bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved cookstoves and the prevalence of metabolic syndrome in the rural Peruvian Andes: a quasi-experimental study
Authors: Sanchez-Samaniego Giuliana , Mäusezahl Daniel , Carcamo Cesar , Probst-Hensch Nicole , Verastegui Héctor , Hartinger Stella Maria 
Published: September 2019

Abstract
Background: Household air pollution increases the risk of non-communicable diseases, such as cardiovascular diseases and metabolic syndrome. This study hypothesised that the reduction of household air pollution through the installation of improved cookstoves is associated with the prevalence of metabolic syndrome. We compared the prevalence of metabolic syndrome between adults using open fire stoves and using improved cookstoves in high altitude provinces of Cajabamba and San Marcos in rural Peruvian Andes.Methods: This is a quasi experimental study nested within a randomised controlled trial (parent study) of 317 children randomised in four study arms. The parents study applied a 2x2 factorial design with three single intervention arms (improved cookstove (ICS), early child development (ECD) and Control) and one combined arm (ICS-ECD). This study was conducted 6-10 months after the ICS intervention was implemented and all parents of the 317 children in the parent study were eligible to participate. Ventilated improved cookstoves using biomass fuel were provided to intervention homes. All participants answered a 24-hour food recall and underwent a physical examination for metabolic syndrome diagnosis. Results: A total of 385 participants were allocated to two groups of improved cookstove users with 190 (112 women and 78 men) and open-fire stove users with 195 (123 women and 72 men). Metabolic syndrome was detected in 21% of all participants and more frequently in women than men (26% versus 13%). In women, the improved cookstove intervention was a protective factor for metabolic syndrome (Prevalence Ratio= 0.70 (0.46 to 1.08), p=0.11). In addition, PR increased with age in women. In both gender, significantly lower PR was found in participants living ≥2500 meters above sea level (PR=0.65 (0.42 to 1.00), p=0.051 in women; (PR=0.25 (0.07 to 0.71), p=0.009 in men).Conclusions: The improved cookstove intervention reducing household air pollution is associated with a lower prevalence of MetS in women users. In addition, residential altitude is an important risk factor for metabolic syndrome even in high altitude populations. Keywords: biomass fuel ventilated improved cookstove, household air pollution, metabolic syndrome, high altitude, Peru Trial registration: Trial registration number ISRCTN26548981 at www.srctn.com . Registered retrospectively, Jan. 15 2018.
First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases
Authors: Hu Jilin , Zhang Jinman , He Guilin , Zhu Shu , Tang Xinhua , Zhu Baosheng , Su Jie , Li Qian , Kong Yamin 
Published: September 2019

Abstract
Purpose: To investigate the predictive values of first-trimester maternal serum alpha-fetoprotein (MS-AFP) to preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). Methods: We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of adverse pregnancy outcomes (APOs) regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), while the risk of stillbirth was not significantly increased (1.33, 0.40~4.41). The areas under ROC curves were 0.572 (P = 0.001), 0.597 (P = 0.060), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, stillbirth, preeclampsia and SGA, respectively. Women with MS-AFP ≥ 2.5MoM had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000) compared to those with MS-AFP < 2.5MoM, but the actual between-group differences were minuscule. Conclusion: Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.
Prevalence of malocclusion in north Cyprus School
Authors: Beleva Nadejda , Kacamak Nazli Idil , Sin Cagla , Kamiloglu Beste 
Published: September 2019

Abstract
Background. The epidemiology of the population living in a country plays an important role in the planning and implementation of dental services. Correct identification of the need for orthodontic treatment in individuals is a very complex subject and requires detailed analysis. The aim of this study was to measure the prevalence of malocclusion among randomly selected subjects aged 12-15 years attending secondary schools regardless of any socio-economic or social status in Northern Cyprus.Methods. After the approval of the competent authorities in the Ministry of National Education and the Ministry of Health of Northern Cyprus and of the parents whose subjects were to take part in the study, the evaluation was carried out by a team of three people, two of whom are in the process of specializing in orthodontics and one doctoral student at the qualification stage. The study included a randomly selected sampling composed of 426 subjects (203 females and 223 males). Results. The statistical evaluation of the samples collected in the study found that 20.6% of the subjects had no occurrence of occlusion, 74.4% had Class I, 21.1% had Class II (part 1, 18.8%, part 2, 2.3%) and 4.5% had Class III malocclusion. Of the 419 patients, 86 (20.2%) were in need of orthodontic treatment. Although not statistically significant, it was determined that 19.7% of female patients and 20.7% of the male patients were in need for orthodontic treatment.Conclusions. The most common orthodontic malocclusion in Cyprus is Class I, the least common malocclusion is Class II division 2.
Information technology tools can automate imaging measures for Emergency Department patients with suspected pulmonary embolism
Authors: Valtchinov Vlad I , Ip Ivan , Khorasani Ramin , Cochon Laila , Lacson Ronilda , Murphy Shawn N. , Raja Ali 
Published: September 2019

Abstract
CT pulmonary angiography (CTPA) utilization rates for patients with suspected pulmonary embolism (PE) in the Emergency Department (ED) have increased steadily with associated radiation exposure, costs and overdiagnosis. A new measure is needed to more precisely assess efficiency of CTPA utilization normalized to numbers of patients presenting with suspected PE, based on patient signs and symptoms. This study used natural language processing (NLP) to develop, automate, and validate SPE (“Suspected Pulmonary Embolism [PE]”), a measure determining CTPA utilization in ED patients with suspected PE. This retrospective study was conducted 4/1/2013-3/31/2014 in a Level-1 ED. A NLP engine processed “Chief Complaint” sections of ED documentation, identifying patients with PE-suggestive symptoms based on four Concept Unique Identifiers (CUIs: shortness of breath, chest pain, pleuritic chest pain, anterior pleuritic chest pain). SPE was defined as proportion of ED visits for patients with potential PE undergoing CTPA. Manual reviews determined specificity, sensitivity and negative predictive value (NPV). Among 5,768 ED visits with 1+SPE CUI, and 795 CTPAs performed, SPE=13.8% (795/5,768). NLP identified patients with relevant CUIs with specificity=0.94 [95%CI (0.89-0.96)]; sensitivity=0.73 [95%CI (0.45-0.92)]; NPV=0.98. Using NLP on ED documentation can identify patients with suspected PE to computate a more clinically-relevant CTPA measure. This measure might then be used in an audit-and-feedback process to increase the appropriateness of imaging of patients with suspected PE in the ED.
Prevalence and genotyping of Toxoplasma gondii in stray cats in Mashhad area, Iran.
Authors: Khodaverdi Majid , Razmi Gholamreza 
Published: September 2019

Abstract
Background: Cats as a definitive host have an important role in the epidemiology of toxoplasmosis in humans and animals. The aim of the study was to determine the frequency of Toxoplasma gondii infection and isolate and identify the genotypes of T. gondii in stray cats in Mashhad suburb .
Methods: From April 2016 to August 2017, in this study, 175 fecal samples from stray cats and 31 brain samples from cats killed in driving accidents were collected. The fecal samples were examined by fecal flotation technique and T. gondii -specific PCR. The brain samples were investigated by T. gondii -specific PCR and consequently examined by mice bioassay. The DNA of T. gondii isolated were genotyped using SAG1, SAG2, SAG3, BTUB and GRA6 as PCR-restriction fragment length polymorphism (PCR-RFLP) markers .
Results: In the present study, oocysts-like Toxoplasma were microscopically observed in 2.2% (4/175) fecal samples. The presence of Toxoplasma oocysts was confirmed in one microscopy-positive sample by PCR. In addition, T. gondii DNA was detected in 4% (7/175) microscopy-negative samples using PCR. T. gondii was isolated from one brain PCR-positive sample by mice bioassay. The isolate was avirulent and many T. gondii cysts were observed in mice brain. The isolate was successfully genotyped by PCR-RLFP analysis .The isolated genotyped was type II. Beside, eight Toxoplasma- positive fecal samples contained insufficient DNA and only amplified at SAG-3 locus in PCR. These samples were also showed type II pattern at this locus.
Conclusions: Parasitological and molecular results showed low frequency of Toxoplasma infection in the stray cats, and identified the genotype of T. gondii isolate as type II, for the first time in Mashhad area, Khorasan Razavi Province.
Clinical characteristics and relating factors of somatization symptoms of outpatients with psychological disorders: A cross-sectional observational study
Authors: Gong Shan , Zhang Yanan , Jin Chao , Ning Liang , Xiao Yi , Yu Guolong 
Published: September 2019

Abstract
Abstract Background:Cardiovascular disease patients associated with psychological disorders are very common clinically.It has been demonstrated in previous study that a higher prevalence of psychiatric disorders in the patients with CVD than the general population.Anxiety and depression are found to be the most common types of psychiatric disorders in the patients with CVD.Objective:Exploring the clinical characteristics and relating factors of somatization symptoms of the outpatients with psychological disorders. Methods:From August 2017 to July 2018,we used the General Anxiety Disorder-7, Patient Health Questionnaire, Patient Health Questionnaire-15 and self-made general demographic data questionnaire to investigate the outpatients suspected with psychiatric disorders in cardiology department in a general hospital,who were screened with the"three questions"method.Results:Among the 508 effective patients, the total detection rate of anxiety/depression was 81.1%(412/508),and the detection rate of somatization symptoms was 93.1%(473/508).The positive number of PHQ-15 symptom items was 8.54±2.67,and the detection rate of anxiety/depression was 78.7% in 473 patients with somatization symptoms.Among the patients with mild,moderate and severe somatization symptoms,there were significant differences in the proportion of women, the average number of the patient visits and hospitalizations in the past year(P=0.0341, 0.023),and also in GAD-7 and PHQ-9 scale scores(P=0.0282, 0.0011).Linear correlation analysis showed PHQ-15 score was significantly correlated with GAD-7(r=0.4787, P<0.001) and PHQ-9 score(r=0.5141, P<0.001).Stepwise logistic regression analysis showed that the PHQ-9,GAD-7 scores and female were positive factors on somatizations.Conclusion:The incidence of somatization symptoms is high in patients with psychological disorders in the outpatients of cardiology department.
Functional optical zone and visual quality after SMILE and FS-LASIK treatment for high myopia
Authors: Ding Xuan , Fu Dan , Li Meiyan , Wang Lin , Zhou Xingtao , Yu zhiqiang 
Published: September 2019

Abstract
Background We compared the functional optical zone (FOZ) and wavefront aberrations achieved after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in high-myopia patients.METHODS Thirty four and fourty high myopic (spherical equivalent refraction ≤ -6D) patients were respectively enrolled in FS-LASIK group and SMILE group, only right eye of each patient was analyzed. The planned FOZ (PFOZ), ablation depth/lenticule thickness and other data were acquired from medical records. The achieved FOZs (AFOZ) were assessed using a Pentacam at 1 month, 3 month, 6 month post-surgery. We defined the AFOZ diameter as the mean ring diameter corresponding to average total corneal refractive power (TCRP) in the central 4-mm zone plus 0.5D. The wavefront aberrations were obtained with WASCA system pre-operatively and 6-month-postoperatively.RESULTS The PFOZs in the SMILE and FS-LASIK groups were 6.57±0.22 mm vs 6.54±0.15 mm (P =0.350). In both groups, the AFOZ at every follow-up point was smaller than the PFOZ (P < 0.001). The AFOZ correlated negatively with the wavefront higher order aberrations (HOA), spherical aberration in both groups. HOA, spherical aberration (P<0.001), but not coma (P=0.477) and trefoil (P=0.812), differed significantly between the groups.CONCLUSIONS In high-myopia patients, the AFOZ was smaller than the PFOZ, irrespective of whether SMILE or FS-LASIK. In SMILE group, the AFOZ was larger and more consistent with the PFOZ, probably resulting in with less wavefront aberrations.
Paediatric Glaucoma in Scotland
Authors: Beck Daniel , Galea Martin , Loo Cheng Yi , Schmoll Conrad , Burgess Frederick R. , Montgomery Donald , Tatham Andrew J 
Published: September 2019

Abstract
Background The primary aim was to estimate the incidence of primary and secondary childhood glaucoma in Scotland over a 2-year period. The secondary aim was to gauge the confidence and experience of ophthalmologists in Scotland in managing these patients. Methods A 7 question electronic survey was distributed to all consultant members of the Scottish Paediatric Club and Scottish Glaucoma Club. Respondents were asked to report the number of cases and types of childhood glaucoma they had managed in the last 2 years. Respondents were also asked about experience and confidence in a range of glaucoma procedures, number of patients requiring referral to specialist centres and interest in the development of a centre of excellence in Scotland. Results The survey returned a 56% response rate, reporting 85 new cases of paediatric glaucoma in Scotland over the preceding 2 years. 11 (12.9%) had primary glaucoma and 74 (87.1%) had secondary glaucoma. The most common subtype of secondary glaucoma was uveitic glaucoma (n=29). None of the respondents declared confidence or experience in trabeculotomy or goniotomy procedures. 11 children required referral to a specialist unit outside Scotland. 85.7% of respondents felt Scotland would benefit from a specialist unit for paediatric glaucoma. Conclusions This survey reflects an appetite for a specialist service for paediatric glaucoma in Scotland. However, further consideration is needed to determine if there is sufficient patient load to maintain such a service.
Clinicodemographical assessment of colorectal cancer with emphasis on B3GALNT2, MUC1, P53 and Ki67-related risk of metastasis
Authors: Mehrzad Jalil , Ranjbary Ali Ghorbani , Abdollahi Abbas , Hosseinkhani Saman , Tabatabaee Abbas , Dehghani Hesam 
Published: September 2019

Abstract
Background: The incidence of colorectal cancer (CRC) is rising, worldwide, and is attributed to genetics and epigenetic factors. We aimed to evaluate key demographical/epidemiological/molecular indicators of CRC in CRC patients from a highly populated area in northeastern Iran, retrospective clinical materials-based cohort design and patients were analyzed with respect to age, sex, colorectum anatomy, metastasis, mortality as well as to expression of molecular markers B3GALNT2, mucin I ( MUC1), P53 and Ki67.
Methods: Patients, 6260 registered CRC with 3829 underwent surgery, from three medical university hospitals in the study area, during 2006-2016, were analyzed for the clinicodemographic aspects of age, sex, stage of CRC, history of smoking, familial/occupational status and post-surgery survival period as well as mRNA/protein expression of B3GALNT2, MUC1, P53 and Ki67. Factors were set to estimate mortality and risk of metastatic CRC.
Results: ~75% of adenocarcinomatous CRC was located in colon, of which younger (with highest risk at transvers colon) and older than 50, was mainly located in rectum and colon, respectively. Post-surgery survival period of metastatic CRC patients was remarkably higher in patients aged > 50 than those < 50 years old, and worse in females than males. B3GALNT2 high , MUC1 high , P53 low and Ki67 high mRNA/protein expression in metastatic stage III CRC were highly associated with increased metastasis and mortality. B3GALNT2 high , MUC1 high , P53 low and Ki67 high mRNA/protein expression correlated with increased risk of a progressed CRC state and mortality. The risk to develop metastatic CRC was higher in males, younger individuals, urban residing individuals and employed individuals, indicative of a plausible non-genetics/epigenetics contribution to CRC.
Conclusion: The role of possible diagnostic biomarkers, B3GALNT2, MUC1 and Ki67, but not P53, in the etiology/early detection of metastatic CRC is promising. Epigenetic contribution to metastatic CRC risk is predominant.
Knowledge, attitude and practice of Sri Lankan women towards breast cancer: A cross sectional study
Authors: Ranaweera N.D. , Dinesha P.M.C. , Pathirage C.A.K. , Weerasinghe P.W.D.N. , Senarathna D.M.K.N. , Ariyasena G.A.G.M.S. , Galgamuwa G.L.S. , Wijesiri H.S.M.S.K. , Balawardhana K.A.S.J. 
Published: September 2019

Abstract
Introduction: Breast cancer is a type of cancer that develops from breast tissue. Although the knowledge on breast cancer among women in Sri Lanka is high, their practice of breast self-examination is poor. This study was aimed to determine attitudes, practices and the awareness of early detection techniques and risk factors among women in Sri Lanka. Method: A study was conducted between two groups in National Cancer hospital, Sri Lanka and a peripheral women clinic consisting 317 participants in each group. Self-administered questionnaire was used to collect data regarding the awareness of early detection techniques, signs and symptoms and risk factors for breast cancers. Results: A total of 33.8 % of peripheral women clinic and 65.0 % in National Cancer hospital patients had good knowledge regarding risk factors. The knowledge of risk factors, signs and symptoms and screening methods about breast cancers was significantly high in patients attending to National cancer hospital. Older aged people have less awareness about screening methods compared to younger people. People with high education background and those have a family history of breast cancer had more aware about screening and therapeutic methods. Conclusion: Comparative to the peripheral women clinic, patients attending to National Cancer Hospital had a fairly good knowledge, practice and attitude regarding the early detection techniques, risk factors, signs and symptoms. Key words : Breast cancer, Risk factors, Early detection techniques
Leisure-Time Physical Activity is Associated with reduced Risk of Breast Cancer and Triple Negative Breast Cancer in Nigerian Women: a matched case-control study
Authors: Bigman Galya , Adebamowo Sally N. , Yawe King-David Terna , Yilkudi Monday , Olaomi Oluwole , Badejo Olawale , Jedy-Agba Elima , Famooto Ayo , Ezeome Emmanuel , Salu Iliya Karniliyus , Miner Elijah , Anosike Ikechukwu , Achusi Benjamin , Adebamowo Clement 
Published: September 2019

Abstract
Background

Physical activity is associated with reduced risk of breast cancer and its various subtypes but this association is less known in African women, particularly with triple-negative breast cancer that occurs more frequently in Sub-Saharan Africa compared to developed countries. In this study, we examined the association between leisure-time physical activity (LTPA) and breast cancer in total and by its subtypes in Nigerian women.

Methods

Overall, 630 newly diagnosed patients with primary invasive breast cancer were age-matched (±5years) with 630 controls from the Nigerian Integrative Epidemiology of Breast Cancer (NIBBLE) Study from 01/2014-07/2016. We derived the average amount of time spent on LTPA per week over the past year using a modified Nurses’ Health Study-II physical activity questionnaire. We calculated the total metabolic equivalents (METs) for each reported LTPA per hour/week (i.e. walking, cycling, and dancing) and compared odds of breast cancer among participants who attained the World Health Organization (WHO) physical activity(PA) recommendations of at least 150 minutes of moderate-intensity or/and 75 minutes of vigorous-intensity aerobic activity/week with those who did not. In addition, we evaluated this by categories of LTPA in quartiles of METs. We used conditional and unconditional logistic regression models to estimate the adjusted Odds Ratio(OR) of LTPA with overall breast cancer and by hormone receptor-positive and triple-negative breast cancer.

Results

The mean ages of cases and controls were similar after matching, 42.5±10.1 and 41.5±9.2 years (mean±SD), respectively. Women who attained the WHO PA recommendations had a 42% reduction in the odds of having breast cancer(OR=0.58 95% CI:0.43-0.78) compared with those who did not. LTPA was associated with reduced odds of having hormone receptor-positive by 41% and significantly associated with reduced odds of having triple-negative breast cancer by 45%. In addition, a significant dose-response relationship was observed, women with higher levels of LTPA had lower odds of having overall breast cancer as well as having triple-negative and hormone receptor-positive breast cancer.

Conclusions

Increasing LTPA in African women can play a significant role in reducing the incidence of breast cancer, particularly of the more aggressive subtype as triple-negative, which is more prevalent in Sub-Saharan Africa.