bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soap versus sanitiser for preventing the transmission of acute respiratory infections in the community: a systematic review with meta-analysis and dose–response analysis
Authors: Hoffmann Tammy , Bakhit Mina , Krzyzaniak Natalia , Del Mar Chris , Scott Anna Mae , Glasziou Paul 
Published: August 2021

ObjectiveTo compare the effectiveness of hand hygiene using alcohol-based hand sanitiser to soap and water for preventing the transmission of acute respiratory infections (ARIs) and to assess the relationship between the dose of hand hygiene and the number of ARI, influenza-like illness (ILI) or influenza events.DesignSystematic review and meta-analysis.Data sourcesCochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and trial registries were searched in April 2020.Inclusion criteriaWe included randomised controlled trials that compared a community-based hand hygiene intervention (soap and water, or sanitiser) with a control, or trials that compared sanitiser with soap and water, and measured outcomes of ARI, ILI or laboratory-confirmed influenza or related consequences.Data extraction and analysisTwo review authors independently screened the titles and abstracts for inclusion and extracted data.ResultsEighteen trials were included. When meta-analysed, three trials of soap and water versus control found a non-significant increase in ARI events (risk ratio (RR) 1.23, 95% CI 0.78 to 1.93); six trials of sanitiser versus control found a significant reduction in ARI events (RR 0.80, 95% CI 0.71 to 0.89). When hand hygiene dose was plotted against ARI relative risk, no clear dose–response relationship was observable. Four trials were head-to-head comparisons of sanitiser and soap and water but too heterogeneous to pool: two found a significantly greater reduction in the sanitiser group compared with the soap group and two found no significant difference between the intervention arms.ConclusionsAdequately performed hand hygiene, with either soap or sanitiser, reduces the risk of ARI virus transmission; however, direct and indirect evidence suggest sanitiser might be more effective in practice.
How culture affects validity: understanding Japanese residents’ sense-making of evaluating clinical teachers
Authors: Kikukawa Makoto , Stalmeijer Renée E , Matsuguchi Takahiro , Oike Miyako , Sei Emura , Schuwirth Lambert W T , Scherpbier Albert J J A 
Published: August 2021

ObjectivesTraditionally, evaluation is considered a measurement process that can be performed independently of the cultural context. However, more recently the importance of considering raters’ sense-making, that is, the process by which raters assign meaning to their collective experiences, is being recognised. Thus far, the majority of the discussion on this topic has originated from Western perspectives. Little is known about the potential influence of an Asian culture on raters’ sense-making. This study explored residents’ sense-making associated with evaluating their clinical teachers within an Asian setting to better understand contextual dependency of validity.DesignA qualitative study using constructivist grounded theory.SettingThe Japanese Ministry of Health, Labour and Welfare has implemented a system to monitor the quality of clinical teaching within its 2-year postgraduate training programme. An evaluation instrument was developed specifically for the Japanese setting through which residents can evaluate their clinical teachers.Participants30 residents from 10 Japanese teaching hospitals with experience in evaluating their clinical teachers were sampled purposively and theoretically.MethodsWe conducted in-depth semistructured individual interviews. Sensitising concepts derived from Confucianism and principles of response process informed open, axial and selective coding.ResultsTwo themes and four subthemes were constructed. Japanese residents emphasised the awareness of their relationship with their clinical teachers (1). This awareness was fuelled by their sense of hierarchy (1a) and being part of the collective society (1b). Residents described how the meaning of evaluation (2) was coloured by their perceived role as senior (2a) and their experienced responsibility for future generations (2b).ConclusionsJapanese residents’ sense-making while evaluating their clinical teachers appears to be situated and affected by Japanese cultural values. These findings contribute to a better understanding of a culture’s influence on residents’ sense-making of evaluation instruments and the validity argument of evaluation.
Measuring quality of life in trials including patients on dialysis: how are transplants and mortality incorporated into the analysis? A systematic review protocol
Authors: Worboys Hannah M , Cooper Nicola J , Burton James O , Gray Laura J 
Published: August 2021

IntroductionIt is estimated that 25 000 people in the UK receive dialysis. Dialysis is an intrusive and time-consuming intervention that causes significant reductions in quality of life. When enrolled in a clinical trial, often some patients drop out of the study either because they die, receive a kidney transplant or are lost to follow-up for other reasons. It is unclear how these events are dealt with when analysing quality of life measures within clinical trials. This review will assess current practice for dealing with loss to follow-up in trials including patients on haemodialysis. The methods currently used will be analysed in terms of their adequacy and will form the basis of future work assessing the most appropriate methods to employ under these circumstances. The results of this review will feed into recommendations for future nephrology trials.Methods and analysisA systematic search of electronic databases including MEDLINE and the Cochrane Library will be conducted to find clinical trials enrolling patients on haemodialysis that measure quality of life using either the kidney disease quality of life (KDQoL) or the short form 36 health survey (SF-36) (or any variation of these two measures). Ongoing trials will be identified through a search of trial registers. Articles will be screened against inclusion/exclusion criteria and data will be extracted using a predetermined data extraction form. General information such as the title, location, trial design will be extracted along with more specific information on how the study dealt with patients that died or received a transplant before the end of the follow-up period. Two independent reviewers will perform screening and extraction. Disagreements will be resolved by discussion or by a third independent reviewer. Data synthesis will be performed as a narrative summary.Ethics and disseminationEthics approval is not required. Dissemination will be by publication in a peer-reviewed journal.PROSPERO registration numberCRD42020223869.
Ethnic variation in outcome of people hospitalised during the first COVID-19 epidemic wave in Wales (UK): an analysis of national surveillance data using Onomap, a name-based ethnicity classification tool
Authors: Thomas Daniel Rh , Orife Oghogho , Plimmer Amy , Williams Christopher , Karani George , Evans Meirion R , Longley Paul , Janiec Janusz , Saltus Roiyah , Shankar Ananda Giri 
Published: August 2021

ObjectiveTo identify ethnic differences in proportion positive for SARS-CoV-2, and proportion hospitalised, proportion admitted to intensive care and proportion died in hospital with COVID-19 during the first epidemic wave in Wales.DesignDescriptive analysis of 76 503 SARS-CoV-2 tests carried out in Wales to 31 May 2020. Cohort study of 4046 individuals hospitalised with confirmed COVID-19 between 1 March and 31 May. In both analyses, ethnicity was assigned using a name-based classifier.SettingWales (UK).Primary and secondary outcomesAdmission to an intensive care unit following hospitalisation with a positive SARS-CoV-2 PCR test. Death within 28 days of a positive SARS-CoV-2 PCR test.ResultsUsing a name-based ethnicity classifier, we found a higher proportion of black, Asian and ethnic minority people tested for SARS-CoV-2 by PCR tested positive, compared with those classified as white. Hospitalised black, Asian and minority ethnic cases were younger (median age 53 compared with 76 years; p<0.01) and more likely to be admitted to intensive care. Bangladeshi (adjusted OR (aOR): 9.80, 95% CI 1.21 to 79.40) and ‘white – other than British or Irish’ (aOR: 1.99, 95% CI 1.15 to 3.44) ethnic groups were most likely to be admitted to intensive care unit. In Wales, older age (aOR for over 70 years: 10.29, 95% CI 6.78 to 15.64) and male gender (aOR: 1.38, 95% CI 1.19 to 1.59), but not ethnicity, were associated with death in hospitalised patients.ConclusionsThis study adds to the growing evidence that ethnic minorities are disproportionately affected by COVID-19. During the first COVID-19 epidemic wave in Wales, although ethnic minority populations were less likely to be tested and less likely to be hospitalised, those that did attend hospital were younger and more likely to be admitted to intensive care. Primary, secondary and tertiary COVID-19 prevention should target ethnic minority communities in Wales.
Indirect comparison of TIMI, HEART and GRACE for predicting major cardiovascular events in patients admitted to the emergency department with acute chest pain: a systematic review and meta-analysis
Authors: Ke Jun , chen Yiwei , Wang Xiaoping , Wu Zhiyong , Chen Feng 
Published: August 2021

BackgroundThe study aimed to compare the predictive values of the thrombolysis in myocardial infarction (TIMI); History, Electrocardiography, Age, Risk factors and Troponin (HEART) and Global Registry in Acute Coronary Events (GRACE) scoring systems for major adverse cardiovascular events (MACEs) in acute chest pain (ACP) patients admitted to the emergency department (ED).MethodsWe systematically searched PubMed, Embase and the Cochrane Library from their inception to June 2020; we compared the following parameters: sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic OR (DOR) and area under the receiver operating characteristic curves (AUC).ResultsThe pooled sensitivity and specificity for TIMI, HEART and GRACE were 0.95 and 0.36, 0.96 and 0.50, and 0.78 and 0.56, respectively. The pooled PLR and NLR for TIMI, HEART and GRACE were 1.49 and 0.13, 1.94 and 0.08, and 1.77 and 0.40, respectively. The pooled DOR for TIMI, HEART and GRACE was 9.18, 17.92 and 4.00, respectively. The AUC for TIMI, HEART and GRACE was 0.80, 0.80 and 0.70, respectively. Finally, the results of indirect comparison suggested the superiority of values of TIMI and HEART to those of GRACE for predicting MACEs, while there were no significant differences between TIMI and HEART for predicting MACEs.ConclusionsTIMI and HEART were superior to GRACE for predicting MACE risk in ACP patients admitted to the ED.
Improving uptake of Fracture Prevention drug treatments: a protocol for Development of a consultation intervention (iFraP-D)
Authors: Paskins Zoe , Bullock Laurna , Crawford-Manning Fay , Cottrell Elizabeth , Fleming Jane , Leyland Sarah , Edwards John James , Clark Emma , Thomas Simon , Chapman Stephen Robert , Ryan Sarah , Lefroy J E , Gidlow Christopher J , Iglesias C , Protheroe Joanne , Horne Robert , O'Neill Terence W , Mallen Christian , Jinks Clare 
Published: August 2021

IntroductionPrevention of fragility fractures, a source of significant economic and personal burden, is hindered by poor uptake of fracture prevention medicines. Enhancing communication of scientific evidence and elicitation of patient medication-related beliefs has the potential to increase patient commitment to treatment. The Improving uptake of Fracture Prevention drug treatments (iFraP) programme aims to develop and evaluate a theoretically informed, complex intervention consisting of a computerised web-based decision support tool, training package and information resources, to facilitate informed decision-making about fracture prevention treatment, with a long-term aim of improving informed treatment adherence. This protocol focuses on the iFraP Development (iFraP-D) work.Methods and analysisThe approach to iFraP-D is informed by the Medical Research Council complex intervention development and evaluation framework and the three-step implementation of change model. The context for the study is UK fracture liaison services (FLS), which enact secondary fracture prevention. An evidence synthesis of clinical guidelines and Delphi exercise will be conducted to identify content for the intervention. Focus groups with patients, FLS clinicians and general practitioners and a usual care survey will facilitate understanding of current practice, and investigate barriers and facilitators to change. Design of the iFraP intervention will be informed by decision aid development standards and theories of implementation, behaviour change, acceptability and medicines adherence. The principles of co-design will underpin all elements of the study through a dedicated iFraP community of practice including key stakeholders and patient advisory groups. In-practice testing of the prototype intervention will inform revisions ready for further testing in a subsequent pilot and feasibility randomised trial.Ethics and disseminationEthical approval was obtained from North West—Greater Manchester West Research Ethics Committee (19/NW/0559). Dissemination and knowledge mobilisation will be facilitated through national bodies and networks, publications and presentations.Trial registration numberresearchregistry5041.
Association between fasting blood glucose levels and stroke events: a large-scale community-based cohort study from China
Authors: Zhang Ya , Gu Shujun , Wang Cuicui , Liu Dong , Zhang Qiuyi , Yang Man , Zhou Zhengyuan , Zuo Hui 
Published: August 2021

ObjectivesDiabetes mellitus has been associated with stroke. However, the association between fasting blood glucose (FBG) and stroke risk in a general population remains not clear. The purpose of our study was to examine the FBG levels on subsequent stroke risk in a community-based cohort in China.DesignProspective cohort study, employing Cox proportional hazard model to analyse the association of FBG levels with stroke risk.SettingA community-based cohort study included adults participating in a baseline survey conducted in 2013 in Changshu, eastern China.Participants16 113 participants were recruited with a multistage sampling method, excluding participants with severe disability, severe cancer, severe psychiatric disturbance or previous stroke before enrolment.Primary outcome measuresStroke events.ResultsDuring a median follow-up of 5.5 years, 417 incident cases of stroke were identified. The adjusted HR for total and ischaemic stroke for participants in the fourth quartile of FBG compared with the first quartile was 1.44 (95% CI 1.07 to 1.94) and 1.57 (95% CI 1.11 to 2.21), respectively. FBG levels of ≥7.0 mmol/L were associated with an increased risk of stroke based on two clinical classifications (American Diabetes Association: 1.68 (1.24 to 2.27); WHO: 1.62 (1.21, 2.13)). In stratified analyses, risk associations existed in women (HR: 1.92, 95% CI 1.22 to 3.01) and postmenopausal women (HR: 1.68, 95% CI 1.06 to 2.68) for the fourth quartile versus the first. More importantly, the meta-analysis observed a positive association between FBG levels and stroke risk (pooled HR: 1.70, 95% CI 1.27 to 2.29; n=7)).ConclusionsHigher FBG level was independently associated with an increased risk of stroke in Chinese adults, especially significant in women.
Treatment pathways in people with type 2 diabetes mellitus: a nationwide cohort study of new users of metformin monotherapy in New Zealand
Authors: Guo Joyce , Parkin Lianne , Zeng Jiaxu , Barson David , Horsburgh Simon 
Published: August 2021

ObjectivesThe aims of this study were to describe the following: (1) the time to change of therapy in patients with type 2 diabetes who had initiated metformin monotherapy as first-line treatment and (2) the sequence in which subsequent therapeutic regimens were introduced.DesignCohort study.SettingNational study based on linked data from the New Zealand Ministry of Health’s National Collections of health and pharmaceutical dispensing data.ParticipantsPeople with type 2 diabetes mellitus who initiated metformin monotherapy between 1 January 2006 and 30 September 2014 (n=93 874).Primary outcome measuresCumulative incidence curves were plotted to show the time taken to move from one regimen to another, while sunburst plots were used to illustrate the sequence in which regimens were introduced.ResultsAbout 10% and 35% of cohort members had moved to a second regimen 1 year and 5 years, respectively, after initiating metformin monotherapy; the majority received a regimen recommended by New Zealand treatment guidelines (mostly metformin and a sulphonylurea). Of those who started a recommended second regimen, 37% and 67% had moved to a third regimen after 1 and 5 years, respectively; the corresponding proportions for those who started an ‘other’ (not listed as recommended) second regimen were 53% and 75%. Most of those who received a third regimen after a recommended second regimen were dispensed an ‘other’ third regimen. Of those who moved to a third regimen from an ‘other’ second regimen, similar proportions received recommended and ‘other’ third regimens.ConclusionsReal-world type 2 diabetes treatment patterns in New Zealand are complex and not always consistent with guidelines.
Lay perspectives of the open-label placebo rationale: a qualitative study of participants in an experimental trial
Authors: Locher Cosima , Buergler Sarah , Frey Nascimento Antje , Kost Linda , Blease Charlotte , Gaab Jens 
Published: August 2021

ObjectivesTo analyse participants’ concepts about the open-label placebo (OLP) effect; to explore their views about the discussion points that are applied in conventional OLP trials and to examine their experiences of taking part in an OLP trial.DesignA qualitative study using thematic analysis of semistructured interviews that were nested within a randomised controlled trial investigating experimental OLP analgesia (registered at ClinicalTrials.gov:NCT02578420).Participants30 healthy adults who took part in the randomised controlled trial.ResultsParticipants mostly conceptualised placebo as something that is inert and requires deception in order to be effective. Interviewees used a broad definition of placebos, going beyond a conventional notion of sugar pills. In contrast to the conventional OLP rationale, participants seldom emphasised classical conditioning as a mechanism of placebo effects, stressing a variety of other well-established components through which placebos might be therapeutic, whereas the conventional OLP disclosures state that ‘a positive attitude helps but is not necessary’, participants in our study applied other attitudes, such as ‘it’s worth a try’. When asked about their experiences during the trial, the majority emphasised that the concept of OLP was completely novel to them. Participants were rather sceptical about the efficacy of the intervention.ConclusionIntegrating lay perspectives into the scientific rationale of OLP treatments might enhance the plausibility and credibility of the rationale in ethical treatments.Trial registration numberNCT02578420.
Identifying non-traditional electronic datasets for population-level surveillance and prevention of cardiometabolic diseases: a scoping review protocol
Authors: Rebinsky Reid , Anderson Laura N , Morgenstern Jason D 
Published: August 2021

IntroductionCardiometabolic diseases, including cardiovascular disease, obesity and diabetes, are leading causes of death and disability worldwide. Modern advances in population-level disease surveillance are necessary and may inform novel opportunities for precision public health approaches to disease prevention. Electronic data sources, such as social media and consumer rewards points systems, have expanded dramatically in recent decades. These non-traditional datasets may enhance traditional clinical and public health datasets and inform cardiometabolic disease surveillance and population health interventions. However, the scope of non-traditional electronic datasets and their use for cardiometabolic disease surveillance and population health interventions has not been previously reviewed. The primary objective of this review is to describe the scope of non-traditional electronic datasets, and how they are being used for cardiometabolic disease surveillance and to inform interventions. The secondary objective is to describe the methods, such as machine learning and natural language processing, that have been applied to leverage these datasets.Methods and analysisWe will conduct a scoping review following recommended methodology. Search terms will be based on the three central concepts of non-traditional electronic datasets, cardiometabolic diseases and population health. We will search EMBASE, MEDLINE, CINAHL, Scopus, Web of Science and Cochrane Library peer-reviewed databases and will also conduct a grey literature search. Articles published from 2000 to present will be independently screened by two reviewers for inclusion at abstract and full-text stages, and conflicts will be resolved by a separate reviewer. We will report this data as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationNo ethics approval is required for this protocol and scoping review, as data will be used only from published studies with appropriate ethics approval. Results will be disseminated in a peer-reviewed publication.