bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic analysis of authorship demographics in global surgery
Authors: Ravi Krithi , Bentounsi Zineb , Tariq Aiman , Brazeal Aurelia , Daudu Davina , Back Francesca , Elhadi Muhammed , Badwi Nermin , Shah Sayed Shah Nur Hussein , Bandyopadhyay Soham , Khalil Halimah , Kimura Hitomi , Sekyi-Djan Mama Ntiriwa , Abdelrahman Ahmed , Shaheen Ahmed , Mbonda Noula Aime Gilbert , Wong Ai-Ting , Ndajiwo Aliyu , Souadka Amine , Maina Ann Nyandia , Nyalundja Arsene Daniel , Sabry Aya , Hind Bourja , Nteranya Daniel Safari , Ngugi Dorcas Wambui , de Wet Elsa , Tolis Engy Amgad , Wafqui F Z , Essangri Hajar , Moujtahid Hajar , Moola Husna , Narain Kapil , Ravi Krupa , Wassim Kyrillos , Odiero Lucianne A , Nyaboke Lucina Stephanie , Metwalli Maram , Naisiae Maryanne , Pueschel Miriam Gerd , Turabi Nafisa , El Aroussi Nouhaila , Makram Omar Mohamed , Shawky Omar A , Outani Oumaima , Carides Peter , Patil Poorvaprabha , Halley-Stott Richard P , Kurbegovic Sabina , Marchant Samantha , Moujtahid Sara , El Hadrati Soukaina , Agarwal Tanishq , Kidavasi Valerie Atonya , Agarwal Vrinda , Steyn Wilme , Matumo Winnie , Fahmy Youssef Ahmed , Omar Zaayid , Amod Zachary , Eloff Madelein , Hussein Nafisa Agil , Sharma Dhananjaya 
Published: October 2021

BackgroundGlobal surgery has recently gained prominence as an academic discipline within global health. Authorship inequity has been a consistent feature of global health publications, with over-representation of authors from high-income countries (HICs), and disenfranchisement of researchers from low-income and middle-income countries (LMICs). In this study, we investigated authorship demographics within recently published global surgery literature.MethodsWe performed a systematic analysis of author characteristics, including gender, seniority and institutional affiliation, for global surgery studies published between 2016 and 2020 and indexed in the PubMed database. We compared the distribution of author gender and seniority across studies related to different topics; between authors affiliated with HICs and LMICs; and across studies with different authorship networks.Results1240 articles were included for analysis. Most authors were male (60%), affiliated only with HICs (51%) and of high seniority (55% were fully qualified specialist or generalist clinicians, Principal Investigators, or in senior leadership or management roles). The proportion of male authors increased with increasing seniority for last and middle authors. Studies related to Obstetrics and Gynaecology had similar numbers of male and female authors, whereas there were more male authors in studies related to surgery (69% male) and Anaesthesia and Critical care (65% male). Compared with HIC authors, LMIC authors had a lower proportion of female authors at every seniority grade. This gender gap among LMIC middle authors was reduced in studies where all authors were affiliated only with LMICs.ConclusionAuthorship disparities are evident within global surgery academia. Remedial actions to address the lack of authorship opportunities for LMIC authors and female authors are required.
Factors associated with shorter length of admission among people with dementia in England and Wales: retrospective cohort study
Authors: Sanatinia Rahil , Burns Alistair , Crome Peter , Gordon Fabiana , Hood Chloe , Lee William , Quirk Alan , Seers Kate , Staniszewska Sophie , Zafarani Gemma , Crawford Mike 
Published: October 2021

ObjectivesTo identify aspects of the organisation and delivery of acute inpatient services for people with dementia that are associated with shorter length of hospital stay.Design and settingRetrospective cohort study of patients admitted to 200 general hospitals in England and Wales.Participants10 106 people with dementia who took part in the third round of National Audit of Dementia.Main outcome measureLength of admission to hospital.ResultsThe median length of stay was 12 days (IQR=6–23 days). People with dementia spent less time in hospital when discharge planning was initiated within 24 hours of admission (estimated effect −0.24, 95% CI: −0.29 to −0.18, p<0.001). People from ethnic minorities had shorter length of stay (difference −0.066, 95% CI: −0.13 to −0.002, p=0.043). Patients with documented evidence of discussions having taken place between their carers and medical staff spent longer in hospital (difference 0.26, 95% CI: 0.21 to 0.32, p<0.001). These associations held true in a subsample of 669 patients admitted with hip fracture and data from 74 hospitals with above average carer-rated quality of care.ConclusionsThe way that services for inpatients with dementia are delivered can influence how long they spend in hospital. Initiating discharge planning within the first 24 hours of admission may help reduce the amount of time that people with dementia spend in hospital.
Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia
Authors: Adler Alma J , Trujillo Celina , Schwartz Leah , Drown Laura , Pierre Jacquelin , Noble Christopher , Allison Theophilus , Cook Rebecca , Randolph Cyrus , Bukhman Gene 
Published: October 2021

IntroductionWhile epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challenges, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in sub-Saharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region.MethodsWe conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and self-management, and barriers and facilitators for accessing T1D care.ResultsThis study found T1D to have a major psychosocial and economic impact on patients and caregivers, who reported stigma, diabetes distress and food insecurity. Patients, caregivers and providers possessed the knowledge necessary to effectively manage T1D but insufficient community awareness leads to delayed diagnosis, often in an emergency department. Most patients reported receiving free services and materials, though the cost of transportation to clinic visits and recommended foods is a barrier to disease management. Many providers noted the lack of national T1D-specific guidelines and registries. Policy-makers reported a lack of prioritisation of and resources for T1D. These barriers, combined with scarcity and expense of appropriate foods, pose severe barriers for self-management of T1D.ConclusionT1D was found to have a significant impact on patients and caregivers, and informants identified several key individual and systems-level barriers to effective T1D care in Liberia. Addressing these concerns is vital for designing sustainable and effective programmes for treating patients living with T1D.
Inclusion of participants from low-income and middle-income countries in core outcome sets development: a systematic review
Authors: Karumbi Jamlick , Gorst Sarah L , Gathara David , Gargon Elizabeth , Young Bridget , Williamson Paula R 
Published: October 2021

ObjectiveOur study aims to describe differences or similarities in the scope, participant characteristics and methods used in core outcome sets (COS) development when only participants from high-income countries (HICs) were involved compared with when participants from low-income and middle-income countries (LMICs) were also involved.DesignSystematic review.Data sourcesAnnual Core Outcome Measures in Effectiveness Trials systematic reviews of COS which are updated based on SCOPUS and MEDLINE, searches. The latest systematic review included studies published up to the end of 2019.Eligibility criteria for selecting studiesWe included studies reporting development of a COS for use in research regardless of age, health condition or setting. Studies reporting the development of a COS for patient-reported outcomes or adverse events or complications were also included.Data extraction and synthesisData were extracted in relation to scope of the COS study, participant categories and the methods used in outcome selection.ResultsStudies describing 370 COS were identified in the database. Of these, 75 (20%) included participants from LMICs. Only four COS were initiated from an LMIC setting. More than half of COS with LMIC participants were developed in the last 5 years. Cancer and rheumatology were the dominant disease domains. Overall, over 259 (70%) of COS explicitly reported including clinical experts; this was higher where LMIC participants were also included 340 (92%). Most LMIC participants were from China, Brazil and South Africa. Mixed methods for consensus building were used across the two settings.ConclusionProgress has been made in including LMIC participants in the development of COS, however, there is a need to explore how to enable initiation of COS development from a range of LMIC settings, how to ensure prioritisation of COS that better reflects the burden of disease in these contexts and how to improve public participation from LMICs.
Knowledge, perceptions and practices of pharmacists regarding generic substitution in China: a cross-sectional study
Authors: Qu Jinghan , Zuo Wei , Wang Shaohong , Du Liping , Liu Xin , Gao Yang , Li Jiantao , Pan Hui , Du Xiaoli , Mei Dan , Took Roxane L , Schafermeyer Kenneth W , Lukas Stephanie , Zhang Bo 
Published: October 2021

ObjectiveTo evaluate pharmacists’ knowledge, perceptions and practices towards generic substitution in the 11 pilot locations in China.DesignAn online cross-sectional survey using questionnaires was conducted. A convenience sampling technique was implemented to recruit pharmacists.Setting and participantsThe study took place in medical institutions of 11 pilot locations that participated in the pilot national centralised procurement programme in 2019. Two thousand two hundred and ninety-one pharmacists including hospital pharmacists or community pharmacists based on health-systems or clinics participated in the study.ResultsMost of the participants had the good knowledge of requirements for evaluating the quality and efficacy of generic drugs (n=2118; 92.4%), and the definition of generic drugs (n=2078; 90.7%). In terms of perceptions, 67.3% of respondents were of the opinion that generic drugs are equally as effective as the brand-name drugs, and 69.0% of respondents were of the opinion that generic drugs are as safe as brand equivalents. A high percentage of participants supported the policy of generic substitution (n=1634; 71.4%). A significant positive correlation was demonstrated between total knowledge score and total perception score (ρ=0.267; p<0.001). Efficacy, safety and the direction of national policies and hospital regulations were the main factors affecting pharmacists’ willingness to dispense generic drugs.ConclusionsThe study identified gaps in respondents’ knowledge and perceptions of generic substitution. Pharmacists who are more knowledgeable in generic drugs tend to hold a more supportive attitude towards generic substitution. Although it appeared that pharmacists in China have largely accepted generic substitution, they still have concerns regarding the reliability and quality of generic drugs. The current issues need to be addressed for the realisation of the true value of generic drugs as part of the country’s healthcare cost-containment strategy as well as the implementation of generic substitution policy in China.
Creation of an electronic patient-reported outcome measure platform Voxe: a mixed methods study protocol in paediatric solid organ transplantation
Authors: Anthony Samantha J , Pol Sarah J , Lin Jia , Barwick Melanie , Brudno Michael , Manase Dorin , Parekh Rulan Savita , Silva Amanda , Stinson Jennifer 
Published: October 2021

IntroductionPatient-reported outcome measures (PROMs) provide an opportunity for meaningful patient engagement and shared decision-making. The objective of this research programme is to improve health outcomes for paediatric solid organ transplant patients by implementing PROMs into clinical care. The current study aims to create Voxe, a paediatric user-centred electronic PROM platform, by engaging patients and healthcare providers throughout the design and development process.Methods and analysisThe creation of Voxe will occur over two phases that build on previous research. The user interface design phase employs a ‘user-centric’ approach to identify end-users’ needs and iteratively refine the look and layout of Voxe to meet these needs. Transplant recipients, aged 10–17, and healthcare providers will participate in three rounds of testing (24 participants total). Participants will: (1) complete task-based activities (outcomes—effectiveness and efficiency), (2) complete questionnaires (outcome—satisfaction) and (3) participate in a semi-structured interview. The following phase involves software development and Voxe usability testing. Transplant recipients, aged 8–17, and healthcare providers will participate in four rounds of iterative testing (24–40 participants total). The think-aloud technique will be employed, and participants will describe their thoughts and feelings while interacting with a Voxe prototype. Participants will: (1) log into Voxe and complete tasks (outcomes—time on task, successful task completion, frequency of critical and non-critical errors and error-free rate), (2) complete questionnaires (outcome—satisfaction) and (3) participate in a semi-structured interview. Findings will result in the creation and launch of a user-centred electronic PROM platform.Ethics and disseminationResearch ethics board approval has been provided by The Hospital for Sick Children. This research is critical to answering methodological and operational questions to inform Voxe implementation in paediatric clinical settings and facilitate PROM data collection. Future investigations will include an implementation-effectiveness evaluation.
Potential effects on cardiometabolic risk factors and body composition by short message service (SMS)-guided training after recent minor stroke or transient ischaemic attack: post hoc analyses of the STROKEWALK randomised controlled trial
Authors: Vahlberg Birgit Maria , Lundström Erik , Eriksson Staffan , Holmback Ulf , Cederholm Tommy 
Published: October 2021

ObjectivesTo evaluate effects of mobile phone text-messaging exercise instructions on body composition, cardiometabolic risk markers and self-reported health at 3 months after stroke.DesignRandomised controlled intervention study with per-protocol analyses.SettingUniversity Hospital in Sweden.ParticipantsSeventy-nine patients (mean (SD) age 64 (10) years, 37% female) ≥18 years with good motor function (modified Rankin Scale ≤2) and capable to perform 6 min walking test at hospital discharge were randomised to either intervention (n=40) or control group (n=39). Key exclusion criteria: subarachnoid bleeding, uncontrolled hypertension, severe psychiatric problems or cognitive limitations.InterventionsThe intervention group received beyond standard care, daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises. The control group received standard care.Main outcome measuresFat mass and fat-free mass were estimated by bioelectric impedance analysis. Cardiometabolic risk factors like blood lipids, glycated haemoglobin and blood glucose were analysed at baseline and after 3 months.ResultsBoth groups changed favourably in fat-free mass (1.83 kg, 95% CI 0.77 to 2.89; p=0.01, effect size (ES)=0.63 vs 1.22 kg, 95% CI 0.39 to 2.0; p=0.05, ES=0.54) and fat mass (−1.30 kg, 95% CI −2.45 to −0.14; p=0.029, ES=0.41 vs −0.76 kg, 95% CI −1.74 to 0.22; p=0.123, ES=0.28). Also, many cholesterol related biomarkers improved; for example, total cholesterol −0.65 mmol/L, 95% CI −1.10 to −0.2; p=0.06, ES: 0.5 vs −1.1 mmol/L, 95% CI −1.47 to −0.56; p>0.001, ES=0.8. However, there were no between-group differences. At 3 months, 94% and 86%, respectively, reported very good/fairly good health in the text messaging and control groups.ConclusionsNo clear effect of 3 months daily mobile phone delivered training instructions was detected on body composition, cardiovascular biochemical risk factors or self-perceived health. Further research is needed to evaluate secondary prevention efforts in larger populations after recent stroke.Trial registration numberNCT02902367.
Prevalence of strabismus among preschool children in eastern China and comparison at a 5-year interval: a population-based cross-sectional study
Authors: Wang Yue , Zhao Andi , Zhang Xiaohan , Huang Dan , Zhu Hui , Sun Qigang , Yu JiaJia , Chen Ji , Zhao Xiaoyan , Li Rui , Han Shu , Dong Weiyi , Ma Fanfei , Chen XueJuan , Liu Hu 
Published: October 2021

ObjectiveTo update data on strabismus and evaluate the changes in prevalence and patterns among preschoolers in eastern China over a period of 5 years.DesignNanjing Eye Study, a longitudinal population-based study.SettingRecruitment and testing in kindergartens in Yuhuatai District, Nanjing.Participants2300 eligible children.Main outcome measuresComprehensive ocular examinations were conducted in 1986 children aged 48–<60 months in Nanjing Eye Study (NES, 2016–2017), including visual acuity, ocular alignment, refractive error and ocular structures evaluation. The prevalence rate and pattern of strabismus were calculated and compared with those from the Nanjing Pediatric Vision Project (NPVP, 2011–2012) in children of the same age, of the same area and using the same diagnostic criteria.ResultsThe overall prevalence rate of strabismus in NES was 5.56% (95% CI 4.54% to 6.57%), which was not significantly different from that in NPVP (4.99%, 95% CI 4.13% to 5.84%, p=0.40). The prevalence of subtypes of strabismus underwent significant changes, with significant increase in intermittent exotropia (IXT) in NES (2.78% vs 4.69%, p=0.001) and significant decrease in constant exotropia (1.17% vs 0.15%, p<0.001). Significant change in pattern was observed in IXT, where the proportion of the convergence insufficiency type (2.90% vs 27.17%) increased and exceeded the divergence excess type (20.29% vs 11.96%) to be the second common type (p<0.001).ConclusionThe prevalence of strabismus appeared stable in children aged 48–<60 months in eastern China at a 5-year interval. The prevalence of IXT increased significantly, and the convergence insufficiency type became more prevalent in patients with IXT. Timely detection and intervention of IXT are important among preschoolers.
Novel biomechanical injury risk score demonstrates correlation with lower limb posterior chain injury in 50 elite-level rugby union athletes
Authors: Hughes Rhys , Cross Matt , Stokes Keith , Tobin Daniel , Power Eoin , McNally Steph , Pamment Jonathan 
Published: October 2021

ObjectivesLower limb posterior chain injury (PCI) is common among athletic populations, with multifactorial risk factors including age, previous injury, strength measurements, range of motion and training load. Biomechanics are commonly considered in the prevention and rehabilitation of PCI by performance staff. However, there is no documented testing method to assess for associations between biomechanics and PCI. The aim of this study was to investigate whether there is an association between an easily applicable, novel biomechanical assessment tool and PCI.MethodsFifty male elite-level rugby union athletes (age 22.83±5.08) participating in the highest tier of England were tested at the start of the 2019 preseason period and PCIs (N=48) were recorded over the 2019/2020 playing season. Participants’ biomechanics were analysed using two-dimensional video analysis against an injury risk score (IRS) system in the performance of the combined movement—prone hip extension and knee flexion. Participants’ biomechanics in carrying out this movement were scored against the 10-point IRS, where the more compensatory movement recorded sees an increase in an individual’s IRS. Participants’ IRS was then compared against the number of PCIs sustained and Spearman’s correlation coefficient was used for statistical analysis.ResultsThere is a significant association between IRS and PCI (R=0.542, p<0.001). Linear regression demonstrated that an increase in 1 in IRS was associated with a 35% increase in PCI incidence (R²=0.346).ConclusionA significance between the IRS and PCI provides preliminary support for its use as an injury risk assessment tool.
Did attending P.A.R.T.Y. change youth perceptions? Results from 148 Queensland schools participating in the Prevent Alcohol and Risk-Related Trauma in Youth Program, 2018–2019
Authors: Cameron Cate M , Eley Rob , Judge Chantelle , O'Neill Roisin , Handy Michael 
Published: October 2021

BackgroundPrevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) is an immersive 1 day in-hospital injury awareness and prevention programme designed to educate high-school students on the consequences of a variety of risk-taking behaviours. This multisite contemporary analysis examined differences in programme effect and temporal changes on participant knowledge and attitudes.MethodsMetropolitan and rural schools were invited to attend the programme at one of the 11 hospital sites throughout Queensland, Australia. Pre–post study design with participant questionnaires provided at three time periods: immediately preprogramme and postprogramme, and 4 months later. The questionnaire used scenarios to determine a participant’s opinion on the safety of drugs/alcohol, driving and risk-taking activities, using Likert scales.ResultsA total of 5999 students participated in the programme between 1 January 2018 and 31 December 2019. Responses to all questions related to safety, harm or risk followed a similar pattern. The immediate postcourse responses demonstrated significant increased awareness of risk or change in action, followed by a decay at 4 months to within 10% of preprogramme levels. Public school students, males and students from Central and North Queensland demonstrated lower risk-aversion (p<0.05).ConclusionThis study demonstrated across more than 100 school sites, the positive change in knowledge and student participant attitudes towards risk-taking behaviours after attending the P.A.R.T.Y. programme. The need to address the significant decay at the 4-month follow-up was identified. Findings offered potential for tailoring of messaging to target key demographic groups/topics where the decay was greatest.