36%), and the fall rate was 0.94 falls per person-year. Predictors included in the final model were educational level, dizziness, alcohol consumption, prior falls, self-perceived falls risk, disability, and depressive symptoms. Mean absolute error (95% CI) was 0.88 falls (0.71–1.16).

Conclusion
We developed a falls prediction model for community-dwelling older adults in a general population setting. The model was developed by selecting predictors from among physical and cognitive tests along with self-report questionnaires. The final model included only the questionnaire-based predictors, and its predictions had an average imprecision of less than one fall, thereby making it appropriate for clinical practice. Future external validation is needed.

Trial registration
Clinicaltrials.gov (NCT03608709).
Eosinophilic interstitial nephritis and cardiac insufficiency in Kimura’s disease: a case report
Authors: Xiang Li , Zhou Hua , Liu Hua , Zhang Dachuan , Li Min , Yang Min , Yang Yan 
Published: June 2021

Abstract
Background
Kimura’s disease (KD) is a rare chronic inflammatory disease and the etiology remains uncharacterized. The typical manifestations are painless lymph node or subcutaneous masses. There is currently no report of prominent renal interstitial injury and cardiac insufficiency in KD.

Case presentation
A 45-year-old man was referred to our hospital with dark urine, subcutaneous masses in forehead and right retroauricular, multiple lymphadenopathy and unexplained cardiac insufficiency. Renal biopsy demonstrated eosinophilic interstitial nephritis. Laboratory tests revealed eosinophilia and a high level of serum IgE. A biopsy of cervical lymph node was performed and KD was diagnosed. Treatment with oral prednisone resulted in a decrease of eosinophil, serum IgE, improvement of cardiac function, and regression of the subcutaneous mass.

Conclusions
We describe an extremely rare KD case presenting with eosinophilic interstitial nephritis, cardiac insufficiency and significant response to prednisone. The clinicians should improve the disease awareness and find optimal treatment.
Prevalence of iron and folic acid supplements consumption and associated factors among pregnant women in Eswatini: a multicenter cross-sectional study
Authors: Mabuza Gugulethu N. , Waits Alexander , Nkoka Owen , Chien Li-Yin 
Published: June 2021

Abstract
Background
During pregnancy, nutritional requirements increase and if not met, pregnancy-related complications may manifest. To prevent these undesirable outcomes, the World Health Organization recommends daily oral iron and folic acid (IFA) supplementation as part of antenatal care. Despite this recommendation, the use of IFA supplements is still very low in several developing countries. Additionally, no prior information exists regarding the level of consumption of IFA in Eswatini. Thus, this study aimed to determine the prevalence of consumption of IFA supplements and to identify factors associated with the consumption of IFA supplements among pregnant women in Eswatini.

Methods
A cross-sectional questionnaire survey was conducted among 330 pregnant women aged ≥ 18 years in their third trimester in Eswatini. Participants were recruited from eight purposively selected healthcare facilities from July 2019 to October 2019. Good consumption was defined as consuming all or almost all IFA supplements throughout pregnancy.

Results
During the first trimester, 10.3 % of the participants consumed all or almost all IFA supplements. In the second and third trimesters, those who consumed all or almost all supplements were 37 and 39.7 %, respectively, for iron and 37.6 and 40.9 %, respectively, for folic acid. Barriers, including side effects, forgetfulness, safe previous pregnancies without IFA, others’ advice against consumption, IFA stock-outs, inability to meet transport costs, and inadequate supply of IFA tablets, contribute to low consumption of IFA. Multivariate logistic regression models showed that the barriers were inversely associated with good consumption of IFA supplements. Better knowledge and attitude toward IFA and older maternal age were positively associated with good consumption of IFA supplements.

Conclusions
Low consumption of IFA supplements in overall pregnancy is mainly owing to the late antenatal care attendance. Strategies such as establishing a preconception care unit and school-based provision of IFA may be helpful. It is evident that most women still lack knowledge, and some have negative attitudes about IFA supplements. Health education to raise awareness and emphasize the importance of starting antenatal care early as well as consuming supplements on time should be revisited and intensified. Multiple strategies such as including community health care workers for distributing IFA supplements, discussing with clients about the measures to reduce forgetfulness, advising ways to prevent and manage the side effects, providing subsidies to cover transport costs, and ensuring adequate supply of IFA supplements in facilities may need to be employed to reduce the identified barriers.
Intralesional injection of rose bengal augments the efficacy of gemcitabine chemotherapy against pancreatic tumors
Authors: Innamarato Patrick , Morse Jennifer , Mackay Amy , Asby Sarah , Beatty Matthew , Blauvelt Jamie , Kidd Scott , Mullinax John E. , Sarnaik Amod A. , Pilon-Thomas Shari 
Published: June 2021

Abstract
Background
Chemotherapy regimens that include the utilization of gemcitabine are the standard of care in pancreatic cancer patients. However, most patients with advanced pancreatic cancer die within the first 2 years after diagnosis, even when treated with standard of care chemotherapy. This study aims to explore combination therapies that could boost the efficacy of standard of care regimens in pancreatic cancer patients.

Methods
In this study, we used PV-10, a 10% solution of rose bengal, to induce the death of human pancreatic tumor cells in vitro. Murine in vivo studies were carried out to examine the effectiveness of the direct injection of PV-10 into syngeneic pancreatic tumors in causing lesion-specific ablation. Intralesional PV-10 treatment was combined with systemic gemcitabine treatment in tumor-bearing mice to investigate the control of growth among treated tumors and distal uninjected tumors. The involvement of the immune-mediated clearance of tumors was examined in immunogenic tumor models that express ovalbumin (OVA).

Results
In this study, we demonstrate that the injection of PV-10 into mouse pancreatic tumors caused lesion-specific ablation. We show that the combination of intralesional PV-10 with the systemic administration of gemcitabine caused lesion-specific ablation and delayed the growth of distal uninjected tumors. We observed that this treatment strategy was markedly more successful in immunogenic tumors that express the neoantigen OVA, suggesting that the combination therapy enhanced the immune clearance of tumors. Moreover, the regression of tumors in mice that received PV-10 in combination with gemcitabine was associated with the depletion of splenic CD11b+Gr-1+ cells and increases in damage associated molecular patterns HMGB1, S100A8, and IL-1α.

Conclusions
These results demonstrate that intralesional therapy with PV-10 in combination with gemcitabine can enhance anti-tumor activity against pancreatic tumors and raises the potential for this strategy to be used for the treatment of patients with pancreatic cancer.
Vanishing pachy-choroid in pachychoroid neovasculopathy under long-term anti-vascular endothelial growth factor therapy
Authors: Schworm Benedikt , Luft Nikolaus , Keidel Leonie F. , Kreutzer Thomas C. , Herold Tina R. , Priglinger Siegfried G. , Siedlecki Jakob 
Published: June 2021

Abstract
Background
To investigate the diagnostic value of choroidal thickness in the definition of pachychoroid neovasculopathy (PNV), especially in eyes treated with anti-vascular endothelial growth factor (VEGF) therapy.

Methods
Twenty-two consecutive eyes of 11 patients with uni- or bilateral PNV were analyzed. Anti-VEGF treatment was correlated with changes in choroidal thickness on enhanced depth imaging optical coherence tomography.

Results
There were 14 eyes with PNV and 8 non-neovascular partner eyes. Mean age was 64.2 ± 4.0 (range: 60–72), total follow-up was 1.8 ± 0.4 (1–2) years. In PNV eyes, choroidal thickness at baseline was 400 ± 58 (269–485) μm. After two years and 13 anti-VEGF injections on average, a mean reduction of − 39 ± 10 (− 26 to − 56) % to final 241 ± 52 (162–327) μm was observed (p < 0.0001). Meanwhile, choroidal thickness in the partner eyes remained stable (p > 0.13 for all comparisons). A significant correlation of choroidal thinning and anti-VEGF injection rate was observed at year one (r = − 0.79; R2 = 0.63; p = 0.00073) and two (r = − 0.69; R2 = 0.48; p = 0.019). While 85.7% of PNV eyes exceeded a pachychoroid threshold of ≥350 μm at baseline, this figure dropped to 21.4% at year one and 0% at year two.

Conclusion
In PNV, choroidal thickness significantly decreases with anti-VEGF therapy, resembling a “vanishing pachy-choroid”, and thus does not represent a valid long-term diagnostic criterium, especially when differentiating PNV from nAMD.
The negative impact of chronic tobacco smoking on adult neuropsychological function: a cross-sectional study
Authors: Nadar Mohammed Sh. , Hasan Abdullah M. , Alsaleh Mohammed 
Published: June 2021

Abstract
Background
The evidence on the effects of chronic tobacco smoking on neuropsychological functions is conflicting. The literature remains limited by inconsistent accounting for potentially confounding biomedical and psychiatric conditions. This study aimed to assess the neuropsychological functions of adult chronic tobacco smokers in comparison to group-matched non-smokers.

Method
The study included 73 smokers and 84 group-matched non-smokers. The data was collected during the year 2019. After an initial interview to collect demographics and smoking profile, the subjects undertook neuropsychological assessments that targeted a wide range of cognitive domains.

Results
The performance of smokers was poorer on almost all neuropsychological domains, namely selective attention (p ≤ .001, p = .044), alternating attention (p = .002) working memory (p ≤ .001), Short-term memory (p = .006 and .003), Long-term memory (p ≤ .001), processing accuracy (p ≤ .001), and executive function (p = .011 and .026). Smokers were intact on processing speed. Smoking accumulation and lower age onset of regular smoking were correlated with lower neuropsychological function.

Conclusion
Our findings add to the growing body of evidence suggesting that chronic tobacco smoking impacts cognition negatively.
Food and health promotion literacy among employees with a low and medium level of education in the Netherlands
Authors: Sponselee Hanne C. S. , Kroeze Willemieke , Poelman Maartje P. , Renders Carry M. , Ball Kylie , Steenhuis Ingrid H. M. 
Published: June 2021

Abstract
Background
Prior research indicates a positive association between socioeconomic position and health literacy levels. We hypothesize comparable socioeconomic gradients for food literacy. This study aims to determine the level of self-perceived food literacy and health promotion literacy among adults with a low and medium level of education and from various subgroups, as well as the association between these food and health literacy levels. Furthermore, this study aims to explore the associations of self-perceived food literacy (SPFL) and health promotion literacy (HPL) in BMI.

Methods
A cross-sectional study was conducted among employees with a low and medium level of education. Descriptive analyses were performed to compute SPFL and HPL levels. Analyses of variance were performed to test differences between subgroups. The correlation between SPFL and HPL was computed by Pearson’s r. Multivariate linear regression analyses were used to explore 1) the association between SPFL and HPL adjusted for demographic characteristics 2) the associations between SPFL and HPL in BMI.

Results
The majority (63.1%) of all participants (n = 222) scored low on SPFL and 34.5% scored inadequate or problematic on HPL. No significant educational or weight-status differences were found in SPFL or HPL levels. On most levels, women compared to men and older compared to younger employees scored significantly higher. A small positive correlation between the two mean levels was found, r = .25, P < .001 (n = 203). Multivariate linear regression analyses showed a significant association between SPFL and HPL (B = .31, 95% CI = .15–.48). No significant associations between SPFL and HPL in BMI were found.

Conclusions
This study suggests there is room for improvement in SPFL and HPL among adults with a low and medium level of education. Future research should consider comparing low and middle socioeconomic with high socioeconomic groups when exploring food and health literacy. Regarding health promotion activities for adults with a low and medium level of education, it is recommended to focus on improving both food and health literacy. Furthermore, more research is needed to explore direct proxies of weight-status to better understand the role of food and health literacy in overweight patterns.
A case of iatrogenic intussusception in adults: a rare case report
Authors: Hu Qiang , Sun Yuanshui , Shi Jianfeng 
Published: June 2021

Abstract
Background
Intussusception has a low incidence rate in adults. Many cases in adults are caused by tumors. Intussusception results from conditions other than tumors are uncommon. This is the first case report about intussusception that occurred after removing a long intestinal tube (LT).

Case presentation
A 69-year-old female complained of “recurrent abdominal pain with reduced flatus passage and frequency of bowel movement for 10 days” was admitted to the hospital. Plain abdominal radiography and abdominal CT upon admission showed intestinal obstruction. The patient’s abdominal pain was not relieved after symptomatic treatments, which involved fluid and electrolyte replacement, LT placement, spasmolytic agents, and analgesics. Hence, surgical exploration was carried out. The patient had a good recovery postoperatively. No abdominal pain or bloating developed after food intake. The patient passed flatus and had bowel movements later. On postoperative day 9, the LT was removed. On the 10th day, the patient suddenly developed abdominal distension and acute abdominal pain. Emergency abdominal CT showed small bowel intussusception. Surgical exploration was then performed. Severe small bowel dilatation located at 1.5 m from the ligament of Treitz was found during the procedure. Intussusception at the site was observed. No color change of the intestinal wall was detected, suggesting that no necrosis was present. So, a manual reduction was done. The patient was discharged on postoperative day 6.

Conclusions
This case serves as a warning that the simple action of pulling out the LT might also cause serious complications, which should be given more attention.
Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review
Authors: Richardson Matt X. , Ehn Maria , Stridsberg Sara Landerdahl , Redekop Ken , Wamala-Andersson Sarah 
Published: June 2021

Abstract
Background
Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care.

Method
Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies.

Result
Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias.

Conclusions
We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.