bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for an economic evaluation and budget impact assessment of a randomised, stepped-wedge controlled trial for practice change support to increase routine provision of antenatal care for maternal alcohol consumption
Authors: Reeves Penny , Szewczyk Zoe , Kingsland Melanie , Doherty Emma , Elliott Elizabeth , Dunlop Adrian , Searles Andrew , Wiggers John 
Published: October 2020

Abstract
Background
Antenatal clinical practice guidelines recommend routine assessment of women’s alcohol consumption during pregnancy. The delivery of advice and referral when necessary are also recommended. However, evidence suggests there are barriers to the uptake of best-care guidelines. Effective, cost-effective and affordable implementation strategies are needed to ensure the intended benefits of guidelines are realised through addressing identified barriers. This paper describes the protocol for evaluating the efficiency and affordability of a practice change intervention compared to the usual practice in an implementation trial.

Methods
The effectiveness of the intervention will be evaluated in a stepped-wedge randomised controlled implementation trial, conducted in an Australian setting. An economic evaluation will be conducted alongside the trial to assess intervention efficiency. A budget impact assessment will be conducted to assess affordability. The prospective trial-based economic evaluation will identify, measure and value key resource and outcome impacts arising from the multi-strategy practice change intervention compared with usual practice. The evaluation will comprise (i) cost-consequence analyses, where a scorecard approach will be used to show the costs and benefits given the multiple primary outcomes included in the trial, and (ii) cost-effectiveness analyses, where the primary outcome will be incremental cost per percent increase in participants reporting receipt of antenatal care for maternal alcohol consumption consistent with the guideline recommendations. Intervention affordability will be evaluated using budget impact assessment and will estimate the financial implications of adoption and diffusion of this implementation strategy from the perspective of relevant fundholders. Results will be extrapolated to estimate the cost and cost-effectiveness of rolling out the model of care.

Discussion
Uptake of clinical guidelines requires practice change support. It is hypothesized that the implementation strategy, if found to be effective, will also be cost-effective, affordable and scalable. This protocol describes the economic evaluation that will address these hypotheses.

Trial registration
Australian and New Zealand Clinical Trials Registry, ACTRN12617000882325. Registered on 16 June 2017
Lithium in drinking water and crime rates in Japan: cross-sectional study
Authors: Kohno Kentaro , Ishii Nobuyoshi , Hirakawa Hirofumi , Terao Takeshi 
Published: October 2020

Background
In pharmacological doses, lithium successfully treats bipolar disorder and it can reduce violent crimes committed by individuals with this disorder.

Aims
To investigate whether naturally occurring lithium in drinking water lowers rates of violent crime in the general population.

Method
We examined lithium levels in the drinking water of the 274 municipalities of Kyushu Island in Japan and compared these with the crime rates in each municipality.

Results
We found that lithium levels were significantly and inversely associated with crime rates in 2009.

Conclusions
Our findings suggest that even very low levels of lithium in drinking water may play a role in reducing crime rates in the general population.
Serum Testosterone is Inversely and Sex Hormone-binding Globulin is Directly Associated with All-cause Mortality in Men
Authors: Yeap Bu B , Marriott Ross J , Antonio Leen , Chan Yi X , Raj Suchitra , Dwivedi Girish , Reid Christopher M , Anawalt Bradley D , Bhasin Shalender , Dobs Adrian S , Hankey Graeme J , Matsumoto Alvin M , Norman Paul E , O’Neill Terence W , Ohlsson Claes , Orwoll Eric S , Vanderschueren Dirk , Wittert Gary A , Wu Frederick C W , Murray Kevin 
Published: October 2020

Abstract

Context
Serum testosterone concentrations decline with age, while serum sex hormone-binding globulin (SHBG) concentrations increase.

Objective
To analyze associations of baseline serum testosterone and SHBG concentrations, and calculated free testosterone (cFT) values, with all-cause and cause-specific mortality in men.

Design, Setting, and Participants
The UK Biobank prospective cohort study of community-dwelling men aged 40–69 years old, followed for 11 years.

Main Outcome Measures
All-cause, atherosclerotic cardiovascular disease (CVD) and cancer-related mortality. Cox proportional hazards regression was performed, adjusting for age, waist circumference, medical conditions, and other covariates. Models for testosterone included SHBG and vice versa.

Results
In a complete case analysis of 149 436 men with 10 053 deaths (1925 CVD and 4927 cancer-related), men with lower testosterone had a higher mortality rate from any cause (lowest vs highest quintile, Q1 vs Q5, fully-adjusted hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.06–1.22, overall trend P &lt; 0.001), and cancer (HR = 1.20, CI = 1.09–1.33, P &lt; 0.001), with no association for CVD deaths. Similar results were seen for cFT. Men with lower SHBG had a lower mortality rate from any cause (Q1 vs Q5, HR = 0.68, CI = 0.63–0.73, P &lt; 0.001), CVD (HR = 0.70, CI = 0.59–0.83, P &lt; 0.001), and cancer (HR = 0.80, CI = 0.72–0.89, P &lt; 0.001). A multiply imputed dataset (N = 208 425, 15 914 deaths, 3128 CVD-related and 7468 cancer-related) and analysis excluding deaths within the first 2 years (9261, 1734, and 4534 events) yielded similar results.

Conclusions
Lower serum testosterone is independently associated with higher all-cause and cancer-related, but not CVD-related, mortality in middle-aged to older men. Lower SHBG is independently associated with lower all-cause, CVD-related, and cancer-related mortality. Confirmation and determination of causality requires mechanistic studies and prospective trials.
The heart of the neural crest: cardiac neural crest cells in development and regeneration
Authors: George Rajani M. , Maldonado-Velez Gabriel , Firulli Anthony B. 
Published: October 2020

ABSTRACT
Cardiac neural crest cells (cNCCs) are a migratory cell population that stem from the cranial portion of the neural tube. They undergo epithelial-to-mesenchymal transition and migrate through the developing embryo to give rise to portions of the outflow tract, the valves and the arteries of the heart. Recent lineage-tracing experiments in chick and zebrafish embryos have shown that cNCCs can also give rise to mature cardiomyocytes. These cNCC-derived cardiomyocytes appear to be required for the successful repair and regeneration of injured zebrafish hearts. In addition, recent work examining the response to cardiac injury in the mammalian heart has suggested that cNCC-derived cardiomyocytes are involved in the repair/regeneration mechanism. However, the molecular signature of the adult cardiomyocytes involved in this repair is unclear. In this Review, we examine the origin, migration and fates of cNCCs. We also review the contribution of cNCCs to mature cardiomyocytes in fish, chick and mice, as well as their role in the regeneration of the adult heart.
A simple manual method to estimate water-equivalent diameter for calculating size-specific dose estimate in chest computed tomography
Authors: Mihailidis Dimitris , Tsapaki Virginia , Tomara Pelagia 
Published: October 2020

Objectives:
The American Association of Physicists in Medicine (AAPM) Task Groups (TG) 204 and 220 introduced a method to estimate patient dose by introducing the Size-Specific Dose Estimate (SSDE). They provided patient size-specific conversion factors that could be applied to volumetric CT Dose Index CTDIvol to estimate patient dose in terms of SSDE based on either effective diameter (Deff) or water equivalent diameter (Dw). Our study presented an alternative method to manually estimate SSDE for the everyday clinical routine chest CT that can be readily used and does not require sophisticated computer programming.

Methods:
For 16 adult patients undergoing chest CT, the method employed an average relative electron density (ρe lung = 0.3) for the lung tissue and a ρe tissue of 1.0 for the other tissues to scale the lateral thickness and compute the effective lateral thickness on the patient’s axial image. The proposed method estimated a “corrected” Deff (Deff corr) to replace Dw and compared results with TG220 and a second method proposed by Huda et al, for the same set of CT studies.

Results:
The results showed comparable behavior for all methods. There is overall agreement especially between this study and TG220. Largest differences were +13.3% and+15.9% from TG220 and Huda values, respectively. Patient size correlation showed strong correlation with the TG220 and Huda et al methods.

Conclusions:
A simple, quick manual method to estimate CT patient radiation dose in terms of SSDE was proposed as an alternative where sophisticated computer programming is not available. It can be readily used during any clinical chest CT scanning.

Advances in knowledge:
The paper is novel as it presents simple, quick manual method to estimate CT patient radiation dose in chest imaging. The process can be used as alternative in cases no sophisticated computer programming is available.
Decentralized solar-powered drinking water ozonation in Western Kenya: an evaluation of disinfection efficacy
Authors: Hendrickson Colin , Oremo Jared , Akello Oscar Oluoch , Bunde Simon , Rayola Isaac , Akello David , Akwiri Daniel , Park Sung-Jin , Dorevitch Samuel 
Published: October 2020

Background: Decentralized drinking water treatment methods generally apply membrane-based treatment approaches. Ozonation of drinking water, which previously has only been possible at large centralized facilities, can now be accomplished on a small-scale using microplasma technology. The efficacy of decentralized solar-powered drinking water treatment systems has not previously been described. Methods: We established a 1,000L decentralized solar-powered water treatment system located in Kisumu County, Kenya. Highly contaminated surface water is pumped to the treatment system, which includes flocculation and filtration steps prior to ozonation. Turbidity, total coliform bacteria, and E. coli were measured at various stages of water treatment, and bacterial log reduction values (LRVs) were calculated. Results: Forty-seven trials were conducted in which1000L of water were flocculated, filtered, and ozonated for 180 minutes. Baseline turbidity and E. coli concentrations were reduced from a median of 238 nephelometric turbidity units (NTU) and 2,419.7 most probable number/100mL, respectively, in surface water to 1.0 NTU and undetectable E. coli after ozonation for 180 minutes. The median E. coli LRV was 3.99. Conclusions: The solar-powered, decentralized water treatment system that utilizes ozonation for disinfection was founded to reduce E. coli by more than 3 log-orders of magnitude despite the high turbidity of the raw water. Further research is needed to characterize limitations, scalability, economic viability, and community perspectives that could help determine the role for similar systems in other settings.
Effectiveness of face masks worn in community settings at reducing the transmission of SARS-CoV-2: A rapid review
Authors: Rohde Daniela , Ahern Susan , Clyne Barbara , Comber Laura , Spillane Susan , Walsh Kieran A. , Carty Paul G. , Drummond Linda , Boland Tina , Smith Susan M. , Connolly Máire A. , Harrington Patricia , Ryan Máirín , O'Neill Michelle 
Published: October 2020

Background: The use of face masks is part of a suite of infection prevention and control measures intended to limit the transmission of respiratory viral diseases. The use of face masks by the general public has been subject to ongoing debate, with limited direct evidence on the effectiveness of face masks in the community during the COVID-19 pandemic. The aim of this review was to synthesise direct evidence on the effectiveness of wearing face masks at reducing the transmission of SARS-CoV-2 in community settings. Methods: A rapid review was conducted. PubMed, Embase, NHS Evidence and Europe PMC were searched systematically from 1 January to 27 August 2020. Clinical trials, cohort, case control, and cross-sectional studies were included if they reported on the effectiveness of face masks in community settings at reducing the transmission of SARS-CoV-2. Studies were critically appraised and synthesised narratively. Results: Seven observational studies were identified, including one study set in households and six in community settings, that reported on the effectiveness of wearing face masks compared with not wearing face masks at reducing the transmission of SARS-CoV-2. Results suggested that face masks reduce the risk of SARS-CoV-2 infection; however, all studies were at high risk of bias and the quality of the evidence was low. Conclusions: This is to date the most comprehensive review of direct evidence on the effectiveness of wearing face masks in the community during the COVID-19 pandemic. There is limited, low certainty direct evidence that wearing face masks reduces the risk of transmission of SARS-CoV-2 in community settings. Further high quality studies are required to confirm these findings.
Case Report: Disseminated, rifampicin resistant Mycobacterium bovis (BCG) infection in an immunocompromised child
Authors: Drysdale Simon B. , Kelly Dominic F. , Morgan Marcus , Peto Tim , Crook Derrick , Matthews Philippa C. , Walker Timothy M. 
Published: October 2020

Background: Bacillus Calmette–Guérin (BCG) is a live-attenuated vaccine used world-wide for prevention of tuberculosis disease. In some immunocompromised hosts it has the potential to cause disease. As with other members of the M. tuberculosis complex it has the potential for acquiring drug resistance. Methods: We reviewed 10 years of paediatric clinical BCG strains referred to our clinical microbiology laboratory in Oxford where they underwent whole genome sequencing. We present a case series comparing clinical, pathogen genetic and pathogen phenotypic data, and consider the clinical implications. Results: We identified 15 BCG isolates from 8 children under 16 years old. Only one child had clinical disease with the other seven reported as local inoculation-site reactions. Case 1 suffered disseminated disease secondary to an undiagnosed IL-12/IFNγ receptor defect and the BCG isolates evolved two different rifampicin resistance mutations. Across all 15 isolates, phenotypic resistance to each first line drug was seen. Conclusions: BCG is a safe and effective vaccine in children. Most clinical specimens in our series were not related to disease. However, in the context of rare pathogen-specific immunocompromise, BCG can cause pathology and acquire drug resistance under selection from therapy.
Study protocol: Comparison of different risk prediction modelling approaches for COVID-19 related death using the OpenSAFELY platform
Authors:   The OpenSAFELY Collaborative, Williamson Elizabeth J. , Tazare John , Bhaskaran Krishnan , Walker Alex J. , McDonald Helen I , Tomlinson Laurie A. , Bacon Sebastian , Bates Chris , Curtis Helen J. , Forbes Harriet , Minassian Caroline , Morton Caroline E. , Nightingale Emily , Mehrkar Amir , Evans Dave , Nicholson Brian D , Leon David , Inglesby Peter , MacKenna Brian , Cockburn Jonathan , Davies Nicholas G. , Hulme Will J. , Morley Jessica , Douglas Ian J. , Rentsch Christopher T. , Mathur Rohini , Wong Angel , Schultze Anna , Croker Richard , Parry John , Hester Frank , Harper Sam , Perera Rafael , Grieve Richard , Harrison David , Steyerberg Ewout , Eggo Rosalind M. , Diaz-Ordaz Karla , Keogh Ruth , Evans Stephen J.W. , Smeeth Liam , Goldacre Ben 
Published: October 2020

On March 11th 2020, the World Health Organization characterised COVID-19 as a pandemic. Responses to containing the spread of the virus have relied heavily on policies involving restricting contact between people. Evolving policies regarding shielding and individual choices about restricting social contact will rely heavily on perceived risk of poor outcomes from COVID-19. In order to make informed decisions, both individual and collective, good predictive models are required. For outcomes related to an infectious disease, the performance of any risk prediction model will depend heavily on the underlying prevalence of infection in the population of interest. Incorporating measures of how this changes over time may result in important improvements in prediction model performance. This protocol reports details of a planned study to explore the extent to which incorporating time-varying measures of infection burden over time improves the quality of risk prediction models for COVID-19 death in a large population of adult patients in England. To achieve this aim, we will compare the performance of different modelling approaches to risk prediction, including static cohort approaches typically used in chronic disease settings and landmarking approaches incorporating time-varying measures of infection prevalence and policy change, using COVID-19 related deaths data linked to longitudinal primary care electronic health records data within the OpenSAFELY secure analytics platform.
Endometriosis and an increased risk of malignancies
Authors: Krasa Aleksandra Maria , Kozioł Magdalena , Piecewicz-Szczęsna Halina , Pawlicki Mateusz , Łopuszyńska Anna , Krawiec Paulina , Piekarska Ewa 
Published: October 2020

Introduction: Endometriosis is a common gynaecological disorder associated with pelvic pain and sub-fertility, affecting 7–15% of women of reproductive age. The disease is defined as the presence of endometrial-like tissue outside the uterine cavity, primarily on pelvic organs. The aetiology of endometriosis is still uncertain. The disease rarely causes mortality, however, it may have a significant impact on a patient's quality of life. Moreover, several studies have consistently shown that endometriosis is associated with a higher risk of some types of malignancies.Results: Endometriosis shares several molecular characteristics with invasive cancer, such as inflammation, tissue invasion, angiogenesis, dysfunction of immune cells and pro-survival features. Studies have shown that ovarian cancer, especially clear cell, endometrioid and serous, has been associated with endometriosis. Furthermore, the risk of cancer of the uterine cervix has shown to be decreased and the results on the risk of the cancers of uterine corpus or breast are inconsistent. Among non‐gynecological cancers, melanoma of the skin, non‐Hodgkin‐lymphoma, brain and thyroid cancers have also been associated with endometriosis.Conclusions: Research results indicate that women with endometriosis have an increased risk for some types of malignancies, therefore, they should be under strict gynecological control, even many years after menopause. Further research is needed to prove the real risk of different types of malignant tumors among women with endometriosis. In addition, it is necessary to establish periodic examination schedules among these patients in order to prevent certain types of malignancies.
Hepatotoxicity of anabolic androgenic steroids in sport
Authors: Sekuła Michał Jakub , Świerczyńska Blanka , Smoluchowski Krzysztof , Undziakiewicz Adrian , Piecewicz-Szczęsna Halina 
Published: October 2020

Introduction and purpose: Anabolic-androgenic steroids (AAS) abuse is a common practice among professional as well as recreational athletes. The prevalence of this phenomenon seems to be continuously escalating, too. Even though AAS abuse may provide a desirable haematopoietic and musculotrophic effect, it causes a wide variety of local and systemic side effects. This review aims to demonstrate the AAS induced hepatotoxicity, it is based on the medical literature from the last 10 years. Brief description of the state of knowledge: Orally administered 17-α-alkylated steroids are considered to be the most hepatotoxic. They increase the number of reactive oxygen species (ROS) which directly injure the liver tissue. It may be manifested as an elevation of liver enzymes, peliosis hepatis or distinctive acute cholestasis. Furthermore, ASS abuse for a prolonged period of time may induce the growth of hepatocellular adenoma and hepatocellular cancer. Moreover, AAS intake can lead to liver enlargement, development of toxicant-associated fatty liver disease (TAFLD) and increase the risk of HCV and HBV infection. Conclusions: The collaboration of scientists, doctors, sports associations and governments is substantial. Introduction of innovative AAS detection methods and enforcement of stricter anti doping law may contribute to prevention of health consequences resulting from AAS abuse among athletes.
Laparoscopic myomectomy in the treatment of large myomas – unnecessary risk or effective method?
Authors: Ozga Alicja Maria , Obuchowska Aleksandra , Standyło Arkadiusz , Wójcik Justyna , Skorupski Paweł 
Published: October 2020

Introduction:Mięśniaki macicy są najczęstszymi łagodnymi guzami macicy. Większość mięśniaków przebiega bezobjawowo i nie wymaga interwencji lekarskiej, jednak jeśli tak się dzieje, podstawą terapii pozostaje dostęp chirurgiczny. Miomektomia to jedna z chirurgicznych metod usuwania mięśniaków dla osób chcących zachować płodność. W dzisiejszych czasach udoskonalono techniki operacyjne i opracowano metody mniej inwazyjne, takie jak laparoskopowa miomektomia (LM). Jednak bezpieczeństwo i skuteczność LM jest dobrze udokumentowana w przypadku mięśniaków średniej wielkości. Dostęp laparoskopowy w przypadku większych guzów macicy (średnica> 10 cm) może budzić kontrowersje i może stanowić wyzwanie ze względu na możliwe trudności. Cel, powód: Ocena skuteczności, wyzwań technicznych i powikłań LM w leczeniu dużych mięśniaków. Materiały i metody: Przeszukaliśmy bazy danych Pubmed, Springer Link i ResearchGate. Wyniki: Systematyczne analizy zakwalifikowane do tego przeglądu sugerowały, że pomimo wielu możliwych komplikacji i trudności, metoda może być z powodzeniem stosowana przez doświadczonego specjalistę. Jednak leczenie LM w dużych mięśniakach jest nadal rzadkie, a dane na ten temat są nadal ograniczone. Wnioski: Miomektomia laparoskopowa może być alternatywną metodą leczenia dużych mięśniaków. Chirurgia laparoskopowa dużych mięśniaków LM może stanowić wyzwanie, a skuteczność takiego leczenia zależy od umiejętności chirurga. Metoda jest również przydatna u kobiet rozważających ciążę.
Creating Exercise Habits Using Incentives: The Trade-off Between Flexibility and Routinization
Authors: Beshears John , Lee Hae Nim , Milkman Katherine L. , Mislavsky Robert , Wisdom Jessica 
Published: October 2020

Habits involve regular, cue-triggered routines. In a field experiment, we tested whether incentivizing exercise routines—paying participants each time they visit the gym within a planned, daily two-hour window—leads to more persistent exercise than offering flexible incentives—paying participants each day they visit the gym, regardless of timing. Routine incentives generated fewer gym visits than flexible incentives, both during our intervention and after incentives were removed. Even among subgroups that were experimentally induced to exercise at similar rates during our intervention, recipients of routine incentives exhibited a larger decrease in exercise after the intervention than recipients of flexible incentives. This paper was accepted by Yan Chen, decision analysis.