bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of interventions for people living with dementia and their carers in Chinese communities: protocol for a systematic review and meta-analysis of randomised controlled trials
Authors: Shi Cheng , Chen Shuangzhou , Salcher-Konrad Maximilian , Choy Jacky C P , Luo Hao , Leung Dara Kiu Yi , Cai Xinxin , Zeng Yue , Dai Ruizhi , Comas-Herrera Adelina , McDaid David , Knapp Martin , Wong Gloria 
Published: August 2021

IntroductionAs the largest and most rapidly ageing population, Chinese people are now the major driver of the continued growth in dementia prevalence globally. The need for evidence-based interventions in Chinese communities is urgent. Although a wide range of pharmacological and non-pharmacological interventions for dementia have been trialled in Chinese populations, the evidence has not been systematically synthesised. This systematic review and meta-analysis aims to map out the interventions for people living with dementia and their carers in Chinese communities worldwide and compare the effectiveness of these interventions.Methods and analysisThis protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist. We will search Chinese (China National Knowledge Infrastructure, WanFang DATA) and English bibliographical databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODelling Outcome and cost impacts of interventions for DEMentia (MODEM) Toolkit, Cochrane Database of Systematic Reviews), complemented by hand searching of reference lists. We will include studies evaluating the effectiveness of interventions for dementia or mild cognitive impairment in Chinese populations, using a randomised controlled trial design, and published between January 2008 and June 2020. We will use a standardised form to extract data and Version 2 of the Cochrane risk-of-bias tool for randomised trials to assess the risk of bias of the included studies. Collected data will be fully interpreted with narrative synthesis and analysed using pairwise and network meta-analyses to pool intervention effects where sufficient information is available. We will perform subgroup analysis and meta-regression to explore potential reasons for heterogeneity.Ethics and disseminationNo formal ethics approval is required for this protocol. The findings will facilitate the development of studies on interventions for dementia and timely inform dementia policymaking and practice. Planned dissemination channels include peer-reviewed publications, conference presentations, public events and websites.PROSPERO registration numberCRD42019134135.
Evaluating the knowledge, attitudes and practices of the UAE community on microbiota composition and the main factors affecting it: a cross-sectional study
Authors: Barqawi Hiba Jawdat , Adra Saryia Farouk , Ramzi Hiba Riad , Abouaggour Mahmoud Alaa , Almehairi Shamma Khamis 
Published: August 2021

ObjectivesThis study aims to explore the knowledge, attitudes and practices (KAP) of the population in the United Arab Emirates (UAE) regarding microbiota and the main factors affecting its composition.Design/settingA cross-sectional study, using a self-administered questionnaire, was conducted from May 2018 to September 2018, recruiting participants in public venues via convenience sampling.ParticipantsUAE residents (aged 18 years and above) who spoke either Arabic or English.Results419 responses were completed and analysed using SPSS V.24. Only 29.3% (n=94) of the participants who defined microbiota correctly had good knowledge. There was a significant difference in knowledge among different age groups (p=0.004) and educational levels (p<0.001). Multiple linear regression (MLR) model indicated that being a university student and a healthcare professional (HCP) are the only significant predictors regarding microbiota knowledge (p=0.014 and p<0.001, respectively). Of the respondents who claimed to be aware of probiotics, only 9.1% (n=15) exhibited good knowledge. MLR model showed that being a postgraduate and an HCP are the only significant predictors for probiotics knowledge (p=0.016 and p<0.001, respectively). 42.4% (n=143) and 34.6% (n=28) of the non-medical and HCP participants, respectively, use antibiotics without a prescription. None of the respondents, with or without a medical background, demonstrated good attitudes and practices toward the use of antibiotics.ConclusionDespite the fact that the participants had a basic understanding of microbiota and probiotics, the overall knowledge was substandard. Additionally, the respondents engaged in improper practices that alter the microbiota composition, especially via antibiotics misuse. Campaigns should target the general population as well as HCPs to upheave their overall KAP.
Incidence of lower limb amputation in people with and without diabetes: a nationwide 5-year cohort study in Japan
Authors: Kamitani Fumika , Nishioka Yuichi , Noda Tatsuya , Myojin Tomoya , Kubo Shinichiro , Higashino Tsuneyuki , Okada Sadanori , Akai Yasuhiro , Ishii Hitoshi , Takahashi Yutaka , Imamura Tomoaki 
Published: August 2021

IntroductionThis study was conducted to investigate the incidence and time trend of lower limb amputation (LLA) among people with and without diabetes.Research design and methodsThis retrospective population-based cohort study was based on the national claims data in Japan, comprising a total population of 150 million. Data of all individuals who had LLA from April 2013 to March 2018 were obtained. We analysed the sex-adjusted and age-adjusted annual LLA rate (every fiscal year) in people with and without diabetes for major and minor amputation. To test for time trend, Poisson regression models were fitted.ResultsIn the 5-year period, 30 187 major and 29 299 minor LLAs were performed in Japan. The sex-adjusted and age-adjusted incidence of major and minor LLAs was 9.5 (people with diabetes, 21.8 vs people without diabetes, 2.3, per 100 000 person-years) and 14.9 (people with diabetes, 28.4 vs people without diabetes, 1.9, per 100 000 person-years) times higher, respectively, in people with diabetes compared with those without. A significant decline in the annual major amputation rate was observed (p<0.05) and the annual minor amputation rate remained stable (p=0.63) when sex, age and people with and without diabetes were included as dependent variables.ConclusionsThis is the first report of the national statistics of LLAs in Japan. The incidence of major and minor LLAs was 10 and 15 times higher, respectively, in people with diabetes compared with those without. A significant decline in the major amputation rate was observed, and the annual minor amputation rate remained stable during the observation period. This information can help to create an effective national healthcare strategy for preventing limb amputations, which affect the quality of life of patients with diabetes and add to the national healthcare expenditure.
Association of depressive symptoms with the progression of carotid intima–media thickness in a community-based cohort in Beijing, China
Authors: Liu Mengyuan , Jia Jia , Fan Fangfang , Sun Pengfei , Wu Zhongli , Jiang Yimeng , He Danmei , Liu Bo , Yang Ying , Zhang Yan 
Published: August 2021

ObjectivesTo determine the relationship between depressive symptoms and progression of carotid intima–media thickness (cIMT) in a Beijing community-based population.DesignProspective cohort study between 2014 and 2018.SettingDwellers without cardiovascular disease, hypertension or diabetes from a Beijing community.Participants3849 Chinese community-dwelling individuals who underwent baseline screening for depressive symptoms were invited to participate in the study in 2014 and follow-up visit in 2018. Among them, 2124 participants completed carotid ultrasound examination both at baseline and a follow-up visit. After further excluding patients with a history of stroke, myocardial infarction or lower extremity arterial stenosis and those with a diagnosis of hypertension or diabetes and ankle–brachial index ≤0.9 at baseline, 1011 eligible participants were finally included.Primary outcome measureThe rate of mean cIMT change.ResultsOver a median follow-up period of 4.40 years, the overall rate of mean cIMT change was 2.23% (−5.64% to 9.51%). After adjustment for 13 covariates, there was an increase of 2.36% (β=2.36, 95% CI: 0.37 to 4.36, p=0.020) for the rates of mean cIMT change in the depressive group compared with the control group. Furthermore, this association was modified by drinking status (β=3.22, 95% CI: 1.25 to 5.19, P-interaction=0.006).ConclusionDepressive symptoms were independently associated with progression of mean cIMT in a community-based cohort in Beijing, China. Furthermore, this relationship was modified by drinking status.
Associations between emergency department crowding and perceptions of interpersonal care in patients presenting with suspected acute coronary syndrome
Authors: Liyanage-Don Nadia A , Edelman David S , Chang Bernard P , Schultebraucks Katharina , Thanataveerat Anusorn , Kronish Ian M 
Published: August 2021

BackgroundEmergency department (ED) crowding is associated with numerous healthcare issues, but little is known about its effect on psychosocial aspects of patient-provider interactions orinterpersonal care. We examined whether ED crowding was associated with perceptions of interpersonal care in patients evaluated for acute coronary syndrome (ACS).MethodsPatients presenting to a quaternary academic medical centre ED in New York City for evaluation of suspected ACS were enrolled between November 2013 and December 2016. ED crowding was measured using the ED Work Index (EDWIN), which incorporates patient volume, triage category, physician staffing and bed availability. Patients completed the 18-item Interpersonal Processes of Care (IPC) survey, which assesses communication, patient-centred decision-making and interpersonal style. Regression analyses examined associations between EDWIN and IPC scores, adjusting for demographics, comorbidities and depression.ResultsAmong 933 included patients, 11% experienced ED overcrowding (EDWIN score >2) at admission, 11% experienced ED overcrowding throughout the ED stay and 30% reported suboptimal interpersonal care (defined as per-item IPC score <5). Higher admission EDWIN score was associated with modestly lower IPC score in both unadjusted (β=–1.70, 95% CI –3.15 to –0.24, p=0.02) and adjusted models (β = –1.77, 95% CI –3.31 to –0.24, p=0.02). EDWIN score averaged over the entire ED stay was not significantly associated with IPC score (unadjusted β=–1.30, 95% CI –3.19 to 0.59, p=0.18; adjusted β=–1.24, 95% CI –3.21 to 0.74, p=0.22).ConclusionIncreased crowding at the time of ED admission was associated with poorer perceptions of interpersonal care among patients with suspected ACS.
Commencing one-handed chest compressions while activating emergency medical system using a handheld mobile device in lone-rescuer basic life support: a randomised cross-over simulation study
Authors: Park Sang O , Shin Dong Hyuk , Kim Changhoon , Lee Young Hwan 
Published: August 2021

IntroductionIn conventional basic life support (c-BLS), a lone rescuer is recommended to start chest compressions (CCs) after activating the emergency medical system. To initiate earlier CCs in lone-rescuer BLS, we designed a modified BLS (m-BLS) sequence in which the lone rescuer commences one-handed CCs while calling for help using a handheld cellular phone with the other free hand. This study aimed to compare the quality of BLS between c-BLS and m-BLS.MethodsThis was a simulation study performed with a randomised cross-over controlled trial design. A total of 108 university students were finally enrolled. After training for both c-BLS and m-BLS, participants performed a 3-minute c-BLS or m-BLS on a manikin with a SkillReporter at random cross-over order. The paired mean difference with SE between c-BLS and m-BLS was assessed using paired t-test.ResultsThe m-BLS had reduced lag time before the initiation of CCs (with a mean estimated paired difference (SE) of −35.0 (90.4) s) (p<0.001). For CC, a significant increase in compression fraction and a higher number of CCs with correct depth were observed in m-BLS (with a mean estimated paired difference (SE) of 16.2% (0.6) and 26.9% (3.3), respectively) (all p<0.001). However, no significant paired difference was observed in the hand position, compression rate and interruption time. For ventilation, the mean tidal volumes did not differ. However, the number of breaths with correct tidal volume was higher in m-BLS than in c-BLS.ConclusionIn simulated lone-rescuer BLS, the m-BLS could deliver significantly earlier CCs than the c-BLS while maintaining high-quality cardiopulmonary resuscitation.
Variation in colon cancer survival for patients living and receiving care in London, 2006–2013: does where you live matter?
Authors: Quaresma Manuela , Carpenter James R , Turculet Adrian , Rachet Bernard 
Published: August 2021

BackgroundMarked geographical disparities in survival from colon cancer have been consistently described in England. Similar patterns have been observed within London, almost mimicking a microcosm of the country’s survival patterns. This evidence has suggested that the area of residence plays an important role in the survival from cancer.MethodsWe analysed the survival from colon cancer of patients diagnosed in 2006–2013, in a pre-pandemic period, living in London at their diagnosis and received care in a London hospital. We examined the patterns of patient pathways between the area of residence and the hospital of care using flow maps, and we investigated whether geographical variations in survival from colon cancer are associated with the hospital of care. To estimate survival, we applied a Bayesian excess hazard model which accounts for the hierarchical structure of the data.ResultsGeographical disparities in colon cancer survival disappeared once controlled for hospitals, and the disparities seemed to be augmented between hospitals. However, close examination of patient pathways revealed that the poorer survival observed in some hospitals was mostly associated with higher proportions of emergency diagnosis, while their performance was generally as expected for patients diagnosed through non-emergency routes.DiscussionThis study highlights the need to better coordinate primary and secondary care sectors in some areas of London to improve timely access to specialised clinicians and diagnostic tests. This challenge remains crucially relevant after the recent successive regroupings of Clinical Commissioning Groups (which grouped struggling areas together) and the observed exacerbation of disparities during the COVID-19 pandemic.
Genotype–phenotype correlation in arrhythmogenic right ventricular cardiomyopathy—risk of arrhythmias and heart failure
Authors: Christensen Alex Hørby , Platonov Pyotr G , Jensen Henrik Kjærulf , Chivulescu Monica , Svensson Anneli , Dahlberg Pia , Madsen Trine , Frederiksen Tanja Charlotte , Heliö Tiina , Lie Øyvind Haugen , Haugaa Kristina H , Hastrup Svendsen Jesper , Bundgaard Henning 
Published: August 2021

BackgroundArrhythmogenic right ventricular cardiomyopathy (ARVC) is predominantly caused by desmosomal genetic variants, and clinical hallmarks include arrhythmias and systolic dysfunction. We aimed at studying the impact of the implicated gene(s) on the disease course.MethodsThe Nordic ARVC Registry holds data on a multinational cohort of ARVC families. The effects of genotype on electrocardiographic features, imaging findings and clinical events were analysed.ResultsWe evaluated 419 patients (55% men), with a mean follow-up of 11.2±7.4 years. A pathogenic desmosomal variant was identified in 62% of the 230 families: PKP2 in 41%, DSG2 in 13%, DSP in 7% and DSC2 in 3%. Reduced left ventricular ejection fraction (LVEF) ≤45% on cardiac MRI was more frequent among patients with DSC2/DSG2/DSP than PKP2 ARVC (27% vs 4%, p<0.01). In contrast, in Cox regression modelling of patients with definite ARVC, we found a higher risk of arrhythmias among PKP2 than DSC2/DSG2/DSP carriers: HR 0.25 (0.10–0.68, p<0.01) for atrial fibrillation/flutter, HR 0.67 (0.44–1.0, p=0.06) for ventricular arrhythmias and HR 0.63 (0.42–0.95, p<0.05) for any arrhythmia. Gene-negative patients had an intermediate risk (16%) of LVEF ≤45% and a risk of the combined arrhythmic endpoint comparable with DSC2/DSG2/DSP carriers. Male sex was a risk factor for both arrhythmias and reduced LVEF across all genotype groups (p<0.01).ConclusionIn this large cohort of ARVC families with long-term follow-up, we found PKP2 genotype to be more arrhythmic than DSC2/DSG2/DSP or gene-negative carrier status, whereas reduced LVEF was mostly seen among DSC2/DSG2/DSP carriers. Male sex was associated with a more severe phenotype.
Exploring the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality early inflammatory arthritis (EIA) care in England and Wales
Authors: Zasada Magdalena , Yates Mark , Ayers Nicola , Ide Zoë , Norton Sam , Galloway James , Taylor Cath 
Published: August 2021

BackgroundEvidence from a national clinical audit of early inflammatory arthritis (EIA) shows considerable variability between hospitals in performance, unexplained by controlling for case-mix.ObjectiveTo explore the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality EIA care.MethodsA qualitative study within 16 purposively sampled rheumatology units across England and Wales. Quality was assessed in relation to 11 quality indicators based on clinical opinion, evidence and variability observed in the data. Data from semi-structured interviews with staff (1–5 from each unit, 56 in total) and an online questionnaire (n=14/16 units) were integrated and analysed using the framework method for thematic analysis using a combined inductive and deductive approach (underpinned by an evidence-based framework of healthcare team effectiveness), and constant comparison of data within and between units and its relationship with the quality criteria.FindingsQuality of care was influenced by an interplay between macro, meso and micro domains. The macro (eg, shared care arrangements and relationships with general practitioners) and meso (eg, managerial support and physical infrastructure) factors were found to act as crucial enablers of and barriers to higher quality service provision at the micro (team) level. These organisational factors directly influenced team structure and function, and thereby EIA care quality.ConclusionsVariability in quality of EIA care is associated with an interplay between macro, meso and micro service features. Tackling macro and meso barriers is likely to have a significant impact on quality of EIA service, and ultimately patient experience and outcomes.
Longitudinal uptake of the human papillomavirus vaccine among gay, bisexual and other men who have sex with men in British Columbia, Canada 2012–2019
Authors: Khatra Jatinder , Sang Jordan Mitchell , Wang Clara , Bacani Nicanor , Lachowsky Nathan John , Grennan Troy , Burchell Ann Natalie , Lal Allan , Roth Eric , Hogg Robert , Card Kiffer , Moore David 
Published: August 2021

ObjectivesIn 2015, a publicly funded human papillomavirus (HPV) vaccination programme was implemented for gay, bisexual and other men who have sex with men (gbMSM) up to age 26 years in British Columbia, Canada. We assessed trends and correlates of HPV vaccine uptake from 2012 to 2019 in a cohort of gbMSM in Vancouver.MethodsWe recruited sexually active gbMSM aged ≥16 years using respondent-driven sampling from February 2012 to February 2015 and followed them until July 2019. We evaluated self-reported HPV vaccine trends using mixed-effects logistic regression and identified factors associated with uptake using multivariable mixed-effects Poisson regression.ResultsA total of 719 participants were recruited and completed the baseline visit, of whom 549 were unvaccinated with at least one follow-up visit. The median age was 33 years and 23% were living with HIV. HPV vaccination increased from 4% in 2012 to 28% in 2019 (p<0.001) among gbMSM >26 years, and from 9% in 2012 to 20% in 2017 (p<0.001) among gbMSM ≤26 years. Vaccination uptake increased after September 2015, following vaccination policy expansion (adjusted rate ratio (aRR)=1.82, 95% CI 1.06 to 3.12). In multivariable models, increased vaccination was associated with age ≤26 years vs ≥45 years (aRR=3.90; 95% CI 1.75 to 8.70), age 27–44 vs ≥45 years (aRR=2.86; 95% CI 1.46 to 5.62), involvement in gay community sports teams (aRR=2.31; 95% CI 1.15 to 4.64) and other groups (aRR=1.71; 95% CI 1.04 to 2.79), awareness of HIV-postexposure prophylaxis (aRR=5.50; 95% CI 1.31 to 23.09), recent sexually transmitted infection testing (aRR=2.72; 95% CI 1.60 to 4.60) and recent sex-work (aRR=2.59; 95% CI 1.08 to 6.19).ConclusionsAlthough we observed increases in HPV vaccination uptake from 2012, by 2019 HPV vaccination still remained below 30% among gbMSM in Vancouver, BC. Additional interventions are needed to increase vaccine uptake.
Inhibition of PDIA3 in club cells attenuates osteopontin production and lung fibrosis
Authors: Kumar Amit , Elko Evan , Bruno Sierra R , Mark Zoe F , Chamberlain Nicolas , Mihavics Bethany Korwin , Chandrasekaran Ravishankar , Walzer Joseph , Ruban Mona , Gold Clarissa , Lam Ying Wai , Ghandikota Sudhir , Jegga Anil G , Gomez Jose L , Janssen-Heininger Yvonne MW , Anathy Vikas 
Published: August 2021

BackgroundThe role of club cells in the pathology of idiopathic pulmonary fibrosis (IPF) is not well understood. Protein disulfide isomerase A3 (PDIA3), an endoplasmic reticulum-based redox chaperone required for the functions of various fibrosis-related proteins; however, the mechanisms of action of PDIA3 in pulmonary fibrosis are not fully elucidated.ObjectivesTo examine the role of club cells and PDIA3 in the pathology of pulmonary fibrosis and the therapeutic potential of inhibition of PDIA3 in lung fibrosis.MethodsRole of PDIA3 and aberrant club cells in lung fibrosis was studied by analyses of human transcriptome dataset from Lung Genomics Research Consortium, other public resources, the specific deletion or inhibition of PDIA3 in club cells and blocking SPP1 downstream of PDIA3 in mice.ResultsPDIA3and club cell secretory protein (SCGB1A1) signatures are upregulated in IPF compared with control patients.PDIA3orSCGB1A1increases also correlate with a decrease in lung function in patients with IPF. The bleomycin (BLM) model of lung fibrosis showed increases in PDIA3 in SCGB1A1 cells in the lung parenchyma. Ablation ofPdia3, specifically in SCGB1A1 cells, decreases parenchymal SCGB1A1 cells along with fibrosis in mice. The administration of a PDI inhibitor LOC14 reversed the BLM-induced parenchymal SCGB1A1 cells and fibrosis in mice. Evaluation of PDIA3 partners revealed that SPP1 is a major interactor in fibrosis. Blocking SPP1 attenuated the development of lung fibrosis in mice.ConclusionsOur study reveals a new relationship with distally localised club cells, PDIA3 and SPP1 in lung fibrosis and inhibition of PDIA3 or SPP1 attenuates lung fibrosis.