bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiplex PCR reveals a high prevalence of multiple pathogens in traveller’s diarrhoea in children
Authors: Pouletty Marie , De Pontual Loïc , Lopez Moreen , Morin Laurence , Poilane Isabelle , Pham Luu Ly , Carbonnelle Etienne , Titomanlio Luigi , Faye Albert , Bonacorsi Stéphane 
Published: July 2018

ObjectiveTraveller’s diarrhoea (TD) is one of the most frequent illnesses affecting children returning from tropical countries. The purpose of this study was to assess the distribution of pathogens associated with TD in children using a multiplex PCR assay on stool samples.DesignAll the children admitted for TD in two university hospitals from 1 August to 15October during 2014 and 2015 were included in a prospective study. Stool samples were tested by a multiplex PCR FilmArray GI panel detecting 22 pathogens. Performances for the detection of major enteropathogenic bacteria (Salmonella, Shigella and Campylobacter spp) by multiplex PCR and conventional culture methods were compared. The prevalence of extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae was also determined.ResultsFifty-nine children were included. In 58 cases (98%), at least one pathogen was identified, including 9 different enteropathogenic bacteria, 5 viruses and 2 parasites. Multiplex PCR enhanced the enteropathogenic bacteria detection by 25%. The most frequent pathogens were enteroaggregative Escherichia coli (n=32), enteropathogenic E. coli (n=26), enterotoxigenic E. coli (n=19), Salmonella enterica, enteroinvasive E. coli/Shigella (n=16 each), Cryptosporidium, sapovirus (n=11 each), Campylobacter jejuni, norovirus (n=10 each), rotavirus (n=9), Giardia (n=8) and Shiga-toxin-producing E. coli (n=4). Fifty-two coinfections were observed, notably including bacteria and viruses (n=21), multiple bacteria (n=14), or bacteria and parasites (n=10). ESBL were detected in 28 cases. Multiplex PCR could optimise the number of treated patients by 27% compared with stool cultures.ConclusionMultiplex PCR on stools revealed a high prevalence of diverse enteric pathogens and coinfections in children with TD. Major enteropathogenic bacteria were more frequently detected by multiplex PCR compared with conventional culture. Finally, this technique allows the start of appropriate and early antibiotic treatment and seems to optimise the number of correctly treated patients.
Towards a demographic risk profile for sedentary behaviours in middle-aged British adults: a cross-sectional population study
Authors: Patterson Freda , Lozano Alicia , Huang Liming , Perkett Mackenzie , Beeson Jacqueline , Hanlon Alexandra 
Published: July 2018

ObjectivesIn response to a call from the American Heart Association to more clearly identify the demographic factors associated with sedentary behaviours, this study aimed to identify the hierarchy of demographic characteristics associated with the sedentary behaviours of television viewing, recreational computer use and driving.DesignCross-sectional analysis of baseline data collected as part of the UK Biobank. The UK Biobank is a population cohort recruited from 22 centres across the UK. Participants aged between 37 and 73 years were recruited between 2006 and 2010.MethodsDecision tree models were generated for the sedentary behaviour outcomes of hours/day spent television viewing, recreational computer use and all driving; a sum of time spent in these sedentary behaviours (‘overall’) was computed. Age, sex, race, college attendance, employment, shift-work, urban versus rural residence as well as physical activity were considered as predictors.ResultsThe analytic sample comprised 415 666 adults who were mostly female (54.2%), white (95.2%), non-college attendee (64.5%), employed (61.7%), lived in an urban centre (85.5%), with a mean age of 56.6 (SD=8.1) years. Television viewing was most common sedentary behaviour (2.7 hour/day vs 1.1 for recreational computer use and 1.0 for all driving). Males (tier 1), who did not attend college (tier 2) were the highest risk group for overall sedentary time. Adults with no college attendance (tier 1) and were retired (tier 2) were the most high-risk demographic group for television viewing. College attendees (tier 1) were highest risk for recreational computer use. Adults who were employed (tier 1), male (tier 2) and did not attend college (tier 3) were most at risk for drivingConclusionsDaily time spent in different sedentary behaviours varies by sex, employment status and college attendance status. The development of targeted interventions to reduce sedentary behaviour in different demographic subgroups is needed.
Association betweenATP2B1andCACNB2polymorphisms and high blood pressure in a population of Lithuanian children and adolescents: a cross-sectional study
Authors: Simonyte Sandrita , Kuciene Renata , Dulskiene Virginija , Lesauskaite Vaiva 
Published: July 2018

ObjectivesRecently, genome-wide associated studies have identified several genetic loci that are associated with elevated blood pressure and could play a critical role in intracellular calcium homeostasis. The aim of this study was to assess the associations ofATP2B1rs2681472 andCACNB2rs12258967 gene polymorphisms with high blood pressure (HBP) among Lithuanian children and adolescents aged 12–15 years.Study design and participantsThis was a cross-sectional study of a randomly selected sample of 646 12–15-year-old adolescents who participated in the survey ‘The Prevalence and Risk Factors of HBP in 12–15 Year-Old Lithuanian Children and Adolescents (from November 2010 to April 2012)’. Anthropometric parameters and BP were measured. The participants with HBP were screened on two separate occasions. Subjects were genotypedATP2B1rs2681472 andCACNB2rs12258967 gene polymorphisms using real-time PCR method.ResultsThe prevalence of HBP was 36.7%, significantly higher for boys than for girls. In the multivariate analysis, after adjustment for body mass index and waist circumference, boys withCACNB2CG genotype,CACNB2GG genotype andCACNB2CG +GG genotype had higher odds of having HBP in codominant (adjusted OR (aOR)=1.92; 95% CI 1.16 to 3.18, p=0.011; and aOR=2.64; 95% CI 1.19 to 5.90, p=0.018) and in dominant (aOR=2.05; 95% CI 1.27 to 3.30, p=0.003) inheritance models. Girls carryingCACNB2CG genotype andCACNB2CG +GG genotype had increased odds of HBP in codominant (aOR=1.82; 95% CI 1.02 to 3.24, p=0.044) and in dominant (aOR=1.89; 95% CI 1.09 to 3.28, p=0.023) inheritance models. Furthermore, significant associations were found in additive models separately for boys (aOR=1.72; 95% CI 1.20 to 2.46, p=0.003) and girls (aOR=1.52; 95% CI 1.05 to 2.20, p=0.027). No significant association was found betweenATP2B1gene polymorphism and the odds of HBP.ConclusionsOur results indicate thatCACNB2gene polymorphism was significantly associated with higher odds of HBP in Lithuanian adolescents aged 12–15 years.
Is mortality-to-incidence ratio associated with health disparity in pancreatic cancer? A cross-sectional database analysis of 57 countries
Authors: Lee Hsiang-Lin , Peng Cheng-Ming , Huang Cheng-Yu , Wu Shin-Yi , Tsai Ming-Chang , Wang Chi-Chih , Chen Sung-Lang , Lin Chun-Che , Huang Chien-Ning , Sung Wen-Wei 
Published: July 2018

ObjectiveThe colorectal cancer mortality-to-incidence ratio (MIR) can reflect healthcare disparities. However, a similar association has not yet been established between the MIR of pancreatic cancer and healthcare disparities.MethodsIn this study, the incidence and mortality rates of pancreatic cancer were obtained from the GLOBOCAN 2012 database. The WHO rankings and total expenditures on health/gross domestic product (e/GDP) were obtained from a public database. Linear regression was performed to determine correlations between the variables.Results57 countries met the inclusion criteria according to the data quality. Developed regions (Europe and the Americas) had high pancreatic cancer incidence and mortality rates. The MIRs were over 0.90 in all regions. No significant correlation was found between MIRs and the WHO rankings, e/GDP or per capita total expenditure on health for analysis in the 57 countries, indicating no association between MIRs and cancer care disparities for pancreatic cancer.ConclusionsThe MIR variations for pancreatic cancer do not correlate with healthcare disparities among countries. Further investigation is necessary to confirm this observation with secondary analysis of databases.
Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
Authors: Walrod Jemie , Seccareccia Erica , Sarmiento Iván , Pimentel Juan Pablo , Misra Shivali , Morales Juana , Doucet Alison , Andersson Neil 
Published: July 2018

ObjectivesWe aimed to implement participatory research to answer a question posed by four Kichwa indigenous communities in Andean Ecuador about what actionable factors are associated with childhood stunting, overweight and food insecurity among their people.DesignWe used mixed methods including household questionnaires, discussion groups with respondents of the questionnaires and anthropometric measurement of children (6 months to 12 years) from surveyed households.SettingThe study involved four Andean indigenous communities transitioning from traditional to Western lifestyles. They subsist mainly on small-scale agriculture and have a rich cultural heritage including their traditional language.ParticipantsAnthropometric data were collected from 298 children from 139 households in four communities; all households completed the questionnaire. We held five discussion groups (6–10 participants each): three composed of mothers and two of farmers.Primary and secondary outcome measuresPrimary outcomes were stunting, overweight, food insecurity and their relationship with demographics, dietary habits and agricultural habits.ResultsOf 298 children, 48.6% were stunted and 43.3% overweight for age. Stunted children were more likely to live in households that sold livestock (ORa 1.77, 95% CIa 1.06 to 2.95) and with illiterate primary caretakers (ORa 1.81, 95% CIa 1.07 to 3.06), but were less likely to live in households with irrigation (ORa 0.47, 95% CIa 0.27 to 0.81). Overweight children were more likely to be male (ORa 1.87, 95% CIa 1.02 to 3.43) and live in a household that sold livestock (ORa 2.14, 95% CIa 1.14 to 4.02). Some 67.8% of children lived in a household with food insecurity, more frequently in those earning below minimum wage (ORa 2.90, 95% CIa 1.56 to 5.41) and less frequently in those that ate quinoa in the past 24 hours (ORa 0.17, 95% CIa 0.06 to 0.48). Discussion groups identified irrigation and loss of agricultural and dietary traditions as important causes of poor childhood nutrition.ConclusionMany indigenous communities face tumultuous cultural, nutritional and epidemiological transitions. Community-based interventions on factors identified here could mitigate negative health outcomes.
Does nephrotic syndrome without chronic kidney disease increase the risk of Parkinson’s disease and secondary parkinsonism? A nationwide population-based study in Taiwan
Authors: Huang Zheng-Hao , Chen Hsiang-Cheng , Chou Yu-Ching , Lin Cheng-Li , Kao Chia-Hung , Lo Hsin-Yi , Yang Tse-Yen , Liu Feng-Cheng 
Published: July 2018

ObjectivesPrevious research has shown that patients with nephrotic syndrome (NS) have a higher risk of cognitive impairment, dementia or neurodegenerative disorder. The present study aimed to examine a relationship, if any exists between NS and Parkinson’s disease (PD), a neurodegenerative disorder and secondary parkinsonism (sPS).MethodsA nationwide retrospective observational study conducted using data from the 2000–2010 Taiwan National Health Insurance Research Database. This study included 3663 patients with NS and 14 652 randomly selected, age-matched and sex-matched patients without NS. A Cox multivariable proportional hazards model was used to evaluate the risk of PD and sPS (PDsPS) in the NS cohort.ResultsThis study identified a positive association between NS and the risk of PDsPS in both men and women and in all age groups (adjusted HR 1.51; 95% CI 1.37 to 1.66). Compared with patients without NS and comorbidities, those with NS with two or more comorbidities exhibited an 8.23-fold higher risk of PDsPS (95% CI 6.22 to 10.9) and patients with NS and one comorbidity exhibited a 2.93-fold higher risk of PDsPS (95% CI 2.37 to 3.63).ConclusionsPatients with NS have an increased risk of PDsPS. This increased risk may be related to brain vascular damage or blood–brain barrier impairment. Further research is necessary to explore the underlying relationship between NS and PDsPS.
A systematic review of barriers and enablers to South Asian women’s attendance for asymptomatic screening of breast and cervical cancers in emigrant countries
Authors: Anderson de Cuevas Rachel Mary , Saini Pooja , Roberts Deborah , Beaver Kinta , Chandrashekar Mysore , Jain Anil , Kotas Eleanor , Tahir Naheed , Ahmed Saiqa , Brown Stephen L 
Published: July 2018

ObjectivesThe aim of this review was to identify the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance in South Asian populations, in order to improve uptake and propose priorities for further research.DesignA systematic review of the literature for inductive, comparative, prospective and intervention studies. We searched the following databases: MEDLINE/In-Process, Web of Science, EMBASE, SCOPUS, CENTRAL, CDSR, CINAHL, PsycINFO and PsycARTICLES from database inception to 23 January 2018. The review included studies on the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance and cervical smear testing (Papanicolaou test) in South Asian populations and those published in the English language. The framework analysis method was used and themes were drawn out following the thematic analysis method.SettingsAsymptomatic breast or cervical screening.ParticipantsSouth Asian women, including Bangladeshi, Indian, Pakistani, Sri Lankan, Bhutanese, Maldivian and Nepali populations.Results51 included studies were published between 1991 and 2018. Sample sizes ranged from 25 to 38 733 and participants had a mean age of 18 to 83 years. Our review showed that South Asian women generally had lower screening rates than host country women. South Asian women had poorer knowledge of cancer and cancer prevention and experienced more barriers to screening. Cultural practices and assumptions influenced understandings of cancer and prevention, emphasising the importance of host country cultures and healthcare systems.ConclusionsHigh-quality research on screening attendance is required using prospective designs, where objectively validated attendance is predicted from cultural understandings, beliefs, norms and practices, thus informing policy on targeting relevant public health messages to the South Asian communities about screening for cancer.PROSPERO registration numberCSD 42015025284.
Risk of pleural empyema in patients with schizophrenia: a nationwide propensity-matched cohort study in Taiwan
Authors: Shen Te-Chun , Chen Chia-Hung , Huang Yu-Jhen , Lin Cheng-Li , Chang Ting-Chang , Tu Chih-Yen , Hsia Te-Chun , Shih Chuen-Ming , Hsu Wu-Huei , Sung Fung-Chang 
Published: July 2018

ObjectiveThoracic infection and pneumonia are prevalent in patients with schizophrenia; however, it is unclear whether patients with schizophrenia are at an increased risk of developing pleural empyema.DesignA retrospective cohort study with propensity-matched cohorts with and without schizophrenia.SettingUsing the National Health Insurance Research Database of Taiwan.ParticipantsWe identified 55 888 patients with schizophrenia newly diagnosed in 2000–2011 and same number of individuals without schizophrenia as the comparison cohort, frequency matched by propensity scores estimated using age, sex, occupation, income, urbanisation, year of diagnosis and comorbidities.Primary outcome measuresWe assessed incident pleural empyema by the end of 2011 and used the Cox proportional hazards model to calculate the schizophrenia cohort to comparison cohort HR of pleural empyema.ResultsThe overall incidence of pleural empyema was 2.44-fold greater in the schizophrenia cohort than in the comparison cohort (4.39vs1.80 per 10 000 person-years), with an adjusted HR of 2.87(95% CI 2.14 to 3.84). Stratified analyses by age, sex, occupation, income, urbanisation and comorbidity revealed significant hazards for pleural empyema associated with schizophrenia in all subgroups.ConclusionsPatients with schizophrenia are at an increased risk of developing pleural empyema and require greater attention and appropriate support.
Different but similar: personality traits of​ surgeons and internists—results of a cross-sectional observational study
Authors: Stienen Martin N , Scholtes Felix , Samuel Robin , Weil Alexander , Weyerbrock Astrid , Surbeck Werner 
Published: July 2018

ObjectivesMedical practice may attract and possibly enhance distinct personality profiles. We set out to describe the personality profiles of surgical and medical specialties focusing on board-certified physicians.DesignProspective, observational.SettingOnline survey containing the Ten-Item Personality Inventory (TIPI), an internationally validated measure of the Five Factor Model of personality dimensions, distributed to board-certified physicians, residents and medical students in several European countries and Canada. Differences in personality profiles were analysed using multivariate analysis of variance and Canonical Linear Discriminant Analysis on age-standardised and sex-standardised z-scores of the personality traits. Single personality traits were analysed using robust t-tests.ParticipantsThe TIPI was completed by 2345 board-certified physicians, 1453 residents and 1350 medical students, who also provided demographic information.ResultsNormal population and board-certified physicians’ personality profiles differed (p<0.001). The latter scored higher on conscientiousness, extraversion and agreeableness, but lower on neuroticism (all p<0.001). There was no difference in openness to experience. Board-certified surgical and medical doctors’ personality profiles were also different (p<0.001). Surgeons scored higher on extraversion (p=0.003) and openness to experience (p=0.002), but lower on neuroticism (p<0.001). There was no difference in agreeableness and conscientiousness. These differences in personality profiles were reproduced at other levels of training, that is, in students and training physicians engaging in surgical versus medical practice.ConclusionThese results indicate the existence of a distinct and consistent average ‘physician personality’. Despite high variability within disciplines, there are moderate but solid and reproducible differences between surgical and medical specialties.
Registration and publication of emergency and elective randomised controlled trials in surgery: a cohort study from trial registries
Authors: Morley Rachael L , Edmondson Matthew J , Rowlands Ceri , Blazeby Jane M , Hinchliffe Robert J 
Published: July 2018

ObjectivesEmergency surgical practice constitutes 50% of the workload for surgeons, but there is a lack of high quality randomised controlled trials (RCTs) in emergency surgery. This study aims to establish the differences between the registration, completion and publication of emergency and elective surgical trials.DesignThe clinicaltrials.gov and ISRCTN.com trials registry databases were searched for RCTs between 12 July 2010 and 12 July 2012 using the keyword ‘surgery’. Publications were systematically searched for in Pubmed, MEDLINE and EMBASE.ParticipantsResults with no surgical interventions were excluded. The remaining results were manually categorised into ‘emergency’ or ‘elective’ and ‘surgical’ or ‘adjunct’ by two reviewers.Primary outcome measuresNumber of RCTs registered in emergency versus elective surgery.Secondary outcome measuresNumber of RCTs published in emergency versus elective surgery; reasons why trials remain unpublished; funding, sponsorship and impact of published articles; number of adjunct trials registered in emergency and elective surgery.Results2700 randomised trials were registered. 1173 trials were on a surgical population and of these, 414 trials were studying surgery. Only 9.4% (39/414) of surgical trials were in emergency surgery. The proportion of trials successfully published did not significantly differ between emergency and elective surgery (0.46 vs 0.52; mean difference (MD) −0.06, 95% CI −0.24 to 0.12). Unpublished emergency surgical trials were statistically equally likely to be terminated early compared with elective trials (0.33 vs 0.16; MD −0.18, 95% CI −0.06 to 0.41). Low accrual accounted for a similar majority in both groups (0.43 vs 0.46; MD −0.04, 95% CI −0.48 to 0.41). Unpublished trials in both groups were statistically equally likely to still be planning publication (0.52 vs 0.71; MD −0.18, 95% CI −0.43 to 0.07).ConclusionFewer RCTs are registered in emergency than elective surgery. Once trials are registered both groups are equally likely to be published.
Maintenance use of non-steroidal anti-inflammatory drugs and risk of gastrointestinal cancer in a nationwide population-based cohort study in Sweden
Authors: Brusselaers Nele , Lagergren Jesper 
Published: July 2018

ObjectivesAspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are potential candidates for chemoprevention of gastrointestinal cancer. We aimed to assess the association between contemporary NSAID use (≥180 days) and gastrointestinal cancer.DesignNationwide Swedish population-based cohort study (2005–2012).SettingSwedenParticipantsAll adults exposed to maintenance NSAIDs use (aspirin, n=783 870; unselective NSAIDs, n=566 209, selective cyclo-oxygenase (COX)-2 inhibitors, n=17 948) compared with the Swedish background population of the same age, sex and calendar period.Outcome measuresThe risk of different gastrointestinal cancer types expressed as standardised incidence ratios (SIR) and 95% CIs, taking into account concurrent proton pump inhibitors (PPIs) and statins usage.ResultsThe SIR for gastrointestinal cancer for aspirin use was 1.02 (95% CI 1.00 to 1.04), with clearly reduced risk for long-term users (SIR=0.31, 95% CI 0.30 to 0.33 for 5.5–7.7 years), but an increased risk for short-term users (SIR=2.77, 95% CI 2.69 to 2.85), and stronger protective effect for low-dose aspirin (SIR=0.86, 95% CI 0.85 to 0.88). Users of non-selective NSAIDs showed an overall decreased risk of gastrointestinal cancer (SIR=0.79, 95% CI 0.77 to 0.82), in particular for cancer of the stomach, colorectum and oesophagus, and the SIRs were further decreased among long-term users. Users of selective COX-2 inhibitors showed a SIR=0.89 (95% CI 0.73 to 1.09) for gastrointestinal cancers. Both aspirin and unselective NSAIDs users who also were using PPIs, had higher risks for all gastrointestinal cancer types; and lower risk if using statins.ConclusionLong-term use of (low-dose) aspirin and non-selective NSAIDs was associated with a decreased risk of all gastrointestinal cancer types.