bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diet in the management of non-dialysis dependent chronic kidney disease: perceptions and practices of health professionals
Authors: Notaras Stephanie , Lambert Kelly , Perz Janette , Makris Angela 
Published: April 2022

Abstract
Background
Therapeutic strategies, including dietary intervention, to target non-dialysis dependent Chronic Kidney Disease (CKD) progression have been at the forefront of recent renal research. Nephrologists and other renal health professionals are key stakeholders in the dietary management of patients with non-dialysis dependent CKD and referrals to dietetic services. The aims of this study were to explore (i) health professional perceptions regarding the role of diet in managing non-dialysis dependent CKD, and (ii) health professional practices regarding the provision of dietary advice and referrals to dietetic services.

Methods
A 31-item online survey was emailed to members of professional renal networks and associations in Australia and New Zealand. Data was analysed descriptively. Categorical variables were assessed to determine associations between referral frequency, demographic variables, health professional role (non-dietetic versus dietetic) and perceptions of the role of diet.

Results
Overall, 189 health professionals completed the survey. Nephrologists (42%), renal nurses (29%) and renal dietitians (24%) were the most common respondents. Non-dietetic health professionals rated the importance of diet in the management of non-dialysis dependent CKD significantly lower than renal dietitians (73% versus 98% ranked as very-extremely important, p = 0.002). Fifty percent of non-dietetic health professionals referred patients to renal dietetic services never or 0–25% of the time. Reasons for not referring included perceptions there is a lack of evidence that diet reduces CKD progression, perceptions that patients will not adhere to dietary recommendations, and a desire to reduce visit burden for patients. Barriers to accessing dietetic services were perceived to be significant and include lengthy wait times and inadequate dietetic staffing.

Conclusion
Inconsistencies exist between non-dietetic health professionals and dietitians regarding the importance of diet in non-dialysis dependent CKD. Referral practices appear to be influenced by beliefs about the evidence base and perceptions regarding the ability of dietitians to meet referral demand. Raising awareness for non-dietetic health professionals working in nephrology regarding the evidence on diet and CKD progression is needed. An improved understanding of this evidence base may improve knowledge and referral patterns. Further, an increase in renal dietetic staffing is recommended to enhance patient access to services.
The role of dieting, psychopathological characteristics and maladaptive personality traits in Orthorexia Nervosa
Authors: Novara C. , Mattioli S. , Piasentin S. , Pardini S. , Maggio E. 
Published: April 2022

Abstract
Background
Pursuing a healthy diet is not a dysfunctional behavior, but dieting could be an important etiological factor for Orthorexia Nervosa (ON). The aim of this study was to investigate the role of diet in groups with high/low orthorexic tendencies. Moreover, some psychopathological characteristics associated with ON and maladaptive personality traits were investigated.

Methods
The sample consisted of three groups: two were on a diet and had high (HIGH-D; n = 52) or low (LOW-D; n = 41) orthorexic tendencies. The other was composed of people with high orthorexic tendencies not on a diet (HIGH; n = 40). Participants filled out self-report questionnaires to investigate orthorexic tendencies, eating disorders features, obsessive–compulsive symptoms, perfectionism, depressive/anxious symptomatology, and maladaptive personality traits.

Results
The HIGH-D group showed more orthorexic tendencies than the HIGH group. More maladaptive personality traits and anxiety symptoms have been highlighted in HIGH and HIGH-D groups. The HIGH group had more eating disorder characteristics than other groups. Only the HIGH-D group showed more depressive symptoms than the LOW-D group.

Conclusions
The features of HIGH and LOW-D groups suggest that diet alone could not explain ON, even if it could be a possible factor related to ON. Therefore, people with high orthorexic tendencies, psychopathological features, and maladaptive personality traits could be in a prodromic condition for disordered eating habits and deserve clinical attention.
Screen time and health issues in Chinese school-aged children and adolescents: a systematic review and meta-analysis
Authors: Zhang Youjie , Tian Shun , Zou Dan , Zhang Hengyan , Pan Chen-Wei 
Published: April 2022

Abstract
Backgrounds
Many literature reviews summarized relationships between screen time and child health, but they only included a few studies conducted in Chinese children and adolescents. The potential influence of screen time may vary by social context. The current systematic review and meta-analysis aimed to evaluate relationships between screen time and health issues among Chinese school-aged children and adolescents.

Methods
Peer-reviewed articles written in Chinese and English were retrieved from CNKI, Wanfang, PubMed, Embase, and Web of Science from inception to June 2020. The Downs & Black checklist was applied to assess study quality. Meta analyses used random effect models and mixed effects model to calculate pooled adjusted odds ratios and 95% confidence intervals. Heterogeneity, sensitivity, and publication bias were assessed using Q and I2 statistics, “one-study removed” analysis, the funnel plot, trim and fill analysis, and classical fail-safe N, respectively.

Results
In total, we identified 252 articles reporting 268 studies with unique samples. These studies investigated relationships between screen time and health issues of adiposity, myopia, psycho-behavioral problems, poor academic performance, cardiometabolic disease risks, sleep disorder, poor physical fitness, musculoskeletal injury, sub-health, and miscellaneous issues of height and pubertal growth, injury, sick leave, and respiratory symptoms. Proportions of studies reporting positive relationships with screen time were lowest in adiposity (50.6%) and higher in myopia (59.2%) and psycho-behavioral problems (81.8%). Other health issues were examined in 10 or less studies, all of which had more than half showing positive relationships. The pooled odds ratio from 19 studies comparing health risks with the screen time cutoff of 2 hours per day was 1.40 (95% CI: 1.31 to 1.50, I2 = 85.9%). The pooled effect size was 1.29 (95% CI: 1.20 to 1.39) after trimming 7 studies for publication bias adjustments.

Conclusions
Findings exclusively generated from Chinese school-aged children and adolescents resonate those mainly from western countries. Evidence suggests that higher levels of screen time are related with greater risks of various health issues, although the relationships appear to be weak and intertwined with other confounding factors. Future studies need to investigate health-specific dose effects and mechanisms of screen time.
The political determinants of the health of undocumented immigrants: a comparative analysis of mortality patterns in Switzerland
Authors: Piccoli Lorenzo , Wanner Philippe 
Published: April 2022

Abstract
Background
The health of undocumented immigrants is an important concern in most societies. However, there is no conclusive evidence that inclusive health care policies lead to better outcomes for this group of the population. The aim of this study is to analyse whether there is an association between inclusive health care policies and the mortality patterns of undocumented immigrants, or the distribution of different causes of death among those who have died.

Methods
We analyse individual data concerning the deceased in Switzerland between 2011 and 2017. We proceed in two steps. First, we estimate and compare the patterns of mortality of Swiss citizens, documented immigrants, and undocumented immigrants. Second, we test whether there is an association between cantonal authorities’ policies and differing mortality patterns. We use logistic regressions and multinomial regressions to estimate the relationship between legal status and mortality patterns both in Switzerland and across different cantons.

Results
We find a difference in the patterns of mortality between undocumented immigrants and the other groups of the population. Specifically, death from circulatory system diseases is twice as frequent among undocumented immigrants compared to documented immigrants and Swiss citizens. However, this difference is smaller in the Swiss cantons that have more inclusive health care policies towards undocumented immigrants.

Conclusions
We interpret these results as an indication that policies that expand access to health services lead to better outcomes for undocumented immigrants. This finding has implications for research on civic stratification and public health. Further analysis is needed to evaluate the effects of extending public health care for undocumented immigrants in different contexts.
Co-design and evaluation of a patient-centred transition programme for stroke patients, combining case management and access to an internet information platform: study protocol for a randomized controlled trial - NAVISTROKE
Authors: Termoz Anne , Delvallée Marion , Damiolini Eléonore , Marchal Mathilde , Preau Marie , Huchon Laure , Mazza Stéphanie , Habchi Ouazna , Bravant Estelle , Derex Laurent , Nighoghossian Norbert , Cakmak Serkan , Rabilloud Muriel , Denis Angélique , Schott Anne-Marie , Haesebaert Julie 
Published: April 2022

AbstractBackgroundStroke affects many aspects of life in stroke survivors and their family, and returning home after hospital discharge is a key step for the patient and his or her relatives. Patients and caregivers report a significant need for advice and information during this transition period. Our hypothesis is that, through a comprehensive, individualised and flexible support for patients and their caregivers, a patient-centred post-stroke hospital/home transition programme, combining an Internet information platform and telephone follow-up by a case manager, could improve patients’ level of participation and quality of life.MethodsAn open parallel-group randomized trial will be conducted in two centres in France. We will recruit 170 adult patients who have had a first confirmed stroke, and were directly discharged home from the stroke unit with a modified Rankin score ≤3. Intervention content will be defined using a user-centred approach involving patients, caregivers, health-care professionals and social workers. Patients randomized to the intervention group will receive telephonic support by a trained case manager and access to an interactive Internet information platform during the 12 months following their return home. Patients randomized to the control group will receive usual care. The primary outcome is patient participation, measured by the “participation” dimension score of the Stroke Impact Scale 6 months after discharge. Secondary outcomes will include, for patients, quality of life, activation, care consumption, as well as physical, mental and social outcomes; and for caregivers, quality of life and burden. Patients will be contacted within one week after discharge, at 6 and 12 months for the outcomes collection. A process evaluation alongside the study is planned.DiscussionOur patient-centred programme will empower patients and their carers, through individualised and progressive follow-up, to find their way around the range of available healthcare and social services, to better understand them and to use them more effectively.The action of a centralised case manager by telephone and the online platform will make it possible to disseminate this intervention to a large number of patients, over a wide area and even in cases of geographical isolation.Trial registration:ClinicalTrialsNCT03956160, Posted: May-2019 and Update: September-2021.
Service process factors affecting patients’ and clinicians’ experiences on rapid teleconsultation implementation in out-patient neurology services during COVID-19 pandemic: a scoping review
Authors: Meng Guangxia , McAiney Carrie , Perlman Christopher M. , McKillop Ian , Tisseverasinghe Therese , Chen Helen H. 
Published: April 2022

Abstract
Background
The adoption of teleconsultation for outpatient neurology services was limited until the onset of the COVID-19 pandemic which forced many outpatient neurology services to rapidly switch to virtual models. However, it remains unclear how this change has impacted patients’ and clinicians’ perceptions of service quality. The purpose of this scoping review is to identify process factors that influence patients’ and clinicians’ experiences of outpatient teleconsultation services during COVID-19.

Methods
Arksey and O’Malley scoping review framework was used to search PubMed, Scopus, CINAHL, and PsycInfo for original peer-reviewed research studies that examined the experiences of synchronous teleconsultation between a clinician and patient in a home-setting since the World Health Organization announced the COVID-19 global pandemic. The service quality model SERVQUAL was used to conduct a deductive thematic analysis to identify the key factors that impacted the patients’ and clinicians’ perception of teleconsultation services.

Results
A total of nineteen studies published between January 1, 2020, and April 17, 2021, were identified. The most common service process factors affecting the patients’ and clinicians’ experiences of teleconsultation were technical issues, addressing logistical needs, communication, ability to perform clinical activities, appropriate triage, and administrative support.

Conclusions
Our findings identified six key service process factors affecting the patients’ and clinicians’ teleconsultation experiences in outpatient neurology services. The need for improvement of triage process and standardizing administrative virtual care pathway are identified as important steps to improve patients and clinicians’ teleconsultation experiences compared to pre-COVID era. More research is needed to assess outpatient neurology teleconsultation service quality from patients’ and clinicians’ perspectives.
Dietary fibre in hypertension and cardiovascular disease management: systematic review and meta-analyses
Authors: Reynolds Andrew N. , Akerman Ashley , Kumar Shiristi , Diep Pham Huyen Tran , Coffey Sean , Mann Jim 
Published: April 2022

Abstract
Background
Higher dietary fibre intakes are associated with a reduced risk of developing cardiovascular disease (CVD), and increasing intake has been shown to reduce blood pressure and other cardiometabolic risk factors. The extent to which dietary fibre can further reduce risk for those with CVD and treated with cardioprotective drugs has not been clearly established. We have examined the evidence for dietary fibre as adjunct therapy in those with CVD or hypertension.

Methods
Ovid MEDLINE, Embase, PubMed, and CENTRAL were searched to June 2021. Prospective observational studies reporting on fibre intakes and mortality in those with pre-existing CVD and controlled trials of increasing fibre intakes on cardiometabolic risk factors in those with CVD or hypertension were eligible. Outcomes were mortality (studies) and cardiometabolic risk factors (trials). Data synthesis was with random effects and dose response. Certainty of evidence was assessed using GRADE.

Results
Three prospective studies including 7469 adults with CVD, and 12 trials of 878 adults with CVD or hypertension were identified. Moderate certainty evidence indicates reduced all-cause mortality (relative risk, RR0.75 (95% confidence interval, CI 0.58–0.97)) when comparing higher with lower fibre intakes. Low certainty evidence from trials of adults with cardiovascular disease indicates increasing fibre intakes reduced total (mean difference, MD − 0.42 mmol/L (95%CI − 0.78 to − 0.05) and low-density lipoprotein (LDL) cholesterol (MD − 0.47mmol/L (95%CI − 0.85 to − 0.10)). High certainty evidence from trials of adults with hypertension indicates increasing fibre intakes reduces systolic (MD 4.3 mmHg (95% CI 2.2 to 5.8)) and diastolic blood pressure (MD 3.1 mmHg (95% CI 1.7 to 4.4)). Moderate and low certainty evidence indicated improvements in fasting blood glucose (MD 0.48 mmol/L (− 0.91 to − 0.05)) and LDL cholesterol (MD 0.29 mmol/L (95% CI 0.17 to 0.40)). Benefits were observed irrespective of cardioprotective drug use.

Conclusions
These findings emphasise the likely benefits of promoting greater dietary fibre intakes for patients with CVD and hypertension. Further trials and cohort analyses in this area would increase confidence in these results.
Identifying the vulnerable regions of emergency medical services based on the three-stage of accessibility: a case study in Xi’an, China
Authors: Xu Ning , Bai Jianjun , Yan Ran 
Published: April 2022

AbstractBackgroundEmergency department crowding is an obstacle in the process of obtaining emergency care services, which will lead to the increase of time cost. Most studies focused on the direct access to emergency medical resources, and few studies took the crowding of hospital emergency department as an evaluation index to reflect the convenience of obtaining emergency medical resources. It is a significance for the identification of areas with insufficient access to emergency service resources with this method.MethodsThis paper utilizes the improved potential model and the inverted Two-Step Floating Catchment Area method, combined with network map API service data to evaluate response time, delivery time and waiting time (for emergency department crowding) spent in different residential areas of Xi’an City in the process of emergency. Meanwhile, the vulnerable regions of gaining emergency medical resources are identified through the comprehensive analysis of the three stages of emergency.ResultsThe studies show that the residents in built-up area are more convenient to get ambulance service and arrive at care hospitals than those in suburban areas, but they may face greater hospital crowdedness. Although suburban residents are faced with low hospital crowdedness, they spend more time on getting ambulances and going to care hospitals. The accessibility of emergency medical resources varies greatly among residents in different regions, with 5.38% of the residents were identified in the high-risk area distributing in suburban residential areas in the south of the city center, 21.92% in the medium risk area in the southern mountainous areas and the periphery of the core suburban areas of the city, and 46.11% in the low-risk area which are mainly distributed in built-up areas in gaining emergency medical services.ConclusionsObviously, getting an ambulance and arriving at the nearest hospital quickly shows that it is conducive to access to emergency resources. However, the impact of hospital emergency crowding can not be ignored, especially in the area surrounded by high-grade hospitals in the central area of the city. In considering the spatial layout of emergency stations and emergency hospitals, the dislocation distribution of hospitals at different levels should be reasonably adjusted to balance the equity of residents in obtaining emergency medical resources.
Oxidative stress generated by polycyclic aromatic hydrocarbons from ambient particulate matter enhance vascular smooth muscle cell migration through MMP upregulation and actin reorganization
Authors: Ju Sujin , Lim Leejin , Ki Young-Jae , Choi Dong-Hyun , Song Heesang 
Published: April 2022

Abstract
Background
Epidemiological studies have suggested that elevated concentrations of particulate matter (PM) are strongly associated with the incidence of atherosclerosis, however, the underlying cellular and molecular mechanisms of atherosclerosis by PM exposure and the components that are mainly responsible for this adverse effect remain to be established. In this investigation, we evaluated the effects of ambient PM on vascular smooth muscle cell (VSMC) behavior. Furthermore, the effects of polycyclic aromatic hydrocarbons (PAHs), major components of PM, on VSMC migration and the underlying mechanisms were examined.

Results
VSMC migration was significantly increased by treatment with organic matters extracted from ambient PM. The total amount of PAHs contained in WPM was higher than that in SPM, leading to higher ROS generation and VSMC migration. The increased migration was successfully inhibited by treatment with the anti-oxidant, N-acetyl-cysteine (NAC). The levels of matrix metalloproteinase (MMP) 2 and 9 were significantly increased in ambient PM-treated VSMCs, with MMP9 levels being significantly higher in WPM-treated VSMCs than in those treated with SPM. As expected, migration was significantly increased in all tested PAHs (anthracene, ANT; benz(a)anthracene, BaA) and their oxygenated derivatives (9,10-Anthraquinone, AQ; 7,12-benz(a)anthraquinone, BAQ, respectively). The phosphorylated levels of focal adhesion kinase (FAK) and formation of the focal adhesion complex were significantly increased in ambient PM or PAH-treated VSMCs, and these effects were blocked by administration of NAC or α-NF, an inhibitor of AhR, the receptor that allows PAH uptake. Subsequently, the levels of phosphorylated Src and NRF, the downstream targets of FAK, were altered with a pattern similar to that of p-FAK.

Conclusions
PAHs, including oxy-PAHs, in ambient PM may have dual effects that lead to an increase in VSMC migration. One is the generation of oxidative stress followed by MMP upregulation, and the other is actin reorganization that results from the activation of the focal adhesion complex.