bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative effect of nutraceuticals on lipid profile: a protocol for systematic review and network meta-analysis
Authors: Morze Jakub , Osadnik Tadeusz , Osadnik Kamila , Lejawa Mateusz , Jakubiak Grzegorz , Pawlas Natalia , Gasior Mariusz , Schwingshackl Lukas , Banach Maciej
Published: August 2020

Introduction

According to the common definition, nutraceuticals are components found in food that can act as therapeutic substances. Recently, the International Lipid Expert Panel published two position papers covering the topic of lipid-lowering nutraceuticals and their potential use as a complementary treatment in addition to statins or as an alternative treatment in statin-intolerant patients. The aim of this study was to compare the effect of different nutraceuticals on lipid profiles in a systematic review with pairwise and network meta-analyses.

Methods and analysis

Three databases, including PubMed, Embase and the Cochrane Central Register of Controlled Trials, will be searched without time or publication language restrictions. The estimated end date for the searches will be 29 March 2020. Each stage of the review, including the study section, data extraction, and risk of bias and quality of evidence assessments, will be performed in duplicate. Randomised controlled trials meeting the following criteria will be eligible for inclusion: (1) participants aged ≥18 years, (2) intervention with a selected nutraceutical (artichoke, berberine, bergamot, soluble fibres, green tea, garlic, lupin, plant sterols and stanols, red yeast rice, soybean, spirulina or a combination of the aforementioned nutraceuticals), (3) administration of the treatment in the form of capsules, pills, powders, solutions, tablets or enriched food items, (4) comparison with another nutraceutical or placebo, (5) intervention period ≥3 weeks and (6) lipid profile (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglycerides) as an outcome. Random-effect pairwise and network meta-analyses will be used to summarise the relative effect of each nutraceutical in comparison to the effect of every other nutraceutical. Subgroup analyses will be stratified by age, sex, ethnicity, sample size, length of trial follow-up, baseline cholesterol level and presence of other comorbidities.

Ethics and dissemination

This review will summarise findings from primary studies, and therefore no ethics approval is required. The results will be presented at conferences as well as published in a peer-reviewed journal.

PROSPERO registration number

CRD42019132877.
Is the Yale Global Tic Severity Scale a valid tool for parent-reported assessment in the paediatric population? A prospective observational study in Taiwan
Authors: Ho Che‑Sheng , Huang Jia‑Yun , Yang Chien-Hui , Lin Yi-Jie , Huang Ming-Yuan , Su Yung-Cheng
Published: August 2020

Objective

The Yale Global Tic Severity Scale (YGTSS) is the most commonly used clinician-rated evaluation tool for Tourette syndrome (TS), with established reliability and validity. This study aims to determine whether the YGTSS is a valid parent-reported assessment in the TS population.

Design

A prospective cohort study.

Setting

A major medical centre in Taiwan.

Methods

A total of 594 patients were enrolled. A revised traditional Chinese version of the YGTSS was made available to parents via Google docs. Parents were encouraged to complete the YGTSS the day before each outpatient clinic visit. At each visit, a paediatric neurology fellow also administered the YGTSS assessment. We investigated whether differences in scores between physicians and parents changed as the number of parent evaluations increased. The results of the physician assessments were also taken as the expert standard for evaluating the sensitivity and specificity of the parent-reported assessments was conducted for the same visit.

Results

The differences in the YGTSS scores between participants and physicians were small. The mean difference in the total assessment score was 4.15 points. As the number of times the parent evaluation was performed increased, the difference between the parent and physician scores decreased. Discrimination of moderate-to-severe attacks was good using the parent-assessed YGTSS (area under the receiver operating characteristic curve, 0.858; 95% CI 0.839 to 0.876). The sensitivity for detecting a moderate-to-severe attack by YGTSS parent assessment was 79.7% (95% CI 76.6 to 82.8), and the specificity was 91.8% (95% CI 89.9 to 93.7).

Conclusion

The parent-reported YGTSS is a promising tool for TS assessment, demonstrating good discriminative ability for disease severity, with user precision increasing with experience.
Fast track rehabilitation after reversed total shoulder arthroplasty: a protocol for an international multicentre prospective cohort study
Authors: van Essen Tom , Kornuijt Anke , de Vries Lieke Maria Anna , Stokman Remco , van der Weegen Walter , Bogie Rob , Hillen Robert Jan , van Kampen DA
Published: August 2020

Introduction

The use of reversed total shoulder arthroplasty (rTSA) has increased because of an increasing number of indications for this procedure and by ageing of the population. Usual postoperative care consists of immobilisation of the shoulder for a period of 2–6 weeks to allow healing of the subscapularis tendon and protection of the joint. However, new literature proved that reattachment of the subscapularis tendon is unnecessary. Therefore we hypothesised that immobilisation of the shoulder is not necessary and patients can start safely with mobilisation on the first postoperative day. We expect this fast track protocol to be safe and result in better short-term and long-term functional outcomes.

Methods and analysis

In our prospective cohort, we will include at least 75 patients aged 50 years and older indicated for rTSA, with acute fracture treatment as an exclusion criterion. Patients will be selected and operated in three hospitals: two in the Netherlands and one in Curacao.

Patients will visit the outpatient clinic preoperative, at 6 weeks, 3 months and 1 year postoperative. The data that will be collected includes baseline characteristics, reason for surgery, complications and adverse events, patient reported outcomes (Oxford Shoulder Score, EuroQol-5D and Numeric Rating Scale for pain) and range of motion of the shoulder.

All patients will be instructed to use a sling only for 1 day and to follow a progressive physiotherapy schedule for 12 weeks. The primary outcome is the occurrence of complications and adverse events.

Ethics and dissemination

The Medical Ethics Committee from the VUmc and Curacao reviewed this study protocol and granted exemption from ethical approval (METC VUmc 2019.111, METC Curacao 2019-02). Study results will be presented at (inter)national conferences and published in peer-reviewed journals.

Trial registration number

Netherlands Trial Register (NL7656).
State-level variation in opioid prescribing after knee arthroscopy among the opioid-naïve in the USA: 2015–2019
Authors: Ukert Benjamin , Huang Yanlan , Sennett Brian , Delgado Kit
Published: August 2020

Objective

It has been established that most patients prescribed opioids after minor surgery have tablets left over, better understanding the variation in opioid prescribing and variation in dosage of the prescription could guide efforts to reduce prescribing. This study describes the state-level variation in opioid prescribing after a knee arthroscopy among opioid-naïve patients.

Design

Retrospective cohort study.

Setting

Commercial insurance claims data.

Participants

98 623 individual across the USA with commercial insurance who were opioid-naïve and had a knee arthroscopy between 2015 and 2019.

Exposure

Patients who filled an opioid prescription within 3 days of a knee arthroscopy.

Outcome measures

Opioid prescriptions were measured as a pharmacy claim for filling an opioid within 3 days of a knee arthroscopy. We measured the patient and state-level opioid prescribing rate, tablet count, morphine milligram equivalent dose per prescription and risk-adjusted predicted opioid quantity.

Results

Overall, 72% of patients filled an opioid prescription with a median tablet count of 40 and median morphine milligram equivalent of 250. Patients with an invasive procedure (27.9% vs 22.4%; p<0.001), higher education level (p<0.001) and fewer comorbidities (0.9 vs 1.2, p<0.001) had higher rates of opioid prescribing. The prescribing rate in the highest state, Nebraska (85%), was double the prescribing rate in the lowest state, South Dakota (40%). Comparing the casemix adjusted expected prescribing rate to the observed prescribing rate displayed that 18 states had observed prescribing rates that were higher than their expected prescribing rates.

Conclusion

Wide variation in the likelihood of receiving a prescription, depending on state of residence, was observed. The dosages prescribed were high and have been associated with transition to long-term use. These findings suggest that there is substantial opportunity for the development of guidelines to reduce variability in opioid prescribing for this common ambulatory procedure.
Household coverage, quality and costs of care provided by community health worker teams and the determining factors: findings from a mixed methods study in South Africa
Authors: Goudge Jane , de Kadt Julia , Babalola Olukemi , Muteba Michel , Tseng Yu-hwei , Malatji Hlologelo , Rwafa Teurai , Nxumalo Nonhlanhla , Levin Jonathan , Thorogood Margaret , Daviaud Emmanuelle , Watkins Jocelyn , Griffiths Frances
Published: August 2020

Objective

Community health workers (CHWs) are undertaking more complex tasks as part of the move towards universal health coverage in South Africa. CHW programmes can improve access to care for vulnerable communities, but many such programmes struggle with insufficient supervision. In this paper, we assess coverage (proportion of households visited by a CHW in the past year and month), quality of care and costs of the service provided by CHW teams with differing configurations of supervisors, some based in formal clinics and some in community health posts.

Participants

CHW, their supervisors, clinic staff, CHW clients.

Methods

We used mixed methods (a random household survey, focus group discussions, interviews and observations of the CHW at work) to examine the performance of six CHW teams in vulnerable communities in Sedibeng, South Africa.

Results

A CHW had visited 17% of households in the last year, and we estimated they were conducting one to two visits per day. At household registration visits, the CHW asked half of the questions required. Respondents remembered 20%–25% of the health messages that CHW delivered from a visit in the last month, and half of the respondents took the action recommended by the CHW. Training, supervision and motivation of the CHW, and collaboration with other clinic staff, were better with a senior nurse supervisor. We estimated that if CHW carried out four visits a day, coverage would increase to 30%–90% of households, suggesting that some teams need more CHW, as well as better supervision.

Conclusion

Household coverage was low, and the service was limited. Support from the local facility was key to providing a quality service, and a senior supervisor facilitated this collaboration. Greater investment in numbers of CHW, supervisors, training and equipment is required for the potential benefits of the programme to be delivered.
Development of the generic, multidimensional Treatment Expectation Questionnaire (TEX-Q) through systematic literature review, expert surveys and qualitative interviews
Authors: Alberts Jannis , Löwe Bernd , Glahn Maja Alicia , Petrie Keith , Laferton Johannes , Nestoriuc Yvonne , Shedden-Mora Meike
Published: August 2020

Objective

Patients’ expectations—as a central mechanism of placebo and nocebo effects—are an important predictor of health outcomes. However, the lack of a way to assess expectations across different settings restricts progress in understanding the role of expectations and to quantify their importance in medical and psychological treatments. The aim of this study was to develop a theory-based, generic, multidimensional measure assessing patient expectations of medical and psychological treatments.

Design

The Treatment Expectation Questionnaire (TEX-Q) was developed based on the integrative model of expectations and a systematic literature review of treatment expectation scales. After creating a comprehensive item pool, the scale was further refined by use of expert ratings and patient interviews.

Setting

Patients were recruited in primary care at two hospitals in Hamburg, Germany.

Participants

13 scientific experts participated in the expert survey. 11 patients waiting for psychological or surgical treatments participated in the qualitative interviews.

Results

The 2×2×2 multidimensional structure of the TEX-Q assesses two expectation constructs (probabilistic vs value-based) across two outcome domains with two valences (direct benefits and adverse events, broader positive and negative impact), plus process and behavioural control expectations. We examined 583 items from 38 scales identified in the systematic review and developed 78 initial items. Content validity was then rated by experts according to item fit and comprehensibility. The best 53 items were further evaluated for comprehensibility, acceptability, phrasing preference and understanding by interviewing patients prior to treatment using the ‘think aloud’ technique. This resulted in a first 35-item version of the TEX-Q.

Conclusions

The TEX-Q is a generic, multidimensional measure to assess patient expectations of medical and psychological treatments and allows comparison of the impact of multidimensional expectations across different conditions. The final TEX-Q will be available after psychometric validation.
Effect of music intervention on mental health in patients with diabetes mellitus: protocol for a systematic review and meta-analysis of randomizsed controlled trials
Authors: Zhou Lin-yue , Zhang Yuan , Tian Yuan , Fu Xiaoxu , Wang Li-zhen , Xie Chun-guang
Published: August 2020

Introduction

About 463 million adults aged 20–79 have diabetes globally. Mental disorders often exist in patients with diabetes as comorbidities, which can lead to aggravation of the diseases, increased difficulties in treatment, as well as elevated mortality rates. Music intervention has been applied in the treatment of comorbidities for 12 years now, but there are still no recommendations due to the lack of evidence. Thus, a meta-analysis is necessary to evaluate the effect of music intervention in treating mental disorders of patients with diabetes.

Methods and analysis

We will search the following nine online electronic databases from their inception until March 2020: PubMed, Web of Science, Embase, EBSCO, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journal Database (VIP) and Chinese Biomedical and Medical Database. We also plan to search other relevant resources, including grey literature and the reference lists of relevant publications. Only randomised controlled trials of music intervention to treat depression or anxiety in patients with diabetes will be involved. The primary outcomes include the depression score and anxiety score measured on certain scales, and the secondary outcome is safety. Data extraction will be independently implemented by two researchers. The risk of bias will be evaluated through the Cochrane Collaboration’s Risk of Bias tool. Eventually, all the data will be analysed via the Review Manager V.5.3 software.

Ethics and dissemination

This meta-analysis will provide information about applying music intervention to treat depression or anxiety in patients with diabetes. No ethical approval is required because this meta-analysis is based on published data. The results of this systematic review will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42019146439
Protocol of a multicenter, single-blind, randomised, parallel controlled feeding trial evaluating the effect of a Chinese Healthy Heart (CHH) diet in lowering blood pressure and other cardiovascular risk factors
Authors: Xie Wuxiang , Wang Yanfang , Sun Jianqin , Zeng Guo , Zhu Huilian , Yang Zhenquan , Gao Pei , Yang Jing , Feng Lin , Lin Pao-Hwa , Li Ming , Xu Jianguo , Chen Junshi , Wu Yangfeng
Published: August 2020

Introduction

Unhealthy diet has been identified as the number one attributor of total mortality in China, accounting for more than 20% of total deaths. Although the Dietary Approach to Stop Hypertension (DASH) and Mediterranean diets have been proven beneficial in managing cardiovascular risk factors in Western countries, whether healthy diets with similar cardiovascular benefits can be developed that are consistent with Chinese food culture remains unknown.

Methods/design

The Diet, ExerCIse and CarDiovascular hEalth (DECIDE)-Diet trial is a multicentre, single-blind, randomised controlled feeding trial to evaluate the effect of the Chinese Healthy Heart (CHH) diet, in comparison with the Chinese usual diet, in lowering cardiovascular risk factors among community residents with the increased cardiovascular risk. A total of 360 adults aged between 25 and 75 years old and with systolic blood pressure between 130 and 159 mm Hg will be recruited from four centres located in four areas representing four major Chinese cuisines: Beijing, Shanghai, Guangzhou and Chengdu. After 1 week of run-in period with local usual diet, the compliant participants will be randomised to the intervention group with the CHH diet or the control group with the usual local diet, on a 1:1 ratio, for 4 weeks. Body weight of study participants will be maintained during the entire study period. The primary outcome is the change in SBP from the baseline to the end of the study. DECIDE-Diet trial will be the first randomised controlled feeding trial to evaluate the effect of a CHH diet in lowering cardiovascular risk factors. This trial will provide compelling evidence on the CHH diet in effect of improving cardiovascular health among Chinese food consumers all around the world.

Ethics and dissemination

This trial adheres to the Declaration of Helsinki and guidelines of Good Clinical Practice. Signed informed consent will be obtained from all participants. The trial has been approved by the Peking University Institutional Review Board (approval number: IRB00001052-18094). The results will be disseminated through academic conferences and publications in international peer-reviewed journals.

Trail registration number

ClinicalTrials.gov Registry (NCT03882645); Pre-results.
Treatment of sarcopenia in nursing home residents: a scoping review protocol
Authors: Benzinger Petra , Bauer Jürgen Martin , Schwenk Michael , Grund Stefan , Goisser Sabine
Published: August 2020

Introduction

Sarcopenia has been recognised as a disease that is consistently associated with a range of geriatric syndromes and negative health consequences. The prevalence of sarcopenia is high among nursing home residents. Several systematic reviews have assessed the efficacy of a range of treatment strategies against sarcopenia. However, no systematic review discussing specifically the treatment options for sarcopenic nursing home residents has been conducted so far. The objective of this scoping review, therefore, is to identify and map existing studies that assessed the feasibility and effectiveness of interventions that were conducted with the aim to treat sarcopenic nursing home residents.

Methods and analysis

The protocol was developed using an established scoping review methodological framework. A systematic search of relevant literature databases will be conducted. We will also conduct a search of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform Search Portal for ongoing and recently completed trials, and will search for grey literature. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potentially relevant articles to determine final inclusion. A data extraction sheet will be developed including key study characteristics that will be relevant for collating, summarising and reporting the results of the scoping review.

Ethics and dissemination

The proposed scoping review will undertake a secondary analysis of publicly available data, and therefore does not require ethical approval. The results will be disseminated to researchers in the field by submitting the review to a peer-reviewed international journal and by presenting our findings at relevant conferences. We expect that the results of the final review will help to guide future research in the field of sarcopenia treatment for nursing home residents.
Recovery-oriented social work practice in mental health and addictions: a scoping review protocol
Authors: Kourgiantakis Toula , Hussain Amina , Ashcroft Rachelle , Logan Judith , McNeil Sandra , Williams Charmaine C
Published: August 2020

Introduction

Social work is a key profession in the field of mental health worldwide and the profession has values that are aligned with a recovery paradigm. However, there are gaps in understanding how social workers are applying the recovery paradigm in practice. This study will scope and synthesise the literature related to recovery and social work practice in mental health and addictions. There will also be an exploration of best practices and gaps in recovery-oriented social work practice.

Methods and analysis

Using a scoping review framework developed by Arksey and O’Malley, we will conduct our search in five academic databases: PsycINFO, Medline, CINAHL Plus, Sociological Abstracts and Social Services Abstracts. Articles meeting inclusion criteria will be charted to extract relevant themes and analysed using a qualitative thematic analysis approach.

Ethics and dissemination

This review will provide relevant information about best practices and gaps in recovery-oriented social work practice in mental health and addictions. The study will inform the development of mental health curricula in social work programmes and clinical settings. Results will be disseminated through a peer-reviewed journal and at conferences focusing on mental health, addictions, and social work education. Ethics approval is not required for this scoping review.
Does screening shorten delays to care for post-deployment mental disorders in military personnel? A longitudinal retrospective cohort study
Authors: Boulos David , Garber Bryan
Published: August 2020

Objective

To determine whether post-deployment screening is associated with a shorter delay to diagnosis and care among individuals identified with a deployment-related mental disorder.

Design

Retrospective cohort study.

Setting

Canadian military population.

Participants

The cohort consisted of personnel (n=28 460) with a deployment within the 2009 to 2014 time frame. A stratified random sample (n=3004) was selected for medical chart review. We restricted our analysis to individuals who had an opportunity to undergo screening and were subsequently diagnosed with a mental disorder that a clinician indicated was deployment-related (n=1157).

Interventions

Post-deployment health screening.

Main outcome measure

The outcome was delay to diagnosis and care, the latency from individuals’ deployment return to their mental disorder diagnosis date. Cox proportional hazards regression assessed screening’s influence on this outcome.

Results

74.4% of the study population had screened. Overall, the median delay to care was 766 days, 578 days among screeners and 928 days among non-screeners—a 350-day difference. Cox regression indicated that screeners had a significantly shorter delay to care (adjusted HR (aHR), 1.43 (95% CI, 1.11 to 1.86)). Screening findings had a substantial influence on delay to care. Identification of a mental health concern, whether a ‘major’ concern (aHR, 3.36 (95% CI, 2.38 to 4.73)) or a ‘minor’ concern (aHR, 1.46 (95% CI, 1.08 to 1.99)), and a recommendation for mental health services follow-up (aHR, 2.35 (95% CI, 1.73 to 3.21)) were strongly associated with shorter delays to care relative to non-screeners.

Conclusions

Reduced delays to care are anticipated to lead to beneficial outcomes for both the individual and military organisation. We found that screening was associated with a shortened delay to care for mental disorders that were deployment-related. Future work will further explore this screening’s components and optimisation strategies.
Risk factors for maternal mortality among 1.9 million women in nine empowered action group states in India: secondary analysis of Annual Health Survey data
Authors: Horwood Geneviève , Opondo Charles , Choudhury Saswati Sanyal , Rani Anjali , Nair Manisha
Published: August 2020

Objective

To examine the risk factors for pregnancy-related death in India’s nine Empowered Action Group (EAG) states.

Design

Secondary data analysis of the Indian Annual Health Survey (2010–2013).

Setting

Nine states: Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand.

Participants

1 989 396 pregnant women.

Methods

Maternal mortality ratio (MMR), overall and for each state, with 95% CI was calculated. Stepwise multivariable logistic regression was used to investigate the association of risk factors with maternal mortality. Area under the receiver-operating characteristic (AUROC) curve was used to assess the prediction of the model.

Outcome measures

MMR adjusted for survey design, adjusted OR (aOR)with 95% CI and C-statistic with 95% CI.

Results

MMR calculated for the nine states was 383/100 000 live births (95% CI 346 to 423 per 100 000). Age exhibited a U-shaped association with maternal mortality. Not having a health scheme and belonging to a scheduled caste or scheduled tribe group were significant risk factors for maternal death with aOR of 2.72 (95% CI 2.41 to 3.07), 1.10 (95% CI 1.02 to 1.18) and 1.43 (95% CI 1.31 to 1.56), respectively. Socioeconomic status and rural residence were not associated with maternal mortality after adjusting for access to a healthcare facility. Complications of pregnancy and medical comorbidities were the strongest risk factors for maternal death (aOR 50.2, 95% CI 44.5 to 56.6). Together, the risk factors identified accounted for 89% (95% CI 0.887 to 0.894) of the AUROC.

Conclusions

Maternal mortality in India’s EAG states greatly exceeds the national average. The identified risk factors demonstrate the importance of improving the quality of pregnancy care. Notably, the study showed that the risk conferred by poor socioeconomic status could be mitigated by universal access to healthcare during pregnancy and childbirth.
‘I also take part in caring for the sick child’: a qualitative study on fathers’ roles and responsibilities in seeking care for children in Southwest Ethiopia
Authors: Funk Tjede , Källander Karin , Abebe Ayalkibet , Alfvén Tobias , Alvesson Helle Mølsted
Published: August 2020

Objectives

Fathers play an important role in household decision-making processes and child health development. Nevertheless, they are under-represented in child health research, especially in low-income settings. Little is known about what roles fathers play in the care-seeking processes or how they interact with the health system when their child is sick. This study aimed to understand Ethiopian fathers’ roles and responsibilities in caring for their children when they are or become ill.

Design

Qualitative study using semistructured interviews with fathers.

Setting

This study was conducted in three rural districts of the Southern Nations, Nationalities and People’s Region of Ethiopia.

Participants

Twenty-four fathers who had at least one child between 2 and 59 months who visited a health extension worker with fever.

Results

The overarching theme of this study was ‘changing perceptions of paternal responsibilities during children’s ill health’. It constituted three subthemes, namely, ‘fathers’ burden of earning money for care’, ‘fatherhood entails advocating children’s healthcare needs’ and ‘investing in children’s health can benefit the family in the future’. Fathers described that they were the ones mainly responsible for the financial arrangement of care and that this financial responsibility can involve stress when resources are scarce. Fathers knew what health services were available and accessible to them and were involved in different ways in the care seeking of the child. Changes in the importance ascribed to child health were expressed by fathers who described being more alert to children’s ill-health.

Conclusion

Fathers play various roles in the care-seeking process during children’s illness episodes. This included, for instance, arranging resources to seek care, (co)-deciding where to seek care as well as accompanying the child to the health facility. The inability to organise necessary resources for care can lead to involuntary delays in care seeking for the child. This demonstrates the importance of including fathers in future interventions on maternal and child health.
Efficacy and safety of edaravone for acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis
Authors: Feng Luda , Liang Ning , Li Tingting , Yang Qinyu , Jiang Ping , Guo Shengnan , Zhang Chi , Gao Ying
Published: August 2020

Introduction

Intracerebral haemorrhage (ICH) is a life-threatening condition with no effective internal treatment options. However, edaravone is a promising therapeutic agent, although its beneficial effects are inconclusive based on previous systematic reviews and meta-analyses. While several trials in the last 8 years have reported the favourable long-term functional outcomes, a few reports indicated edaravone to be associated with an increase in adverse events.

Methods and analysis

This protocol was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will perform the comprehensive and manual search for published articles, ongoing trials, dissertations and grey literature. The following databases will be searched from inception to 23 April 2020: Medline, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese scientific periodical database of VIP INFORMATION, Wanfang Data and SinoMed, with no language restrictions. All randomised controlled trials that (1) compared edaravone with placebo or no treatment, and (2) compared edaravone plus routine treatment or cointervention with routine treatment or cointervention for treating acute ICH will be included. Mortality and long-term dependency will be the primary outcomes. The incidence of adverse events will be assessed for safety evaluation. Two reviewers in pairs will independently carry out the article selection, data extraction and quality assessment. Assessment of the risk of bias and data synthesis will be performed using software Review Manager V.5.3. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of the overall evidence.

Ethics and dissemination

There are no ethical considerations associated with this updated systematic review and meta-analysis. The findings will be disseminated in peer-reviewed journals or conference presentations.

PROSPERO registration number

CRD42019147801.
Cohort profile: COpenhagen ROsacea COhort (COROCO) and COpenhagen MIgraine COhort (COMICO)
Authors: Wienholtz Nita Katarina Frifelt , Christensen Casper Emil , Haugaard Jeanette Halskou , Zhang Ditte Georgina , Ashina Messoud , Thyssen Jacob Pontoppidan , Egeberg Alexander
Published: August 2020

Purpose

Migraine has consistently been connected with rosacea. Commonalities in epidemiology, trigger factors and associated neuropeptides support shared aetiology and pathophysiological pathways, though underlying mechanisms remain unclear. We established two cohorts of patients diagnosed with either migraine and/or rosacea. All patients were phenotyped in regard to migraine and rosacea. In this article, we describe the baseline parameters of the cohorts. In the future, we expect that these cohorts will help uncover potential disease overlaps and allow for prolonged follow-up through national Danish health registers.

Participants

COpenhagen ROsacea COhort (COROCO) and COpenhagen MIgraine COhort (COMICO) are prospective cohorts based in the Capital region of Denmark. Participants for COROCO were recruited primarily through two tertiary dermatology clinics in Copenhagen, Denmark and patients for COMICO were recruited through a tertiary neurology clinic in Copenhagen, Denmark.

Findings to date

COROCO: 67.7% women (median age 51 years (interquartile range (IQR) 43.0–61.0)). Family history of migraine: 44.3%. Family history of rosacea: 45%. There were 13% who currently smoked, and 36.6% were former smokers. Regular intake of alcohol was present in 79.3% (median 4 items/week (IQR 1.0–9.0)). Median body mass index (BMI): 25.7 (IQR 23.1–29.0). Median Dermatology Life Quality Index (DLQI): 2 (IQR 1–5).

COMICO: 88.5% women (median age 41 years (IQR 29.5–51.0)). Family history of migraine: 73.4%. Family history of rosacea: 18.4%. There were 17.1% who currently smoked, and 26.0% former smokers. Regular intake of alcohol was present in 62.2% (median intake: 2 item/week (IQR 1.0–3.0)). Median BMI was 24.6 (IQR 21.5–28.2). Median DLQI was 1 (IQR 0–2).

Future plans

COROCO and COMICO serve as strong data sources that will be used for future studies on rosacea and migraine with focus on risk factors, occurrence, treatment, natural history, complications, comorbidities and prognosis.

Trial registration number

ClinicalTrials.gov Registry (NCT03872050).
Adherence to early pulmonary rehabilitation after COPD exacerbation and risk of hospital readmission: a secondary analysis of the COPD-EXA-REHAB study
Authors: Kjærgaard Jakob , Juhl Carsten Bogh , Lange Peter , Wilcke Torgny
Published: August 2020

Background

Early pulmonary rehabilitation after exacerbation of chronic obstructive pulmonary disease (COPD) has previously been shown to reduce the risk of hospital admission and improve physical performance and quality of life. However, the impact of attendance at early rehabilitation programmes has not been established.

Objectives

To evaluate the impact of increasing attendance to pulmonary rehabilitation on the risk of hospital admission, physical performance and quality of life in patients attending an early rehabilitation programme after an exacerbation of COPD.

Methods

This study was a secondary exploratory analysis of the randomised controlled trial COPD-EXA-REHAB study, involving patients hospitalised with an exacerbation of COPD. The COPD-EXA-REHAB study compared early pulmonary rehabilitation, starting within 2 weeks after an exacerbation, with standard treatment, that is, the same programme starting 2 months later. The present analysis included only the 70 patients allocated to early pulmonary rehabilitation.

Results

At 1-year follow-up, we found an association between the number of sessions attended and a reduction in hospital admissions (incidence rate ratio 0.93 (95% CI 0.88 to 0.99), p=0.02), corresponding to a 7% reduction for each session attended. Similarly, at 2-month follow-up, physical performance was positively associated with sessions attended: the mean Incremental Shuttle Walk Test result improved by 8 m with each session (95% CI 2.54 to 13.56, p=0.005) and the Endurance Shuttle Walk Test result by 44 s (95% CI 18.41 to 68.95, p=0.001). Quality of life, assessed using the COPD Assessment Test, was not significantly associated with the number of attended sessions, with the average score increasing by 0.15 points with each session (95% CI −0.35 to 0.65, p=0.55).

Conclusion

Increased attendance at early pulmonary rehabilitation after exacerbation of COPD was associated with reduced risk of hospital admission and improved physical performance.
Study on the combination of brief psychodynamic psychotherapy with Viagra in the treatment of non-organic ED
Authors: Zhang Zhihang , Gao Xiang , Zhou Ying , Yu Chao , Pimolsettapun Jittikorn , Yang Libin , Zhao Youkang
Published: August 2020

Background

Erectile dysfunction (ED) has gradually become an important issue that seriously affects the quality of life of Chinese men. In addition to classic oral medications, psychotherapeutic interventions are increasingly being used in the treatment of ED.

Aim

This study aims to investigate the clinical efficacy of brief psychodynamic psychotherapy (BPP) plus Viagra in the treatment of non-organic ED.

Methods

We initiated this study via a controlled, prospective experimental design with initial optimal efficiency standard greater than 10%. On the standard, 63 patients were enrolled who were assigned to control or treatment group. The control group (including 33 cases) received Viagra treatment for 2 months, and the treatment group (including 30 cases) was cured with BPP plus Viagra. After the treatments, the clinical efficacy was assessed using the International Erectile Function Index (IIEF-5) score, the Self-rating Anxiety Scale (SAS), Sexual Satisfaction (SS) score and Erection Hardness Score (EHS).

Results

In the comparison of efficacy, pretreatment and post-treatment within each group, the two groups showed improvements in IIEF, SAS scores, SS, and EHS (treatment group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001; control group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001). Furthermore, the treatment group presented better performances in IIEF (p=0.040), SAS (p=0.006), SS scores (p=0.045) and EHS (p=0.041) than the control group.

Conclusion

The combination of BPP with Viagra has positive effect on the treatment of non-organic ED.
Collaborative risk assessment in secure and forensic mental health settings in the UK
Authors: Markham Sarah
Published: August 2020

Collaborative risk assessment and management have been recommended in health policy for over a decade. We consider the nature and need for collaborative risk assessment and management between patients and clinicians in secure and forensic mental health settings in the context of shared decision making and personalised care in the UK. We examine the extent to which policy and recent initiatives have influenced the embedding of such practice in services through consideration of the evidence provided by research and the Commissioning for Quality and Innovation framework, and conclude that there is a need for further improvement.
Omega-3 supplementation and cardiovascular disease: formulation-based systematic review and meta-analysis with trial sequential analysis
Authors: Rizos Evangelos C , Markozannes Georgios , Tsapas Apostolos , Mantzoros Christos S , Ntzani Evangelia E
Published: August 2020

Background

Omega-3 supplements are popular for cardiovascular disease (CVD) prevention. We aimed to assess the association between dose-specific omega-3 supplementation and CVD outcomes.

Design

We included double-blind randomised clinical trials with duration ≥1 year assessing omega-3 supplementation and estimated the relative risk (RR) for all-cause mortality, cardiac death, sudden death, myocardial infarction and stroke. Primary analysis was a stratified random-effects meta-analysis by omega-3 dose in 4 a priori defined categories (<1, 1, 2, ≥3 of 1 g capsules/day). Complementary approaches were trial sequential analysis and sensitivity analyses for triglycerides, prevention setting, intention-to-treat analysis, eicosapentaenoic acid, sample size, statin use, study duration.

Results

Seventeen studies (n=83 617) were included. Omega-3 supplementation as ≤1 capsule/day was not associated with any outcome under study; futility boundaries were crossed for all-cause mortality and cardiac death. For two capsules/day, we observed a statistically significant reduction of cardiac death (n=3, RR 0.55, 95% CI 0.33 to 0.90, I2=0%); for ≥3 capsules/day we observed a statistically significant reduction of cardiac death (n=3, RR 0.82, 95% CI 0.68 to 0.99, I2=0%), sudden death (n=1, RR 0.70, 95% CI 0.51 to 0.97) and stroke (n=2, RR 0.74, 95% CI 0.57 to 0.95, I2=0%).

Conclusion

Omega-3 supplementation at <2 1 g capsules/day showed no association with CVD outcomes; this seems unlikely to change from future research. Compared with the robust scientific evidence available for low doses, the evidence for higher doses (2–4 1 g capsules/day) is weak. The emerging postulated benefit from high-dose supplementation needs replication and further evaluation as to the precise formulation and indication.
Bilateral ultrasound-guided thoracic erector spinae plane blocks using a programmed intermittent bolus improve opioid-sparing postoperative analgesia in pediatric patients after open cardiac surgery: a randomized, double-blind, placebo-controlled trial
Authors: Macaire Philippe , Ho Nga , Nguyen Vien , Phan Van Hieu , Dinh Nguyen Thien Kim , Bringuier Sophie , Capdevila Xavier
Published: August 2020

Background

Postoperative pain after pediatric cardiac surgery is usually treated with intravenous opioids. Recently, the focus has been on postoperative regional analgesia with the introduction of ultrasound-guided erector spinae plane blocks (ESPBs). We hypothesized that bilateral ESPB with a programmed intermittent bolus (PIB) regimen decreases postoperative morphine consumption at 48 hours and improves analgesia in children who undergo cardiac surgery.

Methods

This randomized, double-blind, placebo-controlled study comprised 50 children who underwent cardiac surgery through midline sternotomy. The patients were allocated randomly into two groups: ultrasound-guided bilateral ESPB at the level of T3–T4 transverse process then PIB with saline infusion (group 1, n=23) or PIB with 0.2% ropivacaine (group 2, n=27). Intravenous morphine at 30 µg/kg/hour was used as rescue analgesia. Postoperative pain was assessed using the COMFORT-B score for extubation, drain removal, and mobilization, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale at 0, 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 hours after surgery. Adverse events were noted.

Results

The total dose of morphine in 48 hours was significantly decreased in patients receiving a bilateral ESPB with ropivacaine (120±320 µg/kg) compared with patients with saline infusion (512±560 µg/kg; p=0.03). Fourteen per cent of patients required rescue analgesia with morphine in group 2 compared with 41% in group 1 (p=0.05). The patients in group 2 demonstrated significantly reduced COMFORT-B scores at extubation, drain removal, and mobilization compared with those in group 1 and had reduced FLACC scale levels at 20 and 24 hours postoperatively (p=0.05 and p=0.001, respectively). No differences were reported for extubation and drain removal times or for length of hospital stay. In addition, vomiting episodes were decreased in group 2 (p=0.01).

Conclusions

In pediatric cardiac surgery, the results of this study confirm our hypothesis that bilateral ESPB analgesia with ropivacaine decreases the postoperative morphine consumption at 48 hours and demonstrates better postoperative analgesia compared with a control group.

Trial registration number
NCT03593642
.
TET2 expedites coronary heart disease by promoting microRNA-126 expression and inhibiting the E2F3–PI3K–AKT axis
Authors: Xu Yan
Published: August 2020

DNA demethylases of the ten-eleven translocation (TET) family serve as tumor suppressors in various human cancers, but their pathogenic effects in coronary heart disease (CHD) remain unclear. Here we report that TET2 is transcriptionally upregulated in CHD patients, where it shows potential as a diagnostic tool. Mechanistic investigations revealed that TET2 facilitates inflammatory responses and cardiomyocyte apoptosis in rats through demethylation of microRNA-126 (miR-126) promoter. This interaction leads to sequestration of miR-126 from its target E2F transcription factor 3 (E2F3), contributing to E2F3 suppression in CHD. Upregulation of miR-126 when TET2 was silenced restored levels of inflammatory factors and aggravated the degree of cardiac injury and cardiomyocyte apoptosis in rats. By contrast, simultaneous overexpression of E2F3 and miR-126 reduced the levels of inflammatory factors, cardiac injury, and cardiomyocyte apoptosis in rats. Also, TET2 was found to regulate the activity of the PI3K–AKT pathway through the miR-126–E2F3 axis. Our findings uncover a novel function for TET2 in facilitating the progression of CHD.
A new cellular automata traffic flow model considering asynchronous update of vehicle velocity
Authors: Li Qi-Lang , Jiang Rui , Ding Zhong-Jun , Wang Bing-Hong
Published: August 2020

This study examines the cellular automata traffic flow model, which considers the asynchronous update of vehicles’ velocities. Computer simulations are used to identify three typical phases: linear free flow phase, nonlinear moving phase and traffic jam phase. Compared to the original NaSch model, the system of the present model can reach the maximum flow when the vehicle density is higher. The influence of the delay probability and the maximum time step in which drivers intend to keep their current velocity on fundamental diagram is discussed.
CQDs/Au NPs Modified Polysulfone Membrane with Antibacterial Function and Photocatalytic Activity for Degradation of Methylene Blue
Authors: Chen Bin , Zhang Jialu , Zhang Yan , Zhu Lijing , Zhao Haichao
Published: August 2020

Herein, carbon quantum dots (CQDs) and gold nanoparticles (Au NPs) were synthesized and deposited on the surface of Polysulfone (PSF) membrane using polydopamine as the sublayer, resulting in excellent antibacterial property and photocatalytic activity for degradation of organic dyes. Water contact angle (WCA) of the membrane before and after surface modification dropped from [Formula: see text] to [Formula: see text], due to outstanding hydrophilicity of CQDs. The antibacterial test against [Formula: see text]. [Formula: see text] found that the CQDs/Au NPs were beneficial to improve the antibacterial property of the membrane, and the antibacterial rate could reach 90%, effectively prolonging the service life of the membrane. In addition, the adsorption of bovine serum albumin (BSA) molecules on the membrane was significantly reduced, and the irreversible fouling ratio also decreased from 41.3% to 10.7%. On the other hand, the CQDs/Au NPs layer was used as a photocatalytic material for degradation of methylene blue.
Defining Food Supply Chain Management — A Study Based on a Literature Survey
Authors: Haleem Abid , Sufiyan Mohd
Published: August 2020

There is a need to understand food supply chain management (FSCM) with the help of a process-oriented comprehensive definition and consider complex tasks involved therein. The study identifies FSCM and supply chain management’s basic definitions and focuses on a systematic literature review. None of the identified previously proposed definitions of FSCM has comprehensively covered all the significant operational issues in FSCM. Thus, the study further undertook the mapping of identified definitions with six key focusses in FSCM identified through the literature survey. This study systematically proposes a comprehensive definition of FSCM. Findings suggested that “Quality management” includes safety and traceability of the food product and “Sustainable Management,” including proper waste management as the most critical focus in FSCM. This study proposes a comprehensive FSCM definition comprising key managerial that focuses on the food supply chain (FSC). The literature survey is done with 160 selected papers and has subjectivity in mapping and analysis. This definition seems essential for theory building, as none of the available definitions has included all the dominant characteristics of FSCM. A comprehensive definition of FSCM would act as a reference point for supply chain-based research on the food sector.