bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing profiles of cardiovascular disease and risk factors in China: a secondary analysis for the Global Burden of Disease Study 2019
Authors: Wang Huan , Zhang Hao , Zou Zhiyong 
Published: June 2023

Abstract

Background:
Understanding the changing profiles of cardiovascular disease (CVD) and modifiable risk factors is essential for CVD prevention and control. We aimed to report the comprehensive trends in CVD and risk factors in China from 1990 to 2019.

Methods:
Data on the incidence, death, and disability-adjusted life years (DALYs) of total CVD and its 11 subtypes for China were obtained from the Global Burden of Disease Study 2019. The CVD burden attributable to 12 risk factors was also retrieved. A secondary analysis was conducted to summarize the leading causes of CVD burden and attributable risk factors.

Results:
From 1990 to 2019, the number of CVD incidence, death, and DALYs considerably increased by 132.8%, 89.1%, and 52.6%, respectively. Stroke, ischemic heart disease, and hypertensive heart disease accounted for over 95.0% of CVD deaths in 2019 and remained the top three causes during the past 30 years. Between 1990 and 2019, the age-standardized rate of stroke decreased significantly (percentage of decreased incidence: -9.3%; death: -39.8%; DALYs: -41.6%), while the rate of ischemic heart disease increased (percentage of increased incidence: 11.5%; death: 17.6%; DALYs: 2.2%). High systolic blood pressure, unhealthy diet, tobacco, and air pollution continued to be the major contributors to CVD deaths and DALYs (attributing to over 70% of the CVD burden), and the high body mass index (BMI)-associated CVD burden had the largest increase between 1990 and 2019.

Conclusions:
The significant increases in the number of CVD incident cases, deaths, and DALYs suggest that the CVD burden is still a concern. Intensified strategies and policies are needed to maintain promising progress in stroke and to reduce the escalating burden of ischemic heart disease. The CVD burden attributable to risk factors has not yet made adequate achievements; even worse, high BMI has contributed to the increasing CVD burden.
Patient Experiences after Open Trigger Finger Release in Patients with Type 1 and Type 2 Diabetes—A Retrospective Study Using Patient-reported Outcome Measures
Authors: Rydberg Mattias , Zimmerman Malin , Gottsäter Anders , Åkesson Anna , Eeg-Olofsson Katarina , Arner Marianne , Dahlin Lars B. 
Published: June 2023

Background:
Trigger finger is overrepresented among patients with diabetes mellitus (DM). Whether DM affects the outcome after open trigger finger release (OTFR) in patients with DM is not known. Our aim was thus to explore outcomes after OTFR in patients with type 1 (T1D) and type 2 DM (T2D).

Methods:
Data included patient-reported outcome measures (PROMs) from all OTFRs performed between 2010 and 2020 registered in the Swedish national registry for hand surgery in individuals over 18 years cross-linked with the Swedish National Diabetes Register (NDR). PROMs included QuickDASH and HQ8, a questionnaire designed for national registry for hand surgery, preoperative and at 3 and 12 months postoperative. HQ8 included pain on load, pain on motion without load, and stiffness. Outcome was calculated using linear-mixed models and presented as means adjusted for age and stratified by sex.

Results:
In total, 6242 OTFRs were included, whereof 496 had T1D (332, 67% women) and 869 had T2D (451, 52% women). Women with T1D reported more symptoms of stiffness (P < 0.001), and women with T2D reported more pain on load (P < 0.05), motion without load (P < 0.01), and worse overall result at 3 months. At 12 months, however, no differences were found in any of the HQ-8 PROMs among men or women. Women with T2D had slightly higher QuickDASH scores at 3 and 12 months.

Conclusion:
Patients with T1D and T2D can expect the same results after OTFR as individuals without DM, although the improvement might take longer especially among women with T2D.
Risk Factors and Prognosis Analysis of Upper Gastrointestinal Bleeding in Patients With Acute Severe Cerebral Stroke
Authors: Chen Zengdian , Lin Weiguo , Zhang Faqin , Cao Wen 
Published: June 2023

Goals:
We aim to explore the relationship between the use of proton pump inhibitors (PPIs) and upper gastrointestinal bleeding (UGIB). We develop a nomogram model to predict mortality in critically ill stroke patients.

Study:
This is a retrospective study based on the MIMIC IV database. We extracted clinical information including demographic data, comorbidities, and laboratory indicators. Univariate and multivariable logistic regressions were used to assess and identify risk factors for the occurrence of UGIB and for the in-hospital mortality of critically ill stroke patients. The resulting model was used to construct a nomogram for predicting in-hospital mortality.

Results:
Five thousand seven hundred sixteen patients from the MIMIC-IV database were included in our analysis. UGIB occurred in 109 patients (1.9%), whereas the PPI use rate was as high as 60.6%. Chronic liver disease, sepsis, shock, anemia, and increased level of urea nitrogen were independent risk factors for the occurrence of UGIB in severe stroke patients. We identified age, heart failure, shock, coagulopathy, mechanical ventilation, continuous renal replacement therapy, antiplatelet drugs, anticoagulation, simplified acute physiology score-II, and Glasgow coma score as independent risk factors for in-hospital mortality in severe stroke patients. The C-index for the final nomograms was 0.852 (95% confidence interval: 0.840, 0.864).

Conclusions:
We found that the overall rate of UGIB in severe stroke patients is low, whereas the rate of PPI usage is high. In our study, PPI was not identified as a risk factor for the occurrence of UGIB and UGIB was not associated with all-cause mortality. More clinical trials are needed to evaluate the benefits of using PPI in critically ill stroke patients.
Defining the presymptomatic phase of frontotemporal dementia
Authors: Russell Lucy L. , Rohrer Jonathan D. 
Published: June 2023

Purpose of review
Frontotemporal dementia (FTD) is a clinically, pathologically and genetically heterogeneous disorder. Whilst disease modifying therapies trials are mostly focused on the symptomatic phase, future studies will move earlier in the disease aiming to prevent symptom onset. This review summarizes the recent work to better understand this presymptomatic period.

Recent findings
The presymptomatic phase can be split into preclinical and prodromal stages. The onset of the preclinical phase is defined by the first presence of pathological inclusions of tau, TDP-43 or fused in sarcoma in the brain. Definitive biomarkers of these pathologies do not yet exist for FTD. The prodromal phase is defined by the onset of mild symptoms. Recent work has highlighted the wide phenotypic spectrum that occurs, with the concept of mild cognitive ± behavioural ± motor impairment (MCBMI) being put forward, and additions to scales such as the CDR plus NACC FTLD now incorporating neuropsychiatric and motor symptoms.

Summary
It will be important to better characterize the presymptomatic period moving forward and develop robust biomarkers that can be used both for stratification and outcome measures in prevention trials. The work of the FTD Prevention Initiative aims to facilitate this by bringing together data from natural history studies across the world.
Characteristics and Prognosis of Binocular Diplopia in Patients With Giant Cell Arteritis
Authors: Chazal Thibaud , Clavel Gaelle , Leturcq Tifenn , Philibert Manon , Lecler Augustin , Vignal-Clermont Catherine 
Published: June 2023

Background:
Giant cell arteritis (GCA) is a large vessel vasculitis associated with a risk of permanent ophthalmologic complications. Data about diplopia prognosis in GCA are scarce. This study was designed to better characterize diplopia in newly diagnosed GCA patients.

Methods:
All consecutive patients diagnosed with GCA from January 2015 to April 2021 in a French tertiary ophthalmologic center were retrospectively reviewed. GCA diagnosis relied on a positive temporal artery biopsy or high-definition MRI.

Results:
Among 111 patients diagnosed with GCA, 30 patients (27%) had diplopia. Characteristics of patients with diplopia were similar to other GCA patients. Diplopia resolved spontaneously in 6 patients (20%). Diplopia was attributed to cranial nerve palsy in 21/24 patients (88%), especially third (46%) and sixth cranial nerve (42%). Ocular ischemic lesions occurred in 11 of the 30 patients with diplopia (37%); 2 patients developed vision loss after initiation of corticosteroids. In the remaining 13 patients, diplopia resolved after treatment onset in 12 patients (92%) with a median delay of 10 days. Patients treated intravenously tended to have a quicker improvement than those treated orally, but with a similar resolution rate of diplopia at 1 month. Two patients had relapse of diplopia at 4 and 6 weeks after an initial treatment course of 24 and 18 months, respectively.

Conclusions:
Diplopia is a rare feature at GCA diagnosis, but should raise clinician suspicion for GCA when associated with cephalic symptoms and prompt the initiation of corticosteroids to prevent ocular ischemic complications.
A comparison of diffusion MRI presurgical tractography techniques with intraoperative mapping-based validation
Authors: Radwan A.M. , Emsell L. , Vansteelandt K. , Cleeren E. , Peeters R. , De Vleeschouwer S. , Theys T. , Dupont P. , Sunaert S. 
Published: June 2023

AbstractObjectivesAccurate presurgical brain mapping enables preoperative risk assessment and intraoperative guidance. This work investigated whether constrained spherical deconvolution (CSD) methods were more accurate than diffusion tensor imaging (DTI)-based methods for presurgical white matter mapping using intraoperative direct electrical stimulation (DES) as the ground truth.Material and methodsFive different tractography methods were compared (3 DTI-based and 2 CSD-based) in 22 preoperative neurosurgical patients. The corticospinal tract (CST, N=20) and arcuate fasciculus (AF, N=7) bundles were reconstructed, then minimum distances between tractograms and DES coordinates were compared between tractography methods. Receiver-operating characteristic (ROC) curves were used for both bundles. For the CST, binary agreement, linear modeling, and posthoc testing were used to compare tractography methods while correcting for relative lesion and bundle volumes.ResultsDistance measures between 154 positive (functional response, pDES) and negative (no response, nDES) coordinates, and 134 tractograms resulted in 860 data points. Higher agreement was found between pDES coordinates and CSD-based compared to DTI-based tractograms. ROC curves showed overall higher sensitivity at shorter distance cutoffs for CSD (8.5 mm) compared to DTI (14.5 mm). CSD-based CST tractograms showed significantly higher agreement with pDES, which was confirmed by linear modeling and posthoc tests (PFWE < 0.05).ConclusionCSD-based CST tractograms were more accurate than DTI-based ones when validated using DES-based assessment of motor and sensory function. This demonstrates the potential benefits of structural mapping using CSD in clinical practice.Clinical relevance statementCSD-based tractograms of the CST are more sensitive than DTI-based tractograms when validated against sensory-motor DES mapping. This also demonstrated the feasibility of fully-automated CSD-based tractography for presurgical planning of the CST.Graphical abstractPresurgical white matter mapping using probabilistic CSD tractography is more accurate and sensitive than manual DTI FACT or automated probabilistic DTI tractography. This study included 22 patients with DES data, which was used as the ground truth. Distance in mm between tractograms and DES data resulted in 860 datapoints, 685 of which belonged to the CST and were used for linear modeling, DTI = diffusion tensor imaging, CSD = constrained spherical deconvolution, TCK = tractogram/tractography, FWE = family-wise error rate, AUC = area under the curve
Predominance of multidrug-resistant (MDR) bacteria causing urinary tract infections (UTIs) among symptomatic patients in East Africa: a call for action
Authors: Maldonado-Barragán Antonio , Mshana Stephen E. , Keenan Katherine , Ke Xuejia , Gillespie Stephen H. , Stelling John , Maina John , Bazira Joel , Muhwezi Ivan , Mushi Martha F. , Green Dominique L. , Kesby Mike , Lynch Andy G. , Sabiiti Wilber , Sloan Derek J. , Sandeman Alison , Kiiru John , Asiimwe Benon , Holden Matthew T. G. ,   HATUA consortium
Published: June 2023

AbstractIn low-and middle-income countries, antibiotics are often prescribed for patients with symptoms of urinary tract infections (UTIs) without microbiological confirmation. Inappropriate antibiotic use can contribute to antimicrobial resistance (AMR) and the selection of multi-drug resistant (MDR) bacteria. Data on antibiotic susceptibility patterns of cultured bacteria are important in drafting empirical treatment guidelines and monitoring resistance trends, which can prevent the spread of AMR. In East Africa, antibiotic susceptibility data are sparse. To fill the gap, this study reports common microorganisms and their susceptibility patterns isolated from patients with UTI-like symptoms in Kenya, Tanzania, and Uganda in 2019-2020. Microbiologically confirmed UTI was observed in 2,653 (35.0%) of the 7583 patients studied. The predominant bacteria wereEscherichia coli(37.0%),Staphylococcusspp. (26.3%),Klebsiellaspp. (5.8%) andEnterococcusspp. (5.5%).E. colicontributed 982 of the isolates with an MDR proportion of 52.2%.Staphylococcusspp. contributed 697 of the isolates with an MDR rate of 60.3%. The overall proportion of MDR bacteria (n=1,153) was 50.9%. MDR bacteria are common causes of UTI in patients attending healthcare centres in East African countries, which emphasizes the need for investment in laboratory culture capacities and diagnostic algorithms to improve accuracy of diagnosis that will lead to appropriate antibiotic uses to prevent and control AMR.
Effectiveness of a COVID-19 contact tracing app in a simulation model with indirect and informal contact tracing
Authors: Leung Ka Yin , Metting Esther , Ebbers Wolfgang , Veldhuijzen Irene , Andeweg Stijn P. , Luijben Guus , de Bruin Marijn , Wallinga Jacco , Klinkenberg Don 
Published: June 2023

AbstractDuring the COVID-19 pandemic, contact tracing was used to identify individuals who had been in contact with a confirmed case so that these contacted individuals could be tested and quarantined to prevent further spread of the SARS-CoV-2 virus. Many countries developed mobile apps to find these contacted individuals faster. We evaluate the epidemiological effectiveness of the Dutch app CoronaMelder, where we measure effectiveness as the reduction of the reproduction number R. To this end, we use a simulation model of SARS-CoV-2 spread and contact tracing, informed by data collected during the study period (December 2020 - March 2021) in the Netherlands. We show that the tracing app caused a clear but small reduction of the reproduction number, and the magnitude of the effect was found to be robust in sensitivity analyses. The app could have been more effective if more people had used it, and if time intervals between symptom onset and reporting of contacts would have been shorter. The model used is novel as it accounts for the clustered nature of social networks and as it accounts for cases informally alerting their contacts directly after symptom onset, without involvement of health authorities or a tracing app.
Cerebral aneurysm walls contain myoglobin that is possibly produced by myofibroblasts and contributes to wall thickening
Authors: Kimura Hidehito , Mori Tatsuya , Hayashi Kosuke , Ikeuchi Yusuke , Tanaka Kazuhiro , Shinohara Masakazu , Tomiyama Akio , Kohmura Eiji , Sasayama Takashi 
Published: June 2023

AbstractBackgroundCerebral aneurysms are associated with subarachnoid hemorrhages if ruptured; however, mechanisms underlying aneurysmal wall thinning and thickening remain unclear.We previously identified patterns of hemodynamic flow in aneurysms that are associated with wall thickening and thinning, and in this study our objective was to uncover the biological basis for these findings.MethodsCerebral aneurysmal wall samples were collected between August 2020 and March 2022 for proteomic analysis and immunohistological investigation of smooth muscle cells, myoglobin, and inducible nitric oxide synthase (iNOS) expression. We examined the co-localization of myoglobin expression within smooth muscle cells, identified by α-smooth muscle actin (α-SMA) staining, and myofibroblasts, identified by periostin staining. We measured collagen density in the samples using Sirius Red staining and investigated its correlation with myoglobin density.ResultsAnalysis of proteins extracted from an area of thickening in the aneurysmal wall of one patient confirmed the presence of myoglobin. In 24 formalin-fixed aneurysmal wall samples, 19 expressed myoglobin, with 11 showing strong expression, and eight showing weak expression. Myoglobin was scattered or clustered within the vascular smooth muscle layer and tended to be expressed at sites other than where iNOS was identified. Double-label immunofluorescence staining confirmed that the myoglobin-positive rate within α-SMA-positive cells and α-SMA-positive areas was 33.2±23.8% and 31.3±37.8%, respectively, whereas within periostin-positive cells and periostin-positive areas it was 92.2±13.7% and 79.8±29.5, respectively. A moderate correlation was observed between the density of myoglobin and collagen in the same sample field, with a Spearman’s rank correlation coefficient of 0.593 (p = 0.036).ConclusionsCerebral aneurysmal walls express myoglobin, which may be produced by myofibroblasts in the wall. Areas with high myoglobin levels retain high levels of collagen fibers, and myoglobin may be involved in wall thickening by suppressing destructive changes in the extracellular matrix collagen fibers.
Increasing HIV treatment literacy among people living with HIV using a novel health communication aid: Evidence from KwaZulu Natal province, South Africa
Authors: Govathson Caroline , Ndlovu Neo , Rambally-Greener Letitia , Schmucker Laura , Chetty-Makkan Candice , Miot Jacqui , Thirumurthy Harsha , Pascoe Sophie , Malone Shawn , Buttenheim Alison 
Published: June 2023

AbstractIntroductionEffective health communication is important for promoting adherence to antiretroviral therapy (ART). During counselling sessions with people living with HIV (PLHIV) who are initiating or re-initiating ART, we assessed whether a simple visual aid using bead bottles to explain the concept of viral suppression resulted in changes in HIV treatment literacy.MethodsAt three public sector clinics in KwaZulu-Natal KZN) province, South Africa, we enrolled adults who tested HIV-positive and were newly initiating ART or re-engaging in HIV care. Trained HIV counsellors used bottles with coloured beads (“B-OK bottles”) to explain concepts related to viral load, viral suppression, and undetectable=Untransmittable (U=U). We assessed participants’ knowledge, attitudes, and perceptions about ART before and after counselling.ResultsBetween November 2022 and January 2023, we enrolled 80 PLHIV. Participants’ median age was 32 years (IQR: 24–41) and 58% were male. After receiving counselling with the B-OK bottles, understanding of U=U increased from 6% to 99% and understanding of ‘viral suppression’ increased from 20% to 99%. Confidence in the protective effects of ART increased (64% to 100% for one’s own health; 58% to 94% for transmission to partners) and was observed among participants both initiating ART and re-engaging in care. The number of participants agreeing that viral suppression means their sexual partners are safe from HIV even without condoms increased from 14% to 93% p-value =0.0. However, 65% still expressed worry that ART does not completely eliminate the risk of sexually transmitting HIV.ConclusionsUse of B-OK bottles during ART counselling was acceptable and increased HIV treatment literacy. While there was no significant effect on level of confidence in complete elimination of transmission risk when virally suppressed, we observed a significant reduction in concern about transmitting HIV and an increase in confidence in the protective effects of ART.Clinical Trial Number (SANCTR)DOH-27-092022-8067
Theory of radiologist interaction with instant messaging decision support tools: a sequential-explanatory study
Authors: Burns John Lee , Gichoya Judy Wawira , Kohli Marc D , Jones Josette , Purkayastha Saptarshi 
Published: June 2023

AbstractRadiology specific clinical decision support systems (CDSS) and artificial intelligence are poorly integrated into the radiologist workflow. Current research and development efforts of radiology CDSS focus on 5 main interventions, based around exam centric time points– at time of radiology exam ordering, after image acquisition, intra-report support, post-report analysis, and radiology workflow adjacent. We review the literature surrounding CDSS tools in these time points, requirements for CDSS workflow augmentation, and technologies that support clinician to computer workflow augmentation.We develop a theory of radiologist-decision tool interaction using a sequential explanatory study design. The study consists of 2 phases, the first a quantitative survey and the second a qualitative interview study. The phase 1 survey identifies differences between average users and radiologist users in software interventions using the User Acceptance of Information Technology: Toward a Unified View (UTAUT) framework. Phase 2 semi-structured interviews provide narratives on why these differences are found. To build this theory, we propose a novel solution called Radibot - a conversational agent capable of engaging clinicians with CDSS as an assistant using existing instant messaging systems supporting hospital communications. This work contributes an understanding of how radiologist-users differ from the average user and can be utilized by software developers to increase satisfaction of CDSS tools within radiology.Author SummaryThere is a need for human-machine interfaces between radiologists and clinical decision support systems (CDSS). Within the variety of systems radiologists interact with, there is no best fit for CDSS presented in the literature. After reviewing current literature surrounding CDSS use in healthcare and radiology, we propose a novel solution - a conversational agent capable of engaging clinicians as a team member using existing instant messaging systems supporting hospital communications.We test the acceptance of this intervention using the User Acceptance of Information Technology: Toward a Unified View (UTAUT) framework in survey and interview formats. Within our sample group, we found that radiologists have a high intent to use and a positive attitude towards this intervention. Our sample of radiologists deviated from the standard user UTAUT expects, suggesting that radiologist’s acceptance of software tools differs from the standard user. This work builds a theory of radiologist-decision support tool interaction that may be useful for software developers and systems integrators.