bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomised controlled feasibility trial of an active communication education programme plus hearing aid provision versus hearing aid provision alone (ACE To HEAR)
Authors: Watson Judith , Coleman Elizabeth , Jackson Cath , Bell Kerry , Maynard Christina , Hickson Louise , Forster Anne , Fairhurst Caroline , Hewitt Catherine , Gardner Rob , Iley Kate , Gailey Lorraine , Thyer Nicholas J 
Published: April 2021

ObjectiveTo establish the acceptability and feasibility of delivering the Active Communication Education (ACE) programme to increase quality of life through improving communication and hearing aid use in the UK National Health Service.DesignRandomised controlled, open feasibility trial with embedded economic and process evaluations.SettingAudiology departments in two hospitals in two UK cities.ParticipantsTwelve hearing aid users aged 18 years or over who reported moderate or less than moderate benefit from their new hearing aid.InterventionsConsenting participants (along with a significant other) were to be randomised by a remote, centralised randomisation service in groups to ACE plus treatment-as-usual (intervention group) or treatment-as-usual only (control group).Primary outcome measuresThe primary outcomes were related to feasibility: recruitment, retention, treatment adherence and acceptability to participants and fidelity of treatment delivery.Secondary outcome measuresInternational Outcomes Inventory for Hearing Aids, Self-Assessment of Communication, EQ-5D-5L and Short-Form 36. Blinding of the participants and facilitator was not possible.ResultsTwelve hearing aid users and six significant others consented to take part. Eight hearing aid users were randomised: four to the intervention group; and four to treatment-as-usual only. Four significant others participated alongside the randomised participants. Recruitment to the study was very low and centres only screened 466 hearing aid users over the 15-month recruitment period, compared with the approximately 3500 anticipated. Only one ACE group and one control group were formed. ACE could be delivered and appeared acceptable to participants. We were unable to robustly assess attrition and attendance rates due to the low sample size.ConclusionsWhile ACE appeared acceptable to hearing aid users and feasible to deliver, it was not feasible to identify and recruit participants struggling with their hearing aids at the 3-month posthearing aid fitting point.Trial registration numberISRCTN28090877.
Quantifying the association between ethnicity and COVID-19 mortality: a national cohort study protocol
Authors: Dambha-Miller Hajira , Tan Pui San , Saatci Defne , Clift Ashley Kieran , Zaccardi Francesco , Coupland Carol , Locufier Patrick , Davies Firoza , Khunti Kamlesh , Griffin Simon J , Hippisley-Cox Julia 
Published: April 2021

IntroductionRecent evidence suggests that ethnic minority groups are disproportionately at increased risk of hospitalisation and death from SARS-CoV-2 infection. Population-based evidence on potential explanatory factors across minority groups and within subgroups is lacking. This study aims to quantify the association between ethnicity and the risk of hospitalisation and mortality due to COVID-19.Methods and analysisThis is a retrospective cohort study of adults registered across a representative and anonymised national primary care database (QResearch) that includes data on 10 million people in England. Sociodemographic, deprivation, clinical and domicile characteristics will be summarised and compared across ethnic subgroups (categorised as per 2011 census). Cox models will be used to calculate HR for hospitalisation and COVID-19 mortality associated with ethnic group. Potential confounding and explanatory factors (such as demographic, socioeconomic and clinical) will be adjusted for within regression models. The percentage contribution of distinct risk factor classes to the excess risks seen in ethnic groups/subgroups will be calculated.Ethics and disseminationThe study has undergone ethics review in accordance with the QResearch agreement (reference OX102). Findings will be disseminated through peer-reviewed manuscripts, presentations at scientific meetings and conferences with national and international stakeholders.
Association between parental socioeconomic status and offspring overweight/obesity from the China Family Panel Studies: a longitudinal survey
Authors: Ding Suqin , Chen Jingqi , Dong Bin , Hu Jie 
Published: April 2021

ObjectiveTo examine the association between parental socioeconomic status (SES) and the risk of offspring overweight/obesity and the changes of the association that occur as children grow older.DesignWe used data from the nationally representative longitudinal survey of the China Family Panel Studies of 2010 and its three follow-up waves in 2012, 2014 and 2016.ParticipantsA total of 6724 children aged 0–15 years old were included.Primary and secondary outcome measuresAverage household income and paternal and maternal education levels were used as SES indicators. Logistic regression model for panel data was used to examine the associations between SES indicators and child overweight/obesity. A restricted cubic spline linear regression model was used to estimate body mass index (BMI) trajectories with child growth across parental SES levels.ResultsCompared with the lowest education level (primary school or less), the ORs for fathers who had completed junior high school, senior high school and junior college or higher were 0.85 (95% CI 0.75 to 0.97), 0.77 (95% CI 0.64 to 0.92) and 0.72 (95% CI 0.55 to 0.93), respectively. The corresponding ORs for mothers were 0.76 (95% CI 0.67 to 0.86), 0.59 (95% CI 0.47 to 0.72) and 0.45 (95% CI 0.34 to 0.60), respectively. A negative association between parental education and offspring overweight/obesity was observed in the first 10 years but not in children 11–15 years old. BMI differences across parental education levels emerged from birth and widened before 6–7 years old, but decreased before adolescence. High average household income was related to a low risk of offspring overweight/obesity but not when parental education level was adjusted for.ConclusionHigh parental education levels were associated with a low risk of offspring overweight/obesity, especially before adolescence. Effective approaches need to be adopted in early childhood to reduce socioeconomic differences in overweight/obesity.
Emerging responses implemented to prevent and respond to violence against women and children in WHO European member states during the COVID-19 pandemic: a scoping review of online media reports
Authors: Pearson Isabelle , Butler Nadia , Yelgezekova Zhamin , Nihlén Åsa , Yordi Aguirre Isabel , Quigg Zara , Stöckl Heidi 
Published: April 2021

ObjectivesThis study aims to explore the strategies that governments and civil society organisations implemented to prevent and respond to the anticipated rise in violence against women and/or children (VAWC) during the 2019 novel coronavirus (COVID-19) pandemic.DesignA scoping review and content analysis of online media reports.SettingWHO European region.MethodsA scoping review of media reports and publications and a search of other grey literature (published from 1 January to 17 September 2020). Primary and secondary outcome measures included measures implemented by governments, public services and non-governmental and civil organisations to prevent or respond to VAWC during the early months of the COVID-19 pandemic.ResultsOur study found that in 52 of the 53 member states there was at least one measure undertaken to prevent or respond to VAWC during the pandemic. Government-led or government-sponsored measures were the most common, reported in 50 member states. Non-governmental and other civil society-led prevention and response measures were reported in 40 member states. The most common measure was the use of media and social media to raise awareness of VAWC and to provide VAWC services through online platforms, followed by measures taken to expand and/or maintain helpline services for those exposed to violence.ConclusionThe potential increase in VAWC during COVID-19-imposed restrictions and lockdowns resulted in adaptations and/or increases in prevention and response strategies in nearly all member states. The strength of existing public health systems influenced the requirement and choice of strategies and highlights the need for sustaining and improving violence prevention and response services. Innovative strategies employed in several member states may offer opportunities for countries to strengthen prevention and responses in the near future and during similar emergencies.
Retrospective cohort analysis of Spanish national trends of coronary artery bypass grafting and percutaneous coronary intervention from 1998 to 2017
Authors: Carnero Alcazar Manuel , Hernandez-Vaquero Daniel , Cubero-Gallego Hector , Lopez Menendez Jose , Piñon Miguel , Albors Martin Jose , Cuerpo Caballero Gregorio , Cobiella Carnicer Javier , Villamor Cristina , Forteza Alberto , Pascual Isaac , Maroto Castellanos Luis Carlos 
Published: April 2021

IntroductionSpain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG).ObjectivesTo investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain.DesignRetrospective cohort study. Analysis of in-hospital outcomes.SettingMinimum basic data set from the Spanish National Department of Health: mandatory database collecting information of patients who are attended in the Spanish public National Health System.Participants603 976 patients who underwent isolated CABG or PCI in the Spanish National Health System. The study period was divided in four 5-year intervals. Patients with acute myocardial infarction on admission were excluded.Primary and secondary outcomesWe investigated the volume of procedures nationwide, the changes of the risk profile of patients and in-hospital mortality of both techniques.ResultsWe observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). 93 682 (15.5%) had a coronary surgery. PCI to CABG ratio rose from 2.2 (1998–2002) to 8.1 (2013–2017). Charlson’s index increased by 0.8 for CABG and 1 for PCI. The median annual volume of PCI/hospital augmented from 136 to 232, while the volume of CABG was reduced from 137 to 74. In the two decades, we detected a significant reduction of CABG in-hospital mortality (6.5% vs 2.6%, p<0.001) and a small increase in PCI (1.2% vs 1.5%, p<0.001). Risk adjusted mortality rate was reduced for both CABG (1.51 vs 0.48, p<0.001), and PCI (1.42 vs 1.05, p<0.001).ConclusionWe detected a significant increase in the volume of revascularisations (particularly PCI) in Spain. Risk-adjusted in-hospital mortality was significantly reduced.
Economic evaluation of a novel community-based diabetes care model in rural Mexico: a cost and cost-effectiveness study
Authors: Duan Kevin I , Rodriguez Garza Francisco , Flores Hugo , Palazuelos Daniel , Maza Jimena , Martinez-Juarez Luis Alberto , Elliott Patrick F , Moreno Lázaro Elena , Enriquez Rios Natán , Nigenda Gustavo , Palazuelos Lindsay , McBain Ryan K 
Published: April 2021

ObjectivesDiabetes is the leading cause of disability-adjusted life years in Mexico, and cost-effective care models are needed to address the epidemic. We sought to evaluate the cost and cost-effectiveness of a novel community-based model of diabetes care in rural Mexico, compared with usual care.DesignWe performed time-driven activity-based costing to estimate annualised costs associated with typical diabetes care in Chiapas, Mexico, as well as a novel diabetes care model known as Compañeros En Salud Programa de Enfermedades Crónicas (CESPEC). We conducted Markov chain analysis to estimate the cost-effectiveness of CESPEC compared with usual care from a societal perspective. We used patient outcomes from CESPEC in 2016, as well as secondary data from existing literature.SettingRural primary care clinics in Chiapas, Mexico.ParticipantsAdults with diabetes.InterventionsCESPEC is a novel, comprehensive, diabetes care model that integrates community health workers, provider education, supply chain management and active case finding.Outcome measureThe primary outcome was the incremental cost-effectiveness of CESPEC compared with care as usual, per quality-adjusted life year (QALY) gained, expressed in 2016 US dollars.ResultsThe economic cost of the CESPEC diabetes model was US$144 per patient per year, compared with US$125 for diabetes care as usual. However, CESPEC care was associated with 0.13 additional years of health-adjusted life expectancy compared with usual care and 0.02 additional years in the first 5 years of treatment. This translated to an incremental cost-effectiveness ratio (ICER) of US$2981 per QALY gained over a patient’s lifetime and an ICER of US$10 444 over the first 5 years. Findings were robust to multiple sensitivity analyses.ConclusionsCESPEC is a cost-effective, community-based model of diabetes care for patients in rural Mexico. Given the high prevalence and significant morbidity associated with diabetes in Mexico and other countries in Central America, this model should be considered for broader scale up and evaluation.
Prognostic model to identify and quantify risk factors for mortality among hospitalised patients with COVID-19 in the USA
Authors: Incerti Devin , Rizzo Shemra , Li Xiao , Lindsay Lisa , Yau Vincent , Keebler Dan , Chia Jenny , Tsai Larry 
Published: April 2021

ObjectivesTo develop a prognostic model to identify and quantify risk factors for mortality among patients admitted to the hospital with COVID-19.DesignRetrospective cohort study. Patients were randomly assigned to either training (80%) or test (20%) sets. The training set was used to fit a multivariable logistic regression. Predictors were ranked using variable importance metrics. Models were assessed by C-indices, Brier scores and calibration plots in the test set.SettingOptum de-identified COVID-19 Electronic Health Record dataset including over 700 hospitals and 7000 clinics in the USA.Participants17 086 patients hospitalised with COVID-19 between 20 February 2020 and 5 June 2020.Main outcome measureAll-cause mortality while hospitalised.ResultsThe full model that included information on demographics, comorbidities, laboratory results, and vital signs had good discrimination (C-index=0.87) and was well calibrated, with some overpredictions for the most at-risk patients. Results were similar on the training and test sets, suggesting that there was little overfitting. Age was the most important risk factor. The performance of models that included all demographics and comorbidities (C-index=0.79) was only slightly better than a model that only included age (C-index=0.76). Across the study period, predicted mortality was 1.3% for patients aged 18 years old, 8.9% for 55 years old and 28.7% for 85 years old. Predicted mortality across all ages declined over the study period from 22.4% by March to 14.0% by May.ConclusionAge was the most important predictor of all-cause mortality, although vital signs and laboratory results added considerable prognostic information, with oxygen saturation, temperature, respiratory rate, lactate dehydrogenase and white cell count being among the most important predictors. Demographic and comorbidity factors did not improve model performance appreciably. The full model had good discrimination and was reasonably well calibrated, suggesting that it may be useful for assessment of prognosis.
Clinical practice guidelines for the management of atraumatic shoulder conditions: protocol for a systematic review
Authors: Lee Dana Yen Lin , Haas Romi , Wallis Jason A , O’Connor Denise A , Buchbinder Rachelle 
Published: April 2021

IntroductionShoulder conditions are a major cause of morbidity in the general population. Many clinical practice guidelines (CPGs) for shoulder conditions have been developed. Their purpose is to provide evidence-based recommendations to assist clinicians in providing optimal care to maximise patient outcomes. The aim of this systematic review is to identify, appraise, and compare the content and quality of CPGs for atraumatic shoulder conditions.Methods and analysisCPGs for atraumatic shoulder conditions will be included provided they make recommendations about diagnosis and/or management, are identified by their authors as a guideline and are consistent with the Appraisal of Guidelines for Research and Evaluation (AGREE) II definition of a guideline. A systematic search of electronic databases, online guideline repositories and the websites of relevant professional societies will be conducted to identify eligible CPGs. Search terms relating to shoulder conditions (eg, ‘adhesive capsulitis’, ‘rotator cuff’ and ‘bursitis’) will be combined with a validated search filter for CPGs. Pairs of independent reviewers will determine eligibility of CPGs identified by the search. Quality appraisal of included CPGs will be performed using the AGREE II instrument. Recommendations from each CPG and how they were determined will be extracted and compared across similar CPGs. Results from this systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.Ethics and disseminationEthical approval is not required for this systematic review. The results from this study will be published in a peer-reviewed journal and disseminated to professional societies that publish shoulder CPGs, clinical policy groups, clinicians, researchers and consumers.PROSPERO registration numberCRD42020182723.
Symptomatic, biochemical and radiographic recovery in patients with COVID-19
Authors: Mallia Patrick , Meghji Jamilah , Wong Brandon , Kumar Kartik , Pilkington Victoria , Chhabra Shaan , Russell Ben , Chen Jian , Srikanthan Karthikan , Park Mirae , Owles Harriet , Liew Felicity , Alcada Joana , Martin Laura , Coleman Meg , Elkin Sarah , Ross Clare , Agrawal Shweta , Gardiner Thomas , Bell Aaron , White Alice , Hampson Dominic , Vithlani Gauri , Manalan Kavina , Bramer Solange , Martin Segura Alejandra , Kucheria Anushree , Ratnakumar Prashanthi , Sheeka Alexander , Anandan Lavanya , Copley Susan , Russell Georgina , Bloom Chloe I , Kon Onn Min 
Published: April 2021

BackgroundThe symptoms, radiography, biochemistry and healthcare utilisation of patients with COVID-19 following discharge from hospital have not been well described.MethodsRetrospective analysis of 401 adult patients attending a clinic following an index hospital admission or emergency department attendance with COVID-19. Regression models were used to assess the association between characteristics and persistent abnormal chest radiographs or breathlessness.Results75.1% of patients were symptomatic at a median of 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. 18.5% of patients had unscheduled healthcare visits in the 30 days post discharge.ConclusionsPatients with COVID-19 experience persistent symptoms and abnormal blood biomarkers with a gradual resolution of radiological abnormalities over time. These findings can inform patients and clinicians about expected recovery times and plan services for follow-up of patients with COVID-19.
Small airway determinants of airflow limitation in chronic obstructive pulmonary disease
Authors: Polosukhin Vasiliy V , Gutor Sergey S , Du Rui-Hong , Richmond Bradley W , Massion Pierre P , Wu Pingsheng , Cates Justin M , Sandler Kim L , Rennard Stephen I , Blackwell Timothy S 
Published: April 2021

BackgroundAlthough a variety of pathological changes have been described in small airways of patients with COPD, the critical anatomic features determining airflow limitation remain incompletely characterised.MethodsWe examined lung tissue specimens from 18 non-smokers without chronic lung disease and 55 former smokers with COPD for pathological features of small airways that could contribute to airflow limitation. Morphometric evaluation was performed for epithelial and subepithelial tissue thickness, collagen and elastin content, luminal mucus and radial alveolar attachments. Immune/inflammatory cells were enumerated in airway walls. Quantitative emphysema scoring was performed on chest CT scans.ResultsSmall airways from patients with COPD showed thickening of epithelial and subepithelial tissue, mucus plugging and reduced collagen density in the airway wall (in severe COPD). In patients with COPD, we also observed a striking loss of alveolar attachments, which are connective tissue septa that insert radially into the small airway adventitia. While each of these parameters correlated with reduced airflow (FEV1), multivariable regression analysis indicated that loss of alveolar attachments was the major determinant of airflow limitation related to small airways. Neutrophilic infiltration of airway walls and collagen degradation in airway adventitia correlated with loss of alveolar attachments. In addition, quantitative analysis of CT scans identified an association between the extent of emphysema and loss of alveolar attachments.ConclusionIn COPD, loss of radial alveolar attachments in small airways is the pathological feature most closely related to airflow limitation. Destruction of alveolar attachments may be mediated by neutrophilic inflammation.
Prediction and model-assisted estimation of diameter distributions using Norwegian national forest inventory and airborne laser scanning data
Authors: Räty Janne , Astrup Rasmus , Breidenbach Johannes 
Published: April 2021

Diameter at breast height (DBH) distributions offer valuable information for operational and strategic forest management decisions. We predicted DBH distributions using Norwegian national forest inventory and airborne laser scanning data and compared the predictive performances of linear mixed-effects (PPM), generalized linear-mixed (GLM), and k nearest-neighbor (NN) models. While GLM resulted in smaller prediction errors than PPM, both were clearly outperformed by NN. We therefore studied the ability of the NN model to improve the precision of stem frequency estimates by DBH classes in the 8.7 Mha study area using a model-assisted (MA) estimator suitable for systematic sampling. MA estimates yielded greater than or approximately equal efficiencies as direct estimates using field data only. The relative efficiencies (REs) associated with the MA estimates ranged between 0.95–1.47 and 0.96–1.67 for 2 and 6 cm DBH class widths, respectively, when dominant tree species were assumed to be known. The use of a predicted tree species map, instead of the observed information, decreased the REs by up to 10%.
Determination of $$\alpha _{S}$$ beyond NNLO using event shape averages
Authors: Kardos Adam , Somogyi Gábor , Verbytskyi Andrii 
Published: April 2021

AbstractWe consider a method for determining the QCD strong coupling constant using fits of perturbative predictions for event shape averages to data collected at the LEP, PETRA, PEP and TRISTAN colliders. To obtain highest accuracy predictions we use a combination of perturbative $${{{\mathcal {O}}}}(\alpha _{S}^{3})$$

O
(

α

S

3

)

calculations and estimations of the $${{{\mathcal {O}}}}(\alpha _{S}^{4})$$

O
(

α

S

4

)

perturbative coefficients from data. We account for non-perturbative effects using modern Monte Carlo event generators and analytic hadronization models. The obtained results show that the total precision of the $$\alpha _{S}$$

α
S

determination cannot be improved significantly with the higher-order perturbative QCD corrections alone, but primarily requires a deeper understanding of the non-perturbative effects.