bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does undernutrition increase the risk of lost to follow-up in adults living with HIV in sub-Saharan Africa? Protocol for a systematic review and meta-analysis
Authors: Alebel Animut , Demant Daniel , Petrucka Pammla , Sibbritt David 
Published: December 2021

IntroductionUndernutrition is considered a marker for poor prognosis among people living with HIV (PLHIV), particularly in sub-Saharan Africa (SSA), where undernutrition and HIV are both highly prevalent. Evidence suggests that undernutrition (body mass index <18.5 kg/m2) is one of the main factors that significantly increases the risk of lost to follow-up (LTFU) in PLHIV. However, primary studies in SSA have reported inconsistent findings on the relationship between undernutrition and LTFU among adults living with HIV. To the best of our knowledge, no systematic review which aimed to summarise the available evidence. Hence, this review aims to determine the pooled effect of undernutrition on LTFU among adults living with HIV in SSA.Methods and analysisPubMed, EMBASE, Web of Science, Scopus, and, for grey literature, Google Scholar will be systematically searched to include relevant articles published since 2005. Studies reporting the effect of undernutrition on LTFU in adults living with HIV in SSA will be included. The Newcastle-Ottawa Scale will be used for quality assessment. Data from eligible studies will be extracted using a standardised data extraction tool. Heterogeneity between included studies will be assessed using Cochrane Q-test and I2statistics. The Egger’s and Begg’s tests at a 5% significance level will be used to evaluate publication bias. As heterogeneity is anticipated, the pooled effect size will be estimated using a random-effects model. The final effect size will be reported using the adjusted HR with a 95% CI.Ethics and disseminationEthical approval is not required for a protocol for a systematic review. The results of this systematic review will be published in a peer-reviewed journal and will be publicly available.PROSPERO registration numberCRD42021277741.
Quality assessment of clinical practice guidelines for perioperative care and use of GRADE: a systematic review protocol
Authors: Kantorová Lucia , Kantor Jiří , Búřil Jiří , Búřilová Petra , Slezáková Simona , Nečas Tomáš , Klugar Miloslav 
Published: December 2021

IntroductionPerioperative care is a broad field covering an array of elective and emergency procedures. Clinical practice guidelines (CPGs) for perioperative care exist with various degrees of methodological quality. We intend to critically appraise them using AGREE II instrument and investigate the use of Grading of Recommendations, Assessment, Development and Evaluations (GRADE).Methods and analysisWe searched MEDLINE (Ovid), Epistemonikos, Cochrane Database of Systematic Reviews and PROSPERO and did not identify any similar systematic review in this area. We will search databases, repositories and websites of guideline developers and medical societies, including MEDLINE (Ovid), Embase (Ovid), DynaMed, the GIN international guideline library and registry of guidelines in development, BIGG international database of GRADE guidelines, ECRI Guideline Trust or National Institute for Clinical Evidence to identify all CPGs for perioperative care in an adult population in a general clinical setting. We will include CPGs, expert guidance, position papers, guidance documents and consensus statements published in the last 5 years by experts or international organisations that provide guidance or recommendations in the available full text with no geographical or language limitation. Excluded will be those containing only good practice statements. Two independent reviewers will perform critical appraisal using the AGREE II tool. The data presented in a narrative and tabular form will include the results of the critical appraisal for all identified CPGs for all AGREE II domains and an assessment of the use of the GRADE approach.Ethics and disseminationEthics approval is not required. We will disseminate the findings through professional networks and conference presentations and will publish the results.
Impact of a health campaign on Chinese public awareness of stroke: evidence from internet search data
Authors: Cao Man , Guan Tianjia , Han Xueyan , Shen Bingjie , Chao Baohua , Liu Yuanli 
Published: December 2021

IntroductionHealth campaigns have the potential to improve public awareness, but their impact can be difficult to assess. Internet search data provide information concerning online health information-seeking behaviour in the population and may serve as a proxy for public awareness to evaluate health campaigns. This study aimed to measure the impact of World Stroke Day (WSD) in China using Baidu search data.MethodsDaily search index values (SIV) for the term ‘stroke’ were collected from January 2011 to December 2019 using the Baidu Index platform. We examined the mean difference in SIV between the 4 weeks surrounding WSD (period of interest) and the rest of the year (control period) for each year by t-test analysis. The mean difference between the period of interest and the control period was also calculated. The joinpoint regression model was used to analyse the trends of internet search activity 30 days before and after WSD for each year (2011–2019). Finally, the top and rising queries related to stroke during the week of the campaign in 2020 were summarised.ResultsA significant mean increase in SIV of 418.5 (95% CI: 298.8 to 538.2) for the period of interest surrounding WSD was observed, 36.2% greater than the SIV during the control period (2011–2019). Short-term joinpoint analysis showed a significant increase in SIV 3 days before WSD, a peak on WSD and a decrease to the precampaign level 3 days after WSD. The rising related queries suggested that the public had increasing concerns about stroke warning signs, stroke prevention and stroke recovery during the campaign.ConclusionsThe WSD campaign increased internet search activity. These research techniques can be applied to evaluation of other health campaigns. Advancing understanding of public demand will enable tailoring of the campaign and strengthen health management.
Development and testing of the Stakeholder Quality Improvement Perspectives Survey (SQuIPS)
Authors: Fris Eric , Sedlock Emily , Etchegaray Jason , Ottosen Madelene J , Pucio Ronald , Mistry Tejal , Saunders Tamara , Tomoaia-Cotisel Andrada , Thomas Eric J 
Published: December 2021

BackgroundTo create a theory-informed survey that quality improvement (QI) teams can use to understand stakeholder perceptions of an intervention.MethodWe created the survey then performed a cross-sectional survey of QI stakeholders of three QI projects. The projects sought to: (1) reduce unplanned extubations in a neonatal intensive care unit; (2) maintain normothermia during colorectal surgery and (3) reduce specimen processing errors for ambulatory gastroenterology procedures. We report frequencies of responses to survey items, results of exploratory factor analysis, and how QI team leaders used the results.ResultsOverall we received surveys from 319 out of 386 eligible stakeholders (83% response rate, range for the three QI projects 57%–86%). The QI teams found that the survey results confirmed existing concerns (eg, the intervention would not make work easier) and revealed unforeseen concerns such as lack of consensus about the overall purpose of the intervention and its importance. The results of our factor analysis indicate that one 7-item scale (Cronbach’s alpha 0.9) can efficiently measure important aspects of stakeholder perceptions, and that two additional Likert-type items could add valuable information for leaders. Two QI team leaders made changes to their project based on survey responses that indicated the intervention made stakeholders’ jobs harder, and that there was no consensus about the purpose of the intervention.ConclusionsThe Stakeholder Quality Improvement Perspectives Survey was feasible for QI teams to use, and identified stakeholder perspectives about QI interventions that leaders used to alter their QI interventions to potentially increase the likelihood of stakeholder acceptance of the intervention.
Retrospective cohort study of COVID-19 among children in Fulton County, Georgia, March 2020–June 2021
Authors: Barrera Chloe M , Hazell Mallory , Chamberlain Allison T , Gandhi Neel R , Onwubiko Udodirim , Liu Carol Y , Prieto Juliana , Khan Fazle , Shah Sarita 
Published: December 2021

ObjectiveTo describe case rates, testing rates and percent positivity of COVID-19 among children aged 0–18 years by school-age grouping.DesignWe abstracted data from Georgia’s State Electronic Notifiable Disease Surveillance System on all 10 437 laboratory-confirmed COVID-19 cases among children aged 0–18 years during 30 March 2020 to 6 June 2021. We examined case rates, testing rates and percent positivity by school-aged groupings, namely: preschool (0–4 years), elementary school (5–10 years), middle school (11–13 years), and high school (14–18 years) and compared these data among school-aged children with those in the adult population (19 years and older).SettingFulton County, Georgia.Main outcome measuresCOVID-19 case rates, testing rates and percent positivity.ResultsOver time, the proportion of paediatric cases rose substantially from 1.1% (April 2020) to 21.6% (April 2021) of all cases in the county. Age-specific case rates and test rates were consistently highest among high-school aged children. Test positivity was similar across school-age groups, with periods of higher positivity among high-school aged children.ConclusionsLow COVID-19 testing rates among children, especially early in the pandemic, likely underestimated the true burden of disease in this age group. Despite children having lower measured incidence of COVID-19, we found when broader community incidence increased, incidence also increased among all paediatric age groups. As the COVID-19 pandemic continues to evolve, it remains critical to continue learning about the incidence and transmissibility of COVID-19 in children.
Health-related marketing messages on product labels of commercial infant and toddler food packaging in Australia: a cross-sectional audit
Authors: Simmonds Lucy , Brownbill Aimee L , Zee Anthea , Netting Merryn J 
Published: December 2021

BackgroundProper nutrition in early childhood is essential to ensure optimal growth and development. Use of ‘better-for-you’ features on food packaging position products as healthier for children. This study aims to systematically explore the use of better-for-you labelling on infant and toddler food packaging.MethodsA cross-sectional audit of health and nutrition claims, text and images used as ‘better-for-you’ features present on infant and toddler food packaging. Data on infant and toddler food packaging were collected from five large grocery stores in Adelaide, Australia in 2019. The content of 282 unique commercial products (n=215 infant foods, n=67 toddler foods) were analysed for explicit and implicit features positioning them as better-for-you, including health and nutrition claims as well as text and images representing ‘natural.’ResultsAt least one feature of better-for-you positioning was identified on all food packaging coded. All products had characteristics coded as ‘natural’. Almost one-fifth (17%) of the products included statements in addition to mandatory allergen labelling that their products were ‘free from’ certain allergens, or gluten. One-third of the labels had statements related to enhancing development of taste, oro-motor skills and other aspects of childhood development. Of the fruit and vegetable-based infant foods displaying a sugar statement suggesting a low sugar content, 85% were sweetened with fruit puree.ConclusionsThe use of better-for-you features on infant and toddler food packaging is common and pervasive. Allergen-free and developmental claims are being used to position infant and toddler foods as better-for-you. Regulation of toddler food products separately from adult food is required, as is tighter regulation of the appropriate use of sugar and fruit puree statements on infant and toddler food packaging.
Association of women leaders in the C-suite with hospital performance
Authors: Christopher Adrienne N , Nembhard Ingrid M , Wu Liza , Yee Stephanie , Sebastian Albertina , Charan Nidhi , Betchen Simone 
Published: December 2021

BackgroundWomen comprise 50% of the healthcare workforce, but only about 25% of senior leadership positions in the USA. No studies to our knowledge have investigated the performance of hospitals led by women versus those led by men to evaluate the potential explanation that the inequity reflects appropriate selection due to skill or performance differences.MethodsWe conducted a descriptive analysis of the gender composition of hospital senior leadership (C-suite) teams and cross-sectional, regression-based analyses of the relationship between gender composition, hospital characteristics (eg, location, size, ownership), and financial, clinical, safety, patient experience and innovation performance metrics using 2018 data for US adult medical/surgical hospitals with >200 beds. C-suite positions examined included chief executive officer (CEO), chief financial officer (CFO) and chief operating officer (COO). Gender was obtained from hospital web pages and LinkedIn. Hospital characteristics and performance were obtained from American Hospital Directory, American Hospital Association Annual Hospital Survey, Healthcare Cost Report Information System and Hospital Consumer Assessment of Healthcare Providers and Systems surveys.ResultsOf the 526 hospitals studied, 22% had a woman CEO, 26% a woman CFO and 36% a woman COO. While 55% had at least one woman in the C-suite, only 15.6% had more than one. Of the 1362 individuals who held one of the three C-suite positions, 378 were women (27%). Hospital performance on 27 of 28 measures (p>0.05) was similar between women and men-led hospitals. Hospitals with a woman CEO performed significantly better than men-led hospitals on one financial metric, days in accounts receivable (p=0.04).ConclusionHospitals with women in the C-suite have comparable performance to those without, yet inequity in the gender distribution of leaders remains. Barriers to women’s advancement should be recognised and efforts made to rectify this inequity, rather than underusing an equally skilled pool of potential women leaders.
Effect of early Sanguinate (PEGylated carboxyhemoglobin bovine) infusion on cerebral blood flow to the ischemic core in experimental middle cerebral artery occlusion
Authors: Christoforidis Gregory A , Saadat Niloufar , Liu Mira , Jeong Yong Ik , Roth Steven , Niekrasz Marek , Carroll Timothy 
Published: December 2021

BackgroundSanguinate, a bovine PEGylated carboxyhemoglobin-based oxygen carrier with vasodilatory, oncotic and anti-inflammatory properties designed to release oxygen in hypoxic tissue, was tested to determine if it improves infarct volume, collateral recruitment and blood flow to the ischemic core in hyperacute middle cerebral artery occlusion (MCAO).MethodsUnder an IACUC approved protocol, 14 mongrel dogs underwent endovascular permanent MCAO. Seven received Sanguinate (8 mL/kg) intravenously over 10 min starting 30 min following MCAO and seven received a similar volume of normal saline. Relative cerebral blood flow (rCBF) was assessed using neutron-activated microspheres prior to MCAO, 30 min following MCAO and 30 min following intervention. Pial collateral recruitment was scored and measured by arterial arrival time (AAT) immediately prior to post-MCAO microsphere injection. Diffusion-weighted 3T MRI was used to assess infarct volume approximately 2 hours after MCAO.ResultsMean infarct volumes for control and Sanguinate-treated subjects were 4739 mm3and 2585 mm3(p=0.0443; r2=0.687), respectively. Following intervention, rCBF values were 0.340 for controls and 0.715 in the Sanguinate group (r2=0.536; p=0.0064). Pial collateral scores improved only in Sanguinate-treated subjects and AAT decreased by a mean of 0.314 s in treated subjects and increased by a mean of 0.438 s in controls (p<0.0276).ConclusionPreliminary results indicate that topload bolus administration of Sanguinate in hyperacute ischemic stroke significantly improves infarct volume, pial collateral recruitment and CBF in experimental MCAO immediately following its administration.
Cheaper tobacco product prices at US Air Force Bases compared with surrounding community areas, 2019
Authors: Kong Amanda Y , Golden Shelley D , Ribisl Kurt M , Krukowski Rebecca A , Vandegrift Sara M , Little Melissa A 
Published: December 2021

IntroductionIn March 2017, the US Department of Defense (DoD) implemented a policy requiring all military stores to set tobacco prices equal to ‘prevailing prices’ in the ‘local community’ adjusted for state and local taxes. We compared tobacco product prices in a sample of retailers located on five Air Force Bases (AFBs) in Texas and Mississippi with those sold in nearby off-base stores.MethodsWe constructed a list of on-base and off-base tobacco retailers. Off-base retailers included stores that were located within a 1.5-mile road network service area from main AFB gates. Between July and September 2019, a trained auditor visited 23 on-base and 50 off-base retailers to confirm tobacco product sales, and documented the price of cigarettes and Copenhagen smokeless tobacco. For each area, the median price for each product, as well as the difference in median prices by on-base versus off-base status, was calculated.ResultsThe median price of cigarettes and smokeless products was cheaper at on-base retailers. All products were cheaper at on-base stores in Fort Sam Houston and Lackland AFB. Similarly, all products were cheaper in on-base stores at Keesler AFB, with the exception of Marlboro Red packs ($0.22 more), and at Sheppard AFB with the exception of cheapest cigarette cartons ($6.26 more).ConclusionDespite the implementation of the new DoD policy, tobacco products are cheaper in on-base retailers compared with off-base retailers. Refining of the definitions used and improved compliance with the new DoD policy are needed.
VOLN27B: A New Head-Tailed Halovirus Isolated from an Underground Salt Crystal and Infecting Halorubrum
Authors: Chen Shaoxing , Dai Yongpei , Liu Jingwen , Zhang Shimin , Chen Feilong , Jin Fanjie , Ruan Peiyao , Li Lu , Chen Xiangdong 
Published: December 2021

A novel halovirus, VOLN27B, was isolated from a drill core sample taken at a depth of approximately 430 m, from a layer formed during the Cretaceous period (Anhui, China). VOLN27B infects the halophilic archaeon Halorubrum sp. LN27 and has a head-tailed morphotype with a contractile tail, typical of myoviruses. The average head diameter is

64
±
2.0

nm, and uncontracted tails are

15
±
1.0
×
65
±
2.0

nm. The latent period is about 10 h. The maturing time of VOLN27B in cells of Halorubrum sp. LN27 was nearly 8 h. The adsorption time of VOLN27B on cells of Halorubrum sp. LN27 was less than 1 min. Virus particles are unstable at pH values less than 5 or when the NaCl concentration is below 12% (

w
/
v

). VOLN27B and Halorubrum sp. LN27 were recovered from the same hypersaline environment and provide a new virus-host system in haloarchaea.
Objective Response Predicts Survival in Advanced Hepatocellular Carcinoma Treated with Systemic Therapies
Authors: Kudo Masatoshi , Montal Robert , Finn Richard S. , Castet Florian , Ueshima Kazuomi , Nishida Naoshi , Haber Philipp K. , Hu Youyou , Chiba Yasutaka , Schwartz Myron , Meyer Tim , Lencioni Riccardo , Llovet Josep M. 
Published: December 2021

Abstract

Purpose:
Because of the increased number of sequential treatments used for advanced hepatocellular carcinoma (HCC), there is a need for surrogate endpoints of overall survival (OS). We analyze whether objective response (OR) is an independent predictor and surrogate endpoint of OS.

Patients and Methods:
A systematic review of randomized clinical trials (RCT) in advanced HCC published between 2010 and 2020 was conducted to explore OS surrogacy of OR by Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). In parallel, RCTs exploring the impact of OR on OS in a time-dependent multivariate analysis were integrated in a meta-analysis.

Results:
Of 65 RCTs identified in advanced HCC, we analyzed 34 studies including 14,056 patients that reported OS and OR by either RECIST (n = 23), mRECIST (n = 5), or both (n = 6). When exploring surrogacy, the trial-level correlation between OR odds ratio and OS HR was R = 0.677 by mRECIST and R = 0.532 by RECIST. Meta-analysis of five RCTs assessing predictors of survival in multivariate analysis found that patients with OR by mRECIST presented a pooled HR for OS of 0.44 (95% confidence interval, 0.27–0.70; P &lt; 0.001) compared with nonresponders. Responses to atezolizumab-bevacizumab had a greater impact on OS than tyrosine kinase inhibitor responses.

Conclusions:
OR-mRECIST is an independent predictor of OS in patients with advanced HCC. Although correlation of OR-mRECIST and OS is better than with OR-RECIST, the level of surrogacy is modest. Thus, it can be used as endpoint in proof-of-concept phase II trials, but the data do not support its use as a primary endpoint of phase III investigations assessing systemic therapies.
Clinical Impact of Immune Cells and Their Spatial Interactions in Diffuse Large B-Cell Lymphoma Microenvironment
Authors: Autio Matias , Leivonen Suvi-Katri , Brück Oscar , Karjalainen-Lindsberg Marja-Liisa , Pellinen Teijo , Leppä Sirpa 
Published: December 2021

Abstract

Purpose:
Tumor-infiltrating immune cells have prognostic significance and are attractive therapeutic targets. Yet, the clinical significance of their spatial organization and phenotype in diffuse large B-cell lymphoma (DLBCL) is unclear.

Experimental Design:
We characterized T cells, macrophages, and their spatial interactions by multiplex IHC (mIHC) in 178 patients with DLBCL and correlated the data with patient demographics and survival. We validated the findings on gene expression data from two external DLBCL cohorts comprising 633 patients.

Results:
Macrophage and T-cell contents divided the samples into T cell–inflamed (60%) and noninflamed (40%) subgroups. The T cell–inflamed lymphoma microenvironment (LME) was also rich in other immune cells, defining immune hot phenotype, which did not as such correlate with outcome. However, when we divided the patients according to T-cell and macrophage contents, LME characterized by high T-cell/low macrophage content or a corresponding gene signature was associated with superior survival [5-year overall survival (OS): 92.3% vs. 74.4%, P = 0.036; 5-year progression-free survival (PFS): 92.6% vs. 69.8%, P = 0.012]. High proportion of PD-L1- and TIM3-expressing CD163− macrophages in the T cell–inflamed LME defined a group of patients with poor outcome [OS: HR = 3.22, 95% confidence interval (CI), 1.63–6.37, Padj = 0.011; PFS: HR = 2.76, 95% CI, 1.44–5.28, Padj = 0.016]. Furthermore, PD-L1 and PD-1 were enriched on macrophages interacting with T cells.

Conclusions:
Our data demonstrate that the interplay between macrophages and T cells in the DLBCL LME is immune checkpoint dependent and clinically meaningful.