bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in very preterm extrauterine growth in a European multicountry cohort
Authors: El Rafei Rym , Jarreau Pierre-Henri , Norman Mikael , Maier Rolf Felix , Barros Henrique , Reempts Patrick Van , Pedersen Pernille , Cuttini Marina , Zeitlin Jennifer 
Published: December 2020

ObjectiveExtrauterine growth restriction (EUGR) among very preterm infants is related to poor neurodevelopment, but lack of consensus on EUGR measurement constrains international research. Our aim was to compare EUGR prevalence in a European very preterm cohort using commonly used measures.DesignPopulation-based observational study.Setting19 regions in 11 European countries.Patients6792 very preterm infants born before 32 weeks’ gestational age (GA) surviving to discharge.Main outcome measuresWe investigated two measures based on discharge-weight percentiles with (1) Fenton and (2) Intergrowth (IG) charts and two based on growth velocity (1) birth weight and discharge-weight Z-score differences using Fenton charts and (2) weight-gain velocity using Patel’s model. We estimated country-level relative risks of EUGR adjusting for maternal and neonatal characteristics and associations with population differences in healthy newborn size, measured by mean national birth weight at 40 weeks’ GA.ResultsAbout twofold differences in EUGR prevalence were observed between countries for all indicators and these persisted after case-mix adjustment. Discharge weight <10th percentile using Fenton charts varied from 24% (Sweden) to 60% (Portugal) and using IG from 13% (Sweden) to 43% (Portugal), while low weight-gain velocity ranged from 35% (Germany) to 62% (UK). Mean term birth weight strongly correlated with both percentile-based measures (Spearman’s rho=−0.90 Fenton, −0.84 IG, p<0.01), but not Patel’s weight-gain velocity (rho: −0.38, p=0.25).ConclusionsVery preterm infants have a high prevalence of EUGR, with wide variations between countries in Europe. Variability associated with mean term birth weight when using common postnatal growth charts complicates international benchmarking.
Do childhood socioeconomic circumstances moderate the association between childhood cognitive ability and all-cause mortality across the life course? Prospective observational study of the 36-day sample of the Scottish Mental Survey 1947
Authors: Iveson Matthew Henry , Altschul Drew , Deary Ian 
Published: December 2020

BackgroundThere is growing evidence that higher childhood cognitive ability predicts lower all-cause mortality risk across the life course. Whereas this association does not appear to be mediated by childhood socioeconomic circumstances, it is unclear whether socioeconomic circumstances moderate this association.MethodsThe moderating role of childhood socioeconomic circumstances was assessed in 5318 members of the 36-day sample of the Scottish Mental Survey 1947. Univariate, sex-adjusted and age-adjusted, and mutually adjusted Cox models predicting all-cause mortality risk up to age 79 years were created using childhood IQ scores and childhood social class as predictors. Moderation was assessed by adding an interaction term between IQ scores and social class and comparing model fit.ResultsAn SD advantage in childhood IQ scores (HR=0.83, 95% CI 0.79 to 0.86, p<0.001) and a single-class advantage in childhood social class (HR=0.92, 95% CI 0.88 to 0.97, p<0.001) independently predicted lower mortality risk. Adding the IQ–social class interaction effect did not improve model fit (χ2Δ=1.36, p=0.24), and the interaction effect did not predict mortality risk (HR=1.03, 95% CI 0.98 to 1.07, p=0.25).ConclusionsThe present study demonstrated that the association between higher childhood cognitive ability and lower all-cause mortality risk is not conditional on childhood social class. Whereas other measures of socioeconomic circumstances may play a moderating role, these findings suggest that the benefits of higher childhood cognitive ability for longevity apply regardless of the material socioeconomic circumstances experienced in childhood.
How do cancer screening guidelines trade off benefits versus harms and burdens of screening? A systematic survey
Authors: Zeng Linan , Helsingen Lise Mørkved , Kenji Nampo Fernando , Wang Yuting , Yao Liang , Siemieniuk Reed Alexander , Bretthauer Michael , Guyatt Gordon H 
Published: December 2020

ObjectivesCancer screening guidelines differ in their recommendations for or against screening. To be able to provide explicit recommendations, guidelines need to specify thresholds for the magnitude of benefits of screening, given its harms and burdens. We evaluated how current cancer screening guidelines address the relative importance of benefits versus harms and burdens of screening.Data sourceWe searched the Guidelines International Network, International Guideline Library, ECRI Institute and Medline. Two pairs of reviewers independently performed guideline selection and data abstraction.Eligibility criteriaWe included all cancer screening guidelines published in English between January 2014 and April 2019.ResultsOf 68 eligible guidelines, 25 included a statement regarding the trade-off between screening benefits versus harms and burdens (14 guidelines), or a statement of direction of the net effect (defined as benefits minus harms or burdens) (13 guidelines). None of these 25 guidelines defined how large a screening benefit should be to recommend screening, given its harms and burdens. 11 guidelines performed an economic evaluation of screening. Of these, six identified a key benefit outcome; two specified a cost-effectiveness threshold for recommending a screening option. Eight guidelines commented on people’s values and preferences regarding the trade-off between benefits versus harms and burdens.ConclusionsCurrent cancer screening guidelines fail to specify the values and preferences underlying their recommendations. No guidelines provide a threshold at which they believe the benefits of screening outweigh its harms and burdens.PROSPERO registration numberCRD42019138590.
Functional MRI in the effect of transcranial magnetic stimulation therapy for patients with schizophrenia: a meta-analysis protocol
Authors: Zhong Siqian , Hu Yiru , Fu Yu , Cao Liping , Zhang Bin 
Published: December 2020

IntroductionSchizophrenia is a psychiatric illness associated with brain function alterations and varying degree of treatment resistance, often leading to severe social malfunctioning. In recent decades, numerous studies have been investigating the therapeutic potential of transcranial magnetic stimulation (TMS) as a non-invasive therapy for schizophrenia. However, its clinical efficacy remains controversial, as a number of clinical trials indicated moderate therapeutic effect while others failed to reproduce the positive result. Moreover, the neurobiological mechanism of action remains unclear, possibly constricting the application of TMS in clinical practice. The present protocol of meta-analysis aims to investigate the TMS-related functional neuroimaging (ie, functional MRI) features and alterations in subjects with schizophrenia, and to discuss the potential of functional MRI in TMS researches.Methods and analysisThe study selection process will follow the Preferred Reporting Items for Meta-Analyses guideline and quality assessment will be conducted with a customised checklist. We plan to search in the following databases: PubMed, Embase, OVID, China National Knowledge Infrastructure and Wanfang Data, from their respective dates of inception to 1 May 2020, with language restricted to English and Chinese. Studies focusing on the brain functional alterations in patients with schizophrenia treated by TMS will be retrieved.Ethics and disseminationThis work does not require ethics approval as it will be based on published studies. This systematic review will be publicly disseminated in peer-reviewed journals.PROSPERO registration numberCRD42020166288.
Restaurant interventions for salt reduction in China: protocol for a randomised controlled trial
Authors: Du Wenwen , Zhang Jiguo , Li Yuan , He Feng J , Zhou Xue , Xu Zhihua , Gao Yifu , Yin Lei , Chang Xiaoyu , Yan Wei , Tan Monique , MacGregor Graham A , Luo Rong , Zhang Puhong , Wang Huijun 
Published: December 2020

IntroductionSalt intake in China is high, and most of it comes from that added by consumers. Nevertheless, recent years have seen a rapid increase in the frequency at which people eat out. The aim of this study is to evaluate the effectiveness of interventions designed for salt reduction in restaurants through a randomised controlled trial in China.Methods and analysisAs a randomised controlled trial with restaurants as study subjects, we recruited 192 restaurants from 12 counties of 6 provinces in China. After the baseline survey, restaurants were randomly assigned to intervention or control group. Using social cognitive theory, comprehensive intervention activities were designed to encourage salt reduction in all restaurant foods, and at the same time, to encourage consumers to choose lower salt options when eating out. The interventions will be conducted only in restaurants of the intervention group during the first year. The follow-up assessment will be conducted at the end of the trial. The primary outcome is the change in the average salt content of the five best-selling dishes of the restaurant, as measured by laboratory tests. Secondary outcomes include differences in the monthly use of salt and salty condiments between intervention and control restaurants, and the knowledge, attitude and practice on salt among restaurant consumers.Ethics and disseminationThe study was reviewed and approved by the Review Board of the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media.Trial registration numberChiCTR1800019694; Pre-results.
Feasibility and acceptability study on the use of a smartphone application to facilitate balance training in the ageing population
Authors: Papi Enrica , Chiou Shin-Yi , McGregor Alison H 
Published: December 2020

ObjectivesThis study aims to investigate the feasibility and acceptability of using an app-based technology to train balance in the older population.DesignProspective feasibility study.SettingThe study was conducted in a university setting and participants’ homes.ParticipantsThirty-five volunteers ≥55 years old were recruited.InterventionParticipants were asked to follow a balance exercise programme 7 days a week for 3 weeks using a phone application. Seventeen participants trained for a further 3 weeks.Outcome measuresPostural sway measures during quiet standing with feet at shoulder width apart and feet together, one leg standing and tandem stance were measured at baseline, and at the end of the 3 and 6 training weeks; the International Physical Activity Questionnaire (IPAQ) assessed participants’ physical activity level before training; and app acceptability was recorded using a user experience questionnaire.ResultsParticipants on the 3 and 6-week programme on average completed 20 (±5) and 38 (±11) days of training, respectively, and all scored moderate to high on the IPAQ. Between baseline and the 3-week assessments, statistically significant improvements were observed for anteroposterior sway, mediolateral sway, sway area during tandem stance, for anteroposterior sway during one leg standing and for sway area during feet together stance. Improvements were observed at 6 week compared with baseline but those between 3 and 6 weeks were not significant. Based on the questionnaire, participants reported that the app is an appropriate tool for balance training (77%), they reported benefits from the training (50%) and found it easy to fit it into daily routine (88%).ConclusionThe high level of adherence and improvements observed in the analysed measures demonstrate the feasibility of using an app to train balance in moderately to highly physically active older participants. This demonstrates that given appropriate tools the older population is positive towards and receptive of digital interventions aimed to improve balance.
Healthcare for migrant workers in destination countries: a comparative qualitative study of China and Malaysia
Authors: Loganathan Tharani , Rui Deng , Pocock Nicola Suyin 
Published: December 2020

ObjectivesThis paper explores policies addressing migrant worker’s health and barriers to healthcare access in two middle-income, destination countries in Asia with cross-border migration to Yunnan province, China and international migration to Malaysia.DesignQualitative interviews were conducted in Rui Li City and Tenchong County in Yunnan Province, China (n=23) and Kuala Lumpur, Malaysia (n=44), along with review of policy documents. Data were thematically analysed.ParticipantsParticipants were migrant workers and key stakeholders with expertise in migrant issues including representatives from international organisations, local civil society organisations, government agencies, medical professionals, academia and trade unions.ResultsMigrant health policies at destination countries were predominantly protectionist, concerned with preventing transmission of communicable disease and the excessive burden on health systems. In China, foreign wives were entitled to state-provided maternal health services while female migrant workers had to pay out-of-pocket and often returned to Myanmar for deliveries. In Malaysia, immigration policies prohibit migrant workers from pregnancy, however, women do deliver at healthcare facilities. Mandatory HIV testing was imposed on migrants in both countries, where it was unclear whether and how informed consent was obtained from migrants. Migrants who did not pass mandatory health screenings in Malaysia would runaway rather than be deported and become undocumented in the process. Excessive attention on migrant workers with communicable disease control campaigns in China resulted in inadvertent stigmatisation. Language and financial barriers frustrated access to care in both countries. Reported conditions of overcrowding and inadequate healthcare access at immigration detention centres raise public health concern.ConclusionsThis study’s findings inform suggestions to mainstream the protection of migrant workers’ health within national health policies in two middle-income destination countries, to ensure that health systems are responsive to migrants’ needs as well as to strengthen bilateral and regional cooperation towards ensuring better migration management.
Randomised controlled trial for high-dose intravenous zinc as adjunctive therapy in SARS-CoV-2 (COVID-19) positive critically ill patients: trial protocol
Authors: Perera Marlon , El Khoury John , Chinni Vidyasagar , Bolton Damien , Qu Liang , Johnson Paul , Trubiano Jason , McDonald Christine F , Jones Daryl , Bellomo Rinaldo , Patel Oneel , Ischia Joseph 
Published: December 2020

IntroductionSARS-CoV-2 (COVID-19) has caused an international pandemic of respiratory illness, resulting in significant healthcare and economic turmoil. To date, no robust vaccine or treatment has been identified. Elemental zinc has previously been demonstrated to have beneficial effects on coronaviruses and other viral respiratory infections due to its effect on RNA polymerase. Additionally, zinc has well-demonstrated protective effects against hypoxic injury—a clear mechanism of end-organ injury in respiratory distress syndrome. We aimed to assess the effect of high-dose intravenous zinc (HDIVZn) on SARS-CoV-2 infection. The end of study analyses will evaluate the reduction of impact of oxygen saturations or requirement of oxygen supplementation.Methods and analysisWe designed a double-blind randomised controlled trial of daily HDIVZn (0.5 mg/kg) versus placebo. Primary outcome measures are lowest oxygen saturation (or greatest level of supplemental oxygenation) for non-ventilated patients and worst PaO2/FiO2for ventilated patients. Following power calculations, 60 hospitalised patients and 100 ventilated patients will be recruited to demonstrate a 20% difference. The duration of follow-up is up to the point of discharge.Ethics and disseminationEthical approval was obtained through the independent Human Research Ethics Committee. Participant recruitment will commence in May 2020. Results will be published in peer-reviewed medical journals.Trial registration numberACTRN126200000454976.
Maternal metabolic profiling to assess fetal gestational age and predict preterm delivery: a two-centre retrospective cohort study in the US
Authors: Sylvester Karl G , Hao Shiying , You Jin , Zheng Le , Tian Lu , Yao Xiaoming , Mo Lihong , Ladella Subhashini , Wong Ronald J , Shaw Gary M , Stevenson David K , Cohen Harvey J , Whitin John C , McElhinney Doff B , Ling Xuefeng B 
Published: December 2020

ObjectivesThe aim of this study was to develop a single blood test that could determine gestational age and estimate the risk of preterm birth by measuring serum metabolites. We hypothesised that serial metabolic modelling of serum analytes throughout pregnancy could be used to describe fetal gestational age and project preterm birth with a high degree of precision.Study designA retrospective cohort study.SettingTwo medical centres from the USA.ParticipantsThirty-six patients (20 full-term, 16 preterm) enrolled at Stanford University were used to develop gestational age and preterm birth risk algorithms, 22 patients (9 full-term, 13 preterm) enrolled at the University of Alabama were used to validate the algorithms.Outcome measuresMaternal blood was collected serially throughout pregnancy. Metabolic datasets were generated using mass spectrometry.ResultsA model to determine gestational age was developed (R2=0.98) and validated (R2=0.81). 66.7% of the estimates fell within ±1 week of ultrasound results during model validation. Significant disruptions from full-term pregnancy metabolic patterns were observed in preterm pregnancies (R2=−0.68). A separate algorithm to predict preterm birth was developed using a set of 10 metabolic pathways that resulted in an area under the curve of 0.96 and 0.92, a sensitivity of 0.88 and 0.86, and a specificity of 0.96 and 0.92 during development and validation testing, respectively.ConclusionsIn this study, metabolic profiling was used to develop and test a model for determining gestational age during full-term pregnancy progression, and to determine risk of preterm birth. With additional patient validation studies, these algorithms may be used to identify at-risk pregnancies prompting alterations in clinical care, and to gain biological insights into the pathophysiology of preterm birth. Metabolic pathway-based pregnancy modelling is a novel modality for investigation and clinical application development.
Study protocol for evaluation of aid to diagnosis for developmental dysplasia of the hip in general practice: controlled trial randomised by practice
Authors: Roposch Andreas , Warsame Kaltuun , Chater Angel , Green Judith , Hunter Rachael , Wood John , Freemantle Nick , Nazareth Irwin 
Published: December 2020

IntroductionIn the UK, a compulsory ‘6-week hip check’ is performed in primary care for the detection of developmental dysplasia of the hip (DDH). However, missed diagnoses and infants incorrectly labelled with DDH remain a problem, potentially leading to adverse consequences for infants, their families and the National Health Service. National policy states that infants should be referred to hospital if the 6-week check suggests DDH, though there is no available tool to aid examination or offer guidelines for referral. We developed standardised diagnostic criteria for DDH, based on international Delphi consensus, and a 9-item checklist that has the potential to enable non-experts to diagnose DDH in a manner approaching that of experts.Methods and analysisWe will conduct a controlled trial randomised by practice that will compare a diagnostic aid against standard care for the hip check. The primary objective is to determine whether an aid to the diagnosis of DDH reduces the number of clinically insignificant referrals from primary care to hospital and the number of late diagnosed DDH. The trial will include a qualitative process evaluation, an assessment of professional behavioural change and a full health economic evaluation. We will recruit 152 general practitioner practices in England. These will be randomised to conduct the hip checks with use of the study diagnostic aid and/or as per usual practice. The total number of infants seen during a 15-month recruitment period will be 110 per practice. Two years after the 6-week hip check, we will measure the number of referred infants that are (1) clinically insignificant for DDH and (2) those that constitute appropriate referrals.Ethics and disseminationThis study has approval from the Health Research Authority (16/1/2020) and the Confidentiality Advisory Group (18/2/2020). Results will be published in peer-reviewed academic journals, disseminated to patient organisations and the media.Trial registration numberNCT04101903; Pre-results.
Endoscopic polypectomy performed in clinic for chronic rhinosinusitis with nasal polyps: study protocol for the EPIC multicentre randomised controlled trial
Authors: Kilty Shaun , Thavorn Kednapa , Janjua Arif , Lee John , MacDonald Kristian , Meen Eric , Micomonaco Damian , Rotenberg Brian , Sowerby Leigh J , Tewfik Marc , Adams Susan , Frenette Hubert , Lasso Andrea , Fergusson Dean A 
Published: December 2020

IntroductionChronic rhinosinusitis (CRS) is common, with a Canadian prevalence of 5%, and associated with significant morbidity. Understandably, CRS impairs workplace productivity but that productivity substantially increases following surgical treatment. CRS with nasal polyps (CRSwNP), the most common type of CRS, is usually treated with a combination of medications and endoscopic sinus surgery (ESS). Historically, surgical treatment has only been performed in the operating room at a cost of about $C3500. However, recent studies have shown that a de-escalated procedure, endoscopic polypectomy performed in clinic (EPIC), can provide an improvement in patient symptoms to levels equal to those for ESS. Moreover, EPIC has additional proposed advantages including shorter recovery time, significantly lower cost to the healthcare system and shorter wait time for the patient. There is currently insufficient evidence to draw conclusions about the superiority of polypectomy or ESS for the management of CRSwNP.Methods and analysisWe designed a multicentre, open-label, randomised controlled trial to evaluate whether EPIC was non-inferior to the current clinical standard, ESS for the treatment of CRSwNP. The primary outcome is the Sinonasal Outcome Test-22 score measured at baseline and at 3 months after surgery. Other outcomes include peak nasal inspiratory flow, quality of life measured by the EuroQoL 5 Dimensions 5 Levels questionnaire and work impairment using the Work Productivity and Activity Impairment Questionnaire.We aim to recruit 140 patients from sites across Canada. Participants will be randomly assigned to EPIC or ESS and followed up for 3 months in clinic after the procedure. Additionally, participants will enter a 5-year long-term follow-up period.Ethics and disseminationThis study was approved by the Ottawa Health Sciences Network Research Ethics Board for all sites in Ontario, Canada (study number CTO0801). Sites located outside of Ontario obtained approval from their local/institutional research ethics board.Trial registration numberNCT02975310.