bluuebunny/crossref_metadata_2025_split huggingface dataset:
Agreement between ranking metrics in network meta-analysis: an empirical study
Authors: Chiocchia Virginia , Nikolakopoulou Adriani , Papakonstantinou Theodoros , Egger Matthias , Salanti Georgia 
Published: August 2020

ObjectiveTo empirically explore the level of agreement of the treatment hierarchies from different ranking metrics in network meta-analysis (NMA) and to investigate how network characteristics influence the agreement.DesignEmpirical evaluation from re-analysis of NMA.Data232 networks of four or more interventions from randomised controlled trials, published between 1999 and 2015.MethodsWe calculated treatment hierarchies from several ranking metrics: relative treatment effects, probability of producing the best valuep(BV)and the surface under the cumulative ranking curve (SUCRA). We estimated the level of agreement between the treatment hierarchies using different measures: Kendall’s τ and Spearman’s ρ correlation; and the YilmazτAPand Average Overlap, to give more weight to the top of the rankings. Finally, we assessed how the amount of the information present in a network affects the agreement between treatment hierarchies, using the average variance, the relative range of variance and the total sample size over the number of interventions of a network.ResultsOverall, the pairwise agreement was high for all treatment hierarchies obtained by the different ranking metrics. The highest agreement was observed between SUCRA and the relative treatment effect for both correlation and top-weighted measures whose medians were all equal to 1. The agreement between rankings decreased for networks with less precise estimates and the hierarchies obtained frompBVappeared to be the most sensitive to large differences in the variance estimates. However, such large differences were rare.ConclusionsDifferent ranking metrics address different treatment hierarchy problems, however they produced similar rankings in the published networks. Researchers reporting NMA results can use the ranking metric they prefer, unless there are imprecise estimates or large imbalances in the variance estimates. In this case treatment hierarchies based on both probabilistic and non-probabilistic ranking metrics should be presented.
Study protocol: effects, costs and distributional impact of digital primary care for infectious diseases—an observational, registry-based study in Sweden
Authors: Wilkens Jens , Thulesius Hans , Arvidsson Eva , Lindgren Anna , Ekman Bjorn 
Published: August 2020

IntroductionThe ability to provide primary care with the help of a digital platform raises both opportunities and risks. While access to primary care improves, overuse of services and medication may occur. The use of digital care technologies is likely to continue to increase and evidence of its effects, costs and distributional impacts is needed to support policy-making. Since 2016, the number of digital primary care consultations for a range of conditions has increased rapidly in Sweden. This research project aims to investigate health system effects of this development. The overall research question is to what extent such care is a cost-effective and equitable alternative to traditional, in-office primary care in the context of a publicly funded health system with universal access. Three specific areas of investigation are identified: clinical effect; cost and distributional impact. This protocol describes the investigative approach of the project in terms of aims, design, materials, methods and expected results.Methods and analysisThe research project adopts a retrospective study design and aims to apply statistical analyses of patient-level register data on key variables from seven regions of Sweden over the years 2017–2018. In addition to data on three common infectious conditions (upper respiratory tract infection; lower urinary tract infection; and skin and soft-tissue infection), information on other healthcare use, socioeconomic status and demography will be collected.Ethics and disseminationThis registry-based study has received ethical approval by the Swedish Ethical Review Authority. Use of data will follow the Swedish legislation and practice with regards to consent. The results will be disseminated both to the research community, healthcare decision makers and to the general public.
What do children, parents and staff think about a healthy lifestyles intervention delivered in primary schools? a qualitative study
Authors: Goldthorpe Joanna , Epton Tracy , Keyworth Chris , Calam Rachel , Brooks Joanna , Armitage Chris 
Published: August 2020

ObjectivePrimary schools are crucial settings for early weight management interventions but effects on children’s weight are small and evidence shows that deficiencies in intervention implementation may be responsible. Very little is known about the roles of multiple stakeholders in the process of implementation. We used a multiple-stakeholder qualitative research approach to explore the implementation of an intervention developed to improve the diet and increase the levels of physical activity for children living in some of the most deprived areas of England.DesignFor this qualitative study, interviews and focus groups were carried out using semi-structured topic guides. Data were analysed thematically.SettingSeven primary schools (pupils aged 4 to 11) in Manchester, England.ParticipantsWe conducted 14 focus groups with children aged 5 to 10 years and interviews with 19 staff members and 17 parents.InterventionManchester Healthy Schools (MHS) is a multicomponent intervention, developed to improve diet and physical activity in schools with the aim of reducing and preventing childhood obesity.ResultsThree themes were developed from the data: common understandings of health and health behaviours; congruence and consistency of messages; negotiations of responsibility.ConclusionAll participant groups had a common conceptualisation of health as having physical and psychological components and that action could be taken in childhood to change behaviours that protect long-term health. When parents and staff felt a shared sense of responsibility for children’s health and levels of congruence between home and school norms around diet and physical activity were high, parents and children were more likely to accept the policies implemented as part of MHS. Effective two-way communication between home and school is therefore vital for successful implementation of this intervention.
Intervention elements to reduce inappropriate prescribing for older adults with multimorbidity receiving outpatient care: a scoping review
Authors: Lee Jia Qi , Ying Kate , Lun Penny , Tan Keng Teng , Ang Wendy , Munro Yasmin , Ding Yew Yoong 
Published: August 2020

ObjectivePolypharmacy occurs in approximately 30% of older adults aged 65 years or more, particularly among those with multimorbidity. With polypharmacy, there is an associated risk of potentially inappropriate prescribing (PIP). The aims of this scoping review were to (1) identify the intervention elements that have been adopted to reduce PIP in the outpatient setting and (2) determine the behaviour change wheel (BCW) intervention functions performed by each of the identified intervention elements.DesignScoping reviewData sourcesPubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science and Cochrane Library databases, grey literature sources, six key geriatrics journals and the reference lists of review papers.Study selectionAll studies reporting an intervention or strategy that addressed PIP in the older adult population (age ≥65) with multimorbidity in the outpatient setting and in which the primary prescriber is the physician.Data extractionData extracted from the included studies can be broadly categorised into (1) publication details, (2) intervention details and (3) results. This was followed by data synthesis and analysis based on the BCW framework.ResultsOf 8195 studies yielded, 80 studies were included in the final analysis and 14 intervention elements were identified. An average of two to three elements were adopted in each intervention. The three most frequently adopted intervention elements were medication review (70%), training (26.3%) and tool/instrument(s) (22.5%). Among medication reviews, 70% involved pharmacists. The 14 intervention elements were mapped onto five intervention functions: ‘education’, ‘persuasion’, ‘training’, ‘environmental restructuring’ and ‘enablement’.ConclusionPIP is a multifaceted problem that involves multiple stakeholders. As such, interventions that address PIP require multiple elements to target the behaviour of the various stakeholders. The intervention elements and their corresponding functions identified in this scoping review will serve to inform the design of complex interventions that aim to reduce PIP.
Clinical prediction models to diagnose neonatal sepsis: a scoping review protocol
Authors: Neal Samuel R , Musorowegomo David , Gannon Hannah , Cortina Borja Mario , Heys Michelle , Chimhini Gwen , Fitzgerald Felicity 
Published: August 2020

IntroductionNeonatal sepsis is responsible for significant morbidity and mortality worldwide. Diagnosis is often difficult due to non-specific clinical features and the unavailability of laboratory tests in many low-income and middle-income countries (LMICs). Clinical prediction models have the potential to improve diagnostic accuracy and rationalise antibiotic usage in neonatal units, which may result in reduced antimicrobial resistance and improved neonatal outcomes. In this paper, we outline our scoping review protocol to map the literature concerning clinical prediction models to diagnose neonatal sepsis. We aim to provide an overview of existing models and evidence underlying their use and compare prediction models between high-income countries and LMICs.Methods and analysisThe protocol was developed with reference to recommendations by the Joanna Briggs Institute. Searches will include six electronic databases (Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, Global Index Medicus and the Cochrane Library) supplemented by hand searching of reference lists and citation analysis on included studies. No time period restrictions will be applied but only studies published in English or Spanish will be included. Screening and data extraction will be performed independently by two reviewers, with a third reviewer used to resolve conflicts. The results will be reported by narrative synthesis in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and disseminationThe nature of the scoping review methodology means that this study does not require ethical approval. Results will be disseminated through peer-reviewed publications and conference presentations, as well as through engagement with peers and relevant stakeholders.
Retrospective analysis of reported suicide deaths and attempts on veterans health administration campuses and inpatient units
Authors: Mills Peter D , Soncrant Christina , Gunnar William 
Published: August 2020

IntroductionSuicide is the 10th leading cause of death in the USA. Inpatient suicide is the fourth most common sentinel event reported to the Joint Commission. This study reviewed root cause analysis (RCA) reports of suicide events by hospital unit to provide suicide prevention recommendations for each area.MethodsThis is a retrospective analysis of reported suicide deaths and attempts in the US Veterans Health Administration (VHA) hospitals. We searched the VHA National Center for Patient Safety RCA database for suicide deaths and attempts on inpatient units, outpatient clinics and hospital grounds, between December 1999 and December 2018.ResultsWe found 847 RCA reports of suicide attempts (n=758) and deaths (n=89) in VHA hospitals, hanging accounted for 71% of deaths on mental health units and 50% of deaths on medical units. Overdose accounted for 55% of deaths and 68% of attempts in residential units and the only method resulting in death in emergency departments. In VHA community living centres, hanging, overdose and asphyxiation accounted for 64% of deaths. Gunshot accounted for 59% of deaths on hospital grounds and 100% of deaths in clinic areas. All inpatient locations cited issues in assessment and treatment of suicidal patients and environmental risk evaluation.ConclusionsInpatient mental health and medical units should remove anchor points for hanging where possible. On residential units and emergency departments, assessing suicide risk, conducting thorough contraband searches and maintaining observation of suicidal patients is critical. In community living centres, suicidal patients should be under supervision in an environment free of anchor points, medications and means of asphyxiation. Suicide prevention on hospital grounds and outpatient clinics can be achieved through the control of firearms.
CIC de novo loss of function variants contribute to cerebral folate deficiency by downregulating FOLR1 expression
Authors: Cao Xuanye , Wolf Annika , Kim Sung-Eun , Cabrera Robert M. , Wlodarczyk Bogdan J. , Zhu Huiping , Parker Margaret , Lin Ying , Steele John W. , Han Xiao , Ramaekers Vincent Th , Steinfeld Robert , Finnell Richard H. , Lei Yunping 
Published: August 2020

Background Cerebral folate deficiency (CFD) syndrome is characterised by a low concentration of 5-methyltetrahydrofolate in cerebrospinal fluid, while folate levels in plasma and red blood cells are in the low normal range. Mutations in several folate pathway genes, including FOLR1 (folate receptor alpha, FRα), DHFR (dihydrofolate reductase) and PCFT (proton coupled folate transporter) have been previously identified in patients with CFD.Methods In an effort to identify causal mutations for CFD, we performed whole exome sequencing analysis on eight CFD trios and identified eight de novo mutations in seven trios.Results Notably, we found a de novo stop gain mutation in the capicua (CIC) gene. Using 48 sporadic CFD samples as a validation cohort, we identified three additional rare variants in CIC that are putatively deleterious mutations. Functional analysis indicates that CIC binds to an octameric sequence in the promoter regions of folate transport genes: FOLR1, PCFT and reduced folate carrier (Slc19A1; RFC1). The CIC nonsense variant (p.R353X) downregulated FOLR1 expression in HeLa cells as well as in the induced pluripotent stem cell (iPSCs) derived from the original CFD proband. Folate binding assay demonstrated that the p.R353X variant decreased cellular binding of folic acid in cells.Conclusion This study indicates that CIC loss of function variants can contribute to the genetic aetiology of CFD through regulating FOLR1 expression. Our study described the first mutations in a non-folate pathway gene that can contribute to the aetiology of CFD.
Beta-blocker use and acute exacerbations of COPD following myocardial infarction: a Danish nationwide cohort study
Authors: Rasmussen Daniel B , Bodtger Uffe , Lamberts Morten , Torp-Pedersen Christian , Gislason Gunnar , Lange Peter , Jensen Magnus T 
Published: August 2020

IntroductionPatients with chronic obstructive pulmonary disease (COPD) are undertreated with beta-blockers following myocardial infarction (MI), possibly due to fear for acute exacerbations of COPD (AECOPD). Is beta-blocker use associated with increased risk of AECOPD in patients following first-time MI?MethodsDanish nationwide study of patients with COPD following hospitalisation for MI from 2003 to 2015. Multivariable, time-dependent Cox regression accounting for varying beta-blocker use based on claimed prescriptions during up to 13 years of follow-up.ResultsA total of 10 884 patients with COPD were discharged after first-time MI. The 1-year rate of AECOPD was 35%, and 65% used beta-blockers at 1 year. Beta-blocker use was associated with a lower risk of AECOPD (multivariable-adjusted HR 0.78, 95% CI 0.74–0.83). This association was independent of the type of MI (HR 0.70, 95% CI 0.59–0.83 in ST-elevation MI (STEMI) and HR 0.80, 95% CI 0.75–0.84 in non-STEMI), presence or absence of heart failure (HR 0.82, 95% CI 0.74–0.90 and HR 0.77, 95% CI 0.72–0.82, respectively), beta-blocker dosage and type, as well as exacerbation severity. Results were similar in 1118 patients with full data on COPD severity and symptom burden (median forced expiratory volume in 1 s as percentage of predicted was 46 and majority had moderate dyspnoea), and in 1358 patients with severe COPD and frequent AECOPD with a high 1-year rate of AECOPD of 70%.DiscussionBeta-blocker use was not associated with increased risk of AECOPD following MI. This finding was independent of COPD severity, symptom burden and exacerbation history, and supports the safety of beta-blockers in patients with COPD, including high-risk patients with severe disease.
Molecular epidemiology and clinical impact of rhinovirus infections in adults during three epidemic seasons in 11 European countries (2007–2010)
Authors: Zlateva Kalina T , van Rijn Anneloes L , Simmonds Peter , Coenjaerts Frank E J , van Loon Anton M , Verheij Theo J M , de Vries Jutte J C , Little Paul , Butler Christopher C , van Zwet Erik W , Goossens Herman , Ieven Margareta , Claas Eric C J 
Published: August 2020

BackgroundDifferences in clinical impact between rhinovirus (RVs) species and types in adults are not well established. The objective of this study was to determine the epidemiology and clinical impact of the different RV species.MethodsWe conducted a prospective study of RVs infections in adults with acute cough/lower respiratory tract infection (LRTI) and asymptomatic controls. Subjects were recruited from 16 primary care networks located in 11 European countries between 2007 and 2010. RV detection and genotyping was performed by means of real time and conventional reverse-transcriptase polymerase chain reaction assays, followed by sequence analysis. Clinical data were obtained from medical records and patient symptom diaries.ResultsRVs were detected in 566 (19%) of 3016 symptomatic adults, 102 (4%) of their 2539 follow-up samples and 67 (4%) of 1677 asymptomatic controls. Genotyping was successful for 538 (95%) symptomatic subjects, 86 (84%) follow-up infections and 62 (93%) controls. RV-A was the prevailing species, associated with an increased risk of LRTI as compared with RV-B (relative risk (RR), 4.5; 95% CI 2.5 to 7.9; p<0.001) and RV-C (RR 2.2; 95% CI 1.2 to 3.9; p=0.010). In symptomatic subjects, RV-A loads were higher than those of RV-B (p=0.015). Symptom scores and duration were similar across species. More RV-A infected patients felt generally unwell in comparison to RV-C (p=0·023). Of the 140 RV types identified, five were new types; asymptomatic infections were associated with multiple types.InterpretationIn adults, RV-A is significantly more often detected in cases with acute cough/LRTI than RV-C, while RV-B infection is often found in asymptomatic patients.
Arabian nights in Hong Kong: Chinese young adults’ experience of waterpipe smoking
Authors: Lee Jung Jae , Yeung Karly Cheuk Yin , Wang Man Ping , Thorne Sally 
Published: August 2020

BackgroundWaterpipe smoking (WPS) has increased among young adults who may be oblivious to its harmful effects. We explored Chinese young adults’ experiences of using waterpipes.MethodsSemi-structured interviews with 49 Chinese young adults aged between 18 to 30 years who had smoked waterpipes in the past 30 days were undertaken between May and October 2019. We analysed transcripts using interpretive description that includes an inductive analytical approach and constant comparison strategy.ResultsSix themes on the WPS experience emerged: fostering social connections on weekend nights; bars as a natural setting for waterpipe smoking; providing pleasure; securing social status among young females; growing acceptance and a lack of education; lack of regulation on waterpipe smoking.ConclusionsWe provide the first evidence regarding Chinese young adults’ WPS use. Policy measures to de-normalise false perceptions of WPS are urgently needed to deter use among young adults.
Quasi-normal modes and stability of Einstein–Born–Infeld black holes in de Sitter space
Authors: Lee Chong Oh , Kim Jin Young , Park Mu-In 
Published: August 2020

AbstractWe study gravitational perturbations of electrically charged black holes in (3+1)-dimensional Einstein–Born–Infeld gravity with a positive cosmological constant. For the axial perturbations, we obtain a set of decoupled Schrödinger-type equations, whose formal expressions, in terms of metric functions, are the same as those without cosmological constant, corresponding to the Regge–Wheeler equation in the proper limit. We compute the quasi-normal modes (QNMs) of the decoupled perturbations using the Schutz–Iyer–Will’s WKB method. We discuss the stability of the charged black holes by investigating the dependence of quasi-normal frequencies on the parameters of the theory, correcting some errors in the literature. It is found that all the axial perturbations are stable for the cases where the WKB method applies. There are cases where the conventional WKB method does not apply, like the three-turning-points problem, so that a more generalized formalism is necessary for studying their QNMs and stabilities. We find that, for the degenerate horizons with the “point-like” horizons at the origin, the QNMs are quite long-lived, close to the quasi-resonance modes, in addition to the “frozen” QNMs for the Nariai-type horizons and the usual (short-lived) QNMs for the extremal black hole horizons. This is a genuine effect of the branch which does not have the general relativity limit. We also study the exact solution near the (charged) Nariai limit and find good agreements even far beyond the limit for the imaginary frequency parts.
Optical properties of Kerr–Newman spacetime in the presence of plasma
Authors: Babar Gulmina Zaman , Babar Abdullah Zaman , Atamurotov Farruh 
Published: August 2020

AbstractWe have studied the null geodesics in the background of the Kerr–Newman black hole veiled by a plasma medium using the Hamilton–Jacobi method. The influence of black hole’s charge and plasma parameters on the effective potential and the generic photon orbits has been investigated. Furthermore, our discussion embodies the effects of black hole’s charge, plasma and the inclination angle on the shadow cast by the gravity with and without the spin parameter. We examined the energy released from the black hole as a result of the thermal radiations, which exclusively depends on the size of the shadow. The angle of deflection of the massless particles is also explored considering a weak-field approximation. We present our results in juxtaposition to the analogous black holes in General Relativity, particularly the Schwarzschild and Kerr black hole.