bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China
Authors: Yu Bolan , Dai Lijuan , Chen Juanjuan , Sun Wen , Chen Jingsi , Du Lili , Deng Nali , Chen Dunjin 
Published: September 2020

ObjectivesIn this cross-sectional survey, we sought to determine the prevalence of and the influence of prenatal and neonatal factors on childhood visual impairment without correction (VIUC) in a paediatric population from Guangzhou, China.SettingThe health survey covered 11 administrative districts in Guangzhou, including 991 schools.ParticipantsAll of the primary and middle school students in Guangzhou were invited to complete an online questionnaire with the help of their parents. The results of physical examinations were reported by school medical departments. The results of the questionnaire were collected by the researchers. In total, 253 301 questionnaires were collected.Primary outcome measuresThe students’ uncorrected visual acuity (UCVA) was examined by trained optometrists by standard logarithmic visual acuity charts. VIUC was defined by UCVA (of the better eye) (UCVA <6/12) with three levels: light VIUC (UCVA ≥6/18 to <6/12), mild VIUC (UCVA ≥6/60 to <6/18) and severe VIUC (UCVA <6/60).ResultsA total of 39 768 individuals (15.7%) had VIUC, and the rate was much higher among grade 10 to 12 students (51.4%) than among grade 1 to 6 students (6.71%). The following factors were significantly associated with an increased risk of VIUC: female gender, high birth weight, formula feeding, not having siblings, higher level of parents’ education, parental myopia, much homework time and little outdoor activity. Delivery mode was not associated with the risk of VIUC.ConclusionsThis study validates known major prenatal/genetic, perinatal and postnatal factors for childhood VIUC. In conclusion, prenatal and perinatal factors can affect the onset of childhood VIUC, but parental myopia and postnatal factors are the main factors.
Experience of being a frequent user of primary care and emergency department services: a qualitative systematic review and thematic synthesis
Authors: Brodeur Magaly , Margo-Dermer Eva , Chouinard Maud-Christine , Hudon Catherine 
Published: September 2020

BackgroundFrequent users of healthcare services are often categorised as ‘heavy-cost patients’. In the recent years, many jurisdictions have attempted to implement different public policies to optimise the use of health services by frequent users. However, throughout this process, little attention has been paid to their experience as patients.ObjectiveTo thematically synthesise qualitative studies that explore the experience of frequent users of primary care and emergency department services.DesignQualitative systematic review and thematic synthesis.SettingPrimary care and emergency department.ParticipantsFrequent users of primary care and emergency department services.MethodsA qualitative systematic review was conducted using three online databases (MEDLINE with full text, CINAHL with full text and PsycINFO). This search was combined to an extensive manual search of reference lists and related citations. A thematic synthesis was performed to develop descriptive themes and analytical constructs.Study selectionTwelve studies were included. All included studies met the following inclusion criteria: qualitative design; published in English; discussed frequent users’ experiences from their own perspectives and users’ experiences occurred in primary care and/or emergency departments.ResultsThe predominant aspects of frequent users’ experiences were: (1) the experience of being ill and (2) the healthcare experience. The experience of being ill encompassed four central themes: physical limitations, mental suffering, impact on relationships and the role of self-management. The healthcare experience embraced the experience of accessing healthcare and the global experience of receiving care.ConclusionThis synthesis sheds light on potential changes to healthcare delivery in order to improve frequent users’ experiences: individualised care plans or case management interventions to support self-management of symptoms and reduce psychological distress; and giving greater importance on the patient–providers relationship as a central facet of healthcare delivery. This synthesis also highlights future research directions that would benefit frequent users.
Inpatient satisfaction with nursing care in a backward region: a cross-sectional study from northwestern China
Authors: Zhang Juxia , Yang Limei , Wang Xiaoying , Dai Jiao , Shan Wenjing , Wang Jiancheng 
Published: September 2020

ObjectivesThe aim of the study was to examine the level of patient satisfaction with nursing care and identify the factors affecting satisfaction from the inpatient’s perspective in a backward region of China.DesignThis was a cross-sectional study.SettingThe study was conducted at a tertiary hospital located in northwest China.ParticipantsPatients admitted to the ward for at least 48 hours were chosen to participate in the survey.Primary outcome measureThe Newcastle Satisfaction with Nursing Care Scale was used. Data were collected from 219 patients.ResultsThe overall inpatient satisfaction with nursing care was 78.15±4.74. Patients were more satisfied with nurses who respected their privacy and treated them as individuals (67.7%). Patients were least satisfied with the type of information nurses gave them (11.7%) and with the sufficient awareness of their needs. Patients who were married, had a history of hospitalisation, surgery and were taken charge of by junior nurses had higher satisfaction.ConclusionsThe overall level of patient satisfaction was moderate. Patient-centred individualised care and providing sufficient information model of care are needed. There was a need for nurses to be aware of patients’ individualised care needs and to provide them with more information. This study may suggest/urge hospital administrators, policymakers and nurses to be more sensitive with patients’ married status, history of hospitalisation and surgery, the professional title of in charged nurses when care is provided. Ultimately to achieve better outcome of patients’ hospitalisation.
Pain complaints after consecutive nights and quick returns in Norwegian nurses working three-shift rotation: an observational study
Authors: Katsifaraki Maria , Nilsen Kristian Bernhard , Christensen Jan Olav , Wærsted Morten , Knardahl Stein , Bjorvatn Bjørn , Härmä Mikko , Matre Dagfinn 
Published: September 2020

ObjectivesTo determine whether nurses working consecutive night shifts, or short transitions between shifts (quick returns (QRs)), yielded higher risk for pain complaints when compared with regular morning shifts. Sleep duration was tested as a potential mediator.DesignObservational diary study.SettingRandom hospitals.ParticipantsNurses with three-shift rotation (morning, evening and night), n=679, 22–63 years old.Outcomes measuresDaily ratings of working hours, sleep and subjective pain complaints in six anatomical regions (head, neck/shoulder/upper back, upper extremity, low back, lower extremity and abdomen) for 28 days. In addition, we assessed demographics, habitual sleep and pain complaints, work and lifestyle factors. It was tested (1) whether the risk for pain complaints was higher after workday 3 versus after workday 2, and whether the difference was larger for consecutive night shifts versus consecutive morning shifts, and (2) whether the risk for pain complaints was higher after QRs versus after two morning shifts. Risk for pain complaints refers to combined increased risk for any pain and risk for increased intensity.ResultsAdjusted analyses showed no shift type by workday interaction for pain complaints in the neck/shoulder/upper back, upper extremities, low back, lower extremities or abdomen. For headache, a strong trend indicated that the risk was higher on workday 3 compared with workday 2 for night shifts (OR 1.13, 95% CI 0.99 to 1.28). The risk was lowered if sleep duration was taken into account (OR 0.37, 95% CI 0.17 to 0.81). No conclusive support was found for the risk for pain complaints being higher after QRs, compared with after morning shifts.ConclusionsFor five of six pain complaints, the hypotheses were not supported by the current data. For headache, we found potential support for a sleep-relieving effect on headache after working several nights in a row. Pain complaints were not instigated or exacerbated by an evening-to-morning transition between shifts.
Can we prevent poststroke cognitive impairment? An umbrella review of risk factors and treatments
Authors: Obaid Majed , Douiri Abdel , Flach Clare , Prasad Vibhore , Marshall Iain 
Published: September 2020

ObjectivesCognitive impairment poststroke is progressive. We aimed to synthesise the existing evidence evaluating risk factors and the effects of treatments to prevent/improve cognitive function in patients who had a stroke with cognitive impairment.DesignUmbrella review.Data sourceMedline, PsycINFO, EMBASE, Cochrane and PROSPERO were searched from inception until 11 June 2019.Eligibility criteriaPublished systematic review (SR) that incorporated randomised controlled trials to investigate an intervention to improve poststroke cognitive impairment, or SR of longitudinal observational studies that evaluated the risk factors of this condition. No restrictions were applied.Data extraction and synthesisFrom each eligible study, details were recorded by one reviewer in a validated form. Grading of Recommendations, Assessment, Development and Evaluations criteria were used to assess our certainty level of each outcome, and A Measurement Tool to Assess Systematic Reviews 2 to assess quality.ResultsAltogether, 3464 abstracts were retrieved, 135 full texts were evaluated and 22 SRs were included in the final analysis. From four SRs of observational studies, we found 19 significant associations with postulated risk factors, and those which we determined to be confident about were: atrial fibrillation (3 SRs, 25 original studies); relative risk 3.01 (1.96–4.61), ORs 2.4 (1.7–3.5) and 2.0 (1.4–2.8), leukoaraiosis, multiple and recurrent strokes, ORs 2.5 (1.9–3.4), 2.5 (1.9–3.1) and 2.3 (1.5–3.5), respectively. From 18 SRs of interventional trials, we found that interventions including physical activity or cognitive rehabilitation were enhancing cognitive function, while the certainty of the other interventions was rated low, due to limited methodological quality.ConclusionsThis review represents common risk factors related to poststroke cognitive impairment, in particular atrial fibrillation, and points to different interventions that warrant attention in the development of treatment strategies. Physical activity and cognitive rehabilitation interventions showed evidence of enhancing cognitive function; however, we could not recommend a change in practice yet, due to lack of strong evidence.PROSPERO registration numberCRD42018096667.
Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey
Authors: Odland Maria Lisa , Bockarie Tahir , Wurie Haja , Ansumana Rashid , Lamin Joseph , Nugent Rachel , Bakolis Ioannis , Witham Miles , Davies Justine 
Published: September 2020

IntroductionPrevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.MethodsThis study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.ResultsOf 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.ConclusionsIn Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed.
Health and productivity burden of coronary heart disease in the working Indonesian population using life-table modelling
Authors: Uli Regina E , Satyana Regina P U , Zomer Ella , Magliano Dianna , Liew Danny , Ademi Zanfina 
Published: September 2020

ObjectivesThe impact of coronary heart disease (CHD) and its effect on work productivity at a population level remains unknown in Indonesia. This study estimates the health and productivity lost to CHD in terms of years of life, quality-adjusted life years (QALYs) and productivity-adjusted life years (PALYs).Setting and participantsA life-table model was constructed to simulate the experiences of Indonesians currently aged 15–54 years (working age) with CHD, followed-up to 55 years (retirement age). The life-table analysis was then repeated assuming that the cohort did not have CHD. Differences in the results reflected the impact of CHD. Demographical, prevalence and mortality data were based on the 2017 Global Burden of Disease study and 2018 Indonesian National Health Survey. Costs, productivity indices and utilities were derived from published sources. The cost of each PALY was assumed to be equivalent to gross domestic product per equivalent full-time worker (US$11 765). Future costs and outcomes were discounted by 3% annually.Primary and secondary outcome measuresDifferences in total deaths, years of life and PALYs represented the impact of CHD.ResultsAt present, 1 954 543 (1.45%) Indonesians of working-age have CHD. By retirement age, it was estimated that CHD resulted in 32 492 (36.6%) excess deaths, 128 132 (0.5%) years of life lost, 2 331 495 (10.5%) QALYs lost and 1 589 490 (6.9%) PALYs lost. The economic impact of lost productivity amounted to US$33.3 billion, and healthcare costs to US$139 billion.ConclusionThe health and economic burden of CHD in Indonesia looms large. This highlights the importance of its prevention and control, strategies for which, if effective, will deliver financial return.
Respiratory patient experience of measures to reduce risk of COVID-19: findings from a descriptive cross-sectional UK wide survey
Authors: Philip Keir , Cumella Andrew , Farrington-Douglas Joe , Laffan Michael , Hopkinson Nicholas 
Published: September 2020

ObjectivesTo assess the experience of people with long-term respiratory conditions regarding the impact of measures to reduce risk of COVID-19.DesignAnalysis of data (n=9515) from the Asthma UK and British Lung Foundation partnership COVID-19 survey collected online between 1 and 8 April 2020.SettingCommunity.Participants9515 people with self-reported long-term respiratory conditions. 81% female, age ranges from ≤17 years to 80 years and above, from all nations of the UK. Long-term respiratory conditions reported included asthma (83%), chronic obstructive pulmonary disease (10%), bronchiectasis (4%), interstitial lung disease (2%) and ‘other’ (<1%) (eg, lung cancer and pulmonary endometriosis).Outcome measuresStudy responses related to impacts on key elements of healthcare, as well as practical, psychological and social consequences related to the COVID-19 pandemic and social distancing measures.Results45% reported disruptions to care, including cancellations of appointments, investigations, pulmonary rehabilitation, treatment and monitoring. Other practical impacts such as difficulty accessing healthcare services for other issues and getting basic necessities such as food were also common. 36% did not use online prescriptions, and 54% had not accessed online inhaler technique videos. Psychosocial impacts including anxiety, loneliness and concerns about personal health and family were prevalent. 81% reported engaging in physical activity. Among the 11% who were smokers, 48% reported they were planning to quit smoking because of COVID-19.ConclusionsCOVID-19 and related social distancing measures are having profound impacts on people with chronic respiratory conditions. Urgent adaptation and signposting of services is required to mitigate the negative health consequences of the COVID-19 response for this group.
Distinct financial distress profiles in patients with breast cancer prior to and for 12 months following surgery
Authors: Chan Raymond , Cooper Bruce , Paul Steven , Conley Yvette , Kober Kord , Koczwara Bogda , Chan Alexandre , Tan Chia Jie , Gordon Louisa , Thomy Lebogang , Levine Jon , Miaskowski Christine 
Published: September 2020

BackgroundStudy purposes were to identify subgroups of patients with breast cancer with distinct self-reported financial distress (FD) profiles and determine which demographic, clinical and symptom characteristics, as well as quality of life (QOL) outcomes were associated with subgroup membership.MethodsPatients (n=391) who were assessed for changes in FD a total of 10 times from prior to through 12 months after breast cancer surgery. Latent profile analysis was used to identify subgroups of patients with distinct FD profiles.ResultsThree distinct FD profiles (ie, None (14.6%), Low (52.7%), High (32.7%)) were identified. Compared with None and/or Low subgroups, patients in the High subgroup were more likely to report a lower annual household income and performance status; had a higher body mass index, axillary lymph node dissection and more advanced stage disease; had a longer time from cancer diagnosis to surgery; and had received neoadjuvant or adjuvant chemotherapy. In addition, patients in the High subgroup reported higher fatigue, sleep disturbance, state/trait anxiety, depressive symptom scores, and lower attentional function and QOL scores.ConclusionThis study provides new insights on risk factors for and evidence of a higher symptom burden associated with FD. Findings from this study provide clinicians with information on how to identify high-risk patients and to recommend appropriate interventions for both symptom management and FD. Additional research on the mechanisms that underlie the relationships among FD and common physical and psychological symptoms may inform future interventions.
CD25-targeted antibody–drug conjugate depletes regulatory T cells and eliminates established syngeneic tumors via antitumor immunity
Authors: Zammarchi Francesca , Havenith Karin , Bertelli Francois , Vijayakrishnan Balakumar , Chivers Simon , van Berkel Patrick H 
Published: September 2020

BackgroundRegulatory T cells (Tregs) contribute to an immunosuppressive tumor microenvironment. They play an important role in the establishment and progression of tumors with high Tregsinfiltration and present a major obstacle to tumor eradication by immunotherapies. Numerous strategies have been attempted to deplete or block Tregs, although their success has been limited.MethodsA CD25-targeted, pyrrolobenzodiazepine (PBD) dimer-based antibody–drug conjugate (ADC) was investigated for its ability to deplete Tregsand induce antitumor immunity. Antitumor activity of CD25-ADC either alone or in combination with an anti-programmed cell death protein 1 (PD-1) antibody was evaluated in CD25-negative syngeneic models that exhibit tumor infiltration of CD25-expressing Tregs, and its pharmacodynamics and pharmacokinetics were assessed.ResultsSingle low doses of CD25-ADC resulted in potent and durable antitumor activity in established syngeneic solid tumor models and the combination of a suboptimal dose was synergistic with PD-1 blockade. Tumor eradication by the CD25-targeted ADC was CD8+ T cell-dependent and CD25-ADC induced protective immunity. Importantly, while CD25-ADC mediated a significant and sustained intratumoral Tregsdepletion, accompanied by a concomitant increase in the number of activated and proliferating tumor-infiltrating CD8+ T effector cells, systemic Tregsdepletion was transient, alleviating concerns of potential autoimmune side effects.ConclusionsThis study shows that a PBD dimer-based, CD25-targeted ADC is able to deplete Tregsand eradicate established tumors via antitumor immunity. This represents a novel approach to efficiently deplete Tregsvia a very potent DNA damaging toxin known to induce immunogenic cell death. Moreover, this study provides proof of concept for a completely new application of ADCs as immunotherapeutic agents, as the main mode of action relies on the ADC directly targeting immune cells, rather than tumor cells. These strong preclinical data warrant the clinical evaluation of camidanlumab tesirine (ADCT-301), a PBD-based ADC targeting human CD25, either alone or in combination with checkpoint inhibitors in solid tumors with known Tregsinfiltration. A phase I trial (NCT03621982) of camidanlumab tesirine in patients with selected advanced solid tumors is ongoing.
Threshold effects in SO(10) models with one intermediate breaking scale
Authors: Meloni Davide , Ohlsson Tommy , Pernow Marcus 
Published: September 2020

AbstractDespite the successes of the Standard Model of particle physics, it is known to suffer from a number of deficiencies. Several of these can be addressed within non-supersymmetric theories of grand unification based on $$\text {SO}(10)$$

SO
(
10
)

. However, achieving gauge coupling unification in such theories is known to require additional physics below the unification scale, such as symmetry breaking in multiple steps. Many such models are disfavored due to bounds on the proton lifetime. Corrections arising from threshold effects can, however, modify these conclusions. We analyze all seven relevant breaking chains with one intermediate symmetry breaking scale, assuming the “survival hypothesis” for the scalar masses. Two are allowed by proton lifetime and two are disfavored by a failure to unify the gauge couplings. The remaining three unify at a too low scale, but can be salvaged by various amounts of threshold corrections. We parametrize this and thereby rank the models by the size of the threshold corrections required to save them.