bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital nasolacrimal duct obstruction continues trend for spontaneous resolution beyond first year of life
Authors: Nakayama Tomomichi , Watanabe Akihide , Rajak Saul , Yamanaka Yukito , Sotozono Chie 
Published: November 2019

PurposeTo investigate spontaneous resolution of congenital nasolacrimal duct obstruction (CNLDO) beyond 12 months of age in Japanese infants.MethodsRetrospective, observational case series. We retrospectively reviewed the clinical records of patients diagnosed with CNLDO beyond 12 months of age at Kyoto Prefectural University Hospital, Kyoto, Japan. This study involved 155 cases of CNLDO in 133 Japanese infants diagnosed with CNLDO. All patients chose intervention with either dacryoendoscopic guided probing and stenting or conservative management. The proportion and age of patients who had spontaneous CLNDO resolution were analysed.ResultsThe patients were divided into two groups: (1) 62 patients with 70 obstructed nasolacrimal ducts (45%) in whom spontaneous resolution occurred and (2) 71 patients with 85 obstructed nasolacrimal ducts (55%) who underwent dacryoendoscopic guided probing and stenting. The mean age of spontaneous resolution was 17.8±5.3 months (range: 12.0–35.4 months). Dacryoendoscopic guided probing and stenting were successful in 83/85 (97.6%) of cases.ConclusionsSpontaneous resolution of CNLDO can occur in 45% of infants over the age of 12 months. Dacryoendoscopic guided stenting also has high success rates in this patient group, and both treatment options can be proposed to caregivers.
Self-reported health problems and obesity predict sickness absence during a 12-month follow-up: a prospective cohort study in 21 608 employees from different industries
Authors: Pihlajamäki Minna , Uitti Jukka , Arola Heikki , Ollikainen Jyrki , Korhonen Mikko , Nummi Tapio , Taimela Simo 
Published: November 2019

ObjectivesTo study whether self-reported health problems predict sickness absence (SA) from work in employees from different industries.MethodsThe results of a health risk appraisal (HRA) were combined with archival data of SA of 21 608 employees (59% female, 56% clerical). Exposure variables were self-reported health problems, labelled as ‘work disability (WD) risk factors’ in the HRA, presence of problems with occupational well-being and obesity. Age, socioeconomic grading and the number of SA days 12 months before the survey were treated as confounders. The outcome measure was accumulated SA days during 12-month follow-up. Data were analysed separately for males and females. A Hurdle model with negative binomial response was used to analyse zero-inflated count data of SA.ResultsThe HRA results predicted the number of accumulated SA days during the 12-month follow-up, regardless of occupational group and gender. The ratio of means of SA days varied between 2.7 and 4.0 among those with ‘WD risk factors’ and the reference category with no findings, depending on gender and occupational group. The lower limit of the 95% CI was at the lowest 2.0. In the Hurdle model, ‘WD risk factors’, SA days prior to the HRA and obesity were additive predictors for SA and/or the accumulated SA days in all occupational groups.ConclusionSelf-reported health problems and obesity predict a higher total count of SA days in an additive fashion. These findings have implications for both management and the healthcare system in the prevention of WD.
Effectiveness of topical and ablative therapies in treatment of anogenital warts: a systematic review and network meta-analysis
Authors: Barton Samantha , Wakefield Victoria , O'Mahony Colm , Edwards Steven 
Published: November 2019

ObjectiveTo generate estimates of comparative clinical effectiveness for interventions used in the treatment of anogenital warts (AGWs) through the systematic review, appraisal and synthesis of data from randomised controlled trials (RCTs).DesignSystematic review and network meta-analysis of RCTs. Search strategies were developed for MEDLINE, Embase, the Cochrane Library and the Web of Science. For electronic databases, searches were run from inception to March 2018. The systematic review was carried out following the general principles recommended in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.ParticipantsPeople aged ≥16 years with clinically diagnosed AGWs (irrespective of biopsy confirmation).InterventionsTopical and ablative treatments recommended by the British Association for Sexual Health and HIV for the treatment of AGWs, either as monotherapy or in combination versus each other.Outcome measuresComplete clearance of AGWs at the end of treatment and at other scheduled visits, and rate of recurrence.ResultsThirty-seven RCTs met inclusion criteria. Twenty studies were assessed as being at unclear risk of bias, with the remaining studies categorised as high risk of bias. Network meta-analysis indicates that, of the treatment options compared, carbon dioxide laser therapy is the most effective treatment for achieving complete clearance of AGWs at the end of treatment. Of patient-applied topical treatments, podophyllotoxin 0.5% solution was found to be the most effective at achieving complete clearance, and was associated with a statistically significant difference compared with imiquimod 5% cream and polyphenon E 10% ointment (p<0.05). Few data were available on recurrence of AGWs after complete clearance. Of the interventions evaluated, surgical excision was the most effective at minimising risk of recurrence.ConclusionOf the studies assessed, as a collective, the quality of the evidence is low. Few studies are available that evaluate treatment options versus each other.Trial registration numberCRD42013005457
Effectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD)
Authors: Lois Noemi , Cook Jonathan , Aldington Stephen , Waugh Norman , Mistry Hema , Sones William , McAuley Danny , Aslam Tariq , Bailey Claire , Chong Victor , Ghanchi Faruque , Scanlon Peter , Sivaprasad Sobha , Steel David , Styles Caroline , McNally Christine , Rice Rachael , Prior Lindsay , Azuara-Blanco Augusto 
Published: November 2019

IntroductionDiabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) are the major causes of sight loss in people with diabetes. Due to the increased prevalence of diabetes, the workload related to these complications is increasing making it difficult for Hospital Eye Services (HSE) to meet demands.Methods and analysisEffectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD) is a prospective, case-referent, cross-sectional diagnostic study. It aims at determining the diagnostic performance, cost-effectiveness and acceptability of a new form of surveillance for people with stable DMO and/or PDR, which entails multimodal imaging and image review by an ophthalmic grader, using the current standard of care (evaluation of patients in clinic by an ophthalmologist) as the reference standard. If safe, cost-effective and acceptable, this pathway could help HES by freeing ophthalmologist time. The primary outcome of EMERALD is sensitivity of the new surveillance pathway in detecting active DMO/PDR. Secondary outcomes include specificity, agreement between new and the standard care pathway, positive and negative likelihood ratios, cost-effectiveness, acceptability, proportion of patients requiring subsequent full clinical assessment, unable to undergo imaging, with inadequate quality images or indeterminate findings.Ethics and disseminationEthical approval was obtained for this study from the Office for Research Ethics Committees Northern Ireland (reference 17/NI/0124). Study results will be published as a Health Technology Assessment monograph, in peer-reviewed national and international journals and presented at national/international conferences and to patient groups.Trial registration numberNCT03490318andISRCTN10856638.
Studying expressions of loneliness in individuals using twitter: an observational study
Authors: Guntuku Sharath Chandra , Schneider Rachelle , Pelullo Arthur , Young Jami , Wong Vivien , Ungar Lyle , Polsky Daniel , Volpp Kevin G , Merchant Raina 
Published: November 2019

ObjectivesLoneliness is a major public health problem and an estimated 17% of adults aged 18–70 in the USA reported being lonely. We sought to characterise the (online) lives of people who mention the words ‘lonely’ or ‘alone’ in their Twitter timeline and correlate their posts with predictors of mental health.Setting and designFrom approximately 400 million tweets collected from Twitter in Pennsylvania, USA, between 2012 and 2016, we identified users whose Twitter posts contained the words ‘lonely’ or ‘alone’ and compared them to a control group matched by age, gender and period of posting. Using natural-language processing, we characterised the topics and diurnal patterns of users’ posts, their association with linguistic markers of mental health and if language can predict manifestations of loneliness. The statistical analysis, data synthesis and model creation were conducted in 2018–2019.Primary outcome measuresWe evaluated counts of language features in the users with posts including the words lonely or alone compared with the control group. These language features were measured by (a) open-vocabulary topics, (b) Linguistic Inquiry Word Count (LIWC) lexicon, (c) linguistic markers of anger, depression and anxiety, and (d) temporal patterns and number of drug words. Using machine learning, we also evaluated if expressions of loneliness can be predicted in users’ timelines, measured by area under curve (AUC).ResultsTwitter timelines of users (n=6202) with posts including the words lonely or alone were found to include themes about difficult interpersonal relationships, psychosomatic symptoms, substance use, wanting change, unhealthy eating and having troubles with sleep. Their posts were also associated with linguistic markers of anger, depression and anxiety. A random forest model predicted expressions of loneliness online with an AUC of 0.86.ConclusionsUsers’ Twitter timelines with the words lonely or alone often include psychosocial features and can potentially have associations with how individuals express and experience loneliness. This can inform low-resource online assessment for high-risk individuals experiencing loneliness and interventions focused on addressing morbidities in this condition.
Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire
Authors: Shannon Oliver M , Grisotto Giorgia , Babateen Abrar , McGrattan Andrea , Brandt Kirsten , Mathers John C , Siervo Mario 
Published: November 2019

ObjectivesTo examine knowledge and beliefs about the biological roles of dietary inorganic nitrate in UK-based nutrition professionals, and to explore potential differences by participants’ education level.SettingAn online questionnaire was administered to UK-based nutrition professionals, exploring knowledge and/or beliefs across five areas: (1) health and performance effects of nitrate; (2) current and recommended intake values for nitrate; (3) dietary sources of nitrate; (4) methods of evaluating nitrate intake and (5) nitrate metabolism.ParticipantsOne hundred and twenty-five nutrition professionals.Primary outcomeKnowledge and beliefs about inorganic nitrate.ResultsMost nutrition professionals taking part in the survey had previously heard of inorganic nitrate (71%) and perceived it to be primarily beneficial (51%). The majority believed that nitrate consumption can improve sports performance (59%) and reduce blood pressure (54%), but were unsure about effects on cognitive function (71%), kidney function (80%) and cancer risk (70%). Knowledge of dietary sources of nitrate and factors affecting its content in food were generally good (41%–79% of participants providing correct answers). However, most participants were unsure of the average population intake (65%) and the acceptable daily intake (64%) of nitrate. Most participants (65%) recognised at least one compound (ie, nitric oxide or nitrosamines) that is derived from dietary nitrate in the body. Knowledge of nitrate, quantified by a 23-point index created by summing correct responses, was greater in individuals with a PhD (p=0.01; median (IQR)=13 (9–17)) and tended to be better in respondents with a masters degree (p=0.054; 13 (8–15)) compared with undergraduate-level qualifications (10 (2–14)).ConclusionsUK-based nutrition professionals demonstrated mixed knowledge about the physiology of dietary nitrate, which was better in participants with higher education. More efficient dissemination of current knowledge about inorganic nitrate and its effects on health to nutrition professionals will support them to make more informed recommendations about consumption of this compound.
Occurrence and mortality of vasospastic angina pectoris hospitalised patients in Finland: a population-based registry cohort study
Authors: Pikkarainen Essi , Blomster Juuso , Sipilä Jussi , Rautava Päivi , Kytö Ville 
Published: November 2019

ObjectivesThe occurrence and mortality of vasospastic angina pectoris (VAP) is largely unknown in western countries. Our objective was to clarify the occurrence, gender-distribution and mortality of VAP in Finland using a population-based hospital registry.MethodsWe studied consecutive patients aged ≥18 years hospitalized with VAP as the primary cause of admission in Finland during 2004–2014. The data were collected from obligatory nationwide registries. During the study period 1762 admissions were recorded.ResultsMajority of all VAP patients were male (59.7%) and mean age was 65.7±12.0 years. Annual admission rate for VAP was 2.29/100 000 person-years. Men were in higher risk for VAP than women (admission rate 3.00/100 000 vs 1.68/100 000; RR 1.70; p<0.0001). Gender difference was not modified by age. Likelihood of VAP was highest in population aged 70–84 years. Admission rate for VAP decreased notably during the study period. One-year all-cause mortality was 8.0% and 3-year mortality was 15.5% (cardiac mortality 11.1%). Mortality was associated with increasing age, comorbidity burden and lack of detected coronary artery obstruction, but was similar between genders and during the study period.ConclusionsMen have higher risk for vasospastic angina caused admissions. Likelihood of vasospastic angina admission was highest in aged population. The 3-year all-cause mortality was 15.5%. Mortality was associated with increasing age, comorbidities and non-obstructive VAP diagnosis but was similar between genders.
Understanding data and information needs for palliative cancer care to inform digital health intervention development in Nigeria, Uganda and Zimbabwe: protocol for a multicountry qualitative study
Authors: Okunade Kehinde , Bashan Nkhoma Kennedy , Salako Omolola , Akeju David , Ebenso Bassey , Namisango Eve , Soyannwo Olaitan , Namukwaya Elizabeth , Dandadzi Adlight , Nabirye Elizabeth , Mupaza Lovemore , Luyirika Emmanuel , Ddungu Henry , Chirenje Z Mike , Bennett Michael I , Harding Richard , Allsop Matthew J 
Published: November 2019

IntroductionPalliative care is a clinically and cost‐effective component of cancer services in sub-Saharan Africa (SSA). Despite the significant need for palliative cancer care in SSA, coverage remains inadequate. The exploration of digital health approaches could support increases in the quality and reach of palliative cancer care services in SSA. However, there is currently a lack of any theoretical underpinning or data to understand stakeholder drivers for digital health components in this context. This project addresses this gap through engaging with key stakeholders to determine data and information needs that could be supported through digital health interventions.Methods and analysisThis is a multicountry, cross-sectional, qualitative study conducted in Nigeria, Uganda and Zimbabwe. In-depth interviews will be conducted in patients with advanced cancer (n=20), caregivers (n=15), health professionals (n=20) and policy-makers (n=10) in each of the three participating countries. Data from a total of 195 interviews will transcribed verbatim and translated into English before being imported into NVivo software for deductive framework analysis. The analysis will seek to understand the acceptability and define mechanisms of patient-level data capture and usage via digital technologies.Ethics and disseminationEthics approvals have been obtained from the Institutional Review Boards of University of Leeds (Ref: MREC 18–032), Research Council of Zimbabwe (Ref: 03507), Medical Research Council of Zimbabwe (Ref: MRCZ/A/2421), Uganda Cancer Institute (Ref: 19–2018), Uganda National Council of Science and Technology (Ref: HS325ES) and College of Medicine University of Lagos (Ref: HREC/15/04/2015). The project seeks to determine optimal mechanisms for the design and development of subsequent digital health interventions to support development, access to, and delivery of palliative cancer care in SSA. Dissemination of these findings will occur through newsletters and press releases, conference presentations, peer-reviewed journals and social media.Trial registration numberISRCTN15727711
Doctors’ perspectives on adhering to advance care directives when making medical decisions for patients: an Australian interview study
Authors: Moore Nadia , Detering Karen M , Low Tessa , Nolte Linda , Fraser Scott , Sellars Marcus 
Published: November 2019

ObjectiveAdvance care planning (ACP) assists people to identify their goals, values and treatment preferences for future care. Ideally, preferences are documented in an advance care directive (ACD) and used by doctors to guide medical decision-making should the patient subsequently lose their decision-making capacity. However, studies demonstrate that ACDs are not always adhered to by doctors in clinical practice. We aim to describe the attitudes and perspectives of doctors regarding ACD adherence and the utility of ACDs in clinical practice.DesignFace-to-face semistructured interviews were conducted using three case-based vignettes to explore doctors’ decision-making and attitudes towards ACDs. Transcripts were analysed using a thematic analysis.SettingDoctors from a variety of medical specialties and with varying experience levels were recruited from a large tertiary hospital in Melbourne, Australia.ParticipantsA total of 21 doctors were interviewed, 48% female (10/21). Most (19/21) reported having experience using ACDs.ResultsFour themes were identified: aligning with patient preferences (avoiding unwanted care, prioritising autonomy and anticipating family opposition), advocating best interests (defining futile care, relying on clinical judgement, rejecting unreasonable decisions and disregarding legal consequences), establishing validity (doubting rigour of the decision-making process, questioning patients’ ability to understand treatment decisions, distrusting outdated preferences and seeking confirmation) and translating written preferences into practice (contextualising patient preferences, applying subjective terminology and prioritising emergency medical treatment).ConclusionsACDs provide doctors with opportunities to align patient preferences with treatment and uphold patient autonomy. However, doctors experience decisional conflict when attempting to adhere to ACDs in practice, especially when they believe that adhering to the ACD is not in the patients’ best interests, or if they doubt the validity of the ACD. Future ACP programmes should consider approaches to improve the validity and applicability of ACDs. In addition, there is a need for ethical and legal education to support doctors’ knowledge and confidence in ACP and enacting ACDs.
Providing fluid therapy to equine colic patients. Part 1
Authors: Auckburally Adam , Petruccione Ilaria , Voss Sarah 
Published: November 2019

Background: Fluid therapy is a life‐saving measure, which is fundamental in managing horses with colic. It is essential for the clinician to be familiar with the available options when devising a fluid plan, so that it is both beneficial to the patient and financially viable for the owner. Underpinning this is an understanding of basic physiology associated with body fluid compartments and an awareness of the potential adverse effects of fluid therapy.Aim of the article: This article, the first in a two‐part series, discusses basic physiological concepts of body fluids, available fluid types and the practicalities of administration in the adult horse. The second part, covering clinical aspects of fluid therapy in adult horses with colic and some of the controversies surrounding fluid rates, fluid types and the management of metabolic acidosis, will be published in a subsequent issue of In Practice
Association of neighbourhood social and physical attributes with depression in older adults in Hong Kong: a multilevel analysis
Authors: Guo Yingqi , Chang Shu Sen , Chan Chee Hon , Chang Qingsong , Hsu Chia-Yueh , Yip Paul S F 
Published: November 2019

BackgroundPrevious studies investigating the independent effects of neighbourhood-level factors on depression are rare within the Asian context, especially in the elderly population.MethodsData for 29 099 older adults aged 65 years or above who have received health examinations at elderly health centres in Hong Kong in 2008–2011 were analysed. Using multilevel regression modelling, the cross-sectional associations of neighbourhood social attributes (neighbourhood poverty, ethnic minority, residential stability and elderly concentration) and physical (built) attributes (recreational services and walkability) with depression outcomes (depressive symptoms and depression) after adjusting for individual-level characteristics were investigated. Gender interaction effects were also examined.ResultsNeighbourhood poverty was associated with both depressive symptoms and depression in the elderly. Neighbourhood elderly concentration, recreational services and walkability were associated with fewer depressive symptoms. The association between neighbourhood poverty and elderly depressive symptoms was found in women only and not in men.ConclusionPolicies aimed at reducing neighbourhood poverty, increasing access to recreational services and enhancing walkability might be effective strategies to prevent depression in older adults in the urban settings.