bluuebunny/crossref_metadata_2025_split huggingface dataset:
A combination of two methods for evaluating the usability of a hospital information system
Authors: Khajouei Reza , Farahani Fatemeh 
Published: May 2020

Abstract
Background
None of the evaluation methods can identify all the usability problems of information systems. So far, no study has sufficiently investigated the potential of a combination of these methods to identify usability problems. The present study aimed at examining the potential for combining two commonly utilized user-based and expert-based methods to evaluate the usability of a hospital information system.

Methods
Think aloud (TA) and Heuristic evaluation (HE) methods were used to identify the usability problems of two subsystems of the Social Security Electronic System in Iran. To this end, the problems were categorized into five groups based on ISO-Nielsen usability attributes. The Chi-square test was applied to compare the intended methods based on the total number of problems and the number of problems within each group, followed by utilizing the Mann-Whitney U test to compare the mean severity scores of these methods.

Results
The evaluation by combining these methods yielded 423 problems of which 75% varied between the methods. The two methods were significantly different in terms of the total number of problems, the number of problems in each usability group, and the mean severity of two satisfaction and efficiency attributes (P < 0.05). However, no significant difference was observed between the two methods based on the mean severity of problems and severity scores related to three usability attributes i.e., effectiveness, learnability, and error prevention (P > 0.05). In addition, the mean severity of problems identified by each method was at the “Major” level.

Conclusion
Based on the results, although the mean severity scores of the identified problems were not significantly different, these methods identify heterogeneous problems. HE mainly identifies problems related to satisfaction, learnability, and error prevention while TA detects problems related to effectiveness and efficiency attributes. Therefore, using a combination of these two methods can identify a wider range of usability problems.
Rural and urban differences in health system performance among older Chinese adults: cross-sectional analysis of a national sample
Authors: Qin Vicky Mengqi , McPake Barbara , Raban Magdalena Z. , Cowling Thomas E. , Alshamsan Riyadh , Chia Kee Seng , Smith Peter C. , Atun Rifat , Lee John Tayu 
Published: May 2020

Abstract
Background
Despite improvement in health outcomes over the past few decades, China still experiences striking rural-urban health inequalities. There is limited research on the rural-urban differences in health system performance in China.

Method
We conducted a cross-sectional analysis to compare health system performance between rural and urban areas in five key domains of the health system: effectiveness, cost, access, patient-centredness and equity, using data from the WHO Study on Global AGEing and adult health (SAGE), China. Multiple logistic and linear regression models were used to assess the first four domains, adjusting for individual characteristics, and a relative index of inequality (RII) was used to measure the equity domain.

Findings
Compared to urban areas, rural areas had poorer performance in the management and control of hypertension and diabetes, with more than 50% lower odds of having breast (AOR = 0.44; 95% CI: 0.30, 0.64) and cervical cancer screening (AOR = 0.49; 95% CI: 0.29, 0.83). There was better performance in rural areas in the patient-centredness domain, with more than twice higher odds of getting prompt attention, respect, clarity of the communication with health provider and involvement in decision making of the treatment in inpatient care (AOR = 2.56, 2.15, 2.28, 2.28). Although rural residents incurred relatively less out-of-pocket expenditures (OOPE) for outpatient and inpatient services than urban residents, they were more likely to incur catastrophic expenditures on health (AOR = 1.30; 95% CI 1.16, 1.44). Wealth inequality was found in many indicators related to the effectiveness, costs and access domains in both rural and urban areas. Rural areas had greater inequalities in the management of hypertension and coverage of cervical cancer (RII = 7.45 vs 1.64).

Conclusion
Our findings suggest that urban areas have achieved better prevention and management of non-communicable disease than rural areas, but access to healthcare was equivalent. A better understanding of the causes of the observed variations is needed to develop appropriate policy interventions which address these disparities.
Hospitalization burden and comorbidities of patients with rheumatoid arthritis in Spain during the period 2002–2017
Authors: Gil-Conesa Mario , Del-Moral-Luque Juan Antonio , Gil-Prieto Ruth , Gil-de-Miguel Ángel , Mazzuccheli-Esteban Ramón , Rodríguez-Caravaca Gil 
Published: May 2020

Abstract
Background
Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease that is associated with multiple comorbidities and has a significant economic impact on the Spanish health system. The objective of this study was to estimate the rates of hospitalization of rheumatoid arthritis in Spain, and describing hospitalization rates and their changing by age, region, RA variant, and when RA as a main cause of hospitalization or a comorbidity.

Methods
Observational descriptive study that reviewed hospital records from the CMBD. We included all hospitalizations of patients in Spain whose main diagnosis or comorbidity in the ICD-9-CM was rheumatoid arthritis during the period of 2002–2017.

Results
A total of 315,190 hospitalizations with the RA code were recorded; 67.3% were in women. The mean age of the patients was 68.5 ± 13.9 years. The median length of hospital stay was 7 days (IQR 3–11 days). In 29,809 of the admissions, RA was coded as the main diagnosis (9.4%). When RA was not coded as the main diagnosis, the most frequent main diagnoses were diseases of the circulatory system (18.9%) and diseases of the respiratory system (17.4%). The hospitalization rate during the period of 2002–2017 was 43.8 (95% CI: 43.7–44.0) per 100,000 inhabitants and constantly increased during the period. The total cost for the healthcare system was 1.476 million euros, with a median of 3542 euros per hospitalization (IQR 2646–5222 euros).

Conclusions
In Spain, the hospitalization rate of patients with RA increased during the study period, despite the decrease in the hospitalization rate when RA was the main diagnosis.
A novel conceptual model and heuristic tool to strengthen understanding and capacities for health inequalities research
Authors: Cash-Gibson Lucinda , Harris Matthew , Guerra Germán , Benach Joan 
Published: May 2020

Abstract
Background
Despite increasing evidence on health inequalities over the past decades, further efforts to strengthen capacities to produce research on this topic are still urgently needed to inform effective interventions aiming to address these inequalities. To strengthen these research capacities, an initial comprehensive understanding of the health inequalities research production process is vital. However, most existing research and models are focused on understanding the relationship between health inequalities research and policy, with less focus on the health inequalities research production process itself. Existing conceptual frameworks provide valuable, yet limited, advancements on this topic; for example, they lack the capacity to comprehensively explain the health (and more specifically the health inequalities) research production process at the local level, including the potential pathways, components and determinants as well as the dynamics that might be involved. This therefore reduces their ability to be empirically tested and to provide practical guidance on how to strengthen the health inequalities research process and research capacities in different settings. Several scholars have also highlighted the need for further understanding and guidance in this area to inform effective action.

Methods
Through a critical review, we developed a novel conceptual model that integrates the social determinants of health and political economy perspectives to provide a comprehensive understanding of how health inequalities research and the related research capacities are likely to be produced (or inhibited) at local level.

Results
Our model represents a global hypothesis on the fundamental processes involved, and can serve as a heuristic tool to guide local level assessments of the determinants, dynamics and relations that might be relevant to better understand the health inequalities research production process and the related research capacities.

Conclusions
This type of knowledge can assist researchers and decision-makers to identify any information gaps or barriers to be addressed, and establish new entry points to effectively strengthen these research capacities. This can lead to the production of a stronger evidence base, both locally and globally, which can be used to inform strategic efforts aimed at achieving health equity.
Pre-transplant MRD negativity predicts favorable outcomes of CAR-T therapy followed by haploidentical HSCT for relapsed/refractory acute lymphoblastic leukemia: a multi-center retrospective study
Authors: Zhao Houli , Wei Jieping , Wei Guoqing , Luo Yi , Shi Jimin , Cui Qu , Zhao Mingfeng , Liang Aibin , Zhang Qing , Yang Jianmin , Li Xin , Chen Jing , Song Xianmin , Jing Hongmei , Li Yuhua , Hao Siguo , Wu Wenjun , Tan Yamin , Yu Jian , Zhao Yanmin , Lai Xiaoyu , Yin Elaine Tan Su , Wei Yunxiong , Li Ping , Huang Jing , Wang Tao , Blaise Didier , Xiao Lei , Chang Alex H. , Nagler Arnon , Mohty Mohamad , Huang He , Hu Yongxian 
Published: May 2020

Abstract
Background
Consolidative allogeneic hematopoietic stem cell transplantation is a controversial option for patients with relapsed/refractory acute lymphoblastic leukemia after chimeric antigen receptor T cell (CAR-T) therapy. We performed a multicenter retrospective study to assess whether patients can benefit from haploidentical hematopoietic stem cell transplantation after CAR-T therapy.

Methods
A total of 122 patients after CAR-T therapy were enrolled, including 67 patients without subsequent transplantation (non-transplant group) and 55 patients with subsequent haploidentical hematopoietic stem cell transplantation (transplant group). Long-term outcome was assessed, as was its association with baseline patient characteristics.

Results
Compared with the non-transplant group, transplantation recipients had a higher 2-year overall survival (OS; 77.0% versus 36.4%; P < 0.001) and leukemia-free survival (LFS; 65.6% versus 32.8%; P < 0.001). Multivariate analysis showed that minimal residual disease (MRD) positivity at transplantation is an independent factor associated with poor LFS (P = 0.005), OS (P = 0.035), and high cumulative incidence rate of relapse (P = 0.045). Pre-transplant MRD-negative recipients (MRD− group) had a lower cumulative incidence of relapse (17.3%) than those in the non-transplant group (67.2%; P < 0.001) and pre-transplant MRD-positive recipients (MRD+ group) (65.8%; P = 0.006). The cumulative incidence of relapse in MRD+ and non-transplant groups did not differ significantly (P = 0.139). The 2-year LFS in the non-transplant, MRD+, and MRD− groups was 32.8%, 27.6%, and 76.1%, respectively. The MRD− group had a higher LFS than the non-transplantation group (P < 0.001) and MRD+ group (P = 0.007), whereas the LFS in the MRD+ and non-transplant groups did not differ significantly (P = 0.305). The 2-year OS of the MRD− group was higher than that of the non-transplant group (83.3% versus 36.4%; P < 0.001) but did not differ from that of the MRD+ group (83.3% versus 62.7%; P = 0.069). The OS in the non-transplant and MRD+ groups did not differ significantly (P = 0.231).

Conclusion
Haploidentical hematopoietic stem cell transplantation with pre-transplant MRD negativity after CAR-T therapy could greatly improve LFS and OS in patients with relapsed/refractory acute lymphoblastic leukemia.

Trial registration
The study was registered in the Chinese clinical trial registry (ChiCTR1900023957).
A real-time immunocapture PCR (RT-IPCR) without interference of protein A for convenient detection of staphylococcal enterotoxin B from food and environmental samples
Authors: Mondal Bhairab , Ramlal Shylaja , Setlem Keerthana , Mahadeva Ashrita , Aradhya Shruthi , Parida Manmohan 
Published: May 2020

Abstract
Purpose
A real-time immunocapture PCR (RT-IPCR) has been fabricated for the detection of Staphylococcus aureus enterotoxin B (SEB) from food and environmental samples.

Methods
Considering the fact, anti-SEB immunoglobulin G (IgG) has affinity towards protein A, produced by nearly all S. aureus, and generates false-positive read out in all immuno-based assay. We have employed avian anti-SEB antibody (SEB-IgY) as capture probe, since IgY interact less efficiently to protein A and biotinylated SEB-specific monoclonal antibody (SEB -MAb) conjugated with reporter DNA as revealing probe for real-time PCR amplification and signal generation. Sensitivity and selectivity of the assay were evaluated employing closely related enterotoxins and other toxins.

Results
The RT-IPCR is highly specific and sensitive (100 fg/mL). The practical applicability of the assay was tested using spiked food sample as well as naturally contaminated food samples. The sensitivity and specificity of RT-IPCR were not compromised by the foods tested and was able to detect SEB conveniently. Further, the assay was validated comparing with the in-house developed PCR, and plausible result was obtained.

Conclusion
The developed assay can be utilized as a low-cost detection system of SEB in routine food testing laboratories.
The prevalence of type 2 diabetes in people with psychiatric disorders: an umbrella review protocol
Authors: Lindekilde N. , Scheuer S. , Rutters F. , Henriksen J. E. , Rubin K. H. , Lasgaard M. , Andersen G. S. , Pouwer F. 
Published: May 2020

Abstract
Background
Many epidemiological studies have investigated the prevalence of type 2 diabetes in individuals with a psychiatric disorder. In an umbrella review, we aim to systematically summarize existing systematic reviews examining the prevalence of type 2 diabetes in people with a psychiatric disorder. When information is available in the identified systematic reviews, comparisons with control groups without a psychiatric disorder will be made. Furthermore, we aim to assess the quality of the included systematic reviews.

Methods
The umbrella review will be based on a comprehensive systematic search of systematic reviews of observational (cross-sectional or longitudinal) studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder. Four electronic databases (Embase, PsycINFO, PubMed, and the Cochrane Database of Systematic Reviews) will be searched. Retrieved papers will be screened for eligibility by two independent reviewers. Furthermore, the reference lists of all included publications will be screened. Data will be extracted by using an a priori developed data extraction form and two independent reviewers will assess the risk of bias in the included systematic reviews using with the Risk of Bias in Systematic Reviews (ROBIS) tool. A narrative data-synthesis and a subsequent meta-analysis based on the primary studies will be made.

Discussion
For each psychiatric disorder, the data regarding the prevalence of type 2 diabetes will be summarized and discussed. When possible, comparisons with control groups will be reported and discussed. Finally, future implications and recommendations for clinical care will be presented.

Systematic review registration
This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on December 9, 2019 (registration number: pending).
Associations of loneliness and social isolation with cardiovascular and metabolic health: a systematic review and meta-analysis protocol
Authors: Winterton Adriano , Rødevand Linn , Westlye Lars T. , Steen Nils Eiel , Andreassen Ole A. , Quintana Daniel S. 
Published: May 2020

Abstract
Background
A growing number of studies suggest that social isolation and loneliness are associated with premature mortality and are more prevalent among people with mental illness than in the general population, outlining many potential paths to disease still to be elucidated. The purpose of this meta-analysis is to examine the relationship between loneliness, social isolation, and established cardiovascular/metabolic risk factors and disorders, especially in severe mental illness, and to account for potential heterogeneity in the literature.

Methods/design
Studies that report measures of loneliness and/or social isolation along with cardiovascular/metabolic risk factors will be identified. PubMed, EMBASE (through Ovid SP), Scopus, and PsycINFO (through Ovid SP) will be searched, along with citation lists of retrieved articles and the Cochrane Database of Systematic Reviews. Grey literature will be searched using Google Scholar. Data will be extracted from eligible studies for a random effects meta-analysis. For each study, a summary effect size, heterogeneity, risk of bias, publication bias, and the effect of categorical and continuous moderator variables will be determined.

Discussion
This proposed systematic review and meta-analysis will identify and synthesise evidence to determine if there is an association between loneliness, social isolation, and cardiovascular/metabolic risk factors, with a special focus on severe mental illnesses. The results will help determine links and promising avenues of further research.

Systematic review registration
PROSPERO CRD42018111911
Taylor theory associated with Hahn difference operator
Authors: Oraby Karima , Hamza Alaa 
Published: May 2020

AbstractIn this paper, we establish Taylor theory based on Hahn’s difference operator $D_{q,\omega}$Dq,ω which is defined by $D_{q,\omega}f(t)=\frac{f(qt+\omega)-f(t)}{t(q-1)+\omega}$Dq,ωf(t)=f(qt+ω)−f(t)t(q−1)+ω, $t\neq\frac {\omega}{1-q}$t≠ω1−q, where $q\in(0,1)$q∈(0,1) and ω is a positive number.
Development of the neurotrophic keratopathy questionnaire: qualitative research
Authors: Murray Lindsey T. , McCormack Julie , Grobeiu Ioana , Wiklund Ingela , Kimel Miriam , Van Nooten Floortje 
Published: May 2020

Abstract
Background
Neurotrophic keratopathy/keratitis (NK) is a rare disease of the cornea that can lead to anatomical loss of the eye. Little is known about the NK experience from the patients’ perspective. The objectives of this study were to examine the symptomatic experience and impacts of NK on patients and assess the overall comprehension, relevance, and content validity of a new questionnaire.

Methods
This was a cross-sectional, qualitative study conducted with NK patients with varying levels of disease severity, recruited from one clinical site. One-on-one interviews using concept elicitation and cognitive interviewing techniques were conducted.

Results
Fourteen NK patients participated; 64.3% were female (n = 9), mean age was 65.7 ± 13.3, and 14.3% (n = 2), 21.4% (n = 3), and 64.3% (n = 9) were classified as Mackie stage I, stage II, or stage III, respectively. Participants reported 24 concepts, including: redness (n = 12, 86%), sensitivity to light (n = 11, 79%), general discomfort (n = 9, 64%), dry eye (n = 9, 64%), reduced visual acuity (n = 9, 64%), blurred vision (n = 8, 57%), and eye fatigue (n = 8, 57%). No new concepts were reported after the 13th interview. The most frequently reported impacts included frustration (n = 10, 71%), driving impairment (n = 8, 57%), reading impairment (n = 7, 50%), difficulty watching television (n = 7, 50%), and concern with potentially losing their eyesight due to NK (n = 6, 43%). Participants provided positive feedback on the draft NK Questionnaire (NKQ) and felt that it was comprehensive and relevant to their experience with NK. Additionally, the recall period, instructions, item concepts, and response options were well-understood by participants. Minor revisions were made to the tool for consistency (i.e., the timeframe “in the past 7 days” was added to items 12–14); item 14 was modified to include “how often”; examples were added to item 9.

Conclusions
The results of the concept elicitation portion of the qualitative study support the content validity of the draft NKQ. The clinically significant concepts identified in the literature and raised during concept elicitation are included as items in the questionnaire. Further assessment of the psychometric properties should be conducted in support of this new tool to measure the effect of new treatments on symptoms and impacts associated with NK.
Patients’ and clinicians’ perspectives on relevant treatment outcomes in depression: qualitative study
Authors: Kan Kaying , Jörg Frederike , Buskens Erik , Schoevers Robert A. , Alma Manna A. 
Published: May 2020

BackgroundAlthough symptomatic remission is considered the optimal outcome in depression, this is not always achieved. Furthermore, symptom indicators do not fully capture patients’ and clinicians’ perspectives on remission. Broader indicators of (partial) remission from depression should be considered.AimsTo investigate relevant outcomes of depression treatment in specialist care from patients’ and clinicians’ perspectives and to investigate whether these perspectives differ from each other.MethodThree focus groups with 11 patients with depression and seven semi-structured interviews with clinicians were conducted exploring their perspectives on remission. All interviews were audio-recorded and transcribed verbatim. We analysed the transcripts thematically using the phenomenologist approach.ResultsIndependently, both patients and clinicians perceived the following outcomes relevant: restoring social functioning and interpersonal relations, regaining quality of life and achieving personal goals. All clinicians emphasised symptom reduction and satisfaction with treatment as relevant outcomes, whereas the former was not an obvious theme in patients. Unlike clinicians, patients made a clear distinction between treatment outcomes in first versus recurrent/chronic depression.ConclusionsClassically defined study outcomes based on symptom resolution only partly reflect issues considered important by patients and clinicians in specialist depression treatment. Incorporating patients’ and clinicians’ perspectives in the development of measurable end-points makes them more suitable for use in trials and subsequent translation to clinical practice. Furthermore, evaluating patients’ perspectives on treatment outcomes helps in the development of tailored interventions according to patients’ needs.
Psychiatry and COVID-19: putting our best foot forward
Authors: Strous Rael D. , Gold Azgad 
Published: May 2020

SummaryCOVID-19 presents new challenges for psychiatry as clinical management, ethical dilemmas and administrative complications need to be addressed. The psychiatrist should protect the needs and rights of the mentally ill while maximising population health and ensuring solidarity, reciprocity and community well-being for all.
Coronavirus disease 2019: achieving good mental health during social isolation
Authors: Diamond Rowan , Willan John 
Published: May 2020

SummaryThe coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.