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Utility of different cardiovascular disease prediction models in rheumatoid arthritis.	25713628	Rheumatoid arthritis comes with a 30% higher probability for cardiovascular disease than the general population. Current guidelines advocate for early and aggressive primary prevention and treatment of risk factors in high-risk populations but this excess risk is under-addressed in RA in real life. This is mainly due to difficulties met in the correct risk evaluation. This study aims to underline the differences in results of the main cardiovascular risk screening models in the real life rheumatoid arthritis population.	BACKGROUND	In a cross-sectional study, patients addressed to a tertiary care center in Romania for an biannual follow-up of rheumatoid arthritis and the ones who were considered free of any cardiovascular disease were assessed for subclinical atherosclerosis. Clinical, biological and carotidal ultrasound evaluations were performed. A number of cardiovascular disease prediction scores were performed and differences between tests were noted in regard to subclinical atherosclerosis as defined by the existence of carotid intima media thickness over 0,9 mm or carotid plaque.	METHODS	In a population of 29 Romanian rheumatoid arthritis patients free of cardiovascular disease, the performance of Framingham Risk Score, HeartSCORE, ARIC cardiovascular disease prediction score, Reynolds Risk Score, PROCAM risk score and Qrisk2 score were compared. All the scores under-diagnosed subclinical atherosclerosis. With an AUROC of 0,792, the SCORE model was the only one that could partially stratify patients in low, intermediate and high-risk categories. The use of the EULAR recommended modifier did not help to reclassify patients.	RESULTS	The only score that showed a statistically significant prediction capacity for subclinical atherosclerosis in a Romanian rheumatoid arthritis population was SCORE. The additional calibration or the use of imaging techniques in CVD risk prediction for the intermediate risk category might be warranted.	CONCLUSION	[ "Area Under Curve", "Arthritis, Rheumatoid", "Cardiovascular Diseases", "Carotid Intima-Media Thickness", "Female", "Humans", "Male", "Middle Aged", "Models, Biological", "ROC Curve", "Reference Standards", "Risk Factors" ]	4316145	null	null	Methods	A cross sectional study conducted on over 6 months, between June 2008 and January 2009 in the Rheumatology Department of “Dr. I. Cantacuzino” Hospital and the Neurology Department of the Emergency University Hospital, both affiliated to “Carol Davila” University of Medicine and Pharmacy, Bucharest. The study represents the initial cross-sectional phase of a longitudinal project and was approved by the Ethical Committees of both hospitals and “Carol Davila” University of Medicine and Pharmacy, Bucharest. An informed consent was obtained from all the subjects enrolled in the study. Patient population: A number of consecutive RA patients free of previous cardiovascular disease who were addressed for their bi-annual evaluation were enrolled in the Rheumatology clinic. Laboratory tests: Serum levels of total cholesterol, triglycerides, HDL cholesterol and creatinine were measured by enzymatic methods adapted to an auto-analyzer (Cormay Accent 300). Renal function was estimated with the MDRD formula. Lipid categories are defined by the ATP III / ESC guidelines [14]. Ultrasound measurements (US): CIMT was measured by using the CIMT imaging protocol [15] with the patient supine by the same trained assessor. It represented the mean of 3 bilateral measurement values of the intima-media thickness of the near and far common carotid artery wall. The measurement was performed at 1 centimeter before the carotid bifurcation. IMT represents the cumulated thickness of the intima (echogenic) and media (echolucent). Plaque is defined as a luminal protruding focal structure of at least 0.5 mm or 50% of the surrounding IMT value or a thickening of more than 1,5 mm of the carotid artery, in conformity with the Mannheim consensus [16] at any focal location in the extra cranial carotid arteries. Measurements were realized with a 7.5 MHz Linear probe (Siemens Sonoline). Gold standard: subclinical atherosclerosis as defined by a mean cIMT greater than 0,9mm or the existence of focal plaque [15,17,18]. Predictive scores: Framingham risk score (FRS) and EULAR modified FRS (mFRS [2]), HearSCORE (SCORE) and EULAR modified SCORE (mSCORE [2]), Qrisk2 score (Qrisk2), PROCAM score (PROCAM), ARIC score (ARIC) were calculated with the official tools provided by the authors. When age limits were crossed, the actual age was substituted with the minimal/ maximal ages accepted by the official tool. Statistical analysis: Data was verified for normality with the Shapiro test and treated accordingly and was presented as median (range) or mean (IC95). Statistical significant variance between groups was calculated with the Mann-Whitney U. The strength of correlation with the primary outcome was assessed by using the Spearman’s Rho correlation coefficient and the chi square test was used to estimate the likelihood ratios. An agreement between the effective score results was assessed with the intra class coefficient (ICC). ICC values over .6 were considered statistically significant, values over .8 were considered good and over .9 were considered excellent. Goodman–Kruskal γ test was used to measure the strength of association at the ordinal levels. The statistical analysis was performed by using SPSS for Windows release 22, Chicago, Illinois, and p<.05 was considered significant.	null	null	null	null	[ "Objectives" ]	[ "To evaluate the advantages, limits and differences of several models for CVD risk assessment in Romanian rheumatoid arthritis population, free of cardiovascular disease." ]	[ null ]	[ "Introduction", "Objectives", "Methods", "Results", "Discussion", "Conclusion" ]	[ "Cardiovascular disease (CVD) is responsible for a 30%-50% mortality excess in rheumatoid arthritis (RA) patients [1]. Similar to the general population, intensified measures to control the risk factor are recommended in high-risk patients [2,3]. This relies on an accurate capacity to predict this CVD risk which itself reposes on the use of the two guideline-recommended [2] clinical scores. These recommendations are based on data with a low level of evidence and their impact in real life is not yet well known.\nSCORE [4] is the first of the two models recommended both by the European Cardiology Society [5] (ESC) and The European League against Rheumatism [2] (EULAR) for the estimation of the 10 year CVD mortality in the general population and rheumatoid arthritis. It is derived from pooled European cohorts and modifiers apply to the geographical diversity. In order to comply with the proven excess mortality in RA, EULAR advocates for the use of a multiplier adapted to the disease’s specific conditions resulting in a new SCORE: the mSCORE. SCORE BMI is an office-based tool derived from the same model, which replaces the lipid profile with the more office-friendly body mass index (BMI). The second score recommended by EULAR is the Framingham risk score (FRS) [6], using the same multiplier for RA patients. It is the best-known CVD prediction model and it derives from an US cohort, FRS. It is not specifically customized for the European populations and it measures both fatal and nonfatal CVD events. Several other risk scores are available: PROCAM [7] is derived from a German cohort and it is tested as CVD risk prediction. QRisk2 [8] and its office based alternative (QRisk2 - BMI) are models designed in UK as a multi-ethnic tool for the 10y prediction of the CVD events. It has the particularity to include RA as an independent risk factor and to adapt to social deprivation as another risk factor. The Reynolds Risk Score (RRS) [9] is derived from an US cohort by a team of pioneers of the inflammatory hypothesis in atherosclerosis and uses hs CRP as a risk factor. The ARIC model is based on another US cohort and it is based on the same traditional risk factors. It has a variant using the carotid intima media thickness as a variable [10]. The ARIC, PROCAM, Qrisk, RRS and FRS were not calibrated for a wider European population.\nSubclinical atherosclerosis, a predictor of CVD events, can be assessed with ultrasound techniques. Carotid intima media thickness (cIMT) is widely used as an independent surrogate marker of subclinical atherosclerosis and cardiovascular events [11,12] and in RA it seems to have an advantage over the other imaging techniques [13].", "To evaluate the advantages, limits and differences of several models for CVD risk assessment in Romanian rheumatoid arthritis population, free of cardiovascular disease.", "A cross sectional study conducted on over 6 months, between June 2008 and January 2009 in the Rheumatology Department of “Dr. I. Cantacuzino” Hospital and the Neurology Department of the Emergency University Hospital, both affiliated to “Carol Davila” University of Medicine and Pharmacy, Bucharest. The study represents the initial cross-sectional phase of a longitudinal project and was approved by the Ethical Committees of both hospitals and “Carol Davila” University of Medicine and Pharmacy, Bucharest. An informed consent was obtained from all the subjects enrolled in the study.\nPatient population: A number of consecutive RA patients free of previous cardiovascular disease who were addressed for their bi-annual evaluation were enrolled in the Rheumatology clinic.\nLaboratory tests: Serum levels of total cholesterol, triglycerides, HDL cholesterol and creatinine were measured by enzymatic methods adapted to an auto-analyzer (Cormay Accent 300). Renal function was estimated with the MDRD formula. Lipid categories are defined by the ATP III / ESC guidelines [14].\nUltrasound measurements (US): CIMT was measured by using the CIMT imaging protocol [15] with the patient supine by the same trained assessor. It represented the mean of 3 bilateral measurement values of the intima-media thickness of the near and far common carotid artery wall. The measurement was performed at 1 centimeter before the carotid bifurcation. IMT represents the cumulated thickness of the intima (echogenic) and media (echolucent). Plaque is defined as a luminal protruding focal structure of at least 0.5 mm or 50% of the surrounding IMT value or a thickening of more than 1,5 mm of the carotid artery, in conformity with the Mannheim consensus [16] at any focal location in the extra cranial carotid arteries. Measurements were realized with a 7.5 MHz Linear probe (Siemens Sonoline).\nGold standard: subclinical atherosclerosis as defined by a mean cIMT greater than 0,9mm or the existence of focal plaque [15,17,18].\nPredictive scores: Framingham risk score (FRS) and EULAR modified FRS (mFRS [2]), HearSCORE (SCORE) and EULAR modified SCORE (mSCORE [2]), Qrisk2 score (Qrisk2), PROCAM score (PROCAM), ARIC score (ARIC) were calculated with the official tools provided by the authors. When age limits were crossed, the actual age was substituted with the minimal/ maximal ages accepted by the official tool.\nStatistical analysis: Data was verified for normality with the Shapiro test and treated accordingly and was presented as median (range) or mean (IC95). Statistical significant variance between groups was calculated with the Mann-Whitney U. The strength of correlation with the primary outcome was assessed by using the Spearman’s Rho correlation coefficient and the chi square test was used to estimate the likelihood ratios. An agreement between the effective score results was assessed with the intra class coefficient (ICC). ICC values over .6 were considered statistically significant, values over .8 were considered good and over .9 were considered excellent. Goodman–Kruskal γ test was used to measure the strength of association at the ordinal levels. The statistical analysis was performed by using SPSS for Windows release 22, Chicago, Illinois, and p<.05 was considered significant.", "\nMain characteristics of the population:\n\n29 rheumatoid arthritis patients with a mean age of 54.9 (in 2009) were included. They were mainly women (28/29). The mean disease duration was of 10,5 years (1-35) and the disease activity (DAS28- VS) was 5,12 (1,86-6,54). They were all treated with DMARDs (29/29) either alone or in combinations and 5 (17%) received a biological TNF blocker. Methotrexate was used in 26 patients (90%) alone or in association. Glucocorticoids were used at the moment of the census in 7 (24%) out of 29 patients and NSAID, which was used more than occasional, was reported in 9 patients (31%). Extra-articular disease was present in 3 patients (10%). The mean cardiovascular CVD risk factors prevalence was of 2,48 (0-5). One patient smoked. 4 (14%) had a relevant CVD family history. Obesity was present in 9 (31%) patients with a mean BMI of 27.2. High LDL cholesterol was present in 14 patients (48%). The total cholesterol was M= 200mg/dl (136-2981) with an HDL cholesterol of M= 52 mg/dl (25-98). Diabetes was present in 15 patients (51%), hypertension in 11 patients (38%) and chronic kidney disease in 4 patients (14%). Except for ESR, there were no statistically significant differences between the patients with subclinical atherosclerosis and those without.\nAdditional data are presented in Table 1.\nCharacteristics of the population\n\nIMT measurement results\n\nSubclinical atherosclerosis was diagnosed by using the ultrasound carotid evaluation in 12 patients (41,4). Of these, focal plaque was present in 9 (31%) of the 29 patients and a mean cIMT ≥ 0,9mm was found in 7 patients (24%).\n\nClinical scores overall results\n\nCardiovascular disease risk classes were calculated by using 11 prediction models. Of those, 8 were mixed clinical and laboratory models and 3 were office based models substituting the lipid profile with the BMI. The main results are available in Table 2, 3 and 4.\nOverall CVD risk score results\nCrosstab risk classification between the gold standard and the predictive models\nThe overall agreement single models was ICC of 0,504 (0,366-0,665 IC 95%), p<.001 but with the average ICC measures of 0,913 (0,852 - 0,952 IC 95%), p<.001. In the risk categories depicted in Table 3 in concordance with the risk model specific classes (low, intermediary, high) Goodman–Kruskal γ test was used to measure the strength of association with the gold standard risk categories for each individual test. Out of the 9 tests, only two reached statistically significant strength (SCORE γ: 0,778, p=.005 and mSCORE γ:0,778, p=.005). Applying the m modifier led to no change in the classification in either of the risk categories.\nThe AUROCs for the prediction of subclinical atherosclerosis of each of the models are depicted in Table 4 and showed wide variations in prediction capacity. The lowest ranking was ARIC, FRS, modified FRS, PROCAM, RRS, QRisk2 BMI with AUROCs inferior to.7. Three other will reach the .7 AUROC but will not reach the statistical significance (SCORE-BMI, mSCORE-BMI and Qrisk2). Only two scores reached the statistical significance: mSCORE (AUROC 0.775, IC95% 0,602-947, p=013) and SCORE (AUROC 0.792, IC95% 0,627-956, p=.008).\nAUROC for subclinical atherosclerosis", "Predicting cardiovascular risk in rheumatoid arthritis proved to be a difficult task for the tested models. If the overall agreement between scores was good, most of the models tested in our study were not able to predict subclinical atherosclerosis as defined by the gold standard. Rheumatoid arthritis cardiovascular risk was higher than in the general population but also the risk profiles differed [19,20] and this was able to justify our findings. In our population RA was incompletely controlled by the ongoing treatment (high overall DAS 28) and inflammation was prevalent. ESR was found to be significantly higher in those patients with subclinical atherosclerosis at ultrasound. This was consistent with findings from previous studies where ESR was associated with a fourfold increase in CDV risk [21]. Also, the low total cholesterol and HDL cholesterol characterizing active RA (and other inflammatory profiles) would probably interfere with the results [22]. The presence of the rheumatoid factor also proved to increase the CVD risk by a twofold in a previous study where its prevalence was of 68% [19]. In our population, RF was present in 93.3% of the patients. The other particularities of this specific population were a high glucocorticoid and NSAID exposure. Methotrexate was inversely correlated with subclinical atherosclerosis, with a protective role in our study, consistent with the previous findings [23]. What was also noted was a prevalence of diabetes [24] higher than expected, a prevalence of smoking [25] lower than expected, but also a chronic kidney disease. A higher weight (and BMI), even if more prevalent in RA denoted a lower disease burden [26,27]. Our patients were discretely overweight but less than expected in RA [27,28]. These multiple interferences could explain the difficulties encountered by all the models tested in actually predicting subclinical atherosclerosis.\nThe only score reaching statistical significant prediction capacity in our RA population was the European SCORE model. SCORE well defined the low risk category with none of the patients classified in the low risk (below 1%), having either a plaque or a high IMT, but the overall SCORE underestimated the ultrasound predicated atherosclerosis risk. Only one patient reached the high-risk class out of the 12 classified as having subclinical atherosclerosis by ultrasound measurements. In fact, most of the patients found themselves in the intermediate risk class (20 out of 29). Interestingly, applying the EULAR modifier did not lead to any reclassification. It should be noted that the SCORE model used in our study follows the ESC recommendation and it is in conformity with the estimated risk in the Romanian general population.\nAll the office based (BMI) models were outperformed by their lipid based counterparts. This could be explained by the RA specific weight profile and also by a general loss of specificity by the surrogate marker (BMI for lipids). They failed to clearly identify either a low or high-risk populations. In the specific case of mSCORE-BMI, even though it had a lower AUC than its counterpart, the office-based model was a better predictor than all the other lipid- based models discussed.\nEven though FRS is a consecrated risk prediction model, it only had a modest prediction capacity, even when the EULAR modifier was applied (mFRS). The other 2 models derived from the United States cohorts (ARIC, Reynolds) had similar results. When compared to SCORE, the three underestimated CVD risks, fail to clearly identify a low or high-risk category. PROCAM, the German derived model, also failed to do so. These results were also partially consistent with a recently published longitudinal study (Arts et al.) performed on a Netherlands rheumatoid arthritis population comparing SCORE, Reynolds FRS and Qrisk2 [29]. Failure to identify the high-risk category was also consistent with the Spanish cross-sectional study by Gómez-Vaquero et al., where even in a low-risk general population and by using scores specifically calibrated (REGICORE is the Spanish-calibrated variant of FRS and SCORE followed both ESC and EULAR recommendations), the high-risk population was under identified [30].\nQrisk2 is a model derived in UK that takes into consideration two possibly interesting aspects. It is calibrated from baseline to include RA as a risk factor among the other co morbidities like CKD, diabetes and hypertension and takes into account the local socioeconomically factor. In our population, Qrisk2 and Qrisk2 BMI underestimated risk and failed to identify a low-risk category. This result contravenes with the above mentioned study by Arts et al. where Qrisk2 overestimated overall CVD risk [29]. In our case, the specific genetic and socio-economical differences with the derivation population could explain some of the lack of specificity and sensitivity.\nOur study had several limitations. It was a cross-sectional, small sample size study with the inherent limitations. The surrogate gold standard, even though validated and accepted does not imply a 100% specificity and sensitivity. The tertiary care recruitment site could explain a higher overall RA disease burden in our population. The “cardiovascular disease free” criteria might induce a selection bias especially in patients with longstanding RA. If generalized, the results of our study could only be used to characterize a Romanian population of RA, with the specific socio-economical and genetic background.", "Subclinical atherosclerosis and general cardiovascular risk prediction in rheumatoid arthritis by the available model are insufficient. The only model that provided usable information in a Romanian RA population was the SCORE model. Recalibration is needed. As recommended in the general population, the use of imaging diagnostic techniques in the intermediate risk population might ameliorate performance.\n\nAcknowledgments\n\nFunding: This work was funded by a grant of the Romanian Medical Academy, CEEX116/2006." ]	[ "Introduction", null, "methods", "Results", "Discussion", "Conclusion" ]	[ "cardiovascular disease prediction models", "rheumatoid arthritis", "risk assessment", "SCORE", "SCORE", "carotid intima media" ]	Introduction: Cardiovascular disease (CVD) is responsible for a 30%-50% mortality excess in rheumatoid arthritis (RA) patients [1]. Similar to the general population, intensified measures to control the risk factor are recommended in high-risk patients [2,3]. This relies on an accurate capacity to predict this CVD risk which itself reposes on the use of the two guideline-recommended [2] clinical scores. These recommendations are based on data with a low level of evidence and their impact in real life is not yet well known. SCORE [4] is the first of the two models recommended both by the European Cardiology Society [5] (ESC) and The European League against Rheumatism [2] (EULAR) for the estimation of the 10 year CVD mortality in the general population and rheumatoid arthritis. It is derived from pooled European cohorts and modifiers apply to the geographical diversity. In order to comply with the proven excess mortality in RA, EULAR advocates for the use of a multiplier adapted to the disease’s specific conditions resulting in a new SCORE: the mSCORE. SCORE BMI is an office-based tool derived from the same model, which replaces the lipid profile with the more office-friendly body mass index (BMI). The second score recommended by EULAR is the Framingham risk score (FRS) [6], using the same multiplier for RA patients. It is the best-known CVD prediction model and it derives from an US cohort, FRS. It is not specifically customized for the European populations and it measures both fatal and nonfatal CVD events. Several other risk scores are available: PROCAM [7] is derived from a German cohort and it is tested as CVD risk prediction. QRisk2 [8] and its office based alternative (QRisk2 - BMI) are models designed in UK as a multi-ethnic tool for the 10y prediction of the CVD events. It has the particularity to include RA as an independent risk factor and to adapt to social deprivation as another risk factor. The Reynolds Risk Score (RRS) [9] is derived from an US cohort by a team of pioneers of the inflammatory hypothesis in atherosclerosis and uses hs CRP as a risk factor. The ARIC model is based on another US cohort and it is based on the same traditional risk factors. It has a variant using the carotid intima media thickness as a variable [10]. The ARIC, PROCAM, Qrisk, RRS and FRS were not calibrated for a wider European population. Subclinical atherosclerosis, a predictor of CVD events, can be assessed with ultrasound techniques. Carotid intima media thickness (cIMT) is widely used as an independent surrogate marker of subclinical atherosclerosis and cardiovascular events [11,12] and in RA it seems to have an advantage over the other imaging techniques [13]. Objectives: To evaluate the advantages, limits and differences of several models for CVD risk assessment in Romanian rheumatoid arthritis population, free of cardiovascular disease. Methods: A cross sectional study conducted on over 6 months, between June 2008 and January 2009 in the Rheumatology Department of “Dr. I. Cantacuzino” Hospital and the Neurology Department of the Emergency University Hospital, both affiliated to “Carol Davila” University of Medicine and Pharmacy, Bucharest. The study represents the initial cross-sectional phase of a longitudinal project and was approved by the Ethical Committees of both hospitals and “Carol Davila” University of Medicine and Pharmacy, Bucharest. An informed consent was obtained from all the subjects enrolled in the study. Patient population: A number of consecutive RA patients free of previous cardiovascular disease who were addressed for their bi-annual evaluation were enrolled in the Rheumatology clinic. Laboratory tests: Serum levels of total cholesterol, triglycerides, HDL cholesterol and creatinine were measured by enzymatic methods adapted to an auto-analyzer (Cormay Accent 300). Renal function was estimated with the MDRD formula. Lipid categories are defined by the ATP III / ESC guidelines [14]. Ultrasound measurements (US): CIMT was measured by using the CIMT imaging protocol [15] with the patient supine by the same trained assessor. It represented the mean of 3 bilateral measurement values of the intima-media thickness of the near and far common carotid artery wall. The measurement was performed at 1 centimeter before the carotid bifurcation. IMT represents the cumulated thickness of the intima (echogenic) and media (echolucent). Plaque is defined as a luminal protruding focal structure of at least 0.5 mm or 50% of the surrounding IMT value or a thickening of more than 1,5 mm of the carotid artery, in conformity with the Mannheim consensus [16] at any focal location in the extra cranial carotid arteries. Measurements were realized with a 7.5 MHz Linear probe (Siemens Sonoline). Gold standard: subclinical atherosclerosis as defined by a mean cIMT greater than 0,9mm or the existence of focal plaque [15,17,18]. Predictive scores: Framingham risk score (FRS) and EULAR modified FRS (mFRS [2]), HearSCORE (SCORE) and EULAR modified SCORE (mSCORE [2]), Qrisk2 score (Qrisk2), PROCAM score (PROCAM), ARIC score (ARIC) were calculated with the official tools provided by the authors. When age limits were crossed, the actual age was substituted with the minimal/ maximal ages accepted by the official tool. Statistical analysis: Data was verified for normality with the Shapiro test and treated accordingly and was presented as median (range) or mean (IC95). Statistical significant variance between groups was calculated with the Mann-Whitney U. The strength of correlation with the primary outcome was assessed by using the Spearman’s Rho correlation coefficient and the chi square test was used to estimate the likelihood ratios. An agreement between the effective score results was assessed with the intra class coefficient (ICC). ICC values over .6 were considered statistically significant, values over .8 were considered good and over .9 were considered excellent. Goodman–Kruskal γ test was used to measure the strength of association at the ordinal levels. The statistical analysis was performed by using SPSS for Windows release 22, Chicago, Illinois, and p<.05 was considered significant. Results: Main characteristics of the population: 29 rheumatoid arthritis patients with a mean age of 54.9 (in 2009) were included. They were mainly women (28/29). The mean disease duration was of 10,5 years (1-35) and the disease activity (DAS28- VS) was 5,12 (1,86-6,54). They were all treated with DMARDs (29/29) either alone or in combinations and 5 (17%) received a biological TNF blocker. Methotrexate was used in 26 patients (90%) alone or in association. Glucocorticoids were used at the moment of the census in 7 (24%) out of 29 patients and NSAID, which was used more than occasional, was reported in 9 patients (31%). Extra-articular disease was present in 3 patients (10%). The mean cardiovascular CVD risk factors prevalence was of 2,48 (0-5). One patient smoked. 4 (14%) had a relevant CVD family history. Obesity was present in 9 (31%) patients with a mean BMI of 27.2. High LDL cholesterol was present in 14 patients (48%). The total cholesterol was M= 200mg/dl (136-2981) with an HDL cholesterol of M= 52 mg/dl (25-98). Diabetes was present in 15 patients (51%), hypertension in 11 patients (38%) and chronic kidney disease in 4 patients (14%). Except for ESR, there were no statistically significant differences between the patients with subclinical atherosclerosis and those without. Additional data are presented in Table 1. Characteristics of the population IMT measurement results Subclinical atherosclerosis was diagnosed by using the ultrasound carotid evaluation in 12 patients (41,4). Of these, focal plaque was present in 9 (31%) of the 29 patients and a mean cIMT ≥ 0,9mm was found in 7 patients (24%). Clinical scores overall results Cardiovascular disease risk classes were calculated by using 11 prediction models. Of those, 8 were mixed clinical and laboratory models and 3 were office based models substituting the lipid profile with the BMI. The main results are available in Table 2, 3 and 4. Overall CVD risk score results Crosstab risk classification between the gold standard and the predictive models The overall agreement single models was ICC of 0,504 (0,366-0,665 IC 95%), p<.001 but with the average ICC measures of 0,913 (0,852 - 0,952 IC 95%), p<.001. In the risk categories depicted in Table 3 in concordance with the risk model specific classes (low, intermediary, high) Goodman–Kruskal γ test was used to measure the strength of association with the gold standard risk categories for each individual test. Out of the 9 tests, only two reached statistically significant strength (SCORE γ: 0,778, p=.005 and mSCORE γ:0,778, p=.005). Applying the m modifier led to no change in the classification in either of the risk categories. The AUROCs for the prediction of subclinical atherosclerosis of each of the models are depicted in Table 4 and showed wide variations in prediction capacity. The lowest ranking was ARIC, FRS, modified FRS, PROCAM, RRS, QRisk2 BMI with AUROCs inferior to.7. Three other will reach the .7 AUROC but will not reach the statistical significance (SCORE-BMI, mSCORE-BMI and Qrisk2). Only two scores reached the statistical significance: mSCORE (AUROC 0.775, IC95% 0,602-947, p=013) and SCORE (AUROC 0.792, IC95% 0,627-956, p=.008). AUROC for subclinical atherosclerosis Discussion: Predicting cardiovascular risk in rheumatoid arthritis proved to be a difficult task for the tested models. If the overall agreement between scores was good, most of the models tested in our study were not able to predict subclinical atherosclerosis as defined by the gold standard. Rheumatoid arthritis cardiovascular risk was higher than in the general population but also the risk profiles differed [19,20] and this was able to justify our findings. In our population RA was incompletely controlled by the ongoing treatment (high overall DAS 28) and inflammation was prevalent. ESR was found to be significantly higher in those patients with subclinical atherosclerosis at ultrasound. This was consistent with findings from previous studies where ESR was associated with a fourfold increase in CDV risk [21]. Also, the low total cholesterol and HDL cholesterol characterizing active RA (and other inflammatory profiles) would probably interfere with the results [22]. The presence of the rheumatoid factor also proved to increase the CVD risk by a twofold in a previous study where its prevalence was of 68% [19]. In our population, RF was present in 93.3% of the patients. The other particularities of this specific population were a high glucocorticoid and NSAID exposure. Methotrexate was inversely correlated with subclinical atherosclerosis, with a protective role in our study, consistent with the previous findings [23]. What was also noted was a prevalence of diabetes [24] higher than expected, a prevalence of smoking [25] lower than expected, but also a chronic kidney disease. A higher weight (and BMI), even if more prevalent in RA denoted a lower disease burden [26,27]. Our patients were discretely overweight but less than expected in RA [27,28]. These multiple interferences could explain the difficulties encountered by all the models tested in actually predicting subclinical atherosclerosis. The only score reaching statistical significant prediction capacity in our RA population was the European SCORE model. SCORE well defined the low risk category with none of the patients classified in the low risk (below 1%), having either a plaque or a high IMT, but the overall SCORE underestimated the ultrasound predicated atherosclerosis risk. Only one patient reached the high-risk class out of the 12 classified as having subclinical atherosclerosis by ultrasound measurements. In fact, most of the patients found themselves in the intermediate risk class (20 out of 29). Interestingly, applying the EULAR modifier did not lead to any reclassification. It should be noted that the SCORE model used in our study follows the ESC recommendation and it is in conformity with the estimated risk in the Romanian general population. All the office based (BMI) models were outperformed by their lipid based counterparts. This could be explained by the RA specific weight profile and also by a general loss of specificity by the surrogate marker (BMI for lipids). They failed to clearly identify either a low or high-risk populations. In the specific case of mSCORE-BMI, even though it had a lower AUC than its counterpart, the office-based model was a better predictor than all the other lipid- based models discussed. Even though FRS is a consecrated risk prediction model, it only had a modest prediction capacity, even when the EULAR modifier was applied (mFRS). The other 2 models derived from the United States cohorts (ARIC, Reynolds) had similar results. When compared to SCORE, the three underestimated CVD risks, fail to clearly identify a low or high-risk category. PROCAM, the German derived model, also failed to do so. These results were also partially consistent with a recently published longitudinal study (Arts et al.) performed on a Netherlands rheumatoid arthritis population comparing SCORE, Reynolds FRS and Qrisk2 [29]. Failure to identify the high-risk category was also consistent with the Spanish cross-sectional study by Gómez-Vaquero et al., where even in a low-risk general population and by using scores specifically calibrated (REGICORE is the Spanish-calibrated variant of FRS and SCORE followed both ESC and EULAR recommendations), the high-risk population was under identified [30]. Qrisk2 is a model derived in UK that takes into consideration two possibly interesting aspects. It is calibrated from baseline to include RA as a risk factor among the other co morbidities like CKD, diabetes and hypertension and takes into account the local socioeconomically factor. In our population, Qrisk2 and Qrisk2 BMI underestimated risk and failed to identify a low-risk category. This result contravenes with the above mentioned study by Arts et al. where Qrisk2 overestimated overall CVD risk [29]. In our case, the specific genetic and socio-economical differences with the derivation population could explain some of the lack of specificity and sensitivity. Our study had several limitations. It was a cross-sectional, small sample size study with the inherent limitations. The surrogate gold standard, even though validated and accepted does not imply a 100% specificity and sensitivity. The tertiary care recruitment site could explain a higher overall RA disease burden in our population. The “cardiovascular disease free” criteria might induce a selection bias especially in patients with longstanding RA. If generalized, the results of our study could only be used to characterize a Romanian population of RA, with the specific socio-economical and genetic background. Conclusion: Subclinical atherosclerosis and general cardiovascular risk prediction in rheumatoid arthritis by the available model are insufficient. The only model that provided usable information in a Romanian RA population was the SCORE model. Recalibration is needed. As recommended in the general population, the use of imaging diagnostic techniques in the intermediate risk population might ameliorate performance. Acknowledgments Funding: This work was funded by a grant of the Romanian Medical Academy, CEEX116/2006.	Background: Rheumatoid arthritis comes with a 30% higher probability for cardiovascular disease than the general population. Current guidelines advocate for early and aggressive primary prevention and treatment of risk factors in high-risk populations but this excess risk is under-addressed in RA in real life. This is mainly due to difficulties met in the correct risk evaluation. This study aims to underline the differences in results of the main cardiovascular risk screening models in the real life rheumatoid arthritis population. Methods: In a cross-sectional study, patients addressed to a tertiary care center in Romania for an biannual follow-up of rheumatoid arthritis and the ones who were considered free of any cardiovascular disease were assessed for subclinical atherosclerosis. Clinical, biological and carotidal ultrasound evaluations were performed. A number of cardiovascular disease prediction scores were performed and differences between tests were noted in regard to subclinical atherosclerosis as defined by the existence of carotid intima media thickness over 0,9 mm or carotid plaque. Results: In a population of 29 Romanian rheumatoid arthritis patients free of cardiovascular disease, the performance of Framingham Risk Score, HeartSCORE, ARIC cardiovascular disease prediction score, Reynolds Risk Score, PROCAM risk score and Qrisk2 score were compared. All the scores under-diagnosed subclinical atherosclerosis. With an AUROC of 0,792, the SCORE model was the only one that could partially stratify patients in low, intermediate and high-risk categories. The use of the EULAR recommended modifier did not help to reclassify patients. Conclusions: The only score that showed a statistically significant prediction capacity for subclinical atherosclerosis in a Romanian rheumatoid arthritis population was SCORE. The additional calibration or the use of imaging techniques in CVD risk prediction for the intermediate risk category might be warranted.	null	null	2,970	328	6	[ "risk", "score", "patients", "population", "ra", "atherosclerosis", "models", "cvd", "bmi", "subclinical" ]	[ "test", "test" ]	null		null	null		null	null	[CONTENT] cardiovascular disease prediction models \| rheumatoid arthritis \| risk assessment \| SCORE \| SCORE \| carotid intima media [SUMMARY]	null	null	[CONTENT] cardiovascular disease prediction models \| rheumatoid arthritis \| risk assessment \| SCORE \| SCORE \| carotid intima media [SUMMARY]	null	null	[CONTENT] Area Under Curve \| Arthritis, Rheumatoid \| Cardiovascular Diseases \| Carotid Intima-Media Thickness \| Female \| Humans \| Male \| Middle Aged \| Models, Biological \| ROC Curve \| Reference Standards \| Risk Factors [SUMMARY]	null	null	[CONTENT] Area Under Curve \| Arthritis, Rheumatoid \| Cardiovascular Diseases \| Carotid Intima-Media Thickness \| Female \| Humans \| Male \| Middle Aged \| Models, Biological \| ROC Curve \| Reference Standards \| Risk Factors [SUMMARY]	null	null	[CONTENT] test \| test [SUMMARY]	null	null	[CONTENT] test \| test [SUMMARY]	null	null	[CONTENT] risk \| score \| patients \| population \| ra \| atherosclerosis \| models \| cvd \| bmi \| subclinical [SUMMARY]	null	null	[CONTENT] risk \| score \| patients \| population \| ra \| atherosclerosis \| models \| cvd \| bmi \| subclinical [SUMMARY]	null	null	[CONTENT] considered \| score \| university \| values \| carotid \| focal \| defined \| test \| mean \| study [SUMMARY]	null	null	[CONTENT] risk \| score \| population \| patients \| cvd \| models \| model \| ra \| romanian \| study [SUMMARY]	null	null	[CONTENT] tertiary \| Romania \|\|\| \|\|\| mm [SUMMARY]	null	null	[CONTENT] Rheumatoid \| 30% \|\|\| RA \|\|\| \|\|\| \|\|\| tertiary \| Romania \|\|\| \|\|\| mm \|\|\| \|\|\| 29 \| Romanian \| Framingham Risk Score \| HeartSCORE \| ARIC \| Reynolds Risk Score \|\|\| \|\|\| 0,792 \| SCORE \|\|\| EULAR \|\|\| Romanian \|\|\| CVD [SUMMARY]	null
"Transmission-blocking activity of antibodies to Plasmodium falciparum GLURP.10C chimeric protein fo(...TRUNCATED)	26552428	"Plasmodium falciparum is transmitted from person to person by Anopheles mosquitoes after completing(...TRUNCATED)	BACKGROUND	"The recombinant fusion protein R0.10C was produced in Lactococcus lactis and purified by affinity-c(...TRUNCATED)	METHODS	"In general, all R0.10C formulations elicited high levels of antibodies recognizing native Pfs48/45 (...TRUNCATED)	RESULTS	"The combined data provide a strong basis for entering the next phase of clinical grade R0.10C produ(...TRUNCATED)	CONCLUSION	["Adjuvants, Immunologic","Aluminum Hydroxide","Animals","Antibodies, Protozoan","Emulsions","Female(...TRUNCATED)	4640242	Background	"Malaria is primarily confined to the poorest tropical areas of the world and constitutes one of the(...TRUNCATED)	null	null	Results	" Purification of properly folded R0.10C Recently, a correctly folded fragment was produced of Pfs4(...TRUNCATED)	Conclusions	"An investigation of immune responses to R0.10C using different adjuvants resulted in good antibody (...TRUNCATED)	["Background","Construction, fermentation and purification of correctly folded R0.10C","Rat and mous(...TRUNCATED)	["Malaria is primarily confined to the poorest tropical areas of the world and constitutes one of th(...TRUNCATED)	[ null, null, null, null, null, null, null, null, null ]	["Background","Methods","Construction, fermentation and purification of correctly folded R0.10C","Ra(...TRUNCATED)	["Malaria is primarily confined to the poorest tropical areas of the world and constitutes one of th(...TRUNCATED)	[null,"materials\|methods",null,null,null,null,"results",null,null,null,null,"discussion","conclusion(...TRUNCATED)	["Plasmodium falciparum malaria","R0.10C immunogenicity","Alhydrogel","Glucopyranosyl Lipid Adjuvant(...TRUNCATED)	"Background:\nMalaria is primarily confined to the poorest tropical areas of the world and constitut(...TRUNCATED)	"Background:\nPlasmodium falciparum is transmitted from person to person by Anopheles mosquitoes aft(...TRUNCATED)	"Background:\nMalaria is primarily confined to the poorest tropical areas of the world and constitut(...TRUNCATED)	"Background:\nPlasmodium falciparum is transmitted from person to person by Anopheles mosquitoes aft(...TRUNCATED)	14,251	347	13	[ "10c", "r0", "r0 10c", "alum", "sera", "gla", "day", "group", "immunized", "mosquitoes" ]	[ "test", "test" ]		null					"[CONTENT] Plasmodium falciparum malaria \| R0.10C immunogenicity \| Alhydrogel \| Glucopyranosyl Lipid(...TRUNCATED)	null	"[CONTENT] Plasmodium falciparum malaria \| R0.10C immunogenicity \| Alhydrogel \| Glucopyranosyl Lipid(...TRUNCATED)	"[CONTENT] Plasmodium falciparum malaria \| R0.10C immunogenicity \| Alhydrogel \| Glucopyranosyl Lipid(...TRUNCATED)	"[CONTENT] Plasmodium falciparum malaria \| R0.10C immunogenicity \| Alhydrogel \| Glucopyranosyl Lipid(...TRUNCATED)	"[CONTENT] Plasmodium falciparum malaria \| R0.10C immunogenicity \| Alhydrogel \| Glucopyranosyl Lipid(...TRUNCATED)	"[CONTENT] Adjuvants, Immunologic \| Aluminum Hydroxide \| Animals \| Antibodies, Protozoan \| Emulsions(...TRUNCATED)	null	"[CONTENT] Adjuvants, Immunologic \| Aluminum Hydroxide \| Animals \| Antibodies, Protozoan \| Emulsions(...TRUNCATED)	"[CONTENT] Adjuvants, Immunologic \| Aluminum Hydroxide \| Animals \| Antibodies, Protozoan \| Emulsions(...TRUNCATED)	"[CONTENT] Adjuvants, Immunologic \| Aluminum Hydroxide \| Animals \| Antibodies, Protozoan \| Emulsions(...TRUNCATED)	"[CONTENT] Adjuvants, Immunologic \| Aluminum Hydroxide \| Animals \| Antibodies, Protozoan \| Emulsions(...TRUNCATED)	[CONTENT] test \| test [SUMMARY]	null	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] 10c \| r0 \| r0 10c \| alum \| sera \| gla \| day \| group \| immunized \| mosquitoes [SUMMARY]	null	[CONTENT] 10c \| r0 \| r0 10c \| alum \| sera \| gla \| day \| group \| immunized \| mosquitoes [SUMMARY]	[CONTENT] 10c \| r0 \| r0 10c \| alum \| sera \| gla \| day \| group \| immunized \| mosquitoes [SUMMARY]	[CONTENT] 10c \| r0 \| r0 10c \| alum \| sera \| gla \| day \| group \| immunized \| mosquitoes [SUMMARY]	[CONTENT] 10c \| r0 \| r0 10c \| alum \| sera \| gla \| day \| group \| immunized \| mosquitoes [SUMMARY]	"[CONTENT] malaria \| pfs48 45 \| 45 \| pfs48 \| 85rf45 \| gmz2 \| shown \| antibodies \| tbmv \| vaccine [SU(...TRUNCATED)	null	[CONTENT] 10c \| r0 10c \| day \| r0 \| mosquitoes \| 85rf45 \| mab \| group \| different \| sera [SUMMARY]	"[CONTENT] activity clinical \| response tb \| different adjuvants resulted good \| response tb activit(...TRUNCATED)	[CONTENT] 10c \| r0 \| r0 10c \| alum \| gla \| day \| mosquitoes \| activity \| sera \| mm [SUMMARY]	[CONTENT] 10c \| r0 \| r0 10c \| alum \| gla \| day \| mosquitoes \| activity \| sera \| mm [SUMMARY]	[CONTENT] \|\|\| \|\|\| R0.10C \| R0 \| 10C \|\|\| [SUMMARY]	null	"[CONTENT] \|\|\| TB \| SMFA \|\|\| \|\|\| Glucopyranosyl Lipid Adjuvant \| AbISCO-100 \| Freund \|\|\| \|\|\| GLA (...TRUNCATED)	[CONTENT] [SUMMARY]	"[CONTENT] \|\|\| \|\|\| R0.10C \| R0 \| 10C \|\|\| \|\|\| Lactococcus \| mAb 85RF45.1 \| TB \| 1 \| Immune-purifie(...TRUNCATED)	"[CONTENT] \|\|\| \|\|\| R0.10C \| R0 \| 10C \|\|\| \|\|\| Lactococcus \| mAb 85RF45.1 \| TB \| 1 \| Immune-purifie(...TRUNCATED)
Predictors of overweight and obesity in adult women in Nairobi Province, Kenya.	23009185	"Since obesity in urban women is prevalent in Kenya the study aimed to determine predictors of overw(...TRUNCATED)	BACKGROUND	"A cross-sectional study was undertaken in Nairobi Province. The province was purposively selected b(...TRUNCATED)	METHODS	"Higher age, higher socio-economic (SE) group, increased parity, greater number of rooms in the hous(...TRUNCATED)	RESULTS	"The predictors of overweight and obesity showed that urbanization and the nutrition transition were(...TRUNCATED)	CONCLUSIONS	["Adult","Age Factors","Body Mass Index","Cross-Sectional Studies","Diet Surveys","Exercise","Feedin(...TRUNCATED)	3485189	Background	"Overweight and obesity are modifiable risk factors for the development of non-communicable diseases(...TRUNCATED)	Methods	" Study setting and participants The study was undertaken in Kibera Division of Nairobi Province, a(...TRUNCATED)	Results	"Results of the FFQ (Table 1) indicated that in the preceding 7 days 93% of participants had con(...TRUNCATED)	Conclusions	"The predictors of overweight and obesity showed that urbanization and the nutrition transition were(...TRUNCATED)	["Background","Study setting and participants","Research tools","Socio-demographic status","Physical(...TRUNCATED)	["Overweight and obesity are modifiable risk factors for the development of non-communicable disease(...TRUNCATED)	[ null, null, null, null, null, null, null, null, null, null, null, null, null, null, null ]	["Background","Methods","Study setting and participants","Research tools","Socio-demographic status"(...TRUNCATED)	["Overweight and obesity are modifiable risk factors for the development of non-communicable disease(...TRUNCATED)	[null,"methods",null,null,null,null,null,null,null,null,null,null,"results","discussion","conclusion(...TRUNCATED)	[ "Overweight", "Obesity", "Women", "Kenya", "Diet", "Physical activity" ]	"Background:\nOverweight and obesity are modifiable risk factors for the development of non-communic(...TRUNCATED)	"Background:\nSince obesity in urban women is prevalent in Kenya the study aimed to determine predic(...TRUNCATED)	"Background:\nOverweight and obesity are modifiable risk factors for the development of non-communic(...TRUNCATED)	"Background:\nSince obesity in urban women is prevalent in Kenya the study aimed to determine predic(...TRUNCATED)	12,239	373	19	["foods","women","food","body","physical","questionnaire","activity","physical activity","weight","f(...TRUNCATED)	[ "test", "test" ]							[CONTENT] Overweight \| Obesity \| Women \| Kenya \| Diet \| Physical activity [SUMMARY]	[CONTENT] Overweight \| Obesity \| Women \| Kenya \| Diet \| Physical activity [SUMMARY]	[CONTENT] Overweight \| Obesity \| Women \| Kenya \| Diet \| Physical activity [SUMMARY]	[CONTENT] Overweight \| Obesity \| Women \| Kenya \| Diet \| Physical activity [SUMMARY]	[CONTENT] Overweight \| Obesity \| Women \| Kenya \| Diet \| Physical activity [SUMMARY]	[CONTENT] Overweight \| Obesity \| Women \| Kenya \| Diet \| Physical activity [SUMMARY]	"[CONTENT] Adult \| Age Factors \| Body Mass Index \| Cross-Sectional Studies \| Diet Surveys \| Exercise(...TRUNCATED)	"[CONTENT] Adult \| Age Factors \| Body Mass Index \| Cross-Sectional Studies \| Diet Surveys \| Exercise(...TRUNCATED)	"[CONTENT] Adult \| Age Factors \| Body Mass Index \| Cross-Sectional Studies \| Diet Surveys \| Exercise(...TRUNCATED)	"[CONTENT] Adult \| Age Factors \| Body Mass Index \| Cross-Sectional Studies \| Diet Surveys \| Exercise(...TRUNCATED)	"[CONTENT] Adult \| Age Factors \| Body Mass Index \| Cross-Sectional Studies \| Diet Surveys \| Exercise(...TRUNCATED)	"[CONTENT] Adult \| Age Factors \| Body Mass Index \| Cross-Sectional Studies \| Diet Surveys \| Exercise(...TRUNCATED)	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	"[CONTENT] foods \| women \| food \| body \| physical \| questionnaire \| activity \| physical activity \| w(...TRUNCATED)	"[CONTENT] foods \| women \| food \| body \| physical \| questionnaire \| activity \| physical activity \| w(...TRUNCATED)	"[CONTENT] foods \| women \| food \| body \| physical \| questionnaire \| activity \| physical activity \| w(...TRUNCATED)	"[CONTENT] foods \| women \| food \| body \| physical \| questionnaire \| activity \| physical activity \| w(...TRUNCATED)	"[CONTENT] foods \| women \| food \| body \| physical \| questionnaire \| activity \| physical activity \| w(...TRUNCATED)	"[CONTENT] foods \| women \| food \| body \| physical \| questionnaire \| activity \| physical activity \| w(...TRUNCATED)	"[CONTENT] women \| obesity \| overweight \| risk \| factors \| diseases \| overweight obesity \| diabetes (...TRUNCATED)	"[CONTENT] foods \| questionnaire \| food \| weight \| data \| body \| 24 \| tape \| recall \| height [SUMMAR(...TRUNCATED)	"[CONTENT] significant \| bmi \| 001 \| significant differences \| 05 \| body \| mean \| wc \| table \| body (...TRUNCATED)	"[CONTENT] activity \| physical activity \| physical \| groups \| economic groups \| socio economic group(...TRUNCATED)	"[CONTENT] women \| activity \| physical activity \| physical \| questionnaire \| obesity \| foods \| study(...TRUNCATED)	"[CONTENT] women \| activity \| physical activity \| physical \| questionnaire \| obesity \| foods \| study(...TRUNCATED)	[CONTENT] Kenya \| Kenyan [SUMMARY]	[CONTENT] Nairobi Province \|\|\| Kenya \|\|\| 365 \| 25-54 years old [SUMMARY]	"[CONTENT] WC \|\|\| BMI \| 18% \| BMI \|\|\| first \| BMI \| WC \|\|\| two \|\|\| greater than 100% \| DRI \| DRI \| B(...TRUNCATED)	[CONTENT] \|\|\| [SUMMARY]	"[CONTENT] Kenya \| Kenyan \|\|\| Nairobi Province \|\|\| Kenya \|\|\| 365 \| 25-54 years old \|\|\| WC \|\|\| BMI (...TRUNCATED)	"[CONTENT] Kenya \| Kenyan \|\|\| Nairobi Province \|\|\| Kenya \|\|\| 365 \| 25-54 years old \|\|\| WC \|\|\| BMI (...TRUNCATED)
Retrospective analysis of mortalities in a tertiary care hospital in Northeast Ethiopia.	24443798	"Mortalities in the health care set up are prevalent, and causes are multifactorial with variations (...TRUNCATED)	BACKGROUND	"A retrospective analysis of mortalities during a three year period (September 2010-2012) was conduc(...TRUNCATED)	METHODS	"During the last 3 years there were 1,481 (4.8%) mortalities in the hospital. Around 60.0% of the mo(...TRUNCATED)	RESULTS	"Mortalities in the wards of the Dessie Referral Hospital were high and the causes were mainly of in(...TRUNCATED)	CONCLUSION	["Adolescent","Adult","Aged","Aged, 80 and over","Cause of Death","Child","Child, Preschool","Ethiop(...TRUNCATED)	3899922	Background	"Health care settings are not as safe as they should be, due to mortality of the patient, which has (...TRUNCATED)	Methods	" Study area A retrospective descriptive study was conducted from August-September 2, 2012, in the (...TRUNCATED)	Results	"During the last 3 years 1,481 (4.8%) mortalities occurred in the hospital. Majority 880 (59.2%) of (...TRUNCATED)	Conclusion	"In conclusion, mortalities in the hospital were prevalent and the causes are multifactorial. HIV/AI(...TRUNCATED)	["Background","Study area","Study Subjects","Data collection process","Ethical considerations","Comp(...TRUNCATED)	["Health care settings are not as safe as they should be, due to mortality of the patient, which has(...TRUNCATED)	[ null, null, null, null, null, null, null ]	["Background","Methods","Study area","Study Subjects","Data collection process","Ethical considerati(...TRUNCATED)	["Health care settings are not as safe as they should be, due to mortality of the patient, which has(...TRUNCATED)	[ null, "methods", null, null, null, null, "results", "discussion", "conclusions", null, null ]	[ "Mortalities", "Causes", "Wards", "Ethiopia" ]	"Background:\nHealth care settings are not as safe as they should be, due to mortality of the patien(...TRUNCATED)	"Background:\nMortalities in the health care set up are prevalent, and causes are multifactorial wit(...TRUNCATED)	"Background:\nHealth care settings are not as safe as they should be, due to mortality of the patien(...TRUNCATED)	"Background:\nMortalities in the health care set up are prevalent, and causes are multifactorial wit(...TRUNCATED)	3,209	398	11	[ "mortality", "hospital", "study", "health", "causes", "ward", "mortalities", "data", "referral", "care" ]	[ "test", "test" ]							[CONTENT] Mortalities \| Causes \| Wards \| Ethiopia [SUMMARY]	[CONTENT] Mortalities \| Causes \| Wards \| Ethiopia [SUMMARY]	[CONTENT] Mortalities \| Causes \| Wards \| Ethiopia [SUMMARY]	[CONTENT] Mortalities \| Causes \| Wards \| Ethiopia [SUMMARY]	[CONTENT] Mortalities \| Causes \| Wards \| Ethiopia [SUMMARY]	[CONTENT] Mortalities \| Causes \| Wards \| Ethiopia [SUMMARY]	"[CONTENT] Adolescent \| Adult \| Aged \| Aged, 80 and over \| Cause of Death \| Child \| Child, Preschool(...TRUNCATED)	"[CONTENT] Adolescent \| Adult \| Aged \| Aged, 80 and over \| Cause of Death \| Child \| Child, Preschool(...TRUNCATED)	"[CONTENT] Adolescent \| Adult \| Aged \| Aged, 80 and over \| Cause of Death \| Child \| Child, Preschool(...TRUNCATED)	"[CONTENT] Adolescent \| Adult \| Aged \| Aged, 80 and over \| Cause of Death \| Child \| Child, Preschool(...TRUNCATED)	"[CONTENT] Adolescent \| Adult \| Aged \| Aged, 80 and over \| Cause of Death \| Child \| Child, Preschool(...TRUNCATED)	"[CONTENT] Adolescent \| Adult \| Aged \| Aged, 80 and over \| Cause of Death \| Child \| Child, Preschool(...TRUNCATED)	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	"[CONTENT] mortality \| hospital \| study \| health \| causes \| ward \| mortalities \| data \| referral \| c(...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| ward \| mortalities \| data \| referral \| c(...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| ward \| mortalities \| data \| referral \| c(...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| ward \| mortalities \| data \| referral \| c(...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| ward \| mortalities \| data \| referral \| c(...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| ward \| mortalities \| data \| referral \| c(...TRUNCATED)	"[CONTENT] mortality \| causes \| infectious \| disease \| diseases \| causes mortality \| care \| hospital(...TRUNCATED)	"[CONTENT] hospital \| study \| health \| data \| ethical \| included \| referral hospital \| referral \| mo(...TRUNCATED)	"[CONTENT] mortalities \| wards \| years \| ward \| referral hospital 2010 \| referral hospital 2010 2012(...TRUNCATED)	"[CONTENT] mortality \| causes \| reduction \| preventable \| hospital \| health \| causes multifactorial (...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| data \| referral \| ward \| authors \| morta(...TRUNCATED)	"[CONTENT] mortality \| hospital \| study \| health \| causes \| data \| referral \| ward \| authors \| morta(...TRUNCATED)	"[CONTENT] \|\|\| Ethiopian \| Dessie Referral Hospital \|\|\| the Dessie Referral Hospital \| Northeast Et(...TRUNCATED)	"[CONTENT] three year \| September 2010-2012 \| the Dessie Referral Hospital \| August-September, 2012 (...TRUNCATED)	"[CONTENT] the last 3 years \| 1,481 \| 4.8% \|\|\| Around 60.0% \| two third \| 15 years or \|\|\| 38.9% \| 34(...TRUNCATED)	[CONTENT] the Dessie Referral Hospital \|\|\| [SUMMARY]	"[CONTENT] \|\|\| Ethiopian \| Dessie Referral Hospital \|\|\| the Dessie Referral Hospital \| Northeast Et(...TRUNCATED)	"[CONTENT] \|\|\| Ethiopian \| Dessie Referral Hospital \|\|\| the Dessie Referral Hospital \| Northeast Et(...TRUNCATED)
"Relevance or excellence? Setting research priorities for mental health and psychosocial support in (...TRUNCATED)	22335180	"Humanitarian crises are associated with an increase in mental disorders and psychological distress.(...TRUNCATED)	BACKGROUND	"From August 2009 to February 2010, we contacted policymakers, academic researchers, and humanitaria(...TRUNCATED)	METHODS	"Thematic analyses of transcripts show that participants broadly agreed on prioritized research them(...TRUNCATED)	RESULTS	"To advance a collaborative research agenda, actors in this field need to bridge the perceived disco(...TRUNCATED)	CONCLUSIONS	["Altruism","Female","Focus Groups","Health Services Research","Humans","Male","Mental Health","Ment(...TRUNCATED)	3335084	BACKGROUND	"In 2009 alone, more than 119 million people were affected by natural disasters.1 In that year, the (...TRUNCATED)	METHODS	" Study Design The study was directed by a ten-member steering group of the MH-SET initiative—nam(...TRUNCATED)	RESULTS	" Prioritized Research Questions In each focus group, participants agreed upon a list of the ten mo(...TRUNCATED)	null	null	["BACKGROUND","Study Design","Sites and Participants","Data Collection","Analyses","Prioritized Rese(...TRUNCATED)	["In 2009 alone, more than 119 million people were affected by natural disasters.1 In that year, the(...TRUNCATED)	[ null, null, null, null, null, null, null ]	["BACKGROUND","METHODS","Study Design","Sites and Participants","Data Collection","Analyses","RESULT(...TRUNCATED)	["In 2009 alone, more than 119 million people were affected by natural disasters.1 In that year, the(...TRUNCATED)	[ null, "methods", null, null, null, null, "results", null, null, "discussion" ]	["disasters","global mental health","humanitarian crises","political violence","psychosocial support(...TRUNCATED)	"BACKGROUND:\nIn 2009 alone, more than 119 million people were affected by natural disasters.1 In th(...TRUNCATED)	"Background:\nHumanitarian crises are associated with an increase in mental disorders and psychologi(...TRUNCATED)	null	null	12,253	367	10	["research","humanitarian","focus","settings","groups","mental","health","focus groups","participant(...TRUNCATED)	[ "test", "test" ]				null		null	"[CONTENT] disasters \| global mental health \| humanitarian crises \| political violence \| psychosocia(...TRUNCATED)	"[CONTENT] disasters \| global mental health \| humanitarian crises \| political violence \| psychosocia(...TRUNCATED)	"[CONTENT] disasters \| global mental health \| humanitarian crises \| political violence \| psychosocia(...TRUNCATED)	null	"[CONTENT] disasters \| global mental health \| humanitarian crises \| political violence \| psychosocia(...TRUNCATED)	null	"[CONTENT] Altruism \| Female \| Focus Groups \| Health Services Research \| Humans \| Male \| Mental Heal(...TRUNCATED)	"[CONTENT] Altruism \| Female \| Focus Groups \| Health Services Research \| Humans \| Male \| Mental Heal(...TRUNCATED)	"[CONTENT] Altruism \| Female \| Focus Groups \| Health Services Research \| Humans \| Male \| Mental Heal(...TRUNCATED)	null	"[CONTENT] Altruism \| Female \| Focus Groups \| Health Services Research \| Humans \| Male \| Mental Heal(...TRUNCATED)	null	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	null	[CONTENT] test \| test [SUMMARY]	null	"[CONTENT] research \| humanitarian \| focus \| settings \| groups \| mental \| health \| focus groups \| pa(...TRUNCATED)	"[CONTENT] research \| humanitarian \| focus \| settings \| groups \| mental \| health \| focus groups \| pa(...TRUNCATED)	"[CONTENT] research \| humanitarian \| focus \| settings \| groups \| mental \| health \| focus groups \| pa(...TRUNCATED)	null	"[CONTENT] research \| humanitarian \| focus \| settings \| groups \| mental \| health \| focus groups \| pa(...TRUNCATED)	null	"[CONTENT] humanitarian \| mental \| disorder \| health \| research \| mental health \| methodology \| sett(...TRUNCATED)	"[CONTENT] focus \| research \| groups \| humanitarian \| national \| focus groups \| uganda \| nepal \| org(...TRUNCATED)	"[CONTENT] research \| theme \| interventions \| problems \| mental \| workers \| mental health \| level \| (...TRUNCATED)	null	"[CONTENT] research \| humanitarian \| focus \| settings \| mental \| groups \| health \| participants \| fo(...TRUNCATED)	null	[CONTENT] \|\|\| [SUMMARY]	"[CONTENT] August 2009 to February 2010 \| nine \| 114 \| three \| Peru \| Uganda \| Nepal \|\|\| U.N. [SUMMA(...TRUNCATED)	[CONTENT] 1 \| 2 \| 3 \| 4 \| 5 \|\|\| [SUMMARY]	null	"[CONTENT] \|\|\| \|\|\| August 2009 to February 2010 \| nine \| 114 \| three \| Peru \| Uganda \| Nepal \|\|\| U(...TRUNCATED)	null
"Increased risk of hospitalization related to motor vehicle accidents among people taking zolpidem: (...TRUNCATED)	21030794	"Several epidemiological and experimental studies have found a positive association between the risk(...TRUNCATED)	BACKGROUND	"Using a 1-million-person randomly sampled cohort from the Taiwan National Health Insurance reimburs(...TRUNCATED)	METHODS	"The adjusted OR for involvement in an MVA after taking 1 defined daily dose of zolpidem was 1.74 (9(...TRUNCATED)	RESULTS	"Use of zolpidem 1 day before might be associated with an increased risk of MVA. Thus, precautionary(...TRUNCATED)	CONCLUSIONS	["Accidents, Traffic","Adolescent","Adult","Aged","Cross-Over Studies","Databases, Factual","Female"(...TRUNCATED)	3899515	INTRODUCTION	"Insomnia is a frequent complaint in modern society, and zolpidem, zopiclone, and benzodiazepines (B(...TRUNCATED)	METHODS	" Data source The sampling cohort dataset was obtained from the Taiwanese National Health Insurance(...TRUNCATED)	RESULTS	"From our dataset of 1 million individuals randomly selected from the NHI database between the years(...TRUNCATED)	CONCLUSIONS	"Our findings suggest that, among Taiwanese, there is a positive association between the risk of mot(...TRUNCATED)	["INTRODUCTION","Data source","Study subjects","Case–crossover design","Medication use","Cases, co(...TRUNCATED)	["Insomnia is a frequent complaint in modern society, and zolpidem, zopiclone, and benzodiazepines ((...TRUNCATED)	[ null, null, null, null, null, null, null ]	["INTRODUCTION","METHODS","Data source","Study subjects","Case–crossover design","Medication use",(...TRUNCATED)	["Insomnia is a frequent complaint in modern society, and zolpidem, zopiclone, and benzodiazepines ((...TRUNCATED)	[ null, "methods", null, null, null, null, null, null, "results", "discussion", "conclusions" ]	["zolpidem","benzodiazepines","motor vehicle accidents","case–crossover design","pharmacoepidemiol(...TRUNCATED)	"INTRODUCTION:\nInsomnia is a frequent complaint in modern society, and zolpidem, zopiclone, and ben(...TRUNCATED)	"Background:\nSeveral epidemiological and experimental studies have found a positive association bet(...TRUNCATED)	"INTRODUCTION:\nInsomnia is a frequent complaint in modern society, and zolpidem, zopiclone, and ben(...TRUNCATED)	"Background:\nSeveral epidemiological and experimental studies have found a positive association bet(...TRUNCATED)	6,091	295	11	["vehicle","motor","motor vehicle","accidents","use","vehicle accidents","motor vehicle accidents","(...TRUNCATED)	[ "test", "test" ]							"[CONTENT] zolpidem \| benzodiazepines \| motor vehicle accidents \| case–crossover design \| pharmaco(...TRUNCATED)	"[CONTENT] zolpidem \| benzodiazepines \| motor vehicle accidents \| case–crossover design \| pharmaco(...TRUNCATED)	"[CONTENT] zolpidem \| benzodiazepines \| motor vehicle accidents \| case–crossover design \| pharmaco(...TRUNCATED)	"[CONTENT] zolpidem \| benzodiazepines \| motor vehicle accidents \| case–crossover design \| pharmaco(...TRUNCATED)	"[CONTENT] zolpidem \| benzodiazepines \| motor vehicle accidents \| case–crossover design \| pharmaco(...TRUNCATED)	"[CONTENT] zolpidem \| benzodiazepines \| motor vehicle accidents \| case–crossover design \| pharmaco(...TRUNCATED)	"[CONTENT] Accidents, Traffic \| Adolescent \| Adult \| Aged \| Cross-Over Studies \| Databases, Factual (...TRUNCATED)	"[CONTENT] Accidents, Traffic \| Adolescent \| Adult \| Aged \| Cross-Over Studies \| Databases, Factual (...TRUNCATED)	"[CONTENT] Accidents, Traffic \| Adolescent \| Adult \| Aged \| Cross-Over Studies \| Databases, Factual (...TRUNCATED)	"[CONTENT] Accidents, Traffic \| Adolescent \| Adult \| Aged \| Cross-Over Studies \| Databases, Factual (...TRUNCATED)	"[CONTENT] Accidents, Traffic \| Adolescent \| Adult \| Aged \| Cross-Over Studies \| Databases, Factual (...TRUNCATED)	"[CONTENT] Accidents, Traffic \| Adolescent \| Adult \| Aged \| Cross-Over Studies \| Databases, Factual (...TRUNCATED)	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	"[CONTENT] vehicle \| motor \| motor vehicle \| accidents \| use \| vehicle accidents \| motor vehicle acc(...TRUNCATED)	"[CONTENT] vehicle \| motor \| motor vehicle \| accidents \| use \| vehicle accidents \| motor vehicle acc(...TRUNCATED)	"[CONTENT] vehicle \| motor \| motor vehicle \| accidents \| use \| vehicle accidents \| motor vehicle acc(...TRUNCATED)	"[CONTENT] vehicle \| motor \| motor vehicle \| accidents \| use \| vehicle accidents \| motor vehicle acc(...TRUNCATED)	"[CONTENT] vehicle \| motor \| motor vehicle \| accidents \| use \| vehicle accidents \| motor vehicle acc(...TRUNCATED)	"[CONTENT] vehicle \| motor \| motor vehicle \| accidents \| use \| vehicle accidents \| motor vehicle acc(...TRUNCATED)	"[CONTENT] bzds \| zolpidem \| benzodiazepines \| non bzds \| non \| studies \| use \| benzodiazepines non (...TRUNCATED)	"[CONTENT] drugs \| case \| data \| accidents \| period \| nhi \| half \| half life \| life \| motor vehicle (...TRUNCATED)	"[CONTENT] life \| ors \| vehicle \| motor \| motor vehicle \| bzds \| half life bzds \| life bzds \| adjust(...TRUNCATED)	"[CONTENT] association \| suggest taiwanese positive association \| day occurrence \| day occurrence ac(...TRUNCATED)	"[CONTENT] accidents \| motor \| vehicle \| motor vehicle \| bzds \| period \| case \| use \| zolpidem \| mot(...TRUNCATED)	"[CONTENT] accidents \| motor \| vehicle \| motor vehicle \| bzds \| period \| case \| use \| zolpidem \| mot(...TRUNCATED)	[CONTENT] \|\|\| MVA \| 1 day \|\|\| 1 day \| MVA [SUMMARY]	"[CONTENT] 1-million \| the Taiwan National Health Insurance \| 12 929 \| between 1998 and 2004 \| MVA \|(...TRUNCATED)	[CONTENT] MVA \| 1 \| daily \| 1.74 \| 95% \| 1.25 \|\|\| 7 \| 14 \| 21 \| 28 days \| MVA [SUMMARY]	[CONTENT] 1 day \| MVA \|\|\| [SUMMARY]	"[CONTENT] \|\|\| MVA \| 1 day \|\|\| 1 day \| MVA \|\|\| 1-million \| the Taiwan National Health Insurance \| 1(...TRUNCATED)	"[CONTENT] \|\|\| MVA \| 1 day \|\|\| 1 day \| MVA \|\|\| 1-million \| the Taiwan National Health Insurance \| 1(...TRUNCATED)
"Perception of Online Lectures among Students of a Medical College in Kathmandu: A Descriptive Cross(...TRUNCATED)	34506439	"The COVID-19 global pandemic has affected all aspects of human life, with education no exception. O(...TRUNCATED)	INTRODUCTION	"This descriptive cross-sectional study was conducted among the undergraduate students of dentistry,(...TRUNCATED)	METHODS	"Out of 318 valid questionnaires, 143 (44.97%) students agreed that online lectures were effective b(...TRUNCATED)	RESULTS	"Most of the students had a positive attitude towards e-learning when compared to similar studies. F(...TRUNCATED)	CONCLUSIONS	["Adult","COVID-19","Cross-Sectional Studies","Female","Humans","Perception","SARS-CoV-2","Students,(...TRUNCATED)	8369538	INTRODUCTION	"The coronavirus disease (COVID-19) pandemic affected not only health but also education, business, (...TRUNCATED)	METHODS	"This descriptive cross-sectional study was conducted in the Department of Periodontics and Oral Imp(...TRUNCATED)	RESULTS	"Out of total 318 valid questionnaires analysed, 151 (47.49%) participating students agreed that onl(...TRUNCATED)	CONCLUSIONS	"Student participants of this study had a positive attitude for online learning though they lacked c(...TRUNCATED)	[]	[]	[]	[ "INTRODUCTION", "METHODS", "RESULTS", "DISCUSSION", "CONCLUSIONS" ]	["The coronavirus disease (COVID-19) pandemic affected not only health but also education, business,(...TRUNCATED)	[ "intro", "methods", "results", "discussion", "conclusions" ]	[ "\ncurriculum\n", "\nmedical education\n", "\nonline education\n" ]	"INTRODUCTION:\nThe coronavirus disease (COVID-19) pandemic affected not only health but also educat(...TRUNCATED)	"Background:\nThe COVID-19 global pandemic has affected all aspects of human life, with education no(...TRUNCATED)	"INTRODUCTION:\nThe coronavirus disease (COVID-19) pandemic affected not only health but also educat(...TRUNCATED)	"Background:\nThe COVID-19 global pandemic has affected all aspects of human life, with education no(...TRUNCATED)	1,795	333	5	["online","students","study","education","learning","participants","lectures","online education","tr(...TRUNCATED)	[ "test", "test" ]							[CONTENT] curriculum \| medical education \| online education [SUMMARY]	[CONTENT] curriculum \| medical education \| online education [SUMMARY]	[CONTENT] curriculum \| medical education \| online education [SUMMARY]	[CONTENT] curriculum \| medical education \| online education [SUMMARY]	[CONTENT] curriculum \| medical education \| online education [SUMMARY]	[CONTENT] curriculum \| medical education \| online education [SUMMARY]	"[CONTENT] Adult \| COVID-19 \| Cross-Sectional Studies \| Female \| Humans \| Perception \| SARS-CoV-2 \| (...TRUNCATED)	"[CONTENT] Adult \| COVID-19 \| Cross-Sectional Studies \| Female \| Humans \| Perception \| SARS-CoV-2 \| (...TRUNCATED)	"[CONTENT] Adult \| COVID-19 \| Cross-Sectional Studies \| Female \| Humans \| Perception \| SARS-CoV-2 \| (...TRUNCATED)	"[CONTENT] Adult \| COVID-19 \| Cross-Sectional Studies \| Female \| Humans \| Perception \| SARS-CoV-2 \| (...TRUNCATED)	"[CONTENT] Adult \| COVID-19 \| Cross-Sectional Studies \| Female \| Humans \| Perception \| SARS-CoV-2 \| (...TRUNCATED)	"[CONTENT] Adult \| COVID-19 \| Cross-Sectional Studies \| Female \| Humans \| Perception \| SARS-CoV-2 \| (...TRUNCATED)	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	"[CONTENT] online \| students \| study \| education \| learning \| participants \| lectures \| online educa(...TRUNCATED)	"[CONTENT] online \| students \| study \| education \| learning \| participants \| lectures \| online educa(...TRUNCATED)	"[CONTENT] online \| students \| study \| education \| learning \| participants \| lectures \| online educa(...TRUNCATED)	"[CONTENT] online \| students \| study \| education \| learning \| participants \| lectures \| online educa(...TRUNCATED)	"[CONTENT] online \| students \| study \| education \| learning \| participants \| lectures \| online educa(...TRUNCATED)	"[CONTENT] online \| students \| study \| education \| learning \| participants \| lectures \| online educa(...TRUNCATED)	"[CONTENT] education \| aspect \| pandemic affected \| affected \| improve \| lockdown \| health education(...TRUNCATED)	"[CONTENT] bachelor \| informed \| informed consent \| consent \| data \| students \| sample \| forms \| col(...TRUNCATED)	[CONTENT] students \| online \| 18 \| 20 \| lectures \| half \| maximum \| mode \| sem \| median [SUMMARY]	"[CONTENT] online \| face \| online education \| education \| fully \| order increase effectiveness onlin(...TRUNCATED)	"[CONTENT] online \| students \| education \| study \| learning \| online education \| face \| lectures \| p(...TRUNCATED)	"[CONTENT] online \| students \| education \| study \| learning \| online education \| face \| lectures \| p(...TRUNCATED)	[CONTENT] COVID-19 \|\|\| \|\|\| [SUMMARY]	"[CONTENT] Kathmandu Medical College \|\|\| November to December 2020 \|\|\| \|\|\| one hour \|\|\| Google Form(...TRUNCATED)	"[CONTENT] 318 \| 143 \| 44.97% \| 138 \| 43.4% \|\|\| One hundred and forty five \| 45.60% \| 175 \| 55.03% \|(...TRUNCATED)	[CONTENT] \|\|\| [SUMMARY]	"[CONTENT] COVID-19 \|\|\| \|\|\| \|\|\| Kathmandu Medical College \|\|\| November to December 2020 \|\|\| \|\|\| o(...TRUNCATED)	"[CONTENT] COVID-19 \|\|\| \|\|\| \|\|\| Kathmandu Medical College \|\|\| November to December 2020 \|\|\| \|\|\| o(...TRUNCATED)
"Retrospective Evaluation on the Use of a New Polysaccharide Complex in Managing Paediatric Type 1 D(...TRUNCATED)	34684518	"Children and adolescents affected by type 1 diabetes have an increased risk of being overweight or (...TRUNCATED)	BACKGROUND	"Data for 27 paediatric patients with a diagnosis of type 1 diabetes in conjunction with obesity and(...TRUNCATED)	PATIENTS AND METHODS	"PGR significantly reduced BMI standard deviation score (SDS) (p < 0.005), waist SDS (p < 0.005), Hb(...TRUNCATED)	RESULTS	"PGR produces a good auxological and metabolic response in obese patients with MetS who are affected(...TRUNCATED)	CONCLUSIONS	["Adolescent","Blood Glucose","Body Mass Index","Child","Cholesterol, HDL","Cholesterol, LDL","Diabe(...TRUNCATED)	8540288	1. Introduction	"Diabetes mellitus is the most common endocrine disorder among children and adolescents [1]. It is c(...TRUNCATED)	null	null	3. Results	"Clinical, laboratory and demographic data are summarised in Table 1 and Table 2 and Figure 1. Gluco(...TRUNCATED)	5. Conclusion	"Type 1 diabetes patients with MetS showed a good auxological and metabolic response to PGR. There w(...TRUNCATED)	["2.1. Study Design ","2.2. Study Protocol","2.3. Auxological and Clinical Methods","2.4. Laboratory(...TRUNCATED)	["As per clinical practice in our hospitals, type 1 diabetes patients with obesity and MetS were eva(...TRUNCATED)	[ null, null, null, null, null, null, null, null, null, null ]	["1. Introduction","2. Subjects and Methods","2.1. Study Design ","2.2. Study Protocol","2.3. Auxolo(...TRUNCATED)	["Diabetes mellitus is the most common endocrine disorder among children and adolescents [1]. It is (...TRUNCATED)	[ "intro", "subjects", null, null, null, null, null, "results", null, null, null, null, "discussion", null ]	["children","Policaptil Gel Retard®","type 1 diabetes","obesity","overweight","haemoglobin A1c","tr(...TRUNCATED)	"1. Introduction:\nDiabetes mellitus is the most common endocrine disorder among children and adoles(...TRUNCATED)	"Background:\nChildren and adolescents affected by type 1 diabetes have an increased risk of being o(...TRUNCATED)	"1. Introduction:\nDiabetes mellitus is the most common endocrine disorder among children and adoles(...TRUNCATED)	"Background:\nChildren and adolescents affected by type 1 diabetes have an increased risk of being o(...TRUNCATED)	13,639	362	14	[ "patients", "insulin", "mean", "levels", "diabetes", "t0", "vs", "group", "t2", "type" ]	[ "test", "test" ]		null					"[CONTENT] children \| Policaptil Gel Retard® \| type 1 diabetes \| obesity \| overweight \| haemoglobin(...TRUNCATED)	null	"[CONTENT] children \| Policaptil Gel Retard® \| type 1 diabetes \| obesity \| overweight \| haemoglobin(...TRUNCATED)	"[CONTENT] children \| Policaptil Gel Retard® \| type 1 diabetes \| obesity \| overweight \| haemoglobin(...TRUNCATED)	"[CONTENT] children \| Policaptil Gel Retard® \| type 1 diabetes \| obesity \| overweight \| haemoglobin(...TRUNCATED)	"[CONTENT] children \| Policaptil Gel Retard® \| type 1 diabetes \| obesity \| overweight \| haemoglobin(...TRUNCATED)	"[CONTENT] Adolescent \| Blood Glucose \| Body Mass Index \| Child \| Cholesterol, HDL \| Cholesterol, LD(...TRUNCATED)	null	"[CONTENT] Adolescent \| Blood Glucose \| Body Mass Index \| Child \| Cholesterol, HDL \| Cholesterol, LD(...TRUNCATED)	"[CONTENT] Adolescent \| Blood Glucose \| Body Mass Index \| Child \| Cholesterol, HDL \| Cholesterol, LD(...TRUNCATED)	"[CONTENT] Adolescent \| Blood Glucose \| Body Mass Index \| Child \| Cholesterol, HDL \| Cholesterol, LD(...TRUNCATED)	"[CONTENT] Adolescent \| Blood Glucose \| Body Mass Index \| Child \| Cholesterol, HDL \| Cholesterol, LD(...TRUNCATED)	[CONTENT] test \| test [SUMMARY]	null	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	[CONTENT] patients \| insulin \| mean \| levels \| diabetes \| t0 \| vs \| group \| t2 \| type [SUMMARY]	null	[CONTENT] patients \| insulin \| mean \| levels \| diabetes \| t0 \| vs \| group \| t2 \| type [SUMMARY]	[CONTENT] patients \| insulin \| mean \| levels \| diabetes \| t0 \| vs \| group \| t2 \| type [SUMMARY]	[CONTENT] patients \| insulin \| mean \| levels \| diabetes \| t0 \| vs \| group \| t2 \| type [SUMMARY]	[CONTENT] patients \| insulin \| mean \| levels \| diabetes \| t0 \| vs \| group \| t2 \| type [SUMMARY]	"[CONTENT] type \| diabetes \| type diabetes \| disorder \| insulin \| patients \| developing \| children \|(...TRUNCATED)	null	[CONTENT] vs t0 \| vs \| t0 \| t2 \| patients \| 005 \| table \| levels t2 \| group \| levels [SUMMARY]	"[CONTENT] type \| type diabetes \| metabolic \| mets \| compounds especially associated \| compounds \| r(...TRUNCATED)	"[CONTENT] patients \| diabetes \| mean \| type \| insulin \| vs t0 \| type diabetes \| vs \| levels \| t0 [S(...TRUNCATED)	"[CONTENT] patients \| diabetes \| mean \| type \| insulin \| vs t0 \| type diabetes \| vs \| levels \| t0 [S(...TRUNCATED)	[CONTENT] 1 [SUMMARY]	null	[CONTENT] PGR \| BMI \| SDS \| daily \|\|\| daily \| SD of daily BG \| LBGI \| HBGI \| HDL [SUMMARY]	[CONTENT] PGR \| obese \| MetS \| 1 \|\|\| BMI SDS \| SDS \| MetS \|\|\| 1 [SUMMARY]	"[CONTENT] 1 \|\|\| 27 \| 1 \| MetS \| at least 5 years' \|\|\| 16 \| age 12.9 \| 9.5-15.8 years \| PGR \| 11 \| a(...TRUNCATED)	"[CONTENT] 1 \|\|\| 27 \| 1 \| MetS \| at least 5 years' \|\|\| 16 \| age 12.9 \| 9.5-15.8 years \| PGR \| 11 \| a(...TRUNCATED)
[Highly dosed Anderson and Kestenbaum operations for anomalous head posture due to nystagmus].	32219535	"The correction of anomalous head posture associated with infantile nystagmus syndrome (INS) is carr(...TRUNCATED)	BACKGROUND	"The AP (2013-2019) and KP (2003-2013) were used as the exclusive procedures during the respective t(...TRUNCATED)	PATIENTS AND METHODS	"The HT was diminished to 10° (-3-20°)/10° (-7-20°) ca. 3 months after surgery. At the late vis(...TRUNCATED)	RESULTS	"The effectiveness and success rates of AP and KP were similar with the dosing used. Less invasive s(...TRUNCATED)	CONCLUSION	["Child","Head","Humans","Nystagmus, Pathologic","Oculomotor Muscles","Ophthalmologic Surgical Proce(...TRUNCATED)	7717044	null	null	null	null	null	null	Fazit für die Praxis	"Hoch dosierte Anderson-Operationen und Kestenbaum-Operationen waren bezüglich der Reduktion der Ko(...TRUNCATED)	["Patienten und Methoden","Patienten","Diagnostik","Operation","Statistik","Ergebnisse","Diskussion"(...TRUNCATED)	[" Patienten Die von der Ethikkommission der Justus-Liebig-Universität Gießen genehmigte (PN 130/(...TRUNCATED)	[ null, null, null, null, null, null, null ]	["Patienten und Methoden","Patienten","Diagnostik","Operation","Statistik","Ergebnisse","Diskussion"(...TRUNCATED)	[" Patienten Die von der Ethikkommission der Justus-Liebig-Universität Gießen genehmigte (PN 130/(...TRUNCATED)	[ null, null, null, null, null, null, null, "conclusion" ]	["Augenmuskelchirurgie","Kopfschiefhaltung","Neutralzone","Torticollis","Umlagerungsoperation","Eye (...TRUNCATED)	"Patienten und Methoden:\n Patienten Die von der Ethikkommission der Justus-Liebig-Universität Gie(...TRUNCATED)	"Background:\nThe correction of anomalous head posture associated with infantile nystagmus syndrome (...TRUNCATED)	null	null	6,957	483	8	[ "der", "25", "die", "75", "und", "kzh", "mit", "bei", "l10", "patienten" ]	[ "test", "test" ]	null	null	null			null	null	null	null	"[CONTENT] Augenmuskelchirurgie \| Kopfschiefhaltung \| Neutralzone \| Torticollis \| Umlagerungsoperati(...TRUNCATED)	"[CONTENT] Augenmuskelchirurgie \| Kopfschiefhaltung \| Neutralzone \| Torticollis \| Umlagerungsoperati(...TRUNCATED)	null	null	null	null	"[CONTENT] Child \| Head \| Humans \| Nystagmus, Pathologic \| Oculomotor Muscles \| Ophthalmologic Surgi(...TRUNCATED)	"[CONTENT] Child \| Head \| Humans \| Nystagmus, Pathologic \| Oculomotor Muscles \| Ophthalmologic Surgi(...TRUNCATED)	null	null	null	null	[CONTENT] test \| test [SUMMARY]	[CONTENT] test \| test [SUMMARY]	null	null	null	null	[CONTENT] der \| 25 \| die \| 75 \| und \| kzh \| mit \| bei \| l10 \| patienten [SUMMARY]	[CONTENT] der \| 25 \| die \| 75 \| und \| kzh \| mit \| bei \| l10 \| patienten [SUMMARY]	null	null	null	null	"[CONTENT] dosierte anderson \| hoch dosierte anderson \| operationen \| ist \| kestenbaum \| anderson \| (...TRUNCATED)	[CONTENT] der \| 25 \| die \| 75 \| und \| kzh \| wurden \| bei \| mit \| l10 [SUMMARY]	null	null	null	null	[CONTENT] AP \| KP \|\|\| AP [SUMMARY]	"[CONTENT] Kestenbaum \| KP \| Anderson \| AP \|\|\| AP \| 2013-2019 \| KP \| 2003-2013 \|\|\| AP \| 33 \| INS \| K(...TRUNCATED)	null
Role of platelet infiltration as independent prognostic marker for gastric adenocarcinomas.	32233046	"In recent years, the relationship between malignant tumors and platelets has been paid more attenti(...TRUNCATED)	BACKGROUND	"This study retrospectively analyzed the clinical and pathological data of 114 patients with initial(...TRUNCATED)	METHODS	"Platelet count was independent factors affecting prognosis. The stratified analysis showed that the(...TRUNCATED)	RESULTS	"Platelet elevation is closely related to the occurrence, development, and metastasis of gastric can(...TRUNCATED)	CONCLUSION	["Adenocarcinoma","Adult","Aged","Aged, 80 and over","Biomarkers, Tumor","Blood Platelets","Cell Lin(...TRUNCATED)	7439343	INTRODUCTION	"Gastric cancer is one of the most common malignant tumors in China, and its therapeutic effect and (...TRUNCATED)	null	null	RESULTS	" Relationship between preoperative platelet counts of patients with gastric cancer and clinicopatho(...TRUNCATED)	null	null	["INTRODUCTION","Clinical data","Postoperative follow‐up","Collection organization","Main reagents(...TRUNCATED)	["Gastric cancer is one of the most common malignant tumors in China, and its therapeutic effect and(...TRUNCATED)	[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null(...TRUNCATED)	["INTRODUCTION","MATERIALS AND METHODS","Clinical data","Postoperative follow‐up","Collection orga(...TRUNCATED)	["Gastric cancer is one of the most common malignant tumors in China, and its therapeutic effect and(...TRUNCATED)	[null,"materials-and-methods",null,null,null,null,null,null,null,null,null,null,null,null,"results",(...TRUNCATED)	[ "gastric cancer", "invasion", "platelet count", "prognostic indicators", "proliferation" ]	"INTRODUCTION:\nGastric cancer is one of the most common malignant tumors in China, and its therapeu(...TRUNCATED)	"Background:\nIn recent years, the relationship between malignant tumors and platelets has been paid(...TRUNCATED)	null	null	12,039	312	25	["cancer","gastric","gastric cancer","platelets","platelet","minutes","cells","patients","109","grou(...TRUNCATED)	[ "test", "test" ]		null		null		null	"[CONTENT] gastric cancer \| invasion \| platelet count \| prognostic indicators \| proliferation [SUMMA(...TRUNCATED)	null	"[CONTENT] gastric cancer \| invasion \| platelet count \| prognostic indicators \| proliferation [SUMMA(...TRUNCATED)	null	"[CONTENT] gastric cancer \| invasion \| platelet count \| prognostic indicators \| proliferation [SUMMA(...TRUNCATED)	null	"[CONTENT] Adenocarcinoma \| Adult \| Aged \| Aged, 80 and over \| Biomarkers, Tumor \| Blood Platelets \|(...TRUNCATED)	null	"[CONTENT] Adenocarcinoma \| Adult \| Aged \| Aged, 80 and over \| Biomarkers, Tumor \| Blood Platelets \|(...TRUNCATED)	null	"[CONTENT] Adenocarcinoma \| Adult \| Aged \| Aged, 80 and over \| Biomarkers, Tumor \| Blood Platelets \|(...TRUNCATED)	null	[CONTENT] test \| test [SUMMARY]	null	[CONTENT] test \| test [SUMMARY]	null	[CONTENT] test \| test [SUMMARY]	null	"[CONTENT] cancer \| gastric \| gastric cancer \| platelets \| platelet \| minutes \| cells \| patients \| 1(...TRUNCATED)	null	"[CONTENT] cancer \| gastric \| gastric cancer \| platelets \| platelet \| minutes \| cells \| patients \| 1(...TRUNCATED)	null	"[CONTENT] cancer \| gastric \| gastric cancer \| platelets \| platelet \| minutes \| cells \| patients \| 1(...TRUNCATED)	null	"[CONTENT] cancer \| cells \| gastric cancer \| gastric \| elevation \| platelet elevation \| tumors \| epi(...TRUNCATED)	null	"[CONTENT] platelets \| 109 \| plt \| gastric \| gastric cancer \| cancer \| patients \| platelet \| group \|(...TRUNCATED)	null	"[CONTENT] minutes \| platelets \| cancer \| gastric cancer \| gastric \| platelet \| cells \| group \| pati(...TRUNCATED)	null	[CONTENT] recent years \|\|\| [SUMMARY]	null	[CONTENT] \|\|\| 5-year \| TNM \|\|\| \|\|\| CCK-8 \|\|\| [SUMMARY]	null	"[CONTENT] recent years \|\|\| \|\|\| 114 \| August 2005 to August 2018 \| Shandong Provincial Hospital \|\|\|(...TRUNCATED)	null

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