bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emulation‐based inference for spatial infectious disease transmission models incorporating event time uncertainty
Authors: Pokharel Gyanendra , Deardon Rob 
Published: March 2021

AbstractMechanistic models of infectious disease spread are key to inferring spatiotemporal infectious disease transmission dynamics. Ideally, covariate data and the infection status of individuals over time would be used to parameterize such models. However, in reality, complete data are rarely available; for example, infection times are almost never observed. Bayesian data‐augmented Markov chain Monte Carlo (MCMC) methods are commonly used to allow us to infer such missing or censored data. However, for large disease systems, these methods can be highly computationally expensive. In this paper, we propose two methods of approximate inference for such situations based on so‐called emulation techniques. Here, both methods are set in a Bayesian MCMC framework but replace the computationally expensive likelihood function by a Gaussian process‐based likelihood approximation. In the first method, we build an emulator of the discrepancy between summary statistics of simulated and observed epidemic data. In the second method, we develop an emulator of an importance sampling‐based likelihood approximation. We show how both methods offer substantial computational efficiency gains over standard Bayesian MCMC‐based method, and can be used to infer the transmission of complex infectious disease systems. We also show that importance sampling‐based methods tend to perform more satisfactorily.
Central‐local tensions in the decentralization of social policies: Street‐level bureaucrats and social practices in the Netherlands
Authors: Jansen Erik , Javornik Jana , Brummel Annica , Yerkes Mara A. 
Published: March 2021

AbstractEuropean welfare reforms often involve the decentralization of social care services. This potentially creates central‐local tensions for professionals implementing and delivering policies on the ground. Using the capability approach (CA) as a conceptual frame, this article compares local professionals' experiences in the decentralization of social work and care services in an urban and a rural mid‐sized municipality in the Netherlands. It offers a missing insiders' perspective on central‐local tensions, focusing on front‐line workers' capabilities to effectively implement policy on the ground. It finds that perfect policy implementation is hardly achievable locally and that policies are translated through implementation and on‐the‐ground delivery. This leads to central‐local tensions and the absence of reflective space for professionals to deal with normative dilemmas. We conclude that the CA is both useful for identifying these tensions as well as providing a normative framework to guide professionals in reflecting on and negotiating street‐level issues.
Conservation of Rh negative Low Titer O Whole Blood (LTOWB) and the need for a national conversation to define its use in trauma transfusion protocols
Authors: Troughton Marla , Young Pampee P. 
Published: March 2021

AbstractLow‐titer group O whole blood (LTOWB) use is growing steadily in the United States. Although the percentage of O negative LTOWB use by Red Cross hospitals has remained steady at ~23% over the last 2 years, this elevated use rate is twice that of O negative RBC components. Given the more restricted group O donor pool, this level of use will make it difficult to expand the use of this product. Evaluation of hospital practices regarding females of childbearing potential show significant variability with some hospitals transfusing O positive, with others choosing to restrict this population to O negative LTOWB or only O negative RBC component therapy. To ensure access of LTOWB to all patients who may benefit and to maintain sufficient supplies, we recommend developing standardized practice recommendations for its use.
Bayesian spatial modelling of Ebola outbreaks in Democratic Republic of Congo through the INLA‐SPDE approach
Authors: Adegboye Oyelola , Gayawan Ezra , James Adewale , Adegboye Adedayo , Elfaki Faiz 
Published: March 2021

AbstractEbola virus (EBV) disease is a globally acknowledged public health emergency, endemic in the west and equatorial Africa. To understand the epidemiology especially the dynamic pattern of EBV disease, we analyse the EBV case notification data for confirmed cases and reported deaths of the ongoing outbreak in the Democratic Republic of Congo (DRC) between 2018 and 2019, and examined the impact of reported violence on the spread of the virus. Using fully Bayesian geo‐statistical analysis through stochastic partial differential equations (SPDE) allows us to quantify the spatial patterns at every point of the spatial domain. Parameter estimation was based on the integrated nested Laplace approximation (INLA). Our findings revealed a positive association between violent events in the affected areas and the reported EBV cases (posterior mean = 0.024, 95% CI: 0.005, 0.045) and deaths (posterior mean = 0.022, 95% CI: 0.005, 0.041). Translating to an increase of 2.4% and 2.2% in the relative risks of EBV cases and deaths associated with a unit increase in violent events (one additional Ebola case is associated with an average of 45 violent events). We also observed clusters of EBV cases and deaths spread to neighbouring locations in similar manners. Findings from the study are therefore useful for hot spot identification, location‐specific disease surveillance and intervention.
Cumulative risk of compromised physical, mental and social health in adulthood due to family conflict and financial strain during childhood: a retrospective analysis based on survey data representative of 19 European countries
Authors: Santini Ziggi Ivan , Koyanagi Ai , Stewart-Brown Sarah , Perry Bruce D , Marmot Michael , Koushede Vibeke 
Published: March 2021

BackgroundChildhood adversity (CA) has previously been linked to various health problems in adulthood. Investigations into the differential impact of distinct types of CA on a wide range of outcomes are scarce. This study aimed to assess the impact of self-reported childhood family conflict and/or financial strain on health and social functioning in adulthood among Europeans, while taking into account the mediating role of adulthood socioeconomic disadvantage (SED) in these associations.MethodsUsing the European Social Survey (ESS) collected in 2014, nationally representative cross-sectional data from 35 475 participants aged 15 years and older in 19 European countries were analysed. Logistic regressions were conducted to assess associations of retrospectively reported family conflict and/or financial strain in childhood with physical and mental health as well as health behaviours and social functioning in adulthood.ResultsA quarter of the European population reported having experienced family conflict, financial strain or both in childhood. Financial strain was reported more among older age groups and conflict more among younger age groups. A dose-response pattern with increased risk was demonstrated for almost all physical, behavioral, mental and social outcomes for these aspects of CA compared with no CA, with the highest risk observed in those who experienced both financial strain and family conflict. Adulthood SED mediated a significant proportion of the associations with financial strain (ranging from 5.4% to 72.4%), but did not mediate the associations with conflict.ConclusionIndividuals reporting family conflict or financial strain during childhood are at increased risk of developing a wide range of health and social problems. Those who report financial strain in childhood are more likely to experience SED in adulthood, which in turn increases their risk of experiencing health and social problems. Reported family conflict during childhood conferred increased risk of health and social problems, but adulthood SED did not appear to operate as an indirect pathway.
Cost-effectiveness analysis of an intimate partner violence prevention intervention targeting men, women and couples in rural Ethiopia: evidence from the Unite for a Better Life randomised controlled trial
Authors: Leight Jessica , Deyessa Negussie , Sharma Vandana 
Published: March 2021

ObjectivesExperience of intimate partner violence (IPV) is associated with adverse health and psychosocial outcomes for women. However, rigorous economic evaluations of interventions targeting IPV prevention are rare. This paper analyses the cost-effectiveness of Unite for a Better Life (UBL), a gender-transformative intervention designed to prevent IPV and HIV risk behaviours among men, women and couples.DesignWe use an economic evaluation nested within a large-scale cluster randomised controlled trial, analysing financial and economic costs tracked contemporaneously.SettingUBL was implemented in rural southern Ethiopia between 2013 and 2015.ParticipantsThe randomised controlled trial included 6770 households in 64 villages.InterventionsUBL is an intervention delivered within the context of the Ethiopian coffee ceremony, a culturally established forum for community discussion, and designed to assist participants to build skills for healthy, non-violent, equitable relationships.Primary and secondary outcome measuresThis paper reports on the unit cost and cost-effectiveness of the interventions implemented. Cost-effectiveness is measured as the cost per case of past-year physical and/or sexual IPV averted.ResultsThe estimated annualised cost of developing and implementing UBL was 2015 US$296 772, or approximately 2015 US$74 per individual directly participating in the intervention and 2015 US$5 per person annually for each community-level beneficiary (woman of reproductive age in intervention communities). The estimated cost per case of past-year physical and/or sexual IPV averted was 2015 US$2726 for the sample of direct beneficiaries, and 2015 US$194 for the sample of all community-level beneficiaries.ConclusionsUBL is an effective and cost-effective intervention for the prevention of IPV in a low and middle-income country setting. Further research should explore strategies to quantify the positive effects of the intervention across other domains.Trial registration numberNCT02311699 (ClinicalTrials.gov); AEARCTR-0000211 (AEA Registry)
Comparative efficacy and acceptability of different antihypertensive drug classes for cardiovascular disease prevention: protocol for a systematic review and network meta-analysis
Authors: Jussil Heidi , Chaimani Anna , Carlberg Bo , Brunström Mattias 
Published: March 2021

IntroductionClinical practice guidelines differ in their recommendations on first-line antihypertensive drug classes. No adequately powered randomised controlled trial have assessed all major drug classes against each other, and previous meta-analyses have mainly relied on pairwise meta-analyses for treatment comparisons.Methods and analysisA systematic review and network meta-analysis will be carried out to assess the efficacy and acceptability of all major antihypertensive drug classes. PubMed and CENTRAL were searched on 21 February 2020 to identify randomised controlled trials with at least 1000 person-years of follow-up, assessing any antihypertensive agent against other agents or placebo. All trials fulfilling the inclusion criteria will be assessed for risk of bias using the second version of Cochrane’s risk of bias assessment tool. The study selection process, risk of bias assessment and data extraction are done by two authors in duplicate. Relative risks from individual trials will be combined in pairwise meta-analyses; in the absence of important intransitivity, random-effects network meta-analysis will be performed. The primary outcome for efficacy will be major adverse cardiovascular events, whereas the primary acceptability outcome will be treatment discontinuation for any reason. Additional outcomes include all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, heart failure and acute renal failure. The impact of differences within drug classes will be explored through alternative networks, including analysing thiazide-like and thiazide-type diuretics separately.Ethics and disseminationThis review will only process aggregated study level data and does not require ethical approval. The findings will be published in a peer-reviewed medical journal.PROSPERO registration numberCRD42020205482.
Improving peripherally inserted central catheter appropriateness and reducing device-related complications: a quasiexperimental study in 52 Michigan hospitals
Authors: Chopra Vineet , O'Malley Megan , Horowitz Jennifer , Zhang Qisu , McLaughlin Elizabeth , Saint Sanjay , Bernstein Steven J , Flanders Scott 
Published: March 2021

BackgroundThe Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) provides evidence-based criteria for peripherally inserted central catheter (PICC) use. Whether implementing MAGIC improves PICC appropriateness and reduces complications is unknown.MethodsA quasiexperimental study design to implement MAGIC in 52 Michigan hospitals was used. Data were collected from medical records by trained abstractors. Hospital performance on three appropriateness criteria was measured: short-term PICC use (≤5 days), use of multilumen PICCs and PICC placement in patients with chronic kidney disease. PICC appropriateness and device complications preintervention (January 2013 to December 2016) versus postintervention (January 2017 to January 2020) were compared. Change-point analysis was used to evaluate the effect of the intervention on device appropriateness. Logistic regression and Poisson models were fit to assess the association between appropriateness and complications (composite of catheter occlusion, venous thromboembolism (VTE) and central line-associated bloodstream infection (CLABSI)).ResultsAmong 38 592 PICCs, median catheter dwell ranged from 8 to 56 days. During the preintervention period, the mean frequency of appropriate PICC use was 31.9% and the mean frequency of complications was 14.7%. Following the intervention, PICC appropriateness increased to 49.0% (absolute difference 17.1%, p<0.001) while complications decreased to 10.7% (absolute difference 4.0%, p=0.001). Compared with patients with inappropriate PICC placement, appropriate PICC use was associated with a significantly lower odds of complications (OR 0.29, 95% CI 0.25 to 0.34), including decreases in occlusion (OR 0.25, 95% CI 0.21 to 0.29), CLABSI (OR 0.61, 95% CI 0.46 to 0.81) and VTE (OR 0.40, 95% CI 0.33 to 0.47, all p<0.01). Patients with appropriate PICC placement had lower rate of complications than those with inappropriate PICC use (incidence rate ratio 0.987, 95% CI 0.98 to 0.99, p<0.001).ConclusionsImplementation of MAGIC in Michigan hospitals was associated with improved PICC appropriateness and fewer complications. These findings have important quality, safety and policy implications for hospitals, patients and payors.
Effects of the combination of second-generation antipsychotics on serum concentrations of aripiprazole and dehydroaripiprazole in Chinese patients with schizophrenia
Authors: Jiang Ping , Sun Xiujia , Ren Juanjuan , Liu Hongmei , Lin Zhiguang , Liu Junwen , Fang Xinyu , Zhang Chen 
Published: March 2021

BackgroundAripiprazole (ARI) is often prescribed alone or in combination with other second-generation antipsychotics (SGAs) to treat patients with schizophrenia. However, this may increase the potential clinical significance of drug–drug interactions. Therapeutic drug monitoring (TDM) is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics, adjust the dosage and thereby achieve more effective and safer treatment.AimsThis study retrospectively investigated the effects of four SGA comedications (clozapine, risperidone, quetiapine (QTP) and olanzapine) and other potential factors (sex, age and ARI dose) on the serum concentrations of ARI and dehydroaripiprazole (DARI) in Chinese patients with schizophrenia using TDM data.MethodsHigh-performance liquid chromatography was used to test the serum concentrations of ARI, DARI and ARI+DARI. In addition, steady-state dose-adjusted serum concentrations (ie, concentration-to-dose ratios, C:D ratios) of ARI, DARI and ARI+DARI; sex; age; ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed. Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations, respectively.ResultsThere were significant differences in the C:D ratios of ARI (χ2=−3.21, p=0.001) and ARI+DARI (χ2=−2.50, p=0.01) between the ARI and SGA groups, as well as in the C:D ratios of ARI (χ2=−3.59, p<0.001) and ARI+DARI (χ2=−3.10, p=0.002) between the female patients in the two groups. Of the four SGAs, only QTP had significant effects on the C:D ratios of ARI (Z=−4.12, p<0.001) and ARI+DARI (Z=−3.62, p<0.001) when compared with the ARI group in the whole sample and on the C:D ratios of ARI, DARI and ARI+DARI (Z=−3.96, p<0.001; Z=−2.22, p=0.03; Z=−3.75, p<0.001, respectively) in women when compared with their counterparts in the ARI group.ConclusionComedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy, and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy. Despite this statistical significance of our findings, whether the presently observed effect has clinical significance requires exploration by further research. TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication (especially QTP) to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.
Challenging of frozen diagnoses of small sclerosing pneumocytoma
Authors: Shang Zhanxian , Han Yuchen , Shao Jinchen , Zhu Lei , Teng Haohua , Zhang Jie 
Published: March 2021

AimsAn increasing number of small pulmonary nodules are being screened by CT, and an intraoperative diagnosis is necessary for preventing excessive treatment. However, there is limited literature on the frozen diagnosis of small sclerosing pneumocytomas (SPs). In particular, tumours smaller than 1 cm are challenging for pathologists performing intraoperative frozen diagnosis.MethodsIn total, 230 cases of SP were surgically resected between January 2015 and March 2019 at Shanghai Chest Hospital, and of them, 76 cases were smaller than 1 cm. The histology and clinical information of these 76 cases (33.0%, 76/230) were reviewed retrospectively, 54 cases of which were diagnosed intraoperatively, and the pitfalls were summarised. All diagnoses were confirmed on permanent sections and immunohistochemical sections.ResultsHistologically, 78.9% (60/76) of the small SP was dominated by one growth pattern, and solid and papillary growth pattern were the most commonly misdiagnosed circumstances. The rate of intraoperative misdiagnosis of these SP smaller than 1 cm was 11.1% (6/54).ConclusionsThe main reason for misdiagnosis was failure to recognise the dual cell populations and the cellular atypia. Diagnostic clues include the gross morphology, the presence of dual-cell populations and a hypercellular papillary core, foam cell accumulation in glandular spaces and haemorrhage and haemosiderin on the periphery. In spite of awareness of pitfalls some cases may still be essentially impossible to diagnose on frozen section.
Educational disparities in ischaemic heart disease among 0.5 million Chinese adults: a cohort study
Authors: Chen Lu , Tan Yunlong , Yu Canqing , Guo Yu , Pei Pei , Yang Ling , Chen Yiping , Du Huaidong , Wang Xiaohuan , Chen Junshi , Chen Zhengming , Lv Jun , Li Liming 
Published: March 2021

BackgroundThe relationship between educational attainment and ischaemic heart disease (IHD) is limited in evidence in middle-income countries like China. Exploring lifestyle-related mediators, which might be not universal between socioeconomic status and health outcomes in diverse regions, can contribute to interventions targeted at the Chinese to narrow the educational gap in IHD.MethodsBased on the China Kadoorie Biobank of 489 594 participants aged 30–79 years who did not have heart disease or stroke at baseline, this study examined the association of educational attainment with IHD. Total IHD cases were further divided into acute myocardial infarction (AMI) cases and non-AMI cases. The Cox proportional hazard model was performed to estimate the HRs and 95% CIs for mortality and incidence of IHD. Logistic regression was used to estimate the ORs and 95% CIs for case fatality.ResultsDuring the median follow-up period of 11.1 years, this study documented 45 946 (6668) incident IHD (AMI) cases and 5948 (3689) deaths altogether. Lower educational attainment was associated with increased risk of incident AMI as well as death and fatality of total IHD including its subtypes (ptrend<0.001). Although the risk of incident non-AMI was greater for participants with higher levels of education in the whole population (ptrend<0.001), an inverse association of education with its incidence was found in participants from <50 years age group and rural areas. Smoking and dietary habits were the two most potent mediating factors in the associations of education with mortality and AMI incidence; whereas, physical activity was the major mediating factor for non-AMI incidence in the whole population.DiscussionInterventions targeting unhealthy lifestyles are ideal ways to narrow the educational gap in IHD while solving ‘upstream’ causes of health behaviours might be the most fundamental ones.
Analysis of driving simulator performance for post-call orthopaedic surgery residents
Authors: Grandizio Louis C , Barreto Rocha Daniela F , Holbert J Alexander , Pavis Elizabeth J , Hopkins David , Volarich Kathryn , Klena Joel C 
Published: March 2021

AbstractPurposeDespite the associations between workhours, fatigue and motor vehicle accidents, driving abilities for residents post-call have been infrequently analysed. Our purpose was to compare orthopaedic surgery resident performance on a driving simulator after a night of call compared with their baseline.Study designAll residents from a single orthopaedic programme were asked to complete baseline and post-call driving simulator assessments and surveys. The primary outcome measure was brake reaction time (BRT) and secondary outcome measures included lane variance, speed variance and accidents on the driving simulator.ResultsAll 19 orthopaedic residents agreed to participate. Compared with the baseline assessment, residents demonstrated significantly higher levels of sleepiness on the Stanford Sleepiness Scale post-call (1.6 vs 3.4; p&lt;0.0001). Despite higher levels of fatigue post-call, there was no statistically significant differences between baseline and post-call assessments for mean BRT, accidents, lane variation and speed variation.ConclusionsThese data suggest that for orthopaedic residents, driving simulator performance does not appear to be worse after a single night of call compared with baseline. Future collaborative, multicentre investigations on post-call driving safety that incorporate different call types and frequencies are necessary to better define the impact of post-call fatigue on driving performance. Recognising that motor vehicle accidents remain the leading cause of death for people under the age of 30 years, these continued areas of study are necessary to truly establish a culture of resident safety.