bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the zero-mark-up drug policy on drug-related expenditures and use in public hospitals, 2016–2018: an interrupted time series study in Shaanxi
Authors: Yan Kangkang , Yang Caijun , Zhang Hongli , Ye Dan , Liu Shengyuan , Chang Jie , Jiang Minghuan , Zhao Mingyue , Fang Yu 
Published: November 2020

ObjectiveThe aim of this study was to measure the impact of zero-mark-up drug policy (ZMDP) on drug-related expenditures and use in urban hospitals.DesignThis was a retrospective observational study of trends in drug expenses and use in the context of the ZMDP using an interrupted time series analysis.SettingTwelve hospitals (three tertiary hospitals and nine secondary hospitals) in Xi’an, which is the capital of Shaanxi Province in Western China.Data and participantsThe prescription information for all outpatients and inpatients in the study hospitals from January 2016 to April 2018 was used in this study.InterventionsThe Chinese government announced the policy intervention measure of the ZMDP, which was implemented in all public hospitals as of 1 April 2017.Primary measuresMonthly drug expenditures, monthly medical expenditures, the percentage of drug expenditures among total medical expenditures, the average outpatient drug expenditure per visit, the percentage of prescriptions that include an injection and the percentage of prescriptions that include an antibiotic.ResultsMonthly total medical expenses increased in both tertiary and secondary hospitals after the ZMDP was implemented. In tertiary hospitals, the average outpatient drug expenditures per visit showed a slow decreasing trend before the intervention and an increasing trend after the intervention, with statistically significant changes in both the level (p<0.001) and the trend (p=0.02). Secondary hospitals showed a slow increasing trend both before and after the policy implementation, with no significant change in the trend (p=0.205). The proportion of prescriptions, including injections, was over 20% in secondary hospitals and less than 20% in tertiary hospitals, with no significant changes to this indicator observed after implementation of ZMDP.ConclusionsThe effect of the ZMDP on drug-related expenditures and use in Chinese public hospitals was not substantially evident. Future pharmaceutical reform measures should give more consideration to physician prescription behaviours.
Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review
Authors: Gotis-Graham Anna , Macniven Rona , Kong Kelvin , Gwynne Kylie 
Published: November 2020

ObjectiveTo examine the ability of ear, nose and throat (ENT) outreach programmes to improve health outcomes among Aboriginal and Torres Strait Islander people.MethodsWe conducted a systematic literature search of nine databases (Medline, CINAHLS, PsycINFO, Embase, Cochrane, Scopus, Global health, Informit Rural health database and Indigenous collection) and grey literature sources for primary studies evaluating ENT outreach services for Aboriginal and Torres Strait Islander people. This review included English language studies of all types, published between 2000 and 2018, that supplied ENT outreach services to Aboriginal and Torres Strait Islander Australians and provided data to evaluate their aims. Two authors independently evaluated the eligible articles and extracted relevant information. Risk of bias was assessed using the Mixed Methods Assessment Tool.ResultsOf the 506 studies identified, 15 were included in this review. These 15 studies evaluated eight different programs/activities. Studies were heterogeneous in design so a meta-analysis could not be conducted. Seven studies measured health-related outcomes in middle ear or hearing status; six reported overall positive changes one reported no clinically significant improvements. Five programmes/activities and their corresponding studies involved Aboriginal and Torres Strait Islander people and organisations in delivery and evaluation, but involvement in programme or study design was unclear.ConclusionWhile some studies demonstrated improved outcomes, the overall ability of ENT programmes to improve health outcomes for Aboriginal and Torres Strait Islander children is unclear. The impact of ENT outreach may be limited by a lack of quality evidence, service coordination and sustainability. Community codesign and supporting and resourcing local capacity must be a component of outreach programmes and ongoing evaluation is also recommended. Improvements in these areas would likely improve health outcomes.PROSPERO registration numberCRD42019134757.
Longitudinal cohort study of the impact of specialist cancer services for teenagers and young adults on quality of life: outcomes from the BRIGHTLIGHT study
Authors: Taylor Rachel M , Fern Lorna A , Barber Julie , Alvarez-Galvez Javier , Feltbower Richard , Lea Sarah , Martins Ana , Morris Stephen , Hooker Louise , Gibson Faith , Raine Rosalind , Stark Dan P , Whelan Jeremy 
Published: November 2020

ObjectivesIn England, healthcare policy advocates specialised age-appropriate services for teenagers and young adults (TYA), those aged 13 to 24 years at diagnosis. Specialist Principal Treatment Centres (PTC) provide enhanced TYA age-specific care, although many still receive care in adult or children’s cancer services. We present the first prospective structured analysis of quality of life (QOL) associated with the amount of care received in a TYA-PTCDesignLongitudinal cohort study.SettingHospitals delivering inpatient cancer care in England.Participants1114 young people aged 13 to 24 years newly diagnosed with cancer.InterventionExposure to the TYA-PTC defined as patients receiving NO-TYA-PTC care with those receiving ALL-TYA-PTC and SOME-TYA-PTC care.Primary outcomeQuality of life measured at five time points: 6, 12, 18, 24 and 36 months after diagnosis.ResultsGroup mean total QOL improved over time for all patients, but for those receiving NO-TYA-PTC was an average of 5.63 points higher (95% CI 2.77 to 8.49) than in young people receiving SOME-TYA-PTC care, and 4·17 points higher (95% CI 1.07 to 7.28) compared with ALL-TYA-PTC care. Differences were greatest 6 months after diagnosis, reduced over time and did not meet the 8-point level that is proposed to be clinically significant. Young people receiving NO-TYA-PTC care were more likely to have been offered a choice of place of care, be older, from more deprived areas, in work and have less severe disease. However, analyses adjusting for confounding factors did not explain the differences between TYA groups.ConclusionsReceipt of some or all care in a TYA-PTC was associated with lower QOL shortly after cancer diagnosis. The NO-TYA-PTC group had higher QOL 3 years after diagnosis, however those receiving all or some care in a TYA-PTC experienced more rapid QOL improvements. Receipt of some care in a TYA-PTC requires further study.
Pretreatment maternal lifestyle and outcomes of assisted reproduction: an Italian cohort study
Authors: Ricci Elena , Noli Stefania , Ferrari Stefania , La Vecchia Irene , De Cosmi Valentina , Castiglioni Marta , Somigliana Edgardo , Agostoni Carlo , Cipriani Sonia , Mauri Paola Agnese , Parazzini Fabio 
Published: November 2020

ObjectiveWe investigated whether lifestyle affects assisted reproduction technology (ART) outcomes.DesignCohort study.SettingItalian fertility unit.ParticipantsFrom September 2014 to December 2016, women from couples presenting for evaluation and eligible for ART were invited to participate. Information on alcohol intake, current smoking and leisure physical activity (PA) during the year before the interview was collected, using a structured questionnaire. We considered the ART outcomes of the cycle immediately following the interview.Primary and secondary outcome measuresThe primary outcome measure was cumulative pregnancy rate per retrieval. Secondary measures were number of retrieved oocytes, embryo transfer and live birth.ResultsIn 492 women undergoing an ART cycle, 427 (86.8%) underwent embryo transfer, 157 (31.9%) had at least one clinical pregnancy and 121 (24.6%) had live birth. The cumulative pregnancy rate per retrieval was 33.3% (95% CI 28.5% to 38.7%). In women in the third tertile of alcohol intake, adjusted relative risk was 0.97 (95% CI 0.87 to 1.08), 0.90 (95% CI 0.62 to 1.30) and 0.89 (95% CI 0.57 to 1.37) for embryo transfer, clinical pregnancy and live birth, respectively. The corresponding figures in women currently smoking more than 5 cigarettes/day were 1.00 (95% CI 0.88 to 1.16), 0.94 (95% CI 0.60 to 1.48) and 1.14 (95% CI 0.68 to 1.90), and in women with PA ≥5 hours/week were 0.93 (95% CI 0.79 to 1.08), 0.44 (95% CI 0.22 to 0.90) and 0.48 (95% CI 0.22 to 1.05), respectively.ConclusionThere were no significant differences in in vitro fertilisation outcomes among women who used alcohol or tobacco in the year prior to treatment. Conservatively, all women should be advised to limit substance abuse. Moreover, our study suggested that maintaining a moderate, but not high, level of PA could be beneficial.
How much do we know about the effectiveness of warm-up intervention on work related musculoskeletal disorders, physical and psychosocial functions: protocol for a systematic review
Authors: Larinier Nicolas , Balaguier Romain , Vuillerme Nicolas 
Published: November 2020

IntroductionWork-related musculoskeletal disorders (WMSDs) are a growing worldwide burden and effective interventions to prevent them are needed. Physical activity at the workplace is now recognised as a relevant component of WMSDs prevention. Along these lines, warm-up interventions are now offered in a large number of companies to manage WMSDs. Although benefits of warm-up have been previously documented in sports context, to the best of our knowledge, the effectiveness of such intervention in workplaces still remains to be established. Within this context, the aim of the present review is to identify from published literature the available evidence regarding the effects of warm-up on WMSDs and physical and psychosocial functions.MethodsThe following electronic databases will be searched (from inception onwards to June 2020): Cochrane Central Register of Controlled Trials, PubMed (Medline), Web of Science and Physiotherapy Evidence Database. Randomised and non-randomised controlled studies will be included in this review. Participants should be adult employees without specific comorbidities. Interventions should include a warm-up physical intervention in real-workplaces. The primary outcomes will be pain, discomfort or fatigue. The secondary outcomes will be job control or motivation at work. This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and two team members will independently screen all citations, full-text articles and abstract data. A systematic narrative synthesis will be provided with information presented in the text and tables to summarise the characteristics and findings of the included studies.Ethics and disseminationThe approval of an ethical committee is not required. All the included studies will comply with the current ethical standards. The results of this review will summarise the effects of warm-up intervention on WMSDs, physical or psychosocial functions. This information could help professionals in decision making related to the use of these interventions to prevent WMSDs. Findings will be disseminated to academic audiences through peer-reviewed publications, as well as to policy-makers.PROSPERO registration numberCRD42019137211.
Modelling retailer-based exemptions in flavoured tobacco sales restrictions: national estimates on the impact of product availability
Authors: Schillo Barbara A , Benson Adam F , Czaplicki Lauren , Anesetti-Rothermel Andrew , Kierstead Elexis C , Simpson Randall , Phelps Natasha C , Herman Peter , Zhao Chang , Rose Shyanika W 
Published: November 2020

ObjectivesMore than 250 US localities restrict sales of flavoured tobacco products (FTPs), but comprehensiveness varies, and many include retailer-based exemptions. The purpose of this study is to examine resulting changes in the US retail environment for FTPs if there was a hypothetical national tobacco control policy that would prohibit FTP sales in all retailers except (1) tobacco specialty stores or (2) tobacco specialty stores and alcohol outlets.Design and settingA cross-sectional analysis of the FTP retail environment in every US Census tract (n=74 133). FTP retailers (n=3 10 090) were enumerated using nine unique codes from a national business directory (n=296 716) and a national vape shop directory (n=13 374).Outcome measuresWe assessed FTP availability using static-bandwidth and adaptive-bandwidth kernel density estimation. We then calculated the proportion of FTP stores remaining and the mean density of FTP retailers under each policy scenario for the overall population, as well as across populations vulnerable to FTP use.ResultsExempting tobacco specialty stores alone would leave 25 276 (8.2%) FTP retailers nationwide, while exempting both tobacco specialty stores and alcohol outlets would leave 54 091 (17.4%) retailers. On average, the per cent remaining FTP availability per 100 000 total population was 7.1% for a tobacco specialty store exemption and 18.1% for a tobacco specialty store and alcohol outlet exemption. Overall, density estimate trends for remaining FTP availability among racial/ethnic populations averaged across Census tracts mirrored total population density. However, estimates varied when stratified by metropolitan status. Compared with the national average, FTP availability would remain 47%–49% higher for all racial/ethnic groups in large metropolitan areas.ConclusionsRetailer-based exemptions allow greater FTP availability compared with comprehensive policies which would reduce FTP availability to zero. Strong public policies have the greatest potential impact on reducing FTP availability, particularly among urban, and racial/ethnic minority populations.
Laryngopharyngeal reflux in war-torn Syria and its association with smoking and other risks: an online cross-sectional population study
Authors: Kakaje Ameer , Alhalabi Mohammad Marwan , Alyousbashi Ayham , Hamid Aya , Mahmoud Yousef 
Published: November 2020

ObjectivesTo demonstrate the burden of laryngopharyngeal reflux (LPR) in Syria and its associated variables.DesignThis is a cross-sectional study that used online questionnaires that included demographics, smoking, war-related questions and reflux symptom index (RSI).SettingThis research was conducted online across Syria and included the general population.ParticipantsParticipants who lived in Syria, agreed to participate, and responded to all the RSI questions were included. This research comprised 734 participants, with 94.6% response rate, 75.5% being females, and a mean age of 24 years.ResultsOverall, 31.9% of subjects had symptoms suggestive of LPR. Participants who were 30 years and younger had fewer symptoms suggestive of LPR compared with the older group p=0.012 (OR 0.534; 95% CI 0.325 to 0.877). While having an epigastric burning sensation, chest pain and indigestion were the most common symptoms, having a sore throat was the least common. Being distressed from war noises was associated with more symptoms p=0.009 (OR 1.562; 95% CI 1.117 to 2.183). However, losing someone or changing place of living due to war were not significantly associated with these symptoms p>0.05. RSI scores were associated with cigarette and/or shisha smoking p<0.05. Finally, asthma, allergic disorders and having a job were associated with having LPR symptoms p<0.05. No significant findings were observed in consanguinity, marital status, educational level and socioeconomic status.ConclusionsWar, smoking, asthma, allergies, respiratory conditions and having a job were associated with LPR symptoms. However, they may be associated with these symptoms independently from LPR; for instance, similar symptoms can be caused by the mental disorders from war, the unique environment and irritant substances of the laryngeal mucosa.
Chronic back pain in first-degree relatives (FDRs) of patients with ankylosing spondylitis: predictive value of HLA-B27 and persistence of inflammatory back pain over time
Authors: Doughem Karim , Weisman Michael H , Ward Michael M , Gensler Lianne S , Ishimori Mariko , Tahanan Amirali , Kung David C , Diekman Laura , Lee MinJae , Rahbar Mohammad Hossein , Reveille John D 
Published: November 2020

Background/PurposeFirst-degree relatives (FDRs) of patients with ankylosing spondylitis (AS) may be at high risk of spondyloarthritis. We examined the frequency, characteristics of chronic back pain (CBP), associated features, persistence of symptoms, and HLA-B27 allele frequency in FDRs of AS patients, also comparing those FDRs with participants in NHANES 2009–2010 with CBP.Methods399 FDRs of AS probands were divided into: (1) No CBP (subjects >40 years old at study visit without CBP) (n=162); (2) NICBP (non-inflammatory CBP) (n=82), and (3) CIBP (inflammatory CBP) (n=155). White FDRs with CBP were compared with 772 participants in NHANES 2009–2010 with CBP. FDRs were invited to return for reassessment.ResultsFDRs with CIBP had earlier onset of CBP than those with NICBP (p<0.001) and had higher frequency of heel pain than those without CBP (p=0.002). HLA-B27 occurred in 57% of FDRs with CIBP vs 39.6% of those without CBP (p=0.005, OR=1.9). Of 23 patients with CIBP at baseline re-evaluated 67.04±31.02 months later, 16 (73%) still had CIBP, whereas 4 (31%) of 13 NICBP patients seen 61.23±31.84 months later remained symptomatic.ConclusionCIBP in FDRs of AS patients is HLA-B27-associated, has earlier onset and tends to persist compared to NICBP.
Muscarinic agonists inhibit the ATP-dependent potassium current and suppress the ventricle–Purkinje action potential dispersion
Authors: Magyar Tibor , Árpádffy-Lovas Tamás , Pászti Bence , Tóth Noémi , Szlovák Jozefina , Gazdag Péter , Kohajda Zsófia , Gyökeres András , Györe Balázs , Gurabi Zsolt , Jost Norbert , Virág László , Papp Julius Gy. , Nagy Norbert , Koncz István 
Published: November 2020

Activation of the parasympathetic nervous system has been reported to have an antiarrhythmic role during ischemia–reperfusion injury by decreasing the arrhythmia triggers. Furthermore, it was reported that the parasympathetic neurotransmitter acetylcholine is able to modulate the ATP-dependent potassium current (I K-ATP), a crucial current activated during hypoxia. However, the possible significance of this current modulation in the antiarrhythmic mechanism is not fully clarified. Action potentials were measured using the conventional microelectrode technique from canine left ventricular papillary muscle and free-running Purkinje fibers, under normal and hypoxic conditions. Ionic currents were measured using the whole-cell configuration of the patch-clamp method. Acetylcholine at 5 μmol/L did not influence the action potential duration (APD) either in Purkinje fibers or in papillary muscle preparations. In contrast, it significantly lengthened the APD and suppressed the Purkinje–ventricle APD dispersion when it was administered after 5 μmol/L pinacidil application. Carbachol at 3 μmol/L reduced the pinacidil-activated I K-ATP under voltage-clamp conditions. Acetylcholine lengthened the ventricular action potential under simulated ischemia condition. In this study, we found that acetylcholine inhibits the I K-ATP and thus suppresses the ventricle–Purkinje APD dispersion. We conclude that parasympathetic tone may reduce the arrhythmogenic substrate exerting a complex antiarrhythmic mechanism during hypoxic conditions.
Time of Evaluation of Pain Catastrophizing after Surgery for Upper Extremity Motor Disorders
Authors: Hirata Junya , Inoue Keiko 
Published: November 2020

Background: The evaluation of pain catastrophizing, which is a negative emotion associated with pain, is useful for predicting pain after surgery and is also associated with upper extremity disability. Therefore, it is important to evaluate pain catastrophizing after surgery for upper limb musculoskeletal disorders. This study examined the appropriate time to evaluate pain catastrophizing after surgery for upper extremity motor disorders. Methods: A total of 32 patients underwent surgery. Pain catastrophizing (Pain Catastrophizing Scale: PCS) and pain intensity (Numerical Rating Scale: NRS) were measured at the start of rehabilitation and 2, 4, and 8 weeks postoperatively. The subjective ability of the upper extremity was measured 8 weeks postoperatively using the Hand20 questionnaire. The variation in the postoperative PCS and NRS were investigated. Results: The PCS and NRS values were significantly lower 2 weeks postoperatively than at the time rehabilitation started. Pain catastrophizing was a significant predictor of pain, with the greatest degree of prediction at 2 weeks. Pain catastrophizing was also a significant predictor of the Hand20 result at 8 weeks postoperatively. Conclusions: Our data shows that pain catastrophizing should be evaluated 2 weeks postoperatively for the prediction of continuing pain.
СТАН КІСТКОВОЇ ТКАНИНИ ТА ВІТАМІН D-СТАТУС У ДІТЕЙ В ПЕРІОД ДРУГОГО РОСТОВОГО СПУРТУ
Authors: Frolova T. V. , Osman N. S. , Stenkova N. F. 
Published: November 2020

Мета дослідження – визначення структурно-функціонального стану кісткової тканини та статусу вітаміну D3 у школярів у період другого ростового спурту.
Матеріали та методи. Обстежено 205 умовно здорових дітей віком 9–17 років, які були розподілені на групи залежно від наявності ростового спурту (РС) та його інтенсивності. I група – 50 дітей, які за поточний рік прибавили у рості 8–12 см; II група – 46 дітей, які за поточний рік прибавили у рості більше 12 см, III група – 109 дітей, які не мали РС. Обстеження включало аналіз даних анамнезу, оцінку рівня фізичного та статевого розвитку, ультразвукову та рентгенівську денситометрію, визначення рівня 25-(ОН)-D3.
Результати дослідження та їх обговорення. При проведенні ультразвукової денситометрії (УД) дітям зниження мінеральної щільності кісткової тканини (МЩКТ) діагностовано: I група – 24 дитини (48,0 %), середній показник Z-score складав 1,8±0,56; II група – 28 дітей (60,87 %), середній показник Z-score – 1,96±0,27; III група – 43 дитини (39,45 %), середній показник Z-score – 1,68±0,72.
За допомогою DXA було обстежено 32 дитини, у яких при проведенні УД виявлено зниження МЩКТ; у 18 з них (56,25 %) було діагностовано зниження МЩКТ. Відсоток дітей зі зниженням МЩКТ у період ростового спурту (І група) та інтенсивного ростового спурту (ІІ група) складав, відповідно, 38,9 та 50,0 %. Середній рівень вітаміну 25-(ОН)-D3 у дітей I групи зі зниженою МЩКТ становив (39,04±11,84) нмоль/л; у дітей із нормальною МЩКТ – (42,43±6,3) нмоль/л; у дітей II групи зі зниженою МЩКТ його середній рівень становив (45,68±5,48) нмоль/л, при нормальній МЩКТ – (45,47±4,69) нмоль/л; у дітей III групи зі зниженою МЩКТ його середній рівень склав (36,73±8,94) нмоль/л, що вірогідно відрізняється від його значень у дітей з нормальною МЩКТ – (42,91±9,1) нмоль/л (р˂0,05).
Висновки. Зниження мінеральної щільності кісткової тканини у дітей шкільного віку в період ростового спурту відбувається на тлі недостатності або дефіциту вітаміну D3, проте найбільш суттєвим чинником зниження МЩКТ є саме відставання процесів накопичення кісткової маси на тлі інтенсивного лінійного росту скелета.
TUBAL FACTOR AS ONE OF THE LEADING FACTORS OF FEMALE INFERTILITY
Authors: Khmil S. V. , Terletska N. Yu. 
Published: November 2020

Infertility is one of the most urgent problems of today, as this condition makes it impossible for a mature organism to produce offspring. The issue of restoring and maintaining reproductive health is one of the priority issues of modern gynecology and reproductive medicine. The article adduces the main etiological and pathogenetic links of tubal-peritoneal infertility, as well as briefly presents modern views on the diagnosis and treatment of women in this group.
Conclusion. The analysis of current data on the treatment of tubal obstruction will provide an opportunity to more rationally address the issue of choosing to restore their patency.