bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of external evidence for design and Bayesian analysis of clinical trials: a qualitative study of trialists’ views
Authors: Clayton Gemma L. , Elliott Daisy , Higgins Julian P. T. , Jones Hayley E. 
Published: November 2021

Abstract
Background
Evidence from previous studies is often used relatively informally in the design of clinical trials: for example, a systematic review to indicate whether a gap in the current evidence base justifies a new trial. External evidence can be used more formally in both trial design and analysis, by explicitly incorporating a synthesis of it in a Bayesian framework. However, it is unclear how common this is in practice or the extent to which it is considered controversial. In this qualitative study, we explored attitudes towards, and experiences of, trialists in incorporating synthesised external evidence through the Bayesian design or analysis of a trial.

Methods
Semi-structured interviews were conducted with 16 trialists: 13 statisticians and three clinicians. Participants were recruited across several universities and trials units in the United Kingdom using snowball and purposeful sampling. Data were analysed using thematic analysis and techniques of constant comparison.

Results
Trialists used existing evidence in many ways in trial design, for example, to justify a gap in the evidence base and inform parameters in sample size calculations. However, no one in our sample reported using such evidence in a Bayesian framework. Participants tended to equate Bayesian analysis with the incorporation of prior information on the intervention effect and were less aware of the potential to incorporate data on other parameters. When introduced to the concepts, many trialists felt they could be making more use of existing data to inform the design and analysis of a trial in particular scenarios. For example, some felt existing data could be used more formally to inform background adverse event rates, rather than relying on clinical opinion as to whether there are potential safety concerns. However, several barriers to implementing these methods in practice were identified, including concerns about the relevance of external data, acceptability of Bayesian methods, lack of confidence in Bayesian methods and software, and practical issues, such as difficulties accessing relevant data.

Conclusions
Despite trialists recognising that more formal use of external evidence could be advantageous over current approaches in some areas and useful as sensitivity analyses, there are still barriers to such use in practice.
Addressing constraints to informal providers’ involvement in tuberculosis control: a qualitative study of patent medicine dealers and tuberculosis programme managers
Authors: Onah Cosmas Kenan , Azuogu Benedict Ndubueze , Ossai Edmund Ndudi , Agu Adaoha Pearl , Azuogu Victoria Chioma , Alobu Isaac , Ogah Emeka Onwe 
Published: November 2021

Abstract
Background
A major constraint to tuberculosis control is low case finding with under-reporting to national authorities. Evidence shows that Patent Medicine Dealers are first port of call for most people with symptoms of tuberculosis, yet there is poor referral of such clients to tuberculosis treatment facilities for further evaluation. This study investigated constraints to involvement of Patent Medicine Dealers in tuberculosis control.

Methods
This was a cross-sectional qualitative study among Patent Medicine Dealers and Tuberculosis Control Programme Managers in Ebonyi State Nigeria. Sixty-four Patent Medicine Dealers and five Tuberculosis Control Programme Managers were interviewed using Focus Group Discussion and In-Depth Interview respectively. Data was collected with electronic audio-recording device and analyzed using thematic approach.

Results
There are some knowledge gaps about tuberculosis signs, symptoms, free-treatment policy and mode of operation of care service among Patent Medicine Dealers. Patent Medicine Dealers and Tuberculosis Control Programme Managers are willing to collaborate in tuberculosis control effort but constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to keep up with such demands are obvious constraints.

Conclusions
Knowledge gaps in tuberculosis, its control, constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to satisfy such demands are constraints to involvement of Patent Medicine Dealers in tuberculosis control. More robust engagement of Patent Medicine Dealers in tuberculosis control with clear job description through tuberculosis education and provision of incentives to support them are recommended policy approaches to improve linkage of clients to tuberculosis treatment facilities.
Prescreening to Increase Therapeutic Oncology Trial Enrollment at the Largest Public Hospital in the United States
Authors: Wu Jennifer , Yakubov Amin , Abdul-Hay Maher , Love Erica , Kroening Gianna , Cohen Deirdre , Spalink Christy , Joshi Ankeeta , Balar Arjun , Joseph Kathie-Ann , Ravenell Joseph , Mehnert Janice 
Published: November 2021

PURPOSE: The recruitment of underserved patients into therapeutic oncology trials is imperative. The National Institutes of Health mandates the inclusion of minorities in clinical research, although their participation remains under-represented. Institutions have used data mining to match patients to clinical trials. In a public health care system, such expensive tools are unavailable. METHODS: The NYU Clinical Trials Office implemented a quality improvement program at Bellevue Hospital Cancer Center to increase therapeutic trial enrollment. Patients are screened through the electronic medical record, tumor board conferences, and the cancer registry. Our analysis evaluated two variables: number of patients identified and those enrolled into clinical trials. RESULTS: Two years before the program, there were 31 patients enrolled. For a period of 24 months (July 2017 to July 2019), we identified 255 patients, of whom 143 (56.1%) were enrolled. Of those enrolled, 121 (84.6%) received treatment, and 22 (15%) were screen failures. Fifty-five (38.5%) were referred to NYU Perlmutter Cancer Center for therapy. Of the total enrollees, 64% were female, 56% were non-White, and overall median age was 55 years (range: 33-88 years). Our participants spoke 16 different languages, and 57% were non–English-speaking. We enrolled patients into eight different disease categories, with 38% recruited to breast cancer trials. Eighty-three percent of our patients reside in low-income areas, with 62% in both low-income and Health Professional Shortage Areas. CONCLUSION: Prescreening at Bellevue has led to a 4.6-fold increase in patient enrollment to clinical trials. Future research into using prescreening programs at public institutions may improve access to clinical trials for underserved populations.
Physical Fitness and Cardiovascular Risk Factors in Novel Diabetes Subgroups
Authors: Saatmann Nina , Zaharia Oana-Patricia , Strassburger Klaus , Pesta Dominik Hans , Burkart Volker , Szendroedi Julia , Gerdes Norbert , Kelm Malte , Roden Michael 
Published: November 2021

Abstract

Context
Physical inactivity promotes insulin resistance and increases the risk of diabetes and cardiovascular disease. Recently introduced clustering based on simple clinical measures identified diabetes subgroups (clusters) with different risks of diabetes-related comorbidities and complications.

Objective
This study aims to determine differences in physical fitness and cardiovascular risk between diabetes subgroups and a glucose-tolerant control group (CON). We hypothesized that the severe insulin-resistant diabetes (SIRD) subgroup would be associated with lower physical fitness and increased cardiovascular risk.

Methods
The physical fitness and cardiovascular risk of 746 participants with recent-onset diabetes (diabetes duration of &lt; 12 months, aged 18-69 years) and 74 CONs of the German Diabetes Study (GDS), a prospective longitudinal cohort study, were analyzed. Main outcome measures included physical fitness (VO2max from spiroerogometry), endothelial function (flow- and nitroglycerin-mediated dilation), and cardiovascular risk scores (Framingham Risk Scores for Coronary Heart Disease [FRS-CHD] and Atherosclerotic CardioVascular Disease [ASCVD] risk score).

Results
VO2max was lower in SIRD than in CON, severe autoimmune diabetes (SAID) (both P &lt; .001), and mild age-related diabetes (MARD) (P &lt; .01) subgroups, but not different compared to severe insulin-deficient diabetes (SIDD) (P = .98) and moderate obesity-related diabetes (MOD) subgroups (P = .07) after adjustment for age, sex, and body mass index. Endothelial function was similar among all groups, whereas SAID had lower FRS-CHD and ASCVD than SIRD, MOD, and MARD (all P &lt; .001).

Conclusion
Despite comparable endothelial function across all groups, SIRD showed the lowest physical fitness. Of note, SAID had the lowest cardiovascular risk within the first year after diabetes diagnosis compared to the other diabetes subgroups.
Association Between SGLT2 Inhibitors vs DPP-4 Inhibitors and Risk of Pneumonia Among Patients With Type 2 Diabetes
Authors: Au Philip C M , Tan Kathryn C B , Cheung Bernard M Y , Wong Ian C K , Wong Ying , Cheung Ching-Lung 
Published: November 2021

Abstract

Context
Patients with diabetes are at a higher risk of pneumonia and pneumonia mortality. Sodium glucose co-transporter 2 inhibitors (SGLT2is), the latest class of glucose-lowering agents, were shown to reduce the risk of pneumonia in clinical trials. However, the real-world effectiveness of SGLT2is on the risk of pneumonia is largely unknown.

Objective
To investigate the associations between SGLT2is use and the risk of pneumonia and pneumonia mortality compared with dipeptidyl peptidase-4 inhibitors (DPP4is) using an electronic medical database in Hong Kong.

Design
A retrospective cohort study. The “prevalent new-user” design was adopted to account for the previous exposure to the study drugs being compared. Propensity score (PS) matching (1:4) was used to balance the baseline characteristics of the 2 groups.

Setting and participants
Electronic health data of type 2 diabetes patients using SGLT2is and DPP4is between 2015 and 2018 was collected from the Clinical Data Analysis and Reporting System.

Main Outcome Measures
Pneumonia incidence and mortality.

Results
The PS-matched cohort consisted of 6664 users of SGLT2is and 26 656 users of DPP4is, with a mean follow-up of 3.8 years. Poisson regression showed that SGLT2is use was associated with lower risk of pneumonia compared with DPP4is with an absolute rate difference of 4.05 per 1000 person-years (95% CI, 2.61-5.51). The corresponding incidence rate ratio was 0.71 (95% CI, 0.62-0.81). Similar reduction in risk of pneumonia death was observed (hazard ratio 0.57; 95% CI, 0.42-0.77).

Conclusion
Compared with DPP4is, SGLT2is use was associated with a reduced risk of pneumonia and pneumonia mortality in a real-world setting.
Κινηματογραφική εκπαίδευση: Οι απόψεις εκπαιδευτικών και τελειόφοιτων φοιτητριών και φοιτητών του Παιδαγωγικού Τμήματος Δημοτικής Εκπαίδευσης και του Τμήματος Κινηματογράφου.
Authors: Αγοραστούδη-Βλάχου Φωτεινή , Μπίμπου-Νάκου Ιωάννα 
Published: November 2021

ΠερίληψηΕισαγωγή: Η σχέση του κινηματογράφου με την εκπαίδευση είτε στο πλαίσιο της τυπικής εκπαίδευσης είτε όχι, αφορά την ίδια την ιστορία του κινηματογράφου. Η πλούσια βιβλιογραφία για τον κινηματογράφο και τα παιδιά εξωθεσμικά, δεν συνοδεύεται από μελέτες για την εφαρμογή της κινηματογραφικής εκπαίδευσης στα σχολεία (Bernstein, 2019·Παπαδόπουλος, 2014·Reid, 2019). Στόχοι της μελέτης: Η μελέτη έχει ως στόχο την κατανόηση της κινηματογραφικής εκπαίδευσης και τις διεργασίες ένταξής της στην τυπική σχολική εκπαίδευση, με βάση τις απόψεις εκπαιδευτικών, και φοιτητών/τριών από δυο Πανεπιστημιακά Τμήματα (Παιδαγωγικό Τμήμα Δημοτικής & Κινηματογράφου). Μέθοδος: Η συλλογή των δεδομένων βασίστηκε στη συγκρότηση 3 ομάδων εστίασης και αξιοποιήθηκε η θεματική ανάλυση περιεχομένου. Αποτελέσματα: Η κινηματογραφική εκπαίδευση σύμφωνα με τις απόψεις των συμμετεχόντων έχει πολλαπλούς στόχους όπως είναι: η κινητοποίηση των μαθητών, η αξιοποίηση των ταινιών ως διδακτικό εργαλείο σε συγκεκριμένα μαθήματα, η σύνδεση των ταινιών με ενήλικες αξίες και ανησυχίες, οι ταινίες ως συμβολικός χώρος για την συναισθηματική και κοινωνική ανάπτυξη των παιδιών και των νέων, καθώς και η ανάπτυξη κριτικής σκέψης και κοινωνικής συνείδησης. Συμπεράσματα: Με βάση τις καταγραφές των συμμετεχόντων η κινηματογραφική εκπαίδευση συζητείται και ως μέσο και ως στόχος μιας ενεργητικής, κριτικής και δημιουργική διεργασίας που αφορά κατεξοχήν το σχολείο.
Βιβλιοπαρουσίαση: Παπανδρέου, Μ. (2020). Συμμετοχική μάθηση στην προσχολική και πρώτη σχολική ηλικία: Κατανοώντας τις γλώσσες των παιδιών και ενισχύοντας τη συμμετοχή τους σε διαδικασίες μάθησης και έρευνας. Σοφία
Authors: Καμπεζά Μαρία 
Published: November 2021

Βιβλιοπαρουσίαση: Παπανδρέου, Μ. (2020). Συμμετοχική μάθηση στην προσχολική και πρώτη σχολική ηλικία: Κατανοώντας τις γλώσσες των παιδιών και ενισχύοντας τη συμμετοχή τους σε διαδικασίες μάθησης και έρευνας. Σοφία
Differences in total and regional body fat and their association with BMI in UK-born White and South Asian children: findings from the Born in Bradford birth cohort
Authors: Santorelli Gillian , West Jane , Yang Tiffany , Wright John , Bryant Maria , Lawlor D.A. 
Published: November 2021

Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~20% higher, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in SA children compared to white children in the same BMI category. Fat mass index (FMI) was higher in all body regions in SA children in all BMI categories; as was total and truncal FMI in healthy and overweight, but not obese, SA children.. Conclusions: Greater TBF% and total and regional FM in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below the obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.
The ALSPAC fetal and neonatal resource: detailed data abstracted from the clinical records of the new-born
Authors: Birmingham Karen , Iles-Caven Yasmin , Northstone Kate , Golding Jean 
Published: November 2021

In a previous Data Note, we outlined the data obtained from clinical obstetric records concerning many details of the pregnancies resulting in the births of the children in the Avon Longitudinal Study of Parents and Children (ALSPAC). Here we describe the data that have been abstracted from medical records concerning the fetus and neonate. Full details concerning the selection biases regarding the data abstracted are outlined in the previous Data Note. The records that have been abstracted, and described in this Data Note, concern the health of the fetus (measured in relation to the results of fetal monitoring, presentation at various stages of pregnancy, and the method of delivery) as well as the status of the newborn immediately post-delivery. Details of signs, symptoms and treatments of this population of new-born babies, as recorded in the clinical records, are described for the time during which they were in hospital or under the care of a designated midwife. These data add depth to the information collected from elsewhere concerning this period of the child’s life: from the questionnaires completed at the time by the mother; and clinical details from neonatal intensive or special care units which will be detailed in a further Data Note.
Perceptions of Debarking Small-Diameter Stems in the Wood Products Community
Authors: Chahal Azadwinder Singh , Tripathi Jaya , Ciolkosz Daniel , Wurzbacher Sarah , Jacobson Michael 
Published: November 2021

Abstract
Sufficiently valuing small-diameter-stem (diameter < 9 in.) woody material in Pennsylvania forest product markets may incentivize increased utilization of that material, a resource opportunity that would provide economic and ecological benefits to the state's forests and forest products community. Debarking is one primary process that could enhance the value of these small-diameter-stem materials for secondary markets. The wood products community in Pennsylvania was surveyed as to their perceptions of the status and value of economical small-diameter-stem debarking. The largest perceived current market for debarked, small-diameter-stem material identified by respondents is for chips for pulp and paper, and anticipated future demand is expected to be highest for chips for pulp and paper, chips for energy, and small-dimension lumber. Respondents who currently supply a given market tend to be more optimistic about that market than respondents who do not serve that particular market. Shredded wood/hog fuel and mulch are the two markets with the lowest overall scores for anticipated benefit of additional processing by debarking. Seventy-six percent of all respondents indicated that economical small-diameter-stem debarking would benefit their operation.
The impact of errors in medical certification on the accuracy of the underlying cause of death
Authors: Gamage U. S. H. , Adair Tim , Mikkelsen Lene , Mahesh Pasyodun Koralage Buddhika , Hart John , Chowdhury Hafiz , Li Hang , Joshi Rohina , Senevirathna W. M. C. K. , Fernando H. D. N. L. , McLaughlin Deirdre , Lopez Alan D. 
Published: November 2021

Background
Correct certification of cause of death by physicians (i.e. completing the medical certificate of cause of death or MCCOD) and correct coding according to International Classification of Diseases (ICD) rules are essential to produce quality mortality statistics to inform health policy. Despite clear guidelines, errors in medical certification are common. This study objectively measures the impact of different medical certification errors upon the selection of the underlying cause of death.

Methods
A sample of 1592 error-free MCCODs were selected from the 2017 United States multiple cause of death data. The ten most common types of errors in completing the MCCOD (according to published studies) were individually simulated on the error-free MCCODs. After each simulation, the MCCODs were coded using Iris automated mortality coding software. Chance-corrected concordance (CCC) was used to measure the impact of certification errors on the underlying cause of death. Weights for each error type and Socio-demographic Index (SDI) group (representing different mortality conditions) were calculated from the CCC and categorised (very high, high, medium and low) to describe their effect on cause of death accuracy.

Findings
The only very high impact error type was reporting an ill-defined condition as the underlying cause of death. High impact errors were found to be reporting competing causes in Part 1 [of the death certificate] and illegibility, with medium impact errors being reporting underlying cause in Part 2 [of the death certificate], incorrect or absent time intervals and reporting contributory causes in Part 1, and low impact errors comprising multiple causes per line and incorrect sequence. There was only small difference in error importance between SDI groups.

Conclusions
Reporting an ill-defined condition as the underlying cause of death can seriously affect the coding outcome, while other certification errors were mitigated through the correct application of mortality coding rules. Training of physicians in not reporting ill-defined conditions on the MCCOD and mortality coders in correct coding practices and using Iris should be important components of national strategies to improve cause of death data quality.
The mediating role of residents’ wellbeing between program leadership and quality of care: A cross-sectional study
Authors: Msheik-El Khoury Fatima , Naser Diana Dorothea , Htway Zin , Zein El Dine Salah 
Published: November 2021

BackgroundResearch has shown that organizational leadership and support affect organizational outcomes in several sectors, including healthcare. However, less is known about how organizational leadership might influence the wellbeing of clinical trainees as well as the quality of their patient care practices.ObjectivesThis study examined the mediating effects of burnout and engagement between program director-resident relationship quality and residents’ reported quality of care, and the moderating effect of perceived departmental support.MethodsThe authors conducted a cross-sectional study in September 2020, using a 41-item questionnaire, among 20 residency programs in an academic medical center in Lebanon. Measures included program director-resident relationship quality, perceived departmental support, burnout subcomponents, engagement, and self-reported quality of care. Ordinary least squares regression was used to conduct parallel mediation and moderated mediation analyses using SPSS macro-PROCESS, to assess the strength and direction of each of the proposed associations.ResultsA total of 95/332 (28.6%) residents responded. Results revealed that program director-resident relationship quality had a significant indirect effect on residents’ suboptimal patient care practices and attitudes towards patients, through at least one of the wellbeing dimensions (p< .05). Perceived departmental support did not play a dominant role over program director-resident relationship quality, and thus did not influence any of the mediated relationships.ConclusionOur study adds a new dimension to the body of literature suggesting that program director-resident relationship quality plays an important role in promoting residents’ wellbeing and achieving important clinical health outcomes. Such findings imply that the quality of program director-resident relationship could be an important component of residents’ wellbeing and patient safety. If further research confirms these associations, it will become imperative to determine what interventions might improve the quality of relationships between program directors and residents.