bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between normal triglyceride and insulin resistance in US adults without other risk factors: a cross-sectional study from the US National Health and Nutrition Examination Survey, 2007–2014
Authors: Bi Chunli , Wang Lijuan , Sun Chong , Sun Mengzi , Zheng Pingping , Xue Zhiqiang , Shen Li , Pan Pan , Li Jiagen , Lv Yaogai , Zhang Anning , Li Bo , Zhang Xinyao , Yao Yan , Jin Lina 
Published: August 2019

ObjectiveTraditionally, the absence of insulin resistance risk factors (IRRFs) was considered a low risk for insulin resistance (IR). However, IR also existed in certain individuals without IRRFs; thus this study aims to explore predictors of IR targeted at the population without IRRFs.DesignCross-sectional survey.SettingNational Health and Nutrition Examination Survey.ParticipantsParticipants without regular IRRFs (IRRF-Free, n=2478) and a subgroup without optimal IRRFs (IRRF-Optimal, n=1414) were involved in this study.Primary and secondary outcome measureIRRFs and the optimal cut-off value of triglyceride (TG) to predict IR.ResultsOverall, the prevalence of IR was 6.9% and 5.7% in the IRRF-Free group and the IRRF-Optimal group, respectively. TG and waist circumference were independently associated with the prevalence of IR in both the groups (OR=1.010 to 10.20; p<0.05 for all), where TG was positively associated with IR. The area under the receiver operating characteristic curve of TG was 0.7016 (95% CI: 0.7013 to 0.7018) and 0.7219 (95% CI: 0.7215 to 0.7222), and the optimal cut-off value of TG to predict IR was 79.5 mg/dL and 81.5 mg/dL in the IRRF-Free group and the IRRF-Optimal group, respectively.ConclusionThere is an association between TG and IR even in the normal range of TG concentration. Therefore, normal TG could be used as an important indicator to predict the prevalence of IR in the absence of IRRFs.
What causes prescribing errors in children? Scoping review
Authors: Conn Richard L , Kearney Orla , Tully Mary P , Shields Michael D , Dornan Tim 
Published: August 2019

Objectives(1) Systematically assemble, analyse and synthesise published evidence on causes of prescribing error in children. (2) Present results to a multidisciplinary group of paediatric prescribing stakeholders to validate findings and establish how causative factors lead to errors in practice.DesignScoping review using Arksey and O’Malley’s framework, including stakeholder consultation; qualitative evidence synthesis.MethodsWe followed the six scoping review stages. (1) Research question—the research question was ‘What is known about causes of prescribing error in children?’ (2) Search strategy—we searched MEDLINE, EMBASE, CINAHL (from inception to February 2018), grey literature and reference lists of included studies. (3) Article selection—all published evidence contributing information on the causes of prescribing error in children was eligible for inclusion. We included review articles as secondary evidence to broaden understanding. (4) Charting data—results were collated in a custom data charting form. (5) Reporting results—we summarised article characteristics, extracted causal evidence and thematically synthesised findings. (6) Stakeholder consultation—results were presented to a multidisciplinary focus group of six prescribing stakeholders to establish validity, relevance and mechanisms by which causes lead to errors in practice.Results68 articles were included. We identified six main causes of prescribing errors:children’s fundamental differencesled toindividualised dosing and calculations; off-licence prescribing; medication formulations; communication with children; andexperience working with children. Primary evidence clarifying causes was lacking.ConclusionsSpecific factors complicate prescribing for children and increase risk of errors. Primary research is needed to confirm and elaborate these causes of error. In the meantime, this review uses existing evidence to make provisional paediatric-specific recommendations for policy, practice and education.
Support to informal caregivers of patients with severe chronic obstructive pulmonary disease: a qualitative study of caregivers’ and professionals’ experiences in Swedish hospitals
Authors: Strang Susann , Fährn Josefin , Strang Peter , Ronstad Agneta , Danielsson Louise 
Published: August 2019

ObjectivesInformal caregivers of patients with chronic obstructive pulmonary disease (COPD) experience a heavy caregiver burden, but few studies have explored what support they need. The aim of this study was to describe perceptions of healthcare support to informal caregivers, both from the family caregiver’s and the staff’s perspective.DesignA qualitative interview study involving semi-structured interviews and analysed with content analysis.ParticipantsIn total, 54 participated: 36 informal caregivers of patients with severe (stage 3–4) COPD and 17 healthcare staff.ResultsTwo main themes emerged from the analysis: (1) Ambiguity impedes provision of support. Both caregivers and staff experienced ambiguity. The informal caregivers needed emotional, practical and informational support but talked about unclear expectations, while the staff described an uncertainty about their duties regarding the families. There were no routines to unburden the families. Moreover, language and cultural barriers hampered their efforts. (2) Knowledgeable and perceptive communication is key to support. Both caregivers and staff described positive experiences of dialogue. The dialogue may facilitate means to caregiver support and was a support in itself.ConclusionsOur findings suggest that strategies and routines for caregiver support, including communication skills among the staff, should be developed, to move toward the family perspective advocated in palliative- and nursing family care.
Understanding pathways to stimulant use: a mixed-methods examination of the individual, social and cultural factors shaping illicit stimulant use across Europe (ATTUNE): study protocol
Authors: Rosenkranz Moritz , O'Donnell Amy , Verthein Uwe , Zurhold Heike , Addison Michelle , Liebregts Nienke , Rowicka Magdalena , Barták Miroslav , Petruželka Benjamin , Kaner Eileen FS , Martens Marcus-Sebastian 
Published: August 2019

IntroductionAmphetamine-type stimulants (ATS) including amphetamine, methylenedioxymethamphetamine/‘ecstasy’, methamphetamine, synthetic cathinones and ‘Ritalin’ are the second most commonly used illicit drugs globally. Yet, there is little evidence on which factors are associated with the development of different patterns of ATS use over the life course. This study aims to examine which individual, social and environmental factors shape different pathways and trajectories of ATS consumption. The study will be conducted in five European countries: Germany, the Netherlands, Poland, Czech Republic and the UK.Methods and analysisWe will use a sequential mixed-methods study design to investigate the multiple factors (familial, social and occupational situation, critical life events, general risk behaviour, mental and physical health, satisfaction with life) that shape individual ATS use pathways. A systematic literature review will be performed to provide an overview of the current academic literature on the topic. In module 1, qualitative semistructured interviews (n=ATS users and non-users) will be conducted to explore individual experiences of, and perspectives on, dynamics of change in stimulant consumption patterns. In module 2, structured questionnaires (n=2000 ATS users and non-users) will be administered via tablet computers to validate and enhance the generalisability of the interview findings. Data integration will take place at two key points. First, during the study, where the findings from the first qualitative interviews will inform the design of the structured questionnaire. Second, at the end of the study, where mixed methods data will be brought together to generate an in-depth, contextualised understanding of the research topic.Ethics and disseminationThe study has been approved by the respective responsible ethics committee in each participating country. Data will be treated confidentially to ensure participants’ anonymity. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings for policy and practice.
Web-based and mHealth interventions for intimate partner violence prevention: a systematic review protocol
Authors: Anderson Elizabeth J , McClelland Jean , Meyer Krause Caitlin , Krause Keegan C , Garcia David O , Koss Mary P 
Published: August 2019

IntroductionVictims of intimate partner violence (IPV), or those individuals susceptible to IPV victimisation or perpetration, may benefit from participation in primary, secondary or tertiary interventions to address or mitigate exposure to violence despite mixed evidence of IPV intervention effectiveness. However, participation in such programmes is limited by poor access, sociocultural barriers and programme cost. As the world fast approaches universal access to the internet, web-based technologies and low-cost smartphones, new avenues to provide preventive health services including mobile health (mHealth) tools, platforms and services have emerged. The objective of this systematic review is to assess current web-based and mHealth interventions, which include web-based or mobile-based delivery methods for IPV prevention. Interpersonal violence is defined as perpetration or victimisation of a physical, psychological or sexual nature among adults. Interventions may be at the primary, secondary or tertiary level of the public health model.Methods and analysisThis systematic review will incorporate studies focused on any empirical prevention intervention intended for IPV victims or perpetrators of any gender where one or more components is web based or mobile based. Articles will be retrieved from the following academic databases: MEDLINE/PubMed, Embase, CINAHL, PsycInfo and Open Grey, as well Google Scholar. Results will be limited to articles reporting primary data, published since 1998, and in English, Spanish, Portuguese or French. Data extraction procedures will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. The Mixed Methods Appraisal Tool, a critical appraisal tool, will be used to record ratings of quality and risk of bias among studies selected for inclusion. Content analysis and between-study comparisons will be used to answer the objectives of this review.Ethics and disseminationResults from this review will be published in an open access format for the benefit of both academic and non-academic audiences, including community organisations and individuals seeking mHealth strategies to reduce and prevent IPV.Trial registration numberCRD42019123006.
Effectiveness of omega-3 fatty acid administration on completion rate of adjuvant chemotherapy for biliary tract cancer: study protocol for a single-centre, open-label, single-arm, historically controlled study
Authors: Ueno Kimihiko , Ajiki Tetsuo , Tsugawa Daisuke , Akita Masayuki , Hashimoto Yu , Awazu Masahide , Mukubo Hideyo , Komatsu Shohei , Kuramitsu Kaori , Terai Sachio , Tanaka Motofumi , Toyama Hirichika , Kido Masahiro , Fukumoto Takumi 
Published: August 2019

IntroductionMultimodal treatment prolongs the survival of patients with biliary tract cancer (BTC). However, the chemotherapy choices for this disease are few, and completing each chemotherapy session is important. Adjuvant chemotherapy has been attempted for BTC, but has only had a 75% completion rate. Body weight loss and cholangitis are reasons for the interruption of chemotherapy. Previous reports suggested that nutritional intervention with omega-3 fatty acids maintained body weight and improved the completion rate for chemotherapy. Moreover, omega-3 fatty acids have an anti-inflammatory effect. Therefore, we theorised that omega-3 fatty acids would improve the completion rate of adjuvant chemotherapy in patients with BTC. The aim of this study is thus to evaluate the effectiveness of omega-3 fatty acids for patients planning adjuvant chemotherapy for BTC.Method and analysisThis study is a single-centre, open-label, single-arm, historically controlled study with a planned enrolment of 55 participants. Protocol treatment consists of four courses of S-1 adjuvant chemotherapy and an oral omega-3 fatty acid pharmaceutic adjuvant (LOTRIGA 2 g (Takeda Pharmaceutical Co.)), which includes 2 g of omega-3 fatty acids from day 1 until day 168 of the treatment period. The primary endpoint is the completion rate of four total courses of S-1. Secondary endpoints are postoperative cholangitis, time to recurrence or distant metastasis, changes in nutritional index, changes in the lymphocyte blast transformation test induced by phytohaemagglutinin, and concanavalin A and diamine oxidase serum activity during adjuvant chemotherapy. All adverse events will be evaluated.Ethics and disseminationThis protocol was approved by the Institutional Review Board of Kobe University Hospital. The findings from this study will be presented at national and international conferences and published in peer-reviewed journals.Trial registration numberUMIN000031247.
Links between arterial stiffness and bone mineral density in middle-aged and elderly Chinese individuals: a cross-sectional study
Authors: Zhang Meng , Bai Lijuan , Kang Jing , Ge Jing , Peng Wen 
Published: August 2019

ObjectivesTo explore whether bone mineral density (BMD) is associated with arterial stiffness in middle-aged and elderly people with an advanced arterial stiffness index as indicated by the cardio-ankle vascular index (CAVI).DesignA cross-sectional study.SettingThis study was conducted from September 2015 to May 2017 at the geriatrics department of a provincial medical centre in China.ParticipantsA total of 580 patients aged 50 and over were enrolled in the study. The mean age of the group was 64.82±11.4 years, and 63.1% were male.Primary outcome measuresAssociations of age with CAVI values and BMD. Associations between BMD and CAVI values.ResultsWith increasing age, CAVI values gradually increased (p<0.001) and the femoral neck (FN) and total hip (TH) BMD gradually decreased (p<0.001, all). In the bivariate correlation analyses between the covariates and CAVI values, age and CAVI values showed the greatest positive correlation (r=0.631, p<0.001), and CAVI values were negatively correlated with FN BMD (r=−0.229, p<0.001) and TH BMD (r=−0.218, p<0.001). In the linear regression analyses, TH BMD (B=−1.812 (95% CI −2.475 to −1.149), p<0.001) and FN BMD (B=−1.968 (95% CI −2.651 to −1.284), p<0.001) were negatively correlated with CAVI values. After adjusting for age, gender, body mass index, smoking, history of cardiovascular or cerebrovascular disease, history of diabetes mellitus, systolic blood pressure, high-density lipoprotein cholesterol, blood uric acid, fibrinogen and estimated glomerular filtration rate, only TH BMD was still negatively correlated with CAVI values (B=−0.843 (95%CI −1.454 to −0.232), p=0.007). However, there was no consistent and significant correlation between lumbar spine BMD and CAVI values.ConclusionIn this cross-sectional study, a significant correlation between TH BMD and CAVI values was observed in middle-aged and elderly Chinese inpatients. However, our cohort was a small sample of inpatients, and prospective studies from more centres are expected.
Spatial distribution and correlates of smoking in Zambia
Authors: Nyirenda Herbert Tato , Mulenga David , Silitongo Moono , Nyirenda Herbert BC , Nyirenda Tambulani 
Published: August 2019

ObjectiveThe objective of the paper was to investigate the spatial distribution and correlates of tobacco smoking in various regions of Zambia.MethodsThis paper adopts a cross-sectional study design. The study used data from the 2013/2014 Zambia Demographic Health Survey which is a nationwide health survey conducted in all the 10 provinces. A random sample of men and women from 15 920 households was successfully selected and interviewed. All women aged 15–49 and men aged 15–59 who were either permanent residents of the households or visitors present in the households on the night before the survey were eligible to be interviewed.ResultsThe results show that 8.2% and 11% of Zambians in urban and rural areas smoke, respectively. In urban areas, the risk of being a cigarette smoker was 2.31 (CI: 1.69 to 3.16) and 2.03 (CI: 1.36 to 3.02) times higher for the divorced and separated. However, the risk of being a cigarette smoker was lower for those with some formal education. In rural areas, the risk of being a cigarette smoker was lower for the married (relative risk ratios (RRR): 0.69, CI: 0.55 to 0.86) and those with a formal education. Nevertheless, in rural areas, the risk of being a pipe and other smoker was higher for those who were self-employed (RRR: 8.46, CI: 2.95 to 24.20) and with an occupation (RRR: 2.37, CI: 1.39 to 4.02) but was lower among women.ConclusionTobacco smoking varies between and within regions as well as provinces. Therefore, interventions to curbsmoking should target specific demographic, socioeconomic and cultural factors and how they are spatially distributed.
Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016
Authors: Das Gupta Rajat , Bin Zaman Sojib , Wagle Kusum , Crispen Reese , Hashan Mohammad Rashidul , Al Kibria Gulam Muhammed 
Published: August 2019

ObjectivesThis study investigated the determinants of hypertension in Nepal according to both the Joint National Committee 7 (JNC7) and the American College of Cardiology/American Heart Association (2017 ACC/AHA) guidelines.DesignCross-sectional study.SettingThis study used data collected from the 2016 Nepal Demographic and Health Survey data.Participants13 393 weighted adults aged ≥18 years enrolled by a stratified cluster sampling strategy were included in our analysis.Primary and secondary outcome measuresThe primary outcome was hypertension, which was defined according to JNC7 (systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg) and 2017 ACC/AHA guidelines (SBP ≥130 mm Hg and/or DBP ≥80 mm Hg). Antihypertensive medication users were also classified as hypertensive. After descriptive analysis, multilevel logistic regression was applied to obtain ORs.ResultsAbout 21% (n=2827) and 44% (n=5918) of the individuals aged ≥18 years were classified as hypertensive according to the JNC7 and 2017 ACC/AHA guidelines, respectively. Following factors were found to be significantly associated with hypertension according to the 2017 ACC/AHA guideline: ≥70 years (adjusted OR (AOR) 5.2; 95% CI 4.3 to 6.2), 50–69 years (AOR 3.9; 95% CI 3.4 to 4.4) and 30–49 years (AOR 2.7; 95% CI 2.4 to 3.0) age groups, male gender (AOR 1.7; 95% CI 1.6 to 1.9), being overweight/obese (AOR 3.0; 95% CI 2.7 to 3.3), residence in provinces 4 (AOR 1.5; 95% CI 1.2 to 2.0) and 5 (AOR 1.5; 95% CI 1.2 to 1.9). No significant association was identified with household wealth status and ecological regions of residence using the 2017 ACC/AHA guideline.ConclusionsPer both guidelines, multiple factors were associated with hypertension. Public health programme aiming to prevent and control hypertension in Nepal should prioritise these factors and focus on individuals with a higher likelihood of hypertension irrespective of educational level, household wealth status and ecological regions of residence.
Comparison of amblyopia in schoolchildren in Ireland and Northern Ireland: a population-based observational cross-sectional analysis of a treatable childhood visual deficit
Authors: Harrington Siofra , Breslin Karen , O'Dwyer Veronica , Saunders Kathryn 
Published: August 2019

ObjectivesThis study reports the prevalence of persistent amblyopia (post-traditional treatment age) in schoolchildren in the Republic of Ireland (henceforth Ireland) and Northern Ireland (NI), UK; populations with broadly similar refractive and genetic profiles but different eye-care systems.DesignThis is a population-based observational study of amblyopia and refractive error.SettingRecruitment and testing in primary and post-primary schools in Ireland and NI.ParticipantsTwo groups identified through random cluster sampling to represent the underlying population; Ireland 898 participants (12–13 years old) and NI 723 participants (295 aged 9–10 years old, 428 aged 15–16 years old).Main outcome measuresMonocular logMAR visual acuity (presenting and pinhole), refractive error (cycloplegic autorefraction), ocular alignment (cover test) and history of previous eye care. These metrics were used to determine prevalence and type of amblyopia and treatment histories.ResultsChildren examined in NI between 2009 and 2011 had a significantly lower amblyopia prevalence than children examined in Ireland between 2016 and 2018 (two-sample test of proportions, p<0.001). Using a criteria of pinhole acuity 0.2logMAR (6/9.5 Snellen) plus an amblyogenic factor, 4 of 295 participants aged 9–10 years old (1.3%, 95% CIs 0.4 to 3.6) and 3 of 428 participants aged 15–16 years old (0.7%, 95%CIs 0.2 to 2.2) were identified in NI. The corresponding numbers in Ireland were 40 of 898 participants aged 12–13 years old (4.5%, 95% CI 3.2 to 6.1). In NI strabismic amblyopia was the most prevalent type of persistent amblyopia, whereas anisometropic was predominant in Ireland. In Ireland, amblyopia was associated with socioeconomic disadvantage (OR=2.2, 95%CIs 1.4 to 3.6, p=0.002) and poor spectacle compliance (OR 2.5, 95% CIs 2.0 to 3.2, p<0.001).ConclusionsAmblyopia prevalence persisting beyond traditional treatment ages was significantly lower among NI children compared with Ireland. Uncorrected anisometropia, compliance with spectacle wear and socioeconomic disadvantage were contributing factors in Ireland. Children without obvious visible eye defects were less likely to access eye care in Ireland, resulting in missed opportunities for intervention where necessary.