bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air pollution and family related determinants of asthma onset and persistent wheezing in children: nationwide case-control study
Authors: Holst Gitte J , Pedersen Carsten B , Thygesen Malene , Brandt Jørgen , Geels Camilla , Bønløkke Jakob H , Sigsgaard Torben 
Published: August 2020

AbstractObjectiveTo identify risk factors (air pollution and family related) for the onset of asthma and persistent wheezing in children.DesignNationwide case-control study.SettingDenmark.ParticipantsAll Danish children born from 1997 to 2014 and followed for asthma onset and persistent wheezing from age 1 year to 15 years.Main outcome measureOnset of asthma and persistent wheezing.ResultsA higher incidence of asthma was found in children of parents with asthma (adjusted hazard ratio 2.29 (95% confidence interval 2.22 to 2.35) and mothers who smoked during pregnancy (1.20, 1.18 to 1.22), whereas a lower incidence was found in children of parents with high educational attainment (0.72, 0.69 to 0.75) and high incomes (0.85, 0.81 to 0.89). Exposure to particulate matter ≤2.5 µm (PM2.5) and ≤10 µm (PM10) and nitrate was associated with an increased risk of asthma and persistent wheezing, with hazard ratios per 5 µg/m3increase in pollutant concentrations 1.05 (1.03 to 1.07) for PM2.5, 1.04 (1.02 to 1.06) for PM10, and 1.04 (1.03 to 1.04) for nitrogen dioxide. Only the positive association of PM2.5with asthma and persistent wheezing remained robust across the different models and in sensitivity analyses.ConclusionsThe findings of this study suggest that children exposed to higher levels of PM2.5are more likely to develop asthma and persistent wheezing than children who are not exposed. Other risk factors associated with these outcomes were parental asthma, parental education, and maternal smoking during pregnancy.
Facilities are substantially more influential than care providers in the quality of delivery care received: a variance decomposition and clustering analysis in Kenya, Malawi and India
Authors: Helfinstein Sarah , Jain Mokshada , Ramesh Banadakoppa Manjappa , Blanchard James , Kemp Hannah , Gothalwal Vikas , Namasivayam Vasanthakumar , Kumar Pankaj , Sgaier Sema K 
Published: August 2020

IntroductionImproving the quality of care during childbirth is essential for reducing neonatal and maternal mortality. One barrier to improving quality of care is understanding the appropriate level to target interventions. We examine quality of care data during labour and delivery from multiple countries to assess whether quality varies primarily from nurse to nurse within the same facility, or primarily between facilities.MethodsTo assess the relative contributions of nurses and facilities to variance in quality of care, we performed a variance decomposition analysis using a linear mixed effect model on two data sources: (1) the number of vital signs assessed for women in labour from a study of nurse practices in Uttar Pradesh, India; 2) broad-scale indices of respectful and competent care generated from Service Provision Assessments in Kenya and Malawi. We used unsupervised clustering, a data mining technique that groups objects together based on similar characteristics, to identify groups of facilities that displayed distinct patterns of vital signs assessment behaviour.ResultsWe found 3–10 times more variance in quality of care was explained by the facility where a patient received care than by the nurse who provided it. The unsupervised clustering analysis revealed groups of facilities with highly distinctpatternsof vital signs assessment, even when overall rates of vital signs assessments were similar (eg, some facilities consistently test fetal heart rate, but not other vitals, others only blood pressure).ConclusionFacilities within a region can vary substantially in the quality of care they provide to women in labour, but within a facility, nurses tend to provide similar care. This holds true both for care that can be influenced by equipment availability and technical training (eg, vital signs assessment), as well as cultural aspects (eg, respectful care).
Psychological distress among refugees in Germany: a cross-sectional analysis of individual and contextual risk factors and potential consequences for integration using a nationally representative survey
Authors: Walther Lena , Kröger Hannes , Tibubos Ana Nanette , Ta Thi Minh Tam , von Scheve Christian , Schupp Jürgen , Hahn Eric , Bajbouj Malek 
Published: August 2020

ObjectivesResponding to the mental health needs of refugees remains a pressing challenge worldwide. We estimated the prevalence of psychological distress in a large refugee population in Germany and assessed its association with host country factors amenable to policy intervention and integration indicators.DesignA cross-sectional and population-based secondary analysis of the 2017 wave of the IAB-BAMF-SOEP refugee survey.SettingGermany.Participants2639 adult refugees who arrived in Germany between 2013 and 2016.Main outcome measuresPsychological distress involving symptoms of depression, anxiety and post-traumatic stress disorder was measured using the Refugee Health Screener-13.ResultsAlmost half of the population surveyed (41.2% (95% CI: 37.9% to 44.6%)) was affected by mild, moderate or severe levels of psychological distress. 10.9% (8.4% to 13.5%) of the population screened positive for severe distress indicative of an urgent need for care. Prevalence of distress was particularly high for females (53.0% (47.2% to 58.8%)), older refugees (aged ≥55, 70.4% (58.5% to 82.2%)) and Afghans (61.5% (53.5% to 69.5%)). Individuals under threat of deportation were at a greater risk of distress than protection status holder (risk ratio: 1.55 (95% CI: 1.14 to 2.10)), single males at a greater risk than males with nuclear families living in Germany (1.34 (1.04 to 1.74)) and those in refugee housing facilities at a greater risk than those in private housing (1.21 (1.02 to 1.43)). Distressed males had a lower likelihood of employment (0.67 (0.52 to 0.86)) and reduced participation in integration courses (0.90 (0.81 to 0.99)). A trend of reduced participation in educational programmes was observed in affected females (0.42 (0.17 to 1.01)).ConclusionThe finding that a substantial minority of refugees in Germany exhibits symptoms of distress calls for an expansion of mental health services for this population. Service providers and policy-makers should consider the increased prevalence among female, older and Afghan refugees, as well as among single males, residents in housing facilities and those under threat of deportation. The associations between mental health and integration processes such as labour market, educational programme and integration course participation also warrant consideration.
ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy): a randomised controlled trial of an innovative intervention for infants at risk of autism spectrum disorder
Authors: Whittingham Koa , McGlade Andrea , Kulasinghe Kavindri , Mitchell Amy E , Heussler Honey , Boyd Roslyn N 
Published: August 2020

IntroductionAutism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with impacts on behaviour, cognition, communication, social interaction and family mental health. This paper reports the protocol of a randomised controlled trial (RCT) of a very early intervention, ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy), for families of infants at risk of ASD.Methods and analysisWe aim to recruit 66 mothers of infants at risk of ASD (ie, infants with a sibling or parent diagnosed with ASD) to this RCT. Families will be randomly assigned to care-as-usual or ENACT. ENACT is a very early intervention, leveraging parent–child interactions to improve early social reciprocity, while supporting parental mental health and the parent–child relationship through Acceptance and Commitment Therapy. Intervention content is delivered online (approximately 8 hours) and supported by more than 7 consultations with a clinician. Parents will perform the social reciprocity intervention with their child (30 min per day). Assessments at four time points (baseline, 3 months, 6 months, and 12 months corrected age) will assess parent–infant interaction, parental mental health, infant development and early ASD markers. Analysis will be by intention to treat using general linear models for RCTs.Ethics and disseminationThis protocol has been approved by the Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/50131) and the University of Queensland Human Research Ethics Committee (2019000558). If efficacy is demonstrated, the intervention has the potential for wide and accessible dissemination.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12618002046280).
Multiple-dose tranexamic acid for perioperative blood loss in total knee arthroplasty in patients with rheumatoid arthritis：a single-blinded, randomised, parallel-controlled study protocol in China
Authors: Kang Bing-Xin , Xu Hui , Gao Chen-Xin , Zhong Sheng , Zhang Jing , Xie Jun , Sun Song-Tao , Ma Ying-Hui , Zhai Wei-Tao , Xiao Lian-Bo 
Published: August 2020

IntroductionThis clinical trial is designed to evaluate the effect of multiple-dose tranexamic acid (TXA) on perioperative blood loss in patients with rheumatoid arthritis (RA).Methods and analysisA randomised, single-blinded, parallel-controlled study will be designed. Patients with RA (age 50–75 years) undergoing unilateral primary end-stage total knee arthroplasty will be randomly divided into group A or group B. Group A will be treated with one dose of TXA (1 g; intravenous injection 3 hours postsurgery) and group B with three doses (1 g; intravenous injection at 3, 6 and 12 hours postsurgery) after surgery. The primary outcomes will be evaluated with blood loss, maximum haemoglobin drop and transfusion rate. The secondary outcomes will be evaluated with knee function and complications.Ethics and disseminationThe Shanghai Guanghua Hospital of Integrated Traditional Chinese Medicine and Western Medicine Ethics Committee approved in this study in July 2019. Informed consent will be obtained from all participants. Results of the trial will be published in the Dryad and repository in a peer-reviewed journal. Additionally, deidentified data collected and analysed for this study will be available for review from the corresponding author on reasonable request.Trial registration numberChiCTR1900025013.
Association between alcohol consumption/alcohol use disorders and patient complexity: a cross-sectional study
Authors: Sugiyama Yoshifumi , Matsushima Masato , Yoshimoto Hisashi 
Published: August 2020

ObjectivesThe objective was to clarify the relationship between alcohol consumption/alcohol use disorders and patient complexity.DesignCross-sectional study.SettingA clinic located on a remote island in Okinawa, Japan, providing general outpatient practices and round-the-clock emergency services.ParticipantsPatients who lived on the island, visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged ≥20 years and had decision-making capacity were judged to be eligible for this study.Main outcome measuresAlcohol consumption/alcohol use disorders as measured by the Alcohol Use Disorders Identification Test (AUDIT) and patient complexity as scored by the Patient Centered Assessment Method (PCAM).ResultsDuring the 3-month study period, 355 patients (163 women and 192 men) with mean (SD) age of 66.4 (13.6) years were included. Multiple regression analysis of PCAM scores showed that, after adjusting for age, sex, education, occupation, physical activity, smoking, annual medical expenses and number of family members living with the patient, AUDIT scores classified as ‘dependence likely’ were associated with PCAM scores (p value=0.040).ConclusionsAlcohol consumption and alcohol use disorders classified as dependence likely are associated with patient complexity.
Acupuncture for patients with chronic pruritus: protocol of a systematic review and meta-analysis
Authors: Zhang Leixiao , Deng Yanli , Yao Junpeng , Xiao Xianjun , Yu Siyi , Shi Yunzhou , Zheng Hui , Zheng Qianhua , Zhou SiYuan , Cao Wei , Liu Ying , Hao Pingsheng , Li Ying 
Published: August 2020

IntroductionChronic pruritus (CP) frequently occurs in many skin and systemic diseases, and adversely affects quality of life. This systematic review aims to evaluate treatment effects of acupuncture on CP.Methods and analysisAn electronic and manual search will be conducted for all acupuncture treatments for CP, from the inception date of predefined database up to 28 February 2020. Databases include PubMed, Embase, Springer, Web of Science, the Cochrane Library, the World Health Organization International Clinical Trial Registration Platform, the Chinese Medicine Database, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the China Science Journal Database and the Wanfang Database. Other sources, including existing systematic reviews, conference proceedings and reference lists of identified publications will also be searched. Additionally, any clinical randomised controlled trials related to acupuncture treatment for CP, regardless of the publication status and language limitations, will be included. Study selection, data extraction and research quality assessments will be conducted independently by two researchers. The primary outcome measures include the Visual Analogue Scale, Urdu 5D-Itch Scale or other validated scales implemented after at least 2 weeks of treatment. Secondary outcomes include the effective rate, Quality of Life Scale (eg, the EQ-5D third level, the Dermatology Life Quality Index, etc.), Pittsburgh Sleep Quality Index, recurrence rate during the follow-up period and adverse events. If possible, meta-analyses will be performed using RevMan V.5.3 statistical software; otherwise, a descriptive analysis or subgroup analysis will be conducted. The results will be presented as the risk ratio of the binary data and the mean difference (MD) or standardised MD of the continuous data.Ethics and disseminationThis systematic review protocol does not require formal ethical approval because the data are not personalised. It will be published in peer-reviewed journals and presented at international academic conferences.PROSPERO registration numberCRD42019136727.
Gender and other potential biases in peer review: cross-sectional analysis of 38 250 external peer review reports
Authors: Severin Anna , Martins Joao , Heyard Rachel , Delavy François , Jorstad Anne , Egger Matthias 
Published: August 2020

ObjectivesTo examine whether the gender of applicants and peer reviewers and other factors influence peer review of grant proposals submitted to a national funding agency.SettingSwiss National Science Foundation (SNSF).DesignCross-sectional analysis of peer review reports submitted from 2009 to 2016 using linear mixed effects regression models adjusted for research topic, applicant’s age, nationality, affiliation and calendar period.ParticipantsExternal peer reviewers.Primary outcome measureOverall score on a scale from 1 (worst) to 6 (best).ResultsAnalyses included 38 250 reports on 12 294 grant applications from medicine, architecture, biology, chemistry, economics, engineering, geology, history, linguistics, mathematics, physics, psychology and sociology submitted by 26 829 unique peer reviewers. In univariable analysis, male applicants received more favourable evaluation scores than female applicants (+0.18 points; 95% CI 0.14 to 0.23), and male reviewers awarded higher scores than female reviewers (+0.11; 95% CI 0.08 to 0.15). Applicant-nominated reviewers awarded higher scores than reviewers nominated by the SNSF (+0.53; 95% CI 0.50 to 0.56), and reviewers from outside of Switzerland more favourable scores than reviewers affiliated with Swiss institutions (+0.53; 95% CI 0.49 to 0.56). In multivariable analysis, differences between male and female applicants were attenuated (+0.08; 95% CI 0.04 to 0.13) whereas results changed little for source of nomination and affiliation of reviewers. The gender difference increased after September 2011, when new evaluation forms were introduced (p=0.033 from test of interaction).ConclusionsPeer review of grant applications at SNSF might be prone to biases stemming from different applicant and reviewer characteristics. The SNSF abandoned the nomination of peer reviewers by applicants. The new form introduced in 2011 may inadvertently have given more emphasis to the applicant’s track record. We encourage other funders to conduct similar studies, in order to improve the evidence base for rational and fair research funding.
Caste, religion and regional differentials in life expectancy at birth in India: cross-sectional estimates from recent National Family Health Survey
Authors: Kumari Meena , Mohanty Sanjay K 
Published: August 2020

ObjectiveThough estimates of longevity are available by states, age, sex and place of residence in India, disaggregated estimates by social and economic groups are limited. This study estimates the life expectancy at birth and premature mortality by caste, religion and regions of India.DesignThis study primarily used cross-sectional data from the National Family Health Survey (NFHS-4), 2015–2016 and the Sample Registration System (SRS), 2011–2015. The NFHS-4 is the largest ever demographic and health survey covering 601 509 households and 811 808 individuals across all states and union territories in India.MeasuresThe abridged life table is constructed to estimate the life expectancy at birth, adult mortality (45q15) and premature mortality (70q0) by caste, religion and region.ResultsLife expectancy at birth was estimated at 63.1 years (95% CI 62.60 -63.64) for scheduled castes (SC), 64.0 years (95% CI 63.25 - 64.88) for scheduled tribes (ST), 65.1 years (95% CI 64.69 - 65.42) for other backward classes (OBC) and 68.0 years (95% CI 67.44 - 68.45) for others. The life expectancy at birth was higher among o Christians 68.1 years (95% CI 66.44 - 69.60) than Muslims 66.0 years (95% CI 65.29 - 66.54) and Hindus 65.0 years (95% CI 64.74 -65.22). Life expectancy at birth was higher among females than among males across social groups in India. Premature mortality was higher among SC (0.382), followed by ST (0.381), OBC (0.344) and others (0.301). The regional variation in life expectancy by age and sex is large.ConclusionIn India, social and religious differentials in life expectancy by sex are modest and need to be investigated among poor and rich within these groups. Premature mortality and adult mortality are also high across social and religious groups.
Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study
Authors: Umans Devica S , Timmerhuis Hester C , Hallensleben Nora D , Bouwense Stefan A , Anten Marie-Paule GF , Bhalla Abha , Bijlsma Rina A , Boermeester Marja A , Brink Menno A , Hol Lieke , Bruno Marco J , Curvers Wouter L , van Dullemen Hendrik M , van Eijck Brechje C , Erkelens G Willemien , Fockens Paul , van Geenen Erwin J M , Hazen Wouter L , Hoge Chantal V , Inderson Akin , Kager Liesbeth M , Kuiken Sjoerd D , Perk Lars E , Poley Jan-Werner , Quispel Rutger , Römkens Tessa EH , van Santvoort Hjalmar C , Tan Adriaan CITL , Thijssen Annemieke Y , Venneman Niels G , Vleggaar Frank P , Voorburg Annet MCJ , van Wanrooij Roy LJ , Witteman Ben J , Verdonk Robert C , Besselink Marc G , van Hooft Jeanin E 
Published: August 2020

IntroductionIdiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP.Methods and analysisPICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months.Ethics and disseminationPICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.Trial registration numberNetherlands Trial Registry (NL7066). Prospectively registered.
Meanings and senses of being a health professional with tuberculosis: an interpretative phenomenological study
Authors: Santos Marcandra Nogueira Almeida , Sá Antonia Margareth Moita , Quaresma Juarez Antonio Simões 
Published: August 2020

ObjectiveThe aim of the study was to analyse and understand meanings and senses of living with tuberculosis for health professionals.Method/designThis is an interpretative phenomenological study conducted from in-depth interviews to analyse how health professionals understand their personal experience of tuberculosis.ScenarioTwo reference health institutions for tuberculosis diagnosis and treatment located in a municipality of the Eastern Brazilian Amazon.ParticipantsIntentional sample of 15 health professionals with the disease or with a recent history of tuberculosis.ResultsRegarding the personal experience of tuberculosis of the participating health professionals, four superordinate themes were identified: (1) experiencing tuberculosis, (2) experiencing the diagnosis of tuberculosis, (3) facing the treatment of tuberculosis and (4) signifying tuberculosis.ConclusionThis study verified that health professionals live the experience of tuberculosis similar to other people: with fear, anguish, frustration, prejudice and health needs not always met by the services and programmes for the control of the disease. The lived experience has an important impact on the health professionals’ ways of understanding the kind of empathic and sensitive care that should be provided to people with tuberculosis. In addition, it is concluded that specific governmental strategies are needed for tuberculosis prevention, diagnosis and treatment among health professionals.