bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHoosing Active Role Models to INspire Girls (CHARMING): protocol for a cluster randomised feasibility trial of a school-based, community-linked programme to increase physical activity levels in 9–10-year-old girls
Authors: Pell Bethan , Hawkins Jemma , Cannings-John Rebecca , Charles Joanna M. , Hallingberg Britt , Moore Graham , Roberts Joan , van Sluijs Esther , Morgan Kelly 
Published: January 2022

AbstractBackgroundIn the UK, there is evidence that girls’ physical activity tends to decline to a greater extent than boys as they enter adolescence. ‘Role models’ could play a vital role in inspiring girls to become or remain physically active. The CHARMING Programme is a primary school-based community linked role-model programme, co-developed in 2016, with children, parents, schools and wider stakeholders. It involves different types of physical activity delivered for 1-h each week by a community provider and peer role models (e.g. older girls from secondary schools) joining in with the sessions. The programme ultimately aims to increase and sustain physical activity levels among 9–10-year-old girls. This study aims to assess the feasibility and acceptability of the CHARMING Programme and of evaluating it using a randomised trial.MethodsThis study is a feasibility cluster randomised controlled trial, with embedded process evaluation and health economic evaluation. Approximately 90 Year 5 (i.e. 9–10-year-old) girls will be recruited across six primary schools in Mid-South Wales. Participating schools will be allocated to the programme: control on a 2:1 basis; four intervention schools will run the CHARMING Programme and two will continue with usual practice. A survey and accelerometer will be administered at baseline and repeated at 12 months. Interviews and focus groups will be conducted post-intervention delivery. The primary aim is to assess feasibility of a future randomised trial via the recruitment of schools, participants and role models; randomisation; retention; reach; data collection completion rates; programme adherence; and programme fidelity, views on intervention acceptability and programme barriers and facilitators. Secondary aims are to evaluate established physical activity outcome measures for children plus additional health economic outcomes for inclusion in a future full-scale trial.DiscussionThe results of this study will inform decisions on whether and how to proceed to a full-scale evaluation of the effectiveness and cost-effectiveness of the CHARMING Programme to improve or sustain physical activity.Trial registrationClinicalTrials.govISRCTN36223327. Registered March 29, 2021
Korea hypertension fact sheet 2021: analysis of nationwide population-based data with special focus on hypertension in women
Authors: Kim Hyeon Chang , Lee Hokyou , Lee Hyeok-Hee , Seo Eunsun , Kim Eunji , Han Jiyen , Kwon Ja-Young ,   for the Korean Society of Hypertension (KSH)–Hypertension Epidemiology Research Working Group, Kim Hyeon Chang , Ahn Song Vogue , Jee Sun Ha , Park Sungha , Lee Hae-Young , Shin Min Ho , Ihm Sang-Hyun , Lee Seung Won , Lee Hokyou , Park Jong Ku , Suh Il , Lee Tae-Yong 
Published: January 2022

Abstract
Background
The Korean Society of Hypertension has published the Korea Hypertension Fact Sheet 2021 to provide an overview of the magnitude and management status of hypertension and their recent trends.

Methods
The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 1998–2019 Korea National Health and Nutrition Examination Survey and the 2002–2019 National Health Insurance Big Data.

Results
Currently, the population average of systolic/diastolic blood pressure was 119/76 mmHg in Korean adults aged 20 years or older showing little change in the recent decade. It is estimated that 28% of the adult population aged 20 or older (33% of adults aged 30 or older) have hypertension. The estimated number of people with hypertension was 6.30 million for men and 5.77 million for women, and 1.96 million for men and 2.99 million for women among the population aged 65 or older. The number of people diagnosed with hypertension increased from 3.0 million in 2002 to 10.1 million in 2019. During the same period, the number of people using antihypertensive medication increased from 2.5 million to 9.5 million, and the number of people adherent to treatment increased from 0.6 million to 6.9 million. Among antihypertensive prescriptions, 40.6% of the patients received monotherapy, 43.4% received dual therapy, and 16.0% received triple or more therapy. The most commonly prescribed antihypertensive medication was angiotensin receptor blockers (ARB), followed by calcium channel blockers (CCB) and diuretics. In young women, angiotensin-converting enzyme inhibitors (ACEi), ARB and CCB are less frequently prescribed than in men, but 59.5% of hypertensive women aged 20–39 are prescribed ACEi or ARBs. Hypertensive disorders during pregnancy have been increasing over the past 10 years. In 2019, 5.4% of women who gave birth were diagnosed with chronic hypertension and 3.1% with pregnancy-induced hypertension.

Conclusions
To achieve further improvement in management of hypertension, we need to encourage awareness and treatment in young adults. It is required to develop tailored prevention and management strategies that are appropriate for and inclusive of various demographics.
Diabetic retinopathy classification for supervised machine learning algorithms
Authors: Nakayama Luis Filipe , Ribeiro Lucas Zago , Gonçalves Mariana Batista , Ferraz Daniel A. , dos Santos Helen Nazareth Veloso , Malerbi Fernando Korn , Morales Paulo Henrique , Maia Mauricio , Regatieri Caio Vinicius Saito , Mattos Rubens Belfort 
Published: January 2022

Abstract
Background
Artificial intelligence and automated technology were first reported more than 70 years ago and nowadays provide unprecedented diagnostic accuracy, screening capacity, risk stratification, and workflow optimization.
Diabetic retinopathy is an important cause of preventable blindness worldwide, and artificial intelligence technology provides precocious diagnosis, monitoring, and guide treatment. High-quality exams are fundamental in supervised artificial intelligence algorithms, but the lack of ground truth standards in retinal exams datasets is a problem.

Main body
In this article, ETDRS, NHS, ICDR, SDGS diabetic retinopathy grading, and manual annotation are described and compared in publicly available datasets. The various DR labeling systems generate a fundamental problem for AI datasets. Possible solutions are standardization of DR classification and direct retinal-finding identifications.

Conclusion
Reliable labeling methods also need to be considered in datasets with more trustworthy labeling.
Socio-biomedical predictors of child nutrition in India: an ecological analysis from a nationally representative Demographic and Health Survey, 2015–2016
Authors: Prusty Ranjan Kumar , Bairwa Mohan , Anwar Fahmina , Mishra Vijay Kumar , Patel Kamalesh Kumar , Mangal Daya Krishan 
Published: January 2022

Abstract
Background
Despite significant economic growth and development, undernutrition among children remains a major public health challenge for low- and middle-income countries in the twenty-first century. In Millennium Development Goals, India committed halving the prevalence of underweight children by 2015. This study aimed to explain the geographical variation in child malnutrition level and understand the socio-biomedical predictors of child nutrition in India.

Methods
We used the data from India’s National Family Health Survey 2015–2016. The survey provided estimates of stunting, wasting, and underweight at the national, state, and district level to measure nutritional status of under-five children. Level of stunting, wasting and underweight at the district level are considered as outcome variables. We have used variance inflation factor to check the multicollinearity between potential predictors of nutrition. In this study, we performed spatial analysis using ArcGIS and multiple linear regression analysis using Stata version 15.

Results
Five states (Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and Meghalaya) had very high prevalence of stunting (40% and above). High prevalence of wasting was documented in Jharkhand, Madhya Pradesh, Chhattisgarh, and Karnataka (23 to 29%). Jharkhand, Madhya Pradesh, Maharashtra, and Chhattisgarh had the highest proportion of underweight children in the country. We found that electricity and clean fuel use in the household, use of iodized salt, and level of exclusive breastfeeding had significantly negative influence on the stunting level in the districts. The use of iodized salt has similar effect on the wasting status of under-five children in the districts (b: − 0.27, p < 0.10). Further, underweight level had a negative association with clean fuel use for cooking (b: − 0.17, p < 0.01), use of iodized salt (b: − 0.36, p < 0.10), breastfeeding within one hour (b: − 0.18, p < 0.10), semisolid/solid food within 6–8 months (b: − 0.11, p < 0.05) and Gross Domestic Product of the districts (b: − 0.53, p < 0.10).

Conclusion
In the study, a variety of factors including electricity and clean fuel use in the household, use of iodized salt, level of exclusive breastfeeding, breastfeeding within one hour, semisolid/solid food within 6–8 months and Gross Domestic Product of the districts have a significant association with nutritional status of children.
Helicobacter pylori cagA status and gastric mucosa-associated lymphoid tissue lymphoma: a systematic review and meta-analysis
Authors: Keikha Masoud , Sahebkar Amirhossein , Yamaoka Yoshio , Karbalaei Mohsen 
Published: January 2022

Abstract
Background
Recent studies have investigated the role of Helicobacter pylori infection in the development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. It is estimated that approximately 0.1% of people infected with H. pylori develop gastric MALT lymphoma. However, the role of the CagA antigen, the highest causative agent of H. pylori, in increasing the risk of gastric MALT lymphoma remains unclear and controversial. A systematic review and meta-analysis were conducted to evaluate the effect of cagA status on the development of gastric MALT lymphoma.

Methods
All articles evaluating the status of the cagA gene in the development of gastric MALT lymphoma were collected using systematic searches in online databases, including PubMed, Scopus, Embase, and Google Scholar, regardless of publication date. The association between cagA and gastric MALT lymphoma was assessed using the odds ratio (OR) summary. In addition, a random-effects model was used in cases with significant heterogeneity.

Results
A total of 10 studies met our inclusion criteria, among which 1860 patients participated. No association between cagA status and the development of MALT lymphoma (extranodal marginal zone B-cell lymphoma) was found in this study (OR 1.30; 0.906–1.866 with 95% CIs; I2: 45.83; Q-value: 12.92). Surprisingly, a meaningful association was observed between cagA status and diffuse large B-cell lymphoma (OR 6.43; 2.45–16.84 with 95% CIs). We also observed an inverse association between vacA and gastric MALT lymphoma risk (OR 0.92; 0.57–1.50 with 95% CIs).

Conclusions
It seems that the infection with cagA-positive H. pylori strains does not have a meaningful effect on the gastric MALT lymphoma formation, while translocated CagA antigen into the B cells plays a crucial role in the development of diffuse large B-cell lymphoma.
South African and international legislature with relevance to the application of electronic documentation in medicolegal autopsies for practice and research purposes
Authors: Prahladh Salona , Van Wyk Jacqueline 
Published: January 2022

Abstract
Background
Forensic and legal medicine requires all documentation to be recorded in a manner that is admissible in court. Issues surrounding privacy, confidentiality, and security mar the implementation of electronic document systems in medicine. Awareness of current legislature governing record keeping and electronic documentation especially in modern medicine and forensic medicine has not been sufficiently explored. This study explored the current South African and international laws that govern admissibility of evidence, especially relating to electronic evidence, for use in court and research,

Findings
Egypt, UK, Canada and the USA have similar legislation to South Africa regarding admissibility of electronic records. The South African Electronic Communications and Transactions Act no. 25 of 2002 defines data and the Criminal Procedure Act 51 of 1977 further defines the admissibility of evidence in court and the National Health Act regulates publication of deceased information after death.

Conclusions
Forensic medicine requires all documentation to be admissible in court and the storage of data thus requires proper custodianship and a high level of security, which can be achieved with modern technology. Modern medicine is evolving and technology can create secure and efficient methods of record keeping which will benefit forensic and legal medicine. Knowledge of the laws regarding admissibility of evidence can assist in creating electronic evidence that is permitted in court and can be used for research.
Management of Pancreatico-duodenal arterio-venous malformation
Authors: Marcelin Clement , Park Auh Whan , Gilbert Patrick , Bouchard Louis , Therasse Eric , Perreault Pierre , Giroux Marie France , Soulez Gilles 
Published: January 2022

Abstract
Purpose
To describe the interventional management and clinical outcome of pancreatico-duodenal arterio-venous malformations (PDAVMs).

Material and Methods
Seven patients presenting a PDAVM (6 women, 1 male; mean age: 61) were retrospectively reviewed. Technical, clinical success and complications of embolization and surgical management of symptomatic PDAVMs were assessed. Technical success was defined as a complete occlusion of the PDAVM and clinical success as no clinical symptom or recurrence during follow-up. Patients with asymptomatic PDAVMs were followed clinically, by Doppler ultrasound and CT-angiography.

Results
Mean follow-up time was 69 months (15-180). Five symptomatic patients presented with upper gastrointestinal bleeding (n=3), ascites (n=1), and abdominal pain (n=1). Two patients were asymptomatic. The PDAVMs were classified as follow: Yakes I (1), IIIa (2), IIIb (3) and IV (1). Five symptomatic patients were treated with 9 embolization sessions with arterial approach (onyx®, glue, coils) in 7 and venous approach in 2 (plugs, coils, covered stents, STS foam and onyx®). Technical success of embolization was 60% (3/5). Devascularization was incomplete for 2 Yakes IIIB patients. Clinical success of embolization was estimated at 80% (4/5) as one patient required additional surgery (Whipple) because of persistent bleeding. One splenic vein thrombosis was treated successfully by mechanical thrombectomy and heparin. No recurrence occurred during follow-up. No progression was documented in asymptomatic patients.

Conclusion
Embolization of symptomatic PDAVMs is effective and surgery should be performed in second intention. Complete devascularization is more difficult to obtain in Yakes III PDAVM.
Performance of distinct microbial based solutions in a Campylobacter infection challenge model in poultry
Authors: Ty Maxine , Taha-Abdelaziz Khaled , Demey Vanessa , Castex Mathieu , Sharif Shayan , Parkinson John 
Published: January 2022

Abstract
Background
Antibiotic growth promoters (AGPs) are commonly used within poultry production to improve feed conversion, bird growth, and reduce morbidity and mortality from clinical and subclinical diseases. Due to the association between AGP usage and rising antimicrobial resistance, the industry has explored new strategies including the use of probiotics and other microbial-based interventions to promote the development of a healthy microbiome in birds and mitigate against infections associated with food safety and food security. While previous studies have largely focused on the ability of probiotics to protect against Clostridium perfringens and Salmonella enterica, much less is known concerning their impact on Campylobacter jejuni, a near commensal of the chicken gut microbiome that nevertheless is a major cause of food poisoning in humans.

Results
Here we compare the efficacy of four microbial interventions (two single strain probiotics, the bacterium—Pediococcus acidilactici, and the yeast—Saccharomyces cerevisiae boulardii; and two complex, competitive exclusion, consortia—Aviguard and CEL) to bacitracin, a commonly used AGP, to modulate chicken gut microbiota and subsequently impact C. jejuni infection in poultry. Cecal samples were harvested at 30- and 39-days post hatch to assess Campylobacter burden and examine their impact on the gut microbiota. While the different treatments did not significantly decrease C. jejuni burden relative to the untreated controls, both complex consortia resulted in significant decreases relative to treatment with bacitracin. Analysis of 16S rDNA profiles revealed a distinct microbial signature associated with each microbial intervention. For example, treatment with Aviguard and CEL increased the relative abundance of Bacteroidaceae and Rikenellaceae respectively. Furthermore, Aviguard promoted a less complex microbial community compared to other treatments.

Conclusions
Depending upon the individual needs of the producer, our results illustrate the potential of each microbial interventions to serve flock-specific requirements.
Increased psychological distress after the lifting of COVID-19 lockdown in the Saudi population: a cross-sectional study
Authors: Alharbi Hatim Yousef , Alharthi Sami S. , Alzahrani Ahmed S. , Dakhel Mohammed Khalid A. , Alawaji Ziyad Hussain 
Published: January 2022

Abstract
Background
Amid the ongoing COVID-19 pandemic and its global health and socioeconomic aftereffects, the enduring state of crisis is increasingly impacting the coping capacity of the populations. In this study, we aimed to characterize the levels of psychological distress after the lifting of COVID-19 lockdown.

Results
The Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scales-21 items (DASS-21) were used to screen for post-traumatic stress syndrome (PTSD), depression, anxiety, and stress. The prevalence of PTSD was 41.6% and was associated with severe or extremely severe stress (27.8%), anxiety (31.4%), and depression (39.0%). All disorders were strongly correlated with one another. The risk of developing PTSD was independently associated with residence in high COVID-19 prevalence region (OR = 2.25, p = 0.004), poor (OR = 3.98, p = 0.002), or moderate (OR = 1.63, p = 0.048) self-assessed overall physical health, psychiatric comorbidity (OR = 1.87, p = 0.036), number of COVID-19-like symptoms (OR = 1.94, p = 0.039), and severe COVID-19 morbidity in the acquaintances (OR = 1.54, p = 0.026). Four theories were proposed to explain these high figures, with a discussion of their practical implications.

Conclusions
The lifting of lockdown measures was associated with a substantial increase in psychological distress among the Saudi population, referring to figures reported during the lockdown. This may indicate a decline in the overall population’s coping capacity with the enduring crisis.
Early outcomes of aortic valve repair versus replacement for aortic regurgitation: a single-center experience
Authors: Amr Mohamed A. , Fayad Elsayed 
Published: January 2022

Abstract
Background
Aortic valve repair in rheumatic patients is not well-studied. We aimed to present our initial Egyptian experience in the aortic valve repair and compare it with the aortic valve replacement. The study included 85 patients who had an aortic valve surgery for aortic regurgitation (AR) in a single center from 2018 to 2020. We assigned the patients to either aortic valve repair (n= 39) or aortic valve replacement (n= 46). Fifty-nine patients (69.4%) had rheumatic heart disease. Study outcomes were hospital complications and the degree of aortic regurgitation after 6 months in patients who had aortic valve repair.

Results
Patients who had replacement were significantly older (49.6± 7.2 vs. 43.8± 8.6 years: P= 0.002) and had more advanced New York Heart Association (P<0.001) and Canadian Cardiovascular Scoring (P= 0.03) classes. Hypertension (31 (67.4%) vs. 17 (43.6%); P= 0.03) and hypercholesteremia (18 (40%) vs. 17 (18.9%); P= 0.04) were more common in the replacement group. Patients who had replacement had a significantly higher percentage of valve retraction (P<0.001). Cardiopulmonary bypass (54.5 (49.5–60) vs. 45 (41–49) min; P<0.001) and ischemic times (36.5 (31–40) vs. 30 (28–33) min; P<0.001) were longer in patients who had an aortic valve replacement. Blood transfusion (28 (60.9%) vs. 11 (282%); P= 0.003) and ICU stay (24.5 (24–48) vs 23 (20–31) h; P= 0.01) were higher in the replacement group. Hospital mortality was non-significantly different between groups. Four patients had trivial AR (10.3%), and six had mild AR (15.4%) in the repair group. There was no difference in valve pathology or outcomes in aortic valve repair patients for degenerative versus rheumatic pathologies. After a 6-month follow-up, four patients had trivial AR (10.3%), and six patients had mild AR (15.4%) in the repair group.

Conclusions
Aortic valve repair could be an alternative to replacement in selected patients with rheumatic heart disease. Shorter cardiopulmonary bypass and ischemic times may improve repair outcomes compared to replacement.
Predictors of perioperative myocardial infarction in patients undergoing off-pump coronary artery bypass grafting
Authors: Amr Mohamed A. , Fayad Elsayed 
Published: January 2022

Abstract
Background
Perioperative myocardial infarction (PMI) increases morbidity and mortality after off-pump coronary artery bypass grafting (CABG). The objective of the current study was to characterize patients with PMI after off-pump CABG and identify its predictors.

Results
We included 1181 patients who had off-pump CABG from 2010 to 2020; 59 patients (5%) had PMI. We compared patients with PMI to those without PMI. Patients with PMI were older (57 (25th–75th percentiles: 51–63) vs. 54 (48–60) years; P = 0.01) and had higher NYHA class (28 (47.46%) vs. 326 (29.06%): P = 0.01). The distal anastomosis time was longer in patients with PMI (28 (23–35) vs. 24 (16–30) min; P ˂ 0.001). Patients with PMI had higher postoperative low cardiac output (10 (18.18%) vs. 1 (0.1%): P ˂ 0.001), prolonged ventilation (12 (8–39) vs. 8 (6–10) h, P ˂ 0.001), ICU (71 (46–138) vs. 24 (23–42) h; P ˂ 0.001), and hospital stay (9 (6–15) vs. 7 (6–8) days; P ˂ 0.001). Mortality was significantly higher in patients with PMI (20 (33.9%) vs. 6 (0.53%); P ˂ 0.001). Older age (OR: 1.05 (95% CI: 1.01–1.1); P = 0.02), increased number of distal anastomoses (OR: 1.74 (95% CI: 1.20–2.50); P = 0.003), preoperative congestive heart failure (OR: 10.27 (95% CI: 2.58–40.95); P = 0.001), and thrombolysis within 24 h of surgery (OR: 15.34 (1.93–121.9); P = 0.01) were associated with increased PMI, while PMI was lower in male patients (OR: 0.42 (95% CI: 0.19–0.93); P = 0.03) and with higher body surface area (BSA) (OR: 0.08 (95% CI: 0.07–0.86); P = 0.04).

Conclusions
Post-off-pump CABG PMI was associated with increased morbidity and mortality. Risk factors for PMI were older age, lower BSA, females, increased distal anastomoses, preoperative heart failure, and thrombolysis.