bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Framingham 10-year cardiovascular risks in Sweden- and foreign-born primary health care patients in Sweden
Authors: Taloyan Marina , Wågström Victor , Steiner Kristin Hjörleifdottir , Yarbakht Danial , Östenson Claes-Göran , Salminen Helena 
Published: March 2023

Abstract
Background
The prevalence of cardiovascular disease around the world varies by ethnicity and region of birth. Immigrants living in Sweden may have a higher prevalence of cardiovascular diseases than native-born Swedes, but little is known about their actual cardiovascular risk. This study aimed to examine the relationship in Sweden between 10-year cardiovascular risk and birthplace.

Method
This cross-sectional study was based on cardiovascular risk factor data obtained from the 4D Diabetes Project, a Programme 4D subproject in Sweden. Participants were recruited from two primary healthcare centres in Stockholm without a history of diabetes or pre-diabetes. The outcome variable was 10-year cardiovascular risk based on the calculation of a Framingham Risk Score with six risk factors: age, sex, LDL, HDL, BP, diabetes and smoking for each participant. Multiple linear regression was performed to generate β-coefficients for the outcome.

Results
There was an average of 8.86% cardiovascular risk over 10 years in Sweden-born participants and a 5.45% 10-year risk in foreign-born, (P < 0.0001). Foreign-born participants were about 10 years younger (mean age 46 years vs. 56 years, P < 0.001), with a significantly higher proportion of smokers (23.9% vs. 13.7%; P = 0.001). To be born in Sweden (with parents born in Sweden) was significantly associated with a 10-year cardiovascular risk in the crude model (β- coefficient = 3.40, 95% CI 2.59–4.22; P < 0.0001) and when adjusted for education and alcohol consumption (β- coefficient = 2.70 95% CI 1.86–3.54; P < 0.0001). Regardless of the birthplace, 10-year cardiovascular risk was lower for those with higher education compared to those with less than 10 years of education.

Conclusion
This study found a relationship between 10-year calculated cardiovascular risk and place of birth. Sweden-born participants had a higher association with 10-year cardiovascular risk than foreign-born participants. These results contradict previous reports of higher rates of CVD in residents of Middle-Eastern countries and Middle-Eastern immigrants living in Sweden.
Spatial association between green space and COPD mortality: a township-level ecological study in Chongqing, China
Authors: Gou Aiping , Tan Guanzheng , Ding Xianbin , Wang Jiangbo , Jiao Yan , Gou Chunyan , Tan Qiang 
Published: March 2023

Abstract
Background
There are regional differences in the effect of green space on mortality of Chronic obstructive pulmonary disease (COPD). We conduct an ecological study, using the administrative divisions of Chongqing townships in China as the basic unit, to investigate the association between COPD mortality and green space based on data of 313,013 COPD deaths in Chongqing from 2012 to 2020. Green space is defined by Fractional vegetation cover (FVC), which is further calculated based on the normalised vegetation index (NDVI) from satellite remote sensing imagery maps.

Methods
After processing the data, the non-linear relationship between green space and COPD mortality is revealed by generalised additive models; the spatial differences between green space and COPD mortality is described by geographically weighted regression models; and finally, the interpretive power and interaction of each factor on the spatial distribution of COPD mortality is examined by a geographic probe.

Results
The results show that the FVC local regression coefficients ranged from − 0.0397 to 0.0478, 63.0% of the regions in Chongqing have a positive correlation between green space and COPD mortality while 37.0% of the regions mainly in the northeast and west have a negative correlation. The interpretive power of the FVC factor on the spatial distribution of COPD mortality is 0.08.

Conclusions
Green space may be a potential risk factor for increased COPD mortality in some regions of Chongqing. This study is the first to reveal the relationship between COPD mortality and green space in Chongqing at the township scale, providing a basis for public health policy formulation in Chongqing.
Almonertinib-induced interstitial lung disease in a lung adenocarcinoma patient complicated with interstitial lung abnormality
Authors: Zhou Qian , Hu Zhong , Li Xin , Tang Xiaokui 
Published: March 2023

Abstract
Background
With the use of targeted drugs in lung cancer patients, targeted drug-induced interstitial lung disease (ILD) has attracted more and more attention. The incidence, time, and severity of different targeted drug-induced ILD vary. Almonertinib/HS-10296 is a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). Post-marketing safety and effectiveness of almonertinib have been confirmed. The reported adverse events of almonertinib were mainly an increase in creatine phosphokinase, aspartate aminotransferase, and alanine aminotransferase, and onset of rash. Almonertinib-induced ILD is rare.

Case report
This paper reported the case of a patient with lung adenocarcinoma complicated with interstitial lung abnormality (ILA). Gene detection showed L858R mutation in exon 21 of the EGFR gene. After operation, almonertinib (110 mg per day) was prescribed. 3 months later, ILD was found by chest CT due to dyspnea.

Management and outcome
Subsequently, almonertinib was stopped. With the administration of intravenous glucocorticoid and oxygen inhalation, the patient's dyspnea was significantly regressed and lung lesions regressed on follow-up chest CT done after discharge.

Discussion
This case suggested that we should pay attention to the existence of ILD/ILA before using targeted drugs. The use of targeted drugs should be more strictly controlled and monitored in patients with previous ILA or ILD. This paper also reviewed the relevant literature on the drug characteristics and summarized the risk factors of ILD caused by EGFR-TKI.
Diagnostic accuracy of a set of clinical and radiological criteria for screening of COVID-19 using RT-PCR as the reference standard
Authors: Oliveira Mirella Cristine , Scharan Karoleen Oswald , Thomés Bruna Isadora , Bernardelli Rafaella Stradiotto , Reese Fernanda Baeumle , Kozesinski-Nakatani Amanda Christina , Martins Cintia Cristina , Lobo Suzana Margareth Ajeje , Réa-Neto Álvaro 
Published: March 2023

AbstractBackgroundThe gold-standard method for establishing a microbiological diagnosis of COVID-19 is reverse-transcriptase polymerase chain reaction (RT-PCR). This study aimed to evaluate the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a set of clinical-radiological criteria for COVID-19 screening in patients with severe acute respiratory failure (SARF) admitted to intensive care units (ICUs), using reverse-transcriptase polymerase chain reaction (RT-PCR) as the reference standard.MethodsDiagnostic accuracy study including a historical cohort of 1009 patients consecutively admitted to ICUs across six hospitals in Curitiba (Brazil) from March to September, 2020. The sample was stratified into groups by the strength of suspicion for COVID-19 (strongversusweak) using parameters based on three clinical and radiological (chest computed tomography) criteria. The diagnosis of COVID-19 was confirmed by RT-PCR (referent).ResultsWith respect to RT-PCR, the proposed criteria had 98.5% (95% confidence interval [95% CI] 97.5–99.5%) sensitivity, 70% (95% CI 65.8–74.2%) specificity, 85.5% (95% CI 83.4–87.7%) accuracy, PPV of 79.7% (95% CI 76.6–82.7%) and NPV of 97.6% (95% CI 95.9–99.2%). Similar performance was observed when evaluated in the subgroups of patients admitted with mild/moderate respiratory disfunction, and severe respiratory disfunction.ConclusionThe proposed set of clinical-radiological criteria were accurate in identifying patients with strongversusweak suspicion for COVID-19 and had high sensitivity and considerable specificity with respect to RT-PCR. These criteria may be useful for screening COVID-19 in patients presenting with SARF.
Nationwide epidemiologic study for fibrosing interstitial lung disease (F-ILD) in South Korea: a population-based study
Authors: Joung Kyung-In , Park Hyemin , Park Sunyoung , Shin Ju-Young , Kim Yong Hyun 
Published: March 2023

Abstract
Background
Fibrosing interstitial lung disease (F-ILD) is a major public health concern due to its poor prognosis. Recent clinical evidence shows that antifibrotic approaches such as pirfenidone and nintedanib provide better clinical outcome prediction in idiopathic pulmonary fibrosis (IPF) as well as selected progressive fibrosing ILD (PF-ILD) patients. Having epidemiologic insight into these diseases will be essential for the efficient utilization of these therapeutic resources. This study aimed to estimate the current prevalence, incidence, and mortality of F-ILD classified as idiopathic pulmonary fibrosis (IPF), PF-ILD other than IPF, and non-progressive F-ILD and their temporal trend in Korea.

Methods
Population-based retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment (HIRA) database (2011–2018). Patients with IPF were identified using ICD-10 code, RID code, and differential diagnosis approach. By leveraging medical records available from claim data and referencing those used in clinical trials, rigorous diagnostic criteria for PF-ILD detection were implemented.

Results
For the past eight years, the prevalence of IPF and PF-ILD has progressively increased, while non-progressive F-ILD has remained stable. IPF, PF-ILD, and non-progressive F-ILD prevalence per 100,000 in 2018 were 16.9, 10.4, and 11.7, respectively. The incidence of IPF in 2018 was more than twice that of 2012. The incidence of PF-ILD in 2018 was 1.5 times higher than that in 2012. In 2018, the mortalites were 10.3% and 12.2% for IPF and PF-ILD, respectively. The mortality rate of PF-ILD was greater than that of IPF in all years. Unclassifiable PF-ILD and rheumatoid arthritis-PF-ILD had the highest proportion and mortality among the PF-ILD subtypes.

Conclusion
The prevalence and incidence of IPF and PF-ILD have been steadily increasing in recent years. The mortality rate of PF-ILD remained consistently high and exceeded those of IPF in all years.
They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study
Authors: An Yom , Teo Alvin Kuo Jing , Huot Chan Yuda , Tieng Sivanna , Khun Kim Eam , Pheng Sok Heng , Leng Chhenglay , Deng Serongkea , Song Ngak , Nonaka Daisuke , Yi Siyan 
Published: March 2023

Abstract
Background
Latent tuberculosis (TB) infection has been known as a seedbed for TB disease later in life. The interruption from latent TB infection to TB disease can be done through TB preventive treatment (TPT). In Cambodia, only 40.0% of children under five years old who were the household contacts to bacteriologically confirmed TB cases were initiated with TPT in 2021. Scientific studies of context-specific operational challenges in TPT provision and uptake among children are scarce, particularly in high TB-burden countries. This study identified challenges in TPT provision and uptake among children in Cambodia from the perspective of healthcare providers and caregivers.

Methods
Between October and December 2020, we conducted in-depth interviews with four operational district TB supervisors, four clinicians and four nurses in charge of TB in referral hospitals, four nurses in charge of TB in health centers, and 28 caregivers with children currently or previously on TB treatment or TPT, and those who refused TPT for their eligible children. Data were audio recorded along with field notetaking. After verbatim transcription, data analyses were performed using a thematic approach.

Results
The mean age of healthcare providers and caregivers were 40.19 years (SD 12.0) and 47.9 years (SD 14.6), respectively. Most healthcare providers (93.8%) were male, and 75.0% of caregivers were female. More than one-fourth of caregivers were grandparents, and 25.0% had no formal education. Identified key barriers to TPT implementation among children included TPT side effects, poor adherence to TPT, poor understanding of TPT among caregivers, TPT risk perception among caregivers, TPT’s child-unfriendly formula, TPT supply-chain issues, caregivers’ concern about the effectiveness of TPT, being non-parental caregivers, and poor community engagement.

Conclusion
Findings from this study suggest that the national TB program should provide more TPT training to healthcare providers and strengthen supply chain mechanisms to ensure adequate TPT drug supplies. Improving community awareness of TPT among caregivers should also be intensified. These context-specific interventions will play a crucial role in expanding the TPT program to interrupt the development from latent TB infection to active and ultimately lead to ending TB in the country.
An autopsy case of disseminated Cunninghamella bertholletiae infection in an immunocompetent patient: a case report
Authors: Harada Masanori , Yasuda Kazuyo , Uruchida Kazumi , Yamashita Ryoma , Morikawa Keisuke , Ito Yutaro , Mochizuki Eisuke , Matsuura Shun , Tsukui Masaru , Koshimizu Naoki 
Published: March 2023

Abstract
Background
Recently, deaths due to mucormycosis in immunocompromised hosts have increased; however, the clinical and pathological features of mucormycosis are not fully understood, especially in view of the associated high mortality and rare incidence in immunocompetent patients.

Case presentation
We have described a rare autopsy case of a 67-year-old Japanese man with chronic obstructive pulmonary disease who contracted mucormycosis. He had not been on any immunosuppressants, and his immune functions were intact. Since 3 days prior to admission to our hospital, he had experienced progressive dyspnea, productive cough, and fever. Chest computed tomography revealed pleural effusion in the left lower hemithorax and consolidation in the right lung field. Although he was administered with tazobactam-piperacillin hydrate (13.5 g/day), renal dysfunction occurred on the ninth disease day. Therefore, it was switched to cefepime (2 g/day). However, his general condition and lung-field abnormality worsened gradually. Cytological analysis of the sputum sample at admission mainly revealed sporangiophores and unicellular sporangioles, while repeated sputum culture yielded Cunninghamella species. Therefore, he was diagnosed with pulmonary mucormycosis. Liposomal amphotericin B (5 mg/kg/day) was initiated on the 28th disease day. However, chest radiography and electrocardiography detected cardiomegaly and atrial fibrillation, respectively, and he died on the 37th disease day. A postmortem examination revealed clusters of fungal hyphae within the arteries of the right pulmonary cavity wall, the subpericardial artery, intramyocardial capillary blood vessels, and the esophageal subserosa vein. Direct sequencing revealed that all fungal culture samples were positive for Cunninghamella bertholletiae.

Conclusions
Cunninghamella bertholletiae could rapidly progress from colonizing the bronchi to infecting the surrounding organs via vascular invasion even in immunocompetent patients.
Protocol for a multicenter study on effectiveness and economics of the Back At work After Surgery (BAAS): a clinical pathway for knee arthroplasty
Authors: Strijbos Daniël O. , van der Sluis Geert , van Houtert Wim F. C. , Straat A. Carlien , van Zaanen Yvonne , de Groot Stephan , Klomp Simon , Krijnen Wim P. , Kooijman Carolien M. , van den Brand Igor , Reneman Michiel F. , Boymans Tim A. E. J. , Kuijer P. Paul F. M. 
Published: March 2023

Abstract
Background
Optimizing return to work (RTW) after knee arthroplasty (KA) is becoming increasingly important due to a growing incidence of KA and poor RTW outcomes after KA. We developed the Back At work After Surgery (BAAS) clinical pathway for optimized RTW after KA. Since the effectiveness and cost analysis of the BAAS clinical pathway are still unknown, analysis on effectiveness and costs of BAAS is imperative.

Method
This protocol paper has been written in line with the standards of Standard Protocol Items: Recommendations for Interventional Trails. To assess the effectiveness and cost-effectiveness for RTW, we will perform a multicenter prospective cohort study with patients who decided to receive a total KA (TKA) or an unicompartmental KA (UKA). To evaluate the effectiveness of BAAS regarding RTW, a comparison to usual care will be made using individual patient data on RTW from prospectively performed cohort studies in the Netherlands.

Discussion
One of the strengths of this study is that the feasibility for the BAAS clinical pathway was tested at first hand. Also, we will use validated questionnaires and functional tests to assess the patient’s recovery using robust outcomes. Moreover, the intervention was performed in two hospitals serving the targeted patient group and to reduce selection bias and improve generalizability. The limitations of this study protocol are that the lead author has an active role as a medical case manager (MCM) in one of the hospitals. Additionally, we will use the data from other prospective Dutch cohort studies to compare our findings regarding RTW to usual care. Since we will not perform an RCT, we will use propensity analysis to reduce the bias due to possible differences between these cohorts.

Trail Registration
This study was retrospectively registered at clinicaltrails.gov (https://clinicaltrials.gov/ct2/show/NCT05690347, date of first registration: 19–01-2023).
The efficacy and safety of subcutaneous continuous local infiltration analgesia with ropivacaine in patients undergoing total knee arthroplasty: a comparative study
Authors: Al-Saati Maad F. , Alaqaili Sadiq I. , Alshammari Farah A. , ElRaei Mohamed A. N. , Albaiz Alia A. , Tushinski Daniel , Al-Mohrej Omar A. 
Published: March 2023

Abstract
Background
Continuous local infiltration analgesia (CLIA) can be administered via intraarticular or periarticular techniques in patients undergoing total knee arthroplasty (TKA). The purpose of this investigation was to retrospectively report a single-center experience of epidural analgesia with subcutaneous CLIA versus epidural analgesia without CLIA among patients undergoing TKA.

Methods
This single-center retrospective study was conducted in Saudi Arabia. From January 01, 2014, to December 30, 2020, medical records of all patients who underwent TKA were reviewed. Patients who received subcutaneous CLIA with epidural analgesia were assigned to the intervention group, whereas those who received epidural analgesia without subcutaneous CLIA were assigned to the control group. The efficacy endpoints included: (i) postoperative pain scores at 24 h, 48 h, 72 h, and 3 months; (ii) postoperative opioid consumption at 24 h, 48 h, 72 h, and 24–72 h (cumulative); (iii) length of hospital stay; and (iv) postoperative functional recovery of the knee 3 months post-operation, according to the Knee Injury and Osteoarthritis Outcome Score.

Results
At rest and during mobilization, the CLIA group (n = 28) achieved significantly lower postoperative pain scores 24 h, 48 h, 72 h, and 3 months post-operation than the non-CLIA group (n = 35). Subgroup analysis revealed that the CLIA group achieved significantly less opioid consumption 24 h and 48 h post-operation than the non-CLIA group. There was no difference between the groups regarding the length of hospital stay or functional scores 3 months post-operation. There was no significant difference between the groups regarding the rate of wound infection, other infections, and readmission within 30 days.

Conclusion
Subcutaneous CLIA is a technically feasible and safe procedure without major adverse events but with reduced postoperative pain scores (at rest and during mobilization) and opioid consumption. Additional larger studies are warranted to confirm our results. Moreover, a head-to-head comparison between subcutaneous CLIA and periarticular or intraarticular CLIA is an interesting prospective investigation.
Biological effect of bone marrow mesenchymal stem cell- derived extracellular vesicles on the structure of alveolar bone in rats with glucocorticoid-induced osteoporosis
Authors: Sedik Aya S. , Kawana Khadiga Y. , Koura Azza S. , Mehanna Radwa A. 
Published: March 2023

AbstractBackgroundGlucocorticoids are used for the treatment of autoimmune disorders; however, they can elicit several side effects such as osteoporosis. Several approaches can be made to treat glucocorticoid-induced osteoporosis, including the use of stem cells. However, the therapeutic effect of mesenchymal stem cells depends on its released factors, including extracellular vesicles. Extracellular vesicles have been recognized as important mediators of intercellular communication as they participate in many physiological processes. The present study was designed to investigate the effect of bone marrow mesenchymal stem cells derived extracellular vesicles on the structure of alveolar bone in rats with glucocorticoid-induced osteoporosis.MethodsThirty adult albino male rats were divided into 3 groups: control group (CG), glucocorticoid-induced osteoporosis (GOG) and extracellular vesicles treated group (ExTG). Rats in the GOG and ExTG groups were injected with methylprednisolone acetate (40 mg/kg) intramuscularly in the quadriceps muscle 3 times per week for three weeks in the early morning. Afterwards, the rats in GOG group received a single vehicle injection (PBS) while each rat in the ExTG group received a single injection of extracellular vesicles (400 μg/kg suspended in 0.2 ml PBS) in the tail vein. Rats were euthanized 1 month after injection. Mandibles were dissected and the molar segments were prepared for histological preparation, scanning electron microscopy (SEM), and energy dispersive x-ray (EDX).ResultsHistology and scanning electron microscopyof bone tissue showed alveolar bone loss and bone resorption in the GOG group. while in the ExTG group, alveolar bone demostrated normal bone architecture. EDX showed that calcium percentage in GOG group was lower than ExTG group,which showed no statistically significant difference from the control group.ConclusionsExtracellular vesicles may be a promising treatment modality in the treatment of bone diseases and in bone regeneration. However, further research is needed before stating that extracellular vesicles s can be used to treat bone disorders especially when translating to humans.