bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in ANA-positive Chinese patients
Authors: Chung Yuen Kwan , Ho Ling Yin , Lee Carolyn , To Chi Hung , Mok Chi Chiu 
Published: May 2022

Background: The aim of this study was to validate the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) in antinuclear antibody (ANA)-positive Chinese patients. Methods: Medical records of all adult patients who attended the rheumatology out-patient clinics between May and September 2019 were reviewed. Patients with ever ANA positive (titre ⩾1:80) were included and evaluated for the fulfilment of the 2019 EULAR/ACR, 2012 Systemic Lupus International Collaborating Clinics (SLICC) and 1997 ACR criteria for SLE classification. The performance of these criteria in predicting a clinical diagnosis of SLE as judged by an independent panel of rheumatologists was studied and compared in different subgroups. Results: A total of 1533 patients (88.2% women; age at first clinic attendance 45.5 ± 15.6 years) were studied and 562 patients were judged to be clinical SLE. The sensitivity and specificity of the EULAR/ACR (⩾10 points), SLICC and ACR criteria for a clinical diagnosis of SLE was 96.1%, 97.9% and 86.1%; and 85.8%, 86.3% and 94.3%, respectively. Applying the attribution rule to the non-SLE controls, the specificity of the three criteria increased to 95.0%, 92.5% and 98.8%, respectively. The specificity of the EULAR/ACR criteria was higher in male patients (97.9%), those aged >50 years (97.0%) and disease duration of ⩽3 years (97.6%). Using a cut-off of 12 points, the specificity of the EULAR/ACR criteria was further increased (96.6%) while a high sensitivity (95.0%) was maintained. Conclusion: In Chinese patients with a positive ANA, the EULAR/ACR criteria for clinical SLE perform equally well to the SLICC criteria. Both the EULAR/ACR and SLICC are more sensitive but less specific than the ACR criteria. The specificity of all the three criteria is enhanced by applying the attribution rule to controls. The specificity of the EULAR/ACR criteria is higher in certain patient subgroups or when the cut-off score is raised.
Pelvic retroperitoneal pleomorphic hyalinizing angiectatic tumor: A case report and review of literature
Authors: Salehipour Mehdi , Anbardar Mohammad Hossein , Geramizadeh Bita , Jafari Hamed , Zare Ali , Adib Ali 
Published: May 2022

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare tumor of the soft tissue, usually located in lower extremities. There are rarely tumors reported in other anatomic locations. Herein, we report retroperitoneal PHAT in a male patient. A 41-year-old man was referred to our clinic due to an incidentally found retroperitoneal mass. Computed tomography (CT) scan showed a solid hypoechoic lesion containing fat component and calcified elements measuring about 80*72*45 mm in the right lower quadrant (RLQ) of the abdomen. Magnetic resonance imaging (MRI) showed circumscribe lesion measuring about 60 x 48 mm with partial enhancement and fat component. In pelvic exploration, a large mass was found that had encased the right external iliac artery and vein. Therefore, the mass and its surrounding iliac vessels were excised and removed en block. Then, the external iliac vessels were reconstructed with Gortex graft. No recurrence was found in 1 month and 3 months post-operation follow up. We report a pelvic retroperitoneal PHAT as a rare location of this tumor. It seems that PHAT must be considered in differential diagnosis in patients with soft tissue tumors in the pelvic cavity.
The prevalence and predictors of cardiovascular diseases in Kherameh cohort study: a population-based study on 10,663 people in southern Iran
Authors: Baeradeh Najibullah , Ghoddusi Johari Masoumeh , Moftakhar Leila , Rezaeianzadeh Ramin , Hosseini Seyed Vahid , Rezaianzadeh Abbas 
Published: May 2022

Abstract
Background
The prevalence of cardiovascular disease (CVD) is rapidly increasing in the world. The present study aimed to assess the prevalence and Predictors factors of CVD based on the data of Kherameh cohort study.

Methods
The present cross-sectional, analytical study was done based on the data of Kherameh cohort study, as a branch of the Prospective Epidemiological Studies in Iran (PERSIAN). The participants consisted of 10,663 people aged 40–70 years. CVD was defined as suffering from ischemic heart diseases including heart failure, angina, and myocardial infarction. Logistic regression was used to model and predict the factors related to CVD. Additionally, the age-standardized prevalence rate (ASPR) of CVD was determined using the standard Asian population.

Results
The ASPR of CVD was 10.39% in males (95% CI 10.2–10.6%) and 10.21% in females (95% CI 9.9–10.4%). The prevalence of CVD was higher among the individuals with high blood pressure (58.3%, p < 0.001) as well as among those who smoked (28.3%, p = 0.018), used opium (18.2%, p = 0.039), had high triglyceride levels (31.6%, p = 0.011), were overweight and obese (66.2%, p < 0.001), were unmarried (83.9%, p < 0.001), were illiterate (64.2%, p < 0.001), were unemployed (60.9%, p < 0.001), and suffered from diabetes mellitus (28.1%, p < 0.001). The results of multivariable logistic regression analysis showed that the odds of having CVD was 2.25 times higher among the individuals aged 50–60 years compared to those aged 40–50 years, 1.66 folds higher in opium users than in non-opium users, 1.37 times higher in smokers compared to non-smokers, 2.03 folds higher in regular users of sleeping pills than in non-consumers, and 4.02 times higher in hypertensive individuals than in normotensive ones.

Conclusion
The prevalence of CVD was found to be relatively higher in Kherameh (southern Iran) compared to other places. Moreover, old age, obesity, taking sleeping pills, hypertension, drug use, and chronic obstructive pulmonary disease had the highest odds ratios of CVD.
National Emergency Resuscitation Airway Audit (NERAA): a pilot multicentre analysis of emergency intubations in Irish emergency departments
Authors: Umana Etimbuk , Foley James , Grossi Irene , Deasy Conor , O’Keeffe Francis ,   and on behalf of Irish Trainee Emergency Research Network (ITERN) Collaborators, Patton Andrew , Jee Marcus , Mulcaire Jeffery , Ahmed Ahmed Al Rasheed , Vecchia Claudio Dalla , Vainberg Nikita , O’ Reilly Hugh , Daly Joseph , de Buitléir Cathal , Prendergast Conor , Ibrahim Randa , Kukaswadia Shane 
Published: May 2022

Abstract
Background
There is paucity of literature on why and how patients are intubated, and by whom, in Irish Emergency Departments (EDs). The aim of this pilot study was to characterise emergency airway management (EAM) of critically unwell patients presenting to Irish EDs.

Methods
A multisite prospective pilot study was undertaken from February 10 to May 10, 2020. This project was facilitated through the Irish Trainee Emergency Research Network (ITERN). All patients over 16 years of age requiring EAM were included. Eleven EDs participated in the project. Data recorded included patients’ demographics, indication for intubation, technique of airway management, medications used to facilitate intubation, level of training and specialty of the intubating clinician, number of attempts, success/complications rates and variation across centres.

Results
Over a 3-month period, 118 patients underwent 131 intubation attempts across 11 EDs. The median age was 57 years (IQR: 40–70). Medical indications were reported in 83% of patients compared to 17% for trauma. Of the 118 patients intubated, Emergency Medicine (EM) doctors performed 54% of initial intubations, while anaesthesiology/intensive care medicine (ICM) doctors performed 46%. The majority (90%) of intubating clinicians were at registrar level. Emergency intubation check lists, video laryngoscopy and bougie were used in 55, 53 and 64% of first attempts, respectively. The first pass success rate was 89%. Intubation complications occurred in 19% of patients. EM doctors undertook a greater proportion of intubations in EDs with > 50,000 attendance (65%) compared to EDs with < 50,000 attendances (16%) (p < 0.000).

Conclusion
This is the first study to describe EAM in Irish EDs, and demonstrates comparable first pass success and complication rates to international studies. This study highlights the need for continuous EAM surveillance and could provide a vector for developing national standards for EAM and EAM training in Irish EDs.
Association of triglyceride glucose index with all-cause and cause-specific mortality among middle age and elderly US population
Authors: Sun Min , Guo Hongmei , Wang Yi , Ma Dongchao 
Published: May 2022

Abstract
Aims
To investigate the association between the triglyceride glucose (TyG) index and all-cause and cause-specific mortality in middle age and elderly population.

Methods and results
A total of 9,254 participants with age ≥ 45 years were enrolled from the National Health and Nutrition Examination Survey cycle of 1999–2014. The TyG index was determined as ln [fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2]. Primary outcomes were all-cause mortality and cause-specific mortality (cardiovascular diseases and malignant neoplasms). The association between the levels of TyG and the risk of mortality was explored with Cox regression models. After a median follow-up of 7.6 years, 1,774 all-cause death occurred. Univariate analysis showed that the TyG was associated with all-cause mortality (hazard ratio [HR] 1.18, 95% confidence interval [CI] [1.11,1.26]; p < 0.001). Furthermore, multivariate-adjusted analysis found that the third TyG quartile (8.72 ~ 9.16) was associated with the lowest risk of all-cause mortality (HR 0.84, 95%CI [0.73, 0.98]; p < 0.05). Restricted cubic splines showed that the association between levels of TyG index and the risk of all-cause mortality was non-linear (p for nonlinearity < 0.001) and the inflection point was 9.18 using threshold effect analysis. The HR was 0.82 (95%CI [0.71,0.96]) below 9.18 while the HR was 1.32 (95%CI [1.12,1.55]) above 9.18.

Conclusion
TyG index was U-shaped associated with all-cause mortality and the TyG index associated with the lowest risk of all-cause mortality was 9.18.
Effect of a community based social marketing strategy on the uptake of clean delivery kits in peri-urban communities of Karachi, Pakistan
Authors: Usmani Asra , Sultana Shazia , Nisar Imran , Zaidi Shehla , Jehan Imtiaz , Zaidi Anita 
Published: May 2022

Abstract
Background
Pakistan has one of the highest neonatal and maternal mortality rates in the world. Use of clean delivery kits (CDK) at time of delivery improves maternal and newborn outcome. We test effectiveness of a social marketing strategy to increase uptake of CDKs in a low socioeconomic peri-urban community in Pakistan.

Methods
This was a sequential mixed method study. The quantitative component consisted of two arms. In the prospective intervention arm trained community health workers (CHWs) visited pregnant women twice to prepare them for birth and encourage use of CDKs. Availability of these kits was ensured at accessible stores in these communities. The retrospective control arm consisted of women delivering in same area during the past 3 months identified from pregnancy register. Information was collected on sociodemographic, pregnancy characteristics and use of CDKs at time of delivery in both arms. We compared proportion of women using CDKs during home deliveries in the intervention and control arm. We performed logistic regression analysis to identify factors associated with use of CDKs in intervention arm. We carried out separate focused group discussions (FGDs) with women who used CDKs, with women who did not use CDKs and birth attendants.

Results
Total of 568 pregnant women were enrolled in prospective intervention arm and 603 in retrospective control arm. The proportion of women using CDKs during home deliveries in retrospective control arm was 9.4% compared to 23.8% in prospective control arm (p =  < 0.001). In final multivariable model, increasing age of pregnant woman and husband having some education was positively associated with CDK use (aOR 1.1;95% CI 1.1–1.2 and aOR 2.2;95% CI 1.3–3.6 respectively). During FGDs, many women were of the thought that kits should be free or included in the amount charged by birth attendants. Assembly of components of kit into one package was appreciated by birth attendants.

Conclusion
Social marketing strategy targeting pregnant women and their family members resulted in an increase in the uptake of CDKs in our study. Birth attendants were generally satisfied with the assembly of the kit. Many women cited unawareness and cost to be a major impediment in use of CDKs.
Fasting serum fructose is associated with risk of gestational diabetes mellitus
Authors: Zhang Hongmei , Li Xiaoyong , Niu Yixin , Yang Zhen , Lu Youli , Su Qing , Qin Li 
Published: May 2022

Abstract
Objective
To investigate the association of fasting serum fructose concentrations and the incidence of GDM.

Research design and methods
Five hundred twenty six pregnant women who attended the obstetric clinic of Xinhua Hospital, Chongming Branch were recruited prospectively from September 2019 to November 2020. Fasting serum fructose concentrations were measured by a validated liquid chromatography–tandem mass spectrometry method. GDM was diagnosed according to the criteria of the IADPSG. Independent sample t-test was used to compare the differences between groups. Multiple stepwise regression analysis was used to estimate the associations of serum fructose and other variables. Multivariate logistic regression models were adopted to evaluate the odds ratios (ORs) for GDM.

Results
Of the 526 pregnant women, 110 were diagnosed with GDM. Fasting fructose concentrations were increased significantly in GDM patients compared to those without GDM (1.30 ug/ml vs 1.16 ug/ml, p<0.001). Fasting fructose concentration was independently associated with GDM after adjusting the potential confounders, 1 ug/ml increase in fasting serum fructose level was associated with an 81.1% increased risk of GDM (1.811, [1.155-2.840]). Taking fructose <1.036 ug/ml as the reference, the OR for GDM was significantly higher in fructose ≥1.036 ug/ml group (OR, 1.669; 95% CI, 1.031–2.701) after all the potential confounders were adjusted.

Conclusions
Increased fasting serum fructose levels were independently associated with the incidence of GDM.
Health-promoting behaviors and intermediary social determinants of health in low and high-risk pregnant women: an unmatched case-control study
Authors: Masjoudi Marzieh , Khazaeian Somayyeh , Malekzadeh Sanna , Fathnezhad-Kazemi Azita 
Published: May 2022

Abstract
Background
High-risk pregnancies require increased health and care resources to reduce the severe perinatal consequences. The adoption of a health-promoting lifestyle and social determinants is an important strategy for achieving the desired outcomes of pregnancy. This study aimed to compare intermediate determinants of social health in low and high-risk pregnant women.

Methods
This unmatched case-control study was performed with a ratio of 1: 2 and 300 pregnant women including 200 healthy and 100 pregnant women with gestational hypertension were included using the available sampling technique. Data were collected using socio-demographic and obstetrics, Health-promoting behaviors, Self-efficacy, Perceived stress, and Social support questionnaires by the self-report method.

Results
There was no significant difference in the demographic characteristics between the two groups, except for the spouse's education status. The total score of health-promoting behaviors and social support in the healthy group was significantly higher than women with gestational hypertension. However, the perceived stress in women with gestational hypertension was significantly higher than in the healthy group. In the multivariate analysis, those women with high stress [AOR 1.13, 95% CI (1.08–1.18)] and whose Spouse’s Educational status was low [AOR 4.94, 95% CI (1.54–15.81)] had higher odds of gestational hypertension than women who haven’t respectively. The development of gestational hypertension was decreased by increasing the score of social support [AOR 0.96, 95% CI (0.93–0.98)]. The results showed that the two variables of social support (β=0.331) and self-efficacy (β=0.215) have the greatest impact on the score of health-promotion behaviors, respectively. Based on regression analysis, 21.2% of the health-promotion behaviors changes could be explained by three independent variables.

Conclusion
Women with gestational hypertension have unhealthier lifestyles. Having a high level of stress is a risk factor for gestational hypertension but Social support has a protective effect on it. Recognizing the risk factors of gestational hypertension could help the determination of high-risk cases and it is important to pay attention to women's psychosocial to create appropriate sources of social support and provide the necessary action to reduce stress.
Murradambirra Dhangaang (make food secure): Aboriginal community and stakeholder perspectives on food insecurity in urban and regional Australia
Authors: Sherriff Simone , Kalucy Deanna , Tong Allison , Naqvi Nawazish , Nixon Janice , Eades Sandra , Ingram Tangerene , Slater Kym , Dickson Michelle , Lee Amanda , Muthayya Sumithra 
Published: May 2022

AbstractBackgroundIt is widely acknowledged that the invasion by colonial powers of the Australian continent had profound and detrimental impacts on Aboriginal Communities, including food security. Policies of successive governments since European arrival have since further exacerbated the situation, with food insecurity now affecting 20–25% of Aboriginal and Torres Strait Islander people. Food insecurity contributes to long-term impacts on health, in particular diet-sensitive chronic diseases. This study aimed to describe Aboriginal community and stakeholder perspectives on food insecurity to get a better understanding of the key contributing factors and recommendations for potential strategies to address this issue in Aboriginal communities in urban and regional Australia.MethodsSemi-structured interviews were conducted with 44 participants who were purposively selected. This included Aboriginal people in two communities and both Aboriginal and non-Aboriginal stakeholders from local food relief agencies, food suppliers, schools, and government in an urban and regional location in NSW. A conceptual framework was developed from literature on food security, and sensitizing concepts of availability, affordability, accessibility and acceptability or the lack thereof of healthy food were used to elicit responses from the participants. Interview transcripts were analysed thematically.ResultsAll participants felt strongly that food insecurity was a major problem experienced in their local Aboriginal communities. Five core areas impacting on food security were identified: trapped in financial disadvantage; gaps in the local food system; limitations of non-Aboriginal food relief services; on-going impacts of colonization; and maintaining family, cultural and community commitments and responsibilities. Participants suggested a number of actions that could help ease food insecurity and emphasized that Aboriginal values and culture must be strongly embedded in potential programs.ConclusionsThis study found Aboriginal families in urban and regional Australia are experiencing food insecurity on a regular basis, which is impacted by a range of socio-economic, environmental, systemic and cultural factors, as reported by the participants. Study findings highlight the need to address system level changes in the food environment and acknowledge Aboriginal history, culture and food preferences when considering the development of programs to alleviate food insecurity among Aboriginal people.
Associations between the neighbourhood social environment and preschool children’s physical activity and screen time
Authors: Baldwin Jessica , Arundell Lauren , Hnatiuk Jill A. 
Published: May 2022

Abstract
Background
The neighbourhood social environment (NSE) has been associated with physical activity and screen time behaviours in adults and youth however less is known about this relationship in preschool-aged children (2–5 years). This study seeks to explore associations between the NSE and the physical activity and screen time behaviours of preschool-aged children.

Method
Cross-sectional data was collected in 2019. Parents (n = 214) of preschool-aged children (m = 3.8 ± 0.8 years), from 187 different Australian postcodes representing all states and territories were invited to complete an online survey where they answered questions about their NSE (perceived social cohesion, social interaction, sense of community, social norms and neighbourhood crime) and proxy-reported their child’s usual physical activity and screen time (minutes/day). Two hierarchical linear regressions were run separately to assess relationships between NSE predictor variables and physical activity and screen time. Three logistic regressions were run to determine associations between NSE constructs and the likelihood of meeting: 1) physical activity (≥ 180 min/day including ≥ 60 min of moderate-to-vigorous-intensity), 2) screen time (≤ 60 min/day) and 3) both physical activity and screen time guidelines. Child age, gender, childcare attendance, and neighbourhood level socioeconomic status (SES) were controlled for in all analyses.

Results
Social interaction was associated with increased daily physical activity (b = 17.76, 95%CI = 0.81, 34.71), decreased daily screen time (b = -12.77, 95%CI = -23.23, -2.23) and improved the likelihood of meeting physical activity (OR = 1.81, 95%CI = 1.20, 2.75) and combined physical activity and screen time guidelines (OR = 1.51, 95%CI = 1.03, 2.21). Higher neighbourhood crime was associated with a lower likelihood of meeting screen time guidelines (OR = 0.47, 95%CI = 0.47, 0.99). Social cohesion, sense of community and social norms were not statistically significant predictors of daily physical activity, screen time or meeting guidelines.

Conclusion
Social interaction showed the most consistent associations with physical activity and screen time. Future research should consider potential mediators of this relationship, including parental facilitation of children’s outdoor time. Improving understanding of the relationship between the NSE and physical activity and screen time in young children can help to guide community-based initiatives striving to optimise behavioural, health and social outcomes.