bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the correlation between KAP scores regarding sugar-sweetened beverage consumption and hyperuricemia amongst Chinese young adults
Authors: Zhang Yun , Di Hong , Wu Juan , Wang Xiaoxue , Han Xinxin , Zhang Bingqing , Zeng Xuejun 
Published: April 2024

Abstract
Background
The prevalence of hyperuricemia in China has been consistently increasing, particularly among the younger generation. The excessive consumption of sugar-sweetened beverages is associated with hyperuricemia. This study examined the knowledge, attitudes, and practices (KAP) of Chinese young adults regarding sugar-sweetened beverage consumption and the correlation with hyperuricemia.

Methods
This cross-sectional investigation was conducted from June 28th, 2023, to July 21st, 2023, and enrolled Chinese young adults. Demographics and KAP were evaluated using a questionnaire (Cronbach’s α = 0.787). Factors influencing KAP scores were analyzed using multivariable analyses.

Results
A total of 1288 valid questionnaires were analyzed. The median knowledge, attitude, and practice scores were 16 (12,19)/22, 22 (20,24)/30, and 27.5 (23,31.75)/40. The multivariable analysis showed that bachelor’s/associate education (OR = 1.912, 95%CI: 1.128–3.239), white collar/employee (OR = 0.147, 95%CI: 0.105–0.206), educator (OR = 0.300, 95%CI: 0.174–0.518), healthcare worker (OR = 0.277, 95%CI: 0.188–0.407), not suffering from hyperuricemia (OR = 0.386, 95%CI: 0.253–0.590), and not having gout (OR = 0.456, 95%CI: 0.282–0.736) were independently associated with knowledge. Age 26–30 (OR = 1.470, 95%CI: 1.052–2.052), age 31–35 (OR = 1.489, 95%CI: 1.097–2.022), age 36–40 (OR = 0.328, 95%CI: 1.010–1.746), age 41–44 (OR = 1.548, 95%CI: 1.091–2.198), and not having hyperuricemia (OR = 0.512, 95%CI: 0.345–0.760) were independently associated with attitude. White collar/employee (OR = 0.386, 95%CI: 0.285–0.521), educator (OR = 0.534, 95%CI: 0.317–0.899), healthcare worker (OR = 0.341, 95%CI: 0.236–0.493), having siblings (OR = 0.725, 95%CI: 0.573–0.917), and not suffering from hyperuricemia (OR = 0.442, 95%CI: 0.296–0.659), were independently associated with practice.

Conclusion
Chinese young adults display moderate KAP toward sugar-sweetened beverages. Notably, an association was observed between hyperuricemia and each KAP dimension.
Association of daily sitting time and coffee consumption with the risk of all-cause and cardiovascular disease mortality among US adults
Authors: Zhou Huimin , Nie Jing , Cao Yanmei , Diao Linjing , Zhang Xiaoli , Li Jiafu , Chen Siyu , Zhang Xu , Chen Guochong , Zhang Zengli , Li Bingyan 
Published: April 2024

Abstract
Background
Sedentary behavior has been demonstrated to be a modifiable factor for several chronic diseases, while coffee consumption is believed to be beneficial for health. However, the joint associations of daily sitting time and coffee consumption with mortality remains poorly understood. This study aimed to evaluate the independent and joint associations of daily sitting time and coffee intakes with mortality from all-cause and cardiovascular disease (CVD) among US adults.

Methods
An analysis of a prospective cohort from the 2007–2018 National Health and Nutrition Examination Survey of US adults (n = 10,639). Data on mortality were compiled from interview and physical examination data until December 31, 2019. Daily sitting time was self-reported. Coffee beverages were from the 24-hour diet recall interview. The main outcomes of the study were all-cause and cardiovascular disease mortality. The adjusted hazard ratios [HRs] and 95% confidence intervals [CI] were imputed by Cox proportional hazards regression.

Results
Among 10,639 participants in the study cohort, there were 945 deaths, 284 of whom died of CVD during the follow-up period of up to 13 years. Multivariable models showed that sitting more than 8 h/d was associated with higher risks of all-cause (HR, 1.46; 95% CI, 1.17–1.81) and CVD (HR, 1.79; 95% CI, 1.21–2.66) mortality, compared with those sitting for less than 4 h/d. People with the highest quartile of coffee consumption were observed for the reduced risks of both all-cause (HR, 0.67; 95% CI, 0.54–0.84) and CVD (HR, 0.46; 95% CI, 0.30–0.69) mortality compared with non-coffee consumers. Notably, joint analyses firstly showed that non-coffee drinkers who sat six hours or more per day were 1.58 (95% CI, 1.25–1.99) times more likely to die of all causes than coffee drinkers sitting for less than six hours per day, indicating that the association of sedentary with increased mortality was only observed among adults with no coffee consumption but not among those who had coffee intake.

Conclusions
This study identified that sedentary behavior for more than 6 h/d accompanied with non-coffee consumption, were strongly associated with the increased risk of mortality from all-cause and CVD.
Associations between COVID-19 incidence, weight status, and social participation restrictions in the U.S.: evidence from the national population, cross-sectional study
Authors: Jung SuJung 
Published: April 2024

Abstract
Background
To explore the associations between coronavirus infection incidence and weight status and social participation restrictions among community-dwelling adults in the United States.

Methods
We analyzed data from the 2021 National Health Interview Survey (NHIS), which included a representative sample of 29,394 individuals (Coronavirus disease 2019 (COVID-19): 3,205) and a weighted total of 252,461,316 individuals (COVID-19: 31,697,404), considering the complex sampling design used in the survey.

Results
Age, race/ethnicity, education level, family income index, body mass index (BMI), and smoking status were significantly associated with COVID-19 infection. Weight status was significantly correlated with social participation restrictions and strongly associated with COVID-19 infection, particularly among individuals who were overweight or obese.

Conclusion
Weight status was shown to be associated not only with social participation restrictions but also with COVID-19 infection among U.S. adults. Understanding the complex interplay between weight status, social participation, and COVID-19 is crucial for developing effective preventive measures and promoting overall well-being in the community population.
Cystitis glandularis with concomitant Crohn’s disease leading to a paroxysm of Crohn’s disease with ulcerated external iliac vessels
Authors: Ronghua Wu , Ji Zheng , Gang Liu , Yun Zhang , Xubiao Nie 
Published: April 2024

Abstract•we report the case of a 36-year-old female patient who presented to our hospital with a diagnosis of cystitis glandularis manifesting as a vesicovaginal fistula. She underwent cystoscopic biopsy at a local hospital, but anti-inflammatory treatment was ineffective, and the patient was experiencing low urination frequency and urgency, as well as pain. The patient underwent laparoscopic repair of a cystoscopy-confirmed vesicovaginal fistula. After surgery, the patient experienced a paroxysm of Crohn’s disease with multiple small bowel fistulas and erosion of the external iliac vessels that ruptured to form an external iliac vessel small bowel fistula. The fistula was confirmed by surgical exploration, and the patient eventually died.
Association between predicted fat mass, predicted lean mass, predicted percent fat and type 2 diabetes mellitus in Japanese adults: a retrospective study
Authors: Tang Jiaming , Cai Xiaohua , Liu Aijie , Yu Nannan , Wang Shilei 
Published: April 2024

Abstract
Background
Type 2 diabetes mellitus (T2DM) is known to have obesity as a risk factor. Body mass index cannot distinguish between lean mass and fat mass. We aimed to examine the association between predicted fat mass, predicted lean mass, predicted percent fat and risk of T2DM in Japanese adults. We also explored whether these three new parameters could predict T2DM better than other obesity markers.

Methods
This present study is a secondary data analysis. The study enrolled 20,944 Japanese individuals who participated in the NAGALA medical assessment program between 2004 and 2015. 15,453 participants who are eligible and have complete information were included to our analysis. Through the use of Kaplan-Meier curve, restricted cubic spline and univariate and multivariate Cox regression analysis, the relationship between predicted fat mass, predicted lean mass, predicted percent fat and T2DM risk was examined. The area under the curve method was used to assess the differences between these markers of obesity.

Results
A total of 373 cases of T2DM occurred over a median time of 5.4 years. In the male group, we found a U-shaped connection between predicted fat mass, predicted lean mass, and T2DM onset (p value, non-linearity < 0.05). A linear relationship was found between predicted percent fat and T2DM onset. The linear relationship was also found in the female group for predicted fat mass, and predicted percent fat. And for women, predicted lean mass was not an independent predictor. The area under the curve (AUC) for predicted fat mass, predicted lean mass, predicted percent fat in men was 0.673 (95%CI: 0.639 ~ 0.707), 0.598 (95%CI: 0.561 ~ 0.635), 0.715 (95%CI: 0.684 ~ 0.745), respectively. In males, WHtR was the strongest predictor (AUC 0.7151, 95%CI: 0.684 ~ 0.746), followed by predicted percent fat (AUC 0.7150, 95%CI: 0.684 ~ 0.745). In the females, WHtR was also the strongest predictor (AUC 0.758, 95%CI: 0.703 ~ 0.813), followed by body mass index (AUC 0.757, 95%CI: 0.704 ~ 0.811) and predicted percent fat (AUC 0.742, 95%CI: 0.687 ~ 0.798).

Conclusion
Predicted fat mass, predicted lean mass, predicted percent fat were strongly connected with an increased risk for developing T2DM in Japanese, particularly in males. WHtR and predicted percent fat had a slightly better discrimination than other common obesity indicators in males. In the females, predicted fat mass and predicted percent fat were associated with T2DM risk, WHtR and body mass index had the slightly higher predictive power.
NHANES-based analysis of the correlation between leisure-time physical activity, serum cotinine levels and periodontitis risk
Authors: Fu Hua , Zhang Diya , Li Yining 
Published: April 2024

Abstract
Objective
To investigate the association of leisure-time physical activity and serum cotinine levels with the risk of periodontitis in the general population and to further analyze the interaction between leisure-time physical activity and serum cotinine levels on the risk of periodontitis.

Methods
This was a cross-sectional study, extracting data from 9605 (56.19%) participants in the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2014, and analyzing the relationship and interaction effects of serum cotinine level, leisure time physical activity, and risk of periodontitis by weighted univariate logistic modeling; Effect sizes were determined using ratio of ratios (OR), 95% confidence intervals (95% CI).

Results
5,397 (56.19%) of 9,605 participants had periodontitis; an increased risk of periodontitis was found in those in the leisure time physical activity intensity < 750 MET × min/week group (OR = 1.44, 95% CI: 1.17–1.78). Serum cotinine levels ≥ 0.05 ng/ml were associated with an increased risk of periodontitis (OR = 1.99, 95% CI: 1.69–2.33). The group with low leisure physical activity and serum cotinine levels ≥ 0.05 ng/ml had an increased risk of periodontitis compared to the group with high leisure physical activity and serum cotinine levels < 0.05 ng/ml (OR = 2.48, 95% CI: 1.88–3.27). Interaction metrics RERI = 0.90 (95% CI: 0.44–1.36) and API = 0.36 (95% CI: 0.18–0.55); CI for SI = 2.55 (95% CI: 1.03–6.28). for API 0.36.

Conclusion
Leisure time physical activity intensity interacted with smoking exposure on periodontitis risk and may provide the general population with the opportunity to Increasing leisure-time physical activity and smoking cessation may provide recommendations for the general population.
Navigating outpatient care of patients with type 2 diabetes after hospital discharge - a qualitative longitudinal study
Authors: Solh Dost Léa , Gastaldi Giacomo , Dos Santos Mamed Marcelo , Schneider Marie P. 
Published: April 2024

Abstract
Background
The transition from hospital to outpatient care is a particularly vulnerable period for patients as they move from regular health monitoring to self-management. This study aimed to map and investigate the journey of patients with polymorbidities, including type 2 diabetes (T2D), in the 2 months following hospital discharge and examine patients’ encounters with healthcare professionals (HCPs).

Methods
Patients discharged with T2D and at least two other comorbidities were recruited during hospitalization. This qualitative longitudinal study consisted of four semi-structured interviews per participant conducted from discharge up to 2 months after discharge. The interviews were based on a guide, transcribed verbatim, and thematically analyzed. Patient journeys through the healthcare system were represented using the patient journey mapping methodology.

Results
Seventy-five interviews with 21 participants were conducted from October 2020 to July 2021. The participants had a median of 11 encounters (min–max: 6–28) with HCPs. The patient journey was categorized into six key steps: hospitalization, discharge, dispensing prescribed medications by the community pharmacist, follow-up calls, the first medical appointment, and outpatient care.

Conclusions
The outpatient journey in the 2 months following discharge is a complex and adaptive process. Despite the active role of numerous HCPs, navigation in outpatient care after discharge relies heavily on the involvement and responsibilities of patients. Preparation for discharge, post-hospitalization follow-up, and the first visit to the pharmacy and general practitioner are key moments for carefully considering patient care. Our findings underline the need for clarified roles and a standardized approach to discharge planning and post-discharge care in partnership with patients, family caregivers, and all stakeholders involved.
Increasing and sustaining discharges by noon – a multi-year process improvement project
Authors: Bailey Ryan , Segon Ankur , Garcia Sean , Kottewar Saket , Lu Ting , Tuazon Nelson , Sanchez Lisa , Gelfond Jonathan A. , Bowling Gregory 
Published: April 2024

AbstractHigh hospital occupancy degrades emergency department performance by increasing wait times, decreasing patient satisfaction, and increasing patient morbidity and mortality. Late discharges contribute to high hospital occupancy by increasing emergency department (ED) patient length of stay (LOS). We share our experience with increasing and sustaining early discharges at a 650-bed academic medical center in the United States. Our process improvement project followed the Institute of Medicine Model for Improvement of successive Plan‒Do‒Study‒Act cycles. We implemented multiple iterative interventions over 41 months. As a result, the proportion of discharge orders before 10 am increased from 8.7% at baseline to 22.2% (p < 0.001), and the proportion of discharges by noon (DBN) increased from 9.5% to 26.8% (p < 0.001). There was no increase in balancing metrics because of our interventions. RA-LOS (Risk Adjusted Length Of Stay) decreased from 1.16 to 1.09 (p = 0.01), RA-Mortality decreased from 0.65 to 0.61 (p = 0.62) and RA-Readmissions decreased from 0.92 to 0.74 (p < 0.001). Our study provides a roadmap to large academic facilities to increase and sustain the proportion of patients discharged by noon without negatively impacting LOS, 30-day readmissions, and mortality. Continuous performance evaluation, adaptability to changing resources, multidisciplinary engagement, and institutional buy-in were crucial drivers of our success.
Quantifying the impact of hospital catchment area definitions on hospital admissions forecasts: COVID-19 in England, September 2020–April 2021
Authors: Meakin Sophie , Funk Sebastian 
Published: April 2024

Abstract
Background
Defining healthcare facility catchment areas is a key step in predicting future healthcare demand in epidemic settings. Forecasts of hospitalisations can be informed by leading indicators measured at the community level. However, this relies on the definition of so-called catchment areas or the geographies whose populations make up the patients admitted to a given hospital, which are often not well-defined. Little work has been done to quantify the impact of hospital catchment area definitions on healthcare demand forecasting.

Methods
We made forecasts of local-level hospital admissions using a scaled convolution of local cases (as defined by the hospital catchment area) and delay distribution. Hospital catchment area definitions were derived from either simple heuristics (in which people are admitted to their nearest hospital or any nearby hospital) or historical admissions data (all emergency or elective admissions in 2019, or COVID-19 admissions), plus a marginal baseline definition based on the distribution of all hospital admissions. We evaluated predictive performance using each hospital catchment area definition using the weighted interval score and considered how this changed by the length of the predictive horizon, the date on which the forecast was made, and by location. We also considered the change, if any, in the relative performance of each definition in retrospective vs. real-time settings, or at different spatial scales.

Results
The choice of hospital catchment area definition affected the accuracy of hospital admission forecasts. The definition based on COVID-19 admissions data resulted in the most accurate forecasts at both a 7- and 14-day horizon and was one of the top two best-performing definitions across forecast dates and locations. The “nearby” heuristic also performed well, but less consistently than the COVID-19 data definition. The marginal distribution baseline, which did not include any spatial information, was the lowest-ranked definition. The relative performance of the definitions was larger when using case forecasts compared to future observed cases. All results were consistent across spatial scales of the catchment area definitions.

Conclusions
Using catchment area definitions derived from context-specific data can improve local-level hospital admission forecasts. Where context-specific data is not available, using catchment areas defined by carefully chosen heuristics is a sufficiently good substitute. There is clear value in understanding what drives local admissions patterns, and further research is needed to understand the impact of different catchment area definitions on forecast performance where case trends are more heterogeneous.
Kawasaki disease in Kenya and review of the African literature
Authors: Migowa A. , Njeru CM. , Were E. , Ngwiri T. , Colmegna I. , Hitchon C. , Scuccimarri R. 
Published: April 2024

Abstract
Background
Kawasaki disease has been described across the globe, although publications from Africa are limited. To our knowledge, there are no publications on Kawasaki disease from Kenya, which triggered this report.

Methods
A retrospective cross-sectional study was undertaken to identify in-patients with a discharge diagnosis of Kawasaki disease, over 2 different 5-year periods, at two pediatric hospitals in Nairobi, Kenya. We reviewed the medical records of all patients and report their clinical findings, diagnostic workup and treatment. In addition, we undertook a detailed review of the literature.

Results
Twenty-three patients with Kawasaki disease were identified, of those 12 (52.2%) had incomplete disease. The mean age was 2.3 years (SD+/-2.2) (range 0.3–10.3) with a male to female ratio of 1:1. The mean duration of fever at diagnosis was 8.3 days (SD+/-4.7) (range 2–20). Oral changes were the most common clinical feature and conjunctivitis the least common. Thrombocytosis at diagnosis was seen in 52% (12/23). Twenty-one patients (91.3%) were treated with intravenous immunoglobulin and all except 1 received aspirin. Baseline echocardiograms were performed in 95.7% (22/23) and found to be abnormal in 3 (13.6%). Follow-up data was limited. Our literature review identified 79 publications with documented cases of Kawasaki disease in children from 22 countries across the African continent with a total of 1115 patients including those from this report. Only 153 reported cases, or 13.7%, are from sub-Saharan Africa.

Conclusions
This is the first publication on Kawasaki disease from Kenya and one of the largest reports from sub-Saharan Africa. It is the first to have a complete review of the number of published cases from the African continent. Challenges in the diagnosis and management of Kawasaki disease in many African countries include disease awareness, infectious confounders, access and cost of intravenous immunoglobulin, access to pediatric echocardiography and follow-up. Increasing awareness and health care resources are important for improving outcomes of Kawasaki disease in Africa.
Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta
Authors: Yates Martin T , Smith Alexander , Mistirian Alina A , Bigogno Carola M , Lee Michelle , Lopez-Marco Ana 
Published: April 2024

Abstract
Objectives
Aortic pathologies often present with elevated inflammatory biomarkers due to the nature of the disease. Open aortic surgery causes significant trauma to the body due to often mandatory ischemic periods, long cardiopulmonary bypass times and polytransfusion. We aim to determine postoperative trends on inflammation biomarkers for different aortic pathologies and type of surgery in different segments of the aorta.

Methods
Retrospective review of prospectively collected data of 193 consecutive patients who underwent aortic surgery in our centre between 2017 and 2021, grouped according to the type of aortic intervention: (1) Type A aortic dissection (AD) repair with ascending aorta/hemiarch replacement, (2) Aortic root replacement (ARR), (3) Aortic arch + Frozen elephant trunk (FET), (4) Descending thoracic aorta (DTA)/Thoraco-Abdominal aortic repair (TAA). Primary outcomes were daily values of white blood cells (WBC) and C-Reactive Protein (CRP) during the first 15 postoperative days.

Results
All groups had a similar inflammatory peak in the first 2–4 days (WBC 12-15 × 109 c/L). AD and FET groups show similar trends with WBC and CRP peaks on days 2 and 10. The ARR group didn’t experience the 2nd peak as most patients were already discharged. DTA/TAA patients experienced a more prolonged inflammatory response, reaching a plateau by day 5–10. AD group shows the highest WBC levels and the DTA/TAAA group the highest CRP levels. CRP levels remain elevated (100–200 mg/L) in all groups after 15 postoperative days.

Conclusions
Inflammatory biomarkers show different postoperative trends depending on the clinical presentation and complexity of the aortic procedure performed. Further understanding of the inflammatory response to different aortic pathologies and surgical procedures will permit reduction on the liberal use of antibiotics that this cohort of patients are usually exposed to. An earlier version of the data included in this manuscript was presented as Oral Abstract in the UK Society of Cardiothoracic Surgery Annual meeting in 2021