bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between socioeconomic status and chronic obstructive pulmonary disease in Jiangsu province, China: a population-based study
Authors: Zhang Dan-Dan , Liu Jian-Nan , Ye Qing , Chen Zi , Wu Ling , Peng Xue-Qing , Lu Gan , Zhou Jin-Yi , Tao Ran , Ding Zhen , Xu Fei , Zhou Linfu 
Published: June 2021

Abstract

Background:
Chronic obstructive pulmonary disease (COPD) is a common public health problem worldwide. Recent studies have reported that socioeconomic status (SES) is related to the incidence of COPD. This study aimed to investigate the association between SES and COPD among adults in Jiangsu province, China, and to determine the possible direct and indirect effects of SES on the morbidity of COPD.

Methods:
A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province, China. Participants were selected using a multistage sampling approach. COPD, the outcome variable, was diagnosed by physicians based on spirometry, respiratory symptoms, and risk factors. Education, occupation, and monthly family average income (FAI) were used to separately indicate SES as the explanatory variable. Mixed-effects logistic regression models were introduced to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for examining the SES-COPD relationship. A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES.

Results:
The mean age of the 2421 participants was 56.63 ± 9.62 years. The prevalence of COPD was 11.8% (95% CI: 10.5%–13.1%) among the overall sample population. After adjustment for age, gender, residence, outdoor and indoor air pollution, body weight status, cigarette smoking, and potential study area-level clustering effects, educational attainment was negatively associated with COPD prevalence in men; white collars were at lower risk (OR: 0.60, 95% CI: 0.43–0.83) of experiencing COPD than blue collars; compared with those within the lower FAI subgroup, participants in the upper (OR: 0.68, 95% CI: 0.49–0.97) tertiles were less likely to experience COPD. Such negative associations between all these three SES indicators and COPD were significant among men only. Education, FAI, and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC), FEV1, FVC, and FEV1 percentage of predicted. Education, FAI, and occupation had indirect effects on pulmonary function indices of all participants mainly through smoking status, indoor air pollution, and outdoor air pollution. We also found that occupation could affect post-bronchodilator FEV1/FVC through body mass index.

Conclusions:
Education, occupation, and FAI had an adverse relationship with COPD prevalence in Jiangsu province, China. SES has both direct and indirect associations with pulmonary function impairment. SES is of great significance for COPD morbidity. It is important that population-based COPD prevention strategies should be tailored for people with different SES.
HIV and Sexually Transmitted Infection Epidemic Potential of Networks of Men Who Have Sex With Men in Two Cities
Authors: Anderson Emeli J. , Weiss Kevin M. , Morris Martina M. , Sanchez Travis H. , Prasad Pragati , Jenness Samuel M. 
Published: June 2021

Background:
The speed with which a pathogen circulates in a sexual network is a function of network connectivity. Cross-sectional connectivity is a function of network features like momentary degree and assortative mixing. Temporal connectivity is driven by partner acquisition rates. The forward-reachable path (FRP) has been proposed as a summary measure of these two aspects of transmission potential. We use empirical data from San Francisco and Atlanta to estimate the generative parameters of the FRP and compare results to the HIV/sexually transmitted infection epidemics in each city.

Methods:
We used temporal exponential random graph models to estimate the generative parameters for each city’s dynamic sexual network from survey data. We then simulated stochastic dynamic networks from the fitted models and calculated the FRP for each realization, overall, and stratified by partnership type and demographics.

Results:
The overall mean and median paths were higher in San Francisco than in Atlanta. The overall paths for each city were greater than the sum of the paths in each individual partnership network. In the casual partnership network, the mean path was highest in the youngest age group and lowest in the oldest age group, despite the fact that the youngest group had the lowest mean momentary degree and past-year partner counts.

Conclusions:
The FRP by age group revealed the additional utility of the measure beyond the temporal and cross-sectional network connectivity measures. Other nonnetwork factors are still necessary to infer total epidemic potential for any specific pathogen.
Estimating the Impact of Sustained Social Participation on Depressive Symptoms in Older Adults
Authors: Shiba Koichiro , Torres Jacqueline M. , Daoud Adel , Inoue Kosuke , Kanamori Satoru , Tsuji Taishi , Kamada Masamitsu , Kondo Katsunori , Kawachi Ichiro 
Published: June 2021

Background:
Social participation has been suggested as a means to prevent depressive symptoms. However, it remains unclear whether a one-time boost suffices or whether participation needs to be sustained over time for long-term prevention. We estimated the impacts of alternative hypothetical interventions in social participation on subsequent depressive symptoms among older adults.

Methods:
Data were from a nationwide prospective cohort study of Japanese older adults ≥65 years of age (n = 32,748). We analyzed social participation (1) as a baseline exposure from 2010 (approximating a one-time boost intervention) and (2) as a time-varying exposure from 2010 and 2013 (approximating a sustained intervention). We defined binary depressive symptoms in 2016 using the Geriatric Depression Scale. We used the doubly robust targeted maximum likelihood estimation to address time-dependent confounding.

Results:
The magnitude of the association between sustained participation and the lower prevalence of depressive symptoms was larger than the association observed for baseline participation only (e.g., prevalence ratio [PR] for participation in any activity = 0.83 [95% confidence interval = 0.79, 0.88] vs. 0.90 [0.87, 0.94]). For activities with a lower proportion of consistent participation over time (e.g., senior clubs), there was little evidence of an association between baseline participation and subsequent depressive symptoms, while an association for sustained participation was evident (e.g., PR for senior clubs = 0.96 [0.90, 1.02] vs. 0.88 [0.79, 0.97]). Participation at baseline but withholding participation in 2013 was not associated with subsequent depressive symptoms.

Conclusions:
Sustained social participation may be more strongly associated with fewer depressive symptoms among older adults.
Effects of Spironolactone on Hypoxia-Inducible Factor-1α in the Patients Receiving Coronary Artery Bypass Grafting
Authors: Lou Yu-Mei , Zheng Zhe-Lan , Xie Lin-Yuan , Lian Jiang-Fang , Shen Wen-Jun , Zhou Jian-Qing , Shao Guo-Feng , Hu De-Xing 
Published: June 2021

Abstract:
We explored the protective effect of spironolactone on cardiac function in the patients undergoing coronary artery bypass grafting (CABG) by determining serum hypoxia-inducible factor-1α (HIF-1α) before and after CABG. We used the propensity score matching method retrospectively to select 174 patients undergoing CABG in our hospital from March 2018 to December 2019. Of the 174 patients, 87 patients taking spironolactone for more than 3 months before CABG were used as a test group and other 87 patients who were not taking spironolactone as a control group. In all patients, serum HIF-1α and troponin I levels were determined before as well as 24 hours and 7 days after CABG, serum N-terminal probrain natriuretic peptide (NT-proBNP) level was determined before as well as 12, 24, and 36 hours after CABG, and electrocardiographic monitoring was performed within 36 hours after CABG. The results indicated that there were no significant differences in the HIF-1α level between the test group and the control group before and 7 days after CABG, but the HIF-1α level was significantly lower in the test group than that in the control group 24 hours after CABG (P < 0.01). The 2 groups were not significantly different in the troponin I level at any time point. There was no significant difference in the serum NT-proBNP level between the test group and the control group before CABG, but NT-proBNP (BNP) levels were all significantly lower in the test group than those in the control group at postoperative 12, 24, and 36 hour time points (all P <0.05). The incidence of postoperative atrial fibrillation was also significantly lower in the test group than that in the control group (P = 0.035). Spironolactone protects cardiac function probably by improving myocardial hypoxia and inhibiting myocardial remodeling.
Preadmission Statin Therapy and Clinical Outcome in Hospitalized Patients With COVID-19: An Italian Multicenter Observational Study
Authors: Russo Vincenzo , Silverio Angelo , Scudiero Fernando , Attena Emilio , D'Andrea Antonello , Nunziata Luigi , Parodi Guido , Celentani Dario , Varbella Ferdinando , Albani Stefano , Musumeci Giuseppe , Di Micco Pierpaolo , Di Maio Marco 
Published: June 2021

Abstract:
Statin therapy has been recently suggested as possible adjuvant treatment to improve the clinical outcome in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to describe the prevalence of preadmission statin therapy in hospitalized patients with COVID-19 and to investigate its potential association with acute distress respiratory syndrome (ARDS) at admission and in-hospital mortality. We retrospectively recruited 467 patients with laboratory-confirmed COVID-19 admitted to the emergency department of 10 Italian hospitals. The study population was divided in 2 groups according to the ARDS diagnosis at admission and in-hospital mortality. A multivariable regression analysis was performed to assess the risk of ARDS at admission and death during hospitalization among patients with COVID-19. A competing risk analysis in patients taking or not statins before admission was also performed. ARDS at admission was reported in 122 cases (26.1%). There was no statistically significant difference for clinical characteristics between patients presenting with and without ARDS. One hundred seven patients (18.5%) died during the hospitalization; they showed increased age (69.6 ± 13.1 vs. 66.1 ± 14.9; P = 0.001), coronary artery disease (23.4% vs. 12.8%; P = 0.012), and chronic kidney disease (20.6% vs. 11.1%; P = 0.018) prevalence; moreover, they presented more frequently ARDS at admission (48.6% vs. 19.4%; P < 0.001). At multivariable regression model, statin therapy was not associated neither with ARDS at admission nor with in-hospital mortality. Preadmission statin therapy does not seem to show a protective effect in severe forms of COVID-19 complicated by ARDS at presentation and rapidly evolving toward death.
Potential Biomarkers in Atrial Fibrillation: Insight Into Their Clinical Significance
Authors: Charafeddine Khalil , Zakka Patrick , Bou Dargham Bassel , Abdulhai Farah , Zakka Katerina , Zouein Fouad A. , Refaat Marwan 
Published: June 2021

Abstract:
In risk-stratifying patients with atrial fibrillation (AF), physicians rely heavily on clinical parameters that provide risk scores and determine treatment strategies. There has been increasing research on potential biomarkers in the blood that could more accurately determine both risk of complications in AF and risk of incidence of AF. This review highlights the clinical significance of 5 novel biomarkers that have been shown to be linked to AF. These biomarkers are carbohydrate antigen 125, galectin-3, growth differentiation factor-15, a member of the interleukin 1 receptor family, IL1RL1 (ST2), and N-terminal pro B-type natriuretic peptide.
Comparative Results of Treatment and Complications: Pedea in Open Ductus Arteriosus in Premature Infants
Authors: Kemelbekov Kanatzhan , Musaev Yuldash , Bektenova Gulmira , Datkayeva Gulmira , Tuktibayeva Saule , Bekenov Nurlan , Khatamov Furkhat , Ilyassova Gulnara , Gatauova Madina , Zhumabekov Zharylkap , Kuandykov Yerlan , Tazhiyeva Aigul , Abdrakhmanova Zinat , Omarova Balnur , Tasbulatov Nurgeldi 
Published: June 2021

Abstract:
The open ductus arteriosus (ODA) is the vessel through which the pathological communication between the aorta and the pulmonary artery persists after birth. Clinical manifestations depend on the size of the duct and the stage of hemodynamic disorders. The course of the defect varies from asymptomatic to extremely severe. With large duct sizes, the latter manifests itself from the first week of life with signs of heart failure. The current research is devoted to the choice of the optimal method of medical and surgical treatment in premature newborns with an unaffected ductus arteriosus. Drug therapy for pulmonary hypertension is recommended only for those patients who have irreversible pulmonary hypertension. Surgical closure of the ODA is recommended for overloads of the left heart or signs of pulmonary hypertension in the presence of blood discharge from left to right and after previously suffered endocarditis. The article analyzes current information about the treatment of premature infants with ODA.
Pulmonary Embolism in Pregnancy: Ultrasound-Assisted Catheter-Directed Thrombolytic Therapy for the Treatment of a Pulmonary Embolus—A Case Report
Authors: Baracy Michael G. , Olotu Olumide , Marchese Phillip , Gosselin Marc , Vengalil Shyla 
Published: June 2021

Abstract
In the United States, pulmonary embolism (PE) accounts for approximately 10% of all pregnancy related deaths. The standard treatment for a patient with high-risk PE is systemic thrombolysis. Systemic thrombolysis in pregnancy is associated with the risk of maternal hemorrhage and fetal complications, including spontaneous abortion, preterm delivery, and fetal bleeding. Currently, there is limited evidence for a standardized approach for the treatment and management of intermediate- and high-risk PEs in pregnancy. A 36-year-old gravida 3 para 2002 woman at 31+1 weeks of gestation with a history of deep vein thrombosis in her prior pregnancy presented with shortness of breath. A computed tomography angiogram revealed a large pulmonary embolus with a saddle component that extended into the bilateral upper and lower lobes and into the secondary and tertiary pulmonary branches. A subsequent bedside echocardiogram demonstrated a dilated right ventricle with severely reduced right ventricular systolic function. The patient was successfully treated with bilateral ultrasound-assisted catheter-directed thrombolysis. She subsequently delivered a healthy male infant at term. Reported cases of ultrasound-assisted catheter-directed thrombolysis in pregnant patients is limited. Our case demonstrates that localized thrombolysis is a viable treatment option for life-threatening PE in pregnancy. Catheter-directed thrombolysis can be efficacious in treating intermediate- and high-risk PEs in pregnancy while simultaneously reducing the risk of bleeding complications.
Reproductive potential and fertility preservation in transgender and nonbinary individuals
Authors: Schwartz Amanda R. , Moravek Molly B. 
Published: June 2021

Purpose of review
To synthesize recent literature to better understand parenting desires and challenges of transgender individuals as well as the impact of gender-affirming care on reproductive potential.

Recent findings
Survey studies of transgender and nonbinary individuals demonstrate significant parenting interest, yet uptake in fertility preservation services remains low with potential for decisional regret. Masculinizing hormones have demonstrated variable effects on folliculogenesis and follicle distribution in the human ovary. In the mouse model, testosterone administration has demonstrated an increase in atretic late antral follicles without a reduction in primordial or total antral follicle counts and a preserved ability to respond to gonadotropin stimulation. Case series of transgender individuals undergoing oocyte or embryo cryopreservation are promising with outcomes similar to cisgender controls. Feminizing hormones have shown detrimental effects on sperm parameters at time of cryopreservation and spermatogenesis in orchiectomy samples with uncertainty regarding the reversibility of these changes.

Summary
Current evidence demonstrates variable effects of gender-affirming hormones on ovarian and testicular function with potential for detrimental impact on an individual's reproductive potential. As many individuals initiate gender-affirming care prior to or during their reproductive years it is imperative that they receive thorough fertility preservation counseling and improved access to reproductive care services.
Cardiac rehabilitation for coronary artery disease: latest updates
Authors: Epstein Elizabeth , Maisel Sofie , Maysent Kathryn , Taub Pam R. 
Published: June 2021

Purpose of review
To summarize recent innovations in cardiac rehabilitation and provide a view towards the future of cardiac rehabilitation as it adjusts to the pressures of a global pandemic.

Recent findings
Although cardiac rehabilitation has been shown to result in a mortality benefit, research continues to enumerate the benefits of cardiac rehabilitation to patient function and quality of life in a growing range of cardiovascular diseases. In addition, new methodologies and new models of cardiac rehabilitation have emerged with the goal of increasing patient referral and participation.

Summary
Cardiac rehabilitation continues to evolve and adapt to serve a growing and diversifying number of patients with cardiovascular disease with the goal of both decreasing mortality and improving patient function.
Characteristics of people with severe hypertension in France and determinants of medication persistence after 6 years
Authors: Tuppin Philippe , Denis Pierre , Gastaldi Christelle , Olié Valérie , Blacher Jacques 
Published: June 2021

Background:
Low medication persistence is reported in patients with severe hypertension but few data are available according to drug classes.

Method:
Adults without cardiovascular disease who started treatment, in a semester between 2010 and 2012, with two concurrent dispensings of at least three classes were identified in the French national health data system. High persistence after 12 semesters of follow-up was defined by a 6-monthly mean of number of drug classes equal to or greater than 80%.

Results:
Five hundred and seventy-six thousand and forty-eight adults alive at 6 years were included (three classes: 79%, four classes: 18%, five or more classes: 4%) with a mean age of 65.3 years, constituting 42% of men. High persistence was observed for 72% of people and multivariate analysis of baseline factors found a negative association for: female sex, extreme ages, living in an overseas department, at least one comorbidity, absence or frequent general practitioner consultations and a cardiologist consultation. The adjusted odds ratio was low for dispensing of ACEIs (0.87; 95% CI: 0.8–0.95), other RAS antagonists (0.91; 95% CI: 0.83–0.99) and a high number of classes (4: 0.17; 95% CI: 0.15–0.19, five and more: 0.06; 95% CI: 0.05–0.08). An inverse association was observed for diuretics (1.45; 95% CI: 1.33–1.59), calcium channel blockers (1.63; 95% CI: 1.50–1.79), beta-blockers (1.92; 95% CI: 1.76–2.1) and other antihypertensive classes (1.6; 95% CI: 1.5–1.8). No significant association was observed for ARBs (1.0; 95% CI: 0.9–1.1).

Conclusion:
These results based on a large primary prevention population should encourage the implementation of new pharmacological and nonpharmacological management strategies for people with severe hypertension in France.
Maternal myocardial dysfunction after hemolysis, elevated liver enzymes, and low platelets syndrome: a speckle-tracking study
Authors: Sciatti Edoardo , Mohseni Zenab , Orabona Rossana , Mulder Eva G. , Prefumo Federico , Lorusso Roberto , Frusca Tiziana , Ghossein-Doha Chahinda , Spaanderman Marc E.A. 
Published: June 2021

Objectives:
Pregnancy complicated by pre-eclampsia (PE) and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is associated with an increased risk of cardiovascular (CV) diseases later in life. Subclinical cardiac alterations precede eminent CV diseases. Speckle-tracking echocardiography (STE) is an effective method to assess subclinical myocardial dysfunction. We performed a myocardial speckle tracking study to investigate the prevalence of subclinical myocardial dysfunction in former PE patients (with and without HELLP syndrome) compared to normotensive women affected by HELLP syndrome.

Methods:
In this cross-sectional retrospective study, women with a history of normotensive HELLP (n = 32), PE without HELLP (n = 59), and PE with HELLP (n = 101) underwent conventional and STE as part of the clinical CV work-up after their complicated pregnancies from 6 months to 4 years postpartum. We excluded women with comorbidities, including chronic hypertension, hypercholesterolemia, and obesity.

Results:
Women with a history of PE with HELLP syndrome were characterized by a higher prevalence of altered left ventricular circumferential and global longitudinal two-dimensional (2D) strain (74 and 20%, respectively), altered right ventricular longitudinal 2D strain (37%), and left atrial (LA) 2D strain (57%). Moreover, a higher proportion of alterations of biventricular and LA strains was also present in former PE without HELLP as well as in the normotensive HELLP group.

Conclusions:
In the first years after a pregnancy complicated by HELLP syndrome, irrespective of whether there was concomitant PE, a higher rate of abnormal STE myocardial function is observed. Therefore, these women may benefit from CV risk management.
Insulin resistance, metabolic syndrome, and blood pressure progression among Blacks: the Jackson Heart Study
Authors: Kaze Arnaud D. , Musani Solomon K. , Correa Adolfo , Bertoni Alain G. , Golden Sherita H. , Abdalla Marwah , Echouffo-Tcheugui Justin B. 
Published: June 2021

Objective:
There is a paucity of data on the relations of insulin resistance with incident blood pressure (BP) changes among Blacks. We investigated the associations of insulin resistance and metabolic syndrome (MetS) with BP progression in a community-based sample of African Americans.

Methods:
We analyzed 1064 participants without hypertension at baseline (2000–2004) who attended at least one follow-up visit in 2005–2008 or 2009–2013. Four insulin resistance indices [fasting insulin, insulin-to-glucose ratio (IGR), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI)] and MetS (excluding hypertension in the definition) were assessed at baseline. Robust Poisson regression was used to generate risk ratios (RRs) and 95% confidence intervals (CI) for BP progression and incident hypertension.

Results:
Over a median of 7 years, 69.6% progressed to a higher BP category and 62.7% developed hypertension. After multivariable adjustment, participants in the highest quartile of HOMA-IR had higher risks of BP progression [RR 1.25 (95% CI 1.09–1.43), P
trend = 0.004] and hypertension [RR 1.35 (95% CI 1.16–1.58), P
trend < 0.001] compared with those in the lowest quartile. A similar positive association of insulin resistance with BP outcomes was noted with insulin resistance assessed using IGR, fasting insulin, and QUICKI. MetS was associated with increased risks of BP progression [RR 1.15 (95% CI 1.02–1.30), P = 0.02] and incident hypertension [RR 1.23 [95% CI 1.08–1.41], P = 0.002]. These associations were present across baseline BP categories.

Conclusion:
Our findings support the notion that higher insulin resistance levels are associated with greater risks of BP progression and incident hypertension among Blacks.