bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary rehabilitation for pneumoconiosis: protocol for a systematic review and meta-analysis
Authors: Zhao Hulei , Xie Yang , Wang Jiajia , Li Xuanlin , Li Jiansheng 
Published: August 2019

IntroductionPneumoconiosis is characterised by diffuse fibrosis in lung tissue, and its incidence is on the rise. At present, there are limited therapeutic options for pneumoconiosis. Pulmonary rehabilitation (PR) has been widely used to treat pneumoconiosis，however, there is limited evidence concerning its efficacy. Therefore, we plan to conduct a systematic review to investigate the efficacy and safety of PR for pneumoconiosis.Methods and analysisThe following databases will be searched from their inception to 1 April 2019: PubMed, Embase, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chongqing VIP and Wanfang Data. Randomised controlled trials of PR for pneumoconiosis will be included. Primary outcomes will include 6 min walk distance and St. George’s Respiratory Questionnaire. Study selection, extraction of data and assessment of study quality each will be independently undertaken. Statistical analysis will be conducted using Review Manager software.Ethics and disseminationThis systematic review will provide up-to-date information on PR for pneumoconiosis. The review does not require ethical approval and will be disseminated electronically through a peer-reviewed publication or conference presentations.PROSPERO registration numberCRD42018095266.
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium
Authors: Yang Keming , Zhang Ying , Saito Eiko , Rahman Md Shafiur , Gupta Prakash Chandra , Sawada Norie , Tamakoshi Akiko , Gao Yu-Tang , Koh Woon-Puay , Shu Xiao-Ou , Tsuji Ichiro , Sadakane Atsuko , Nagata Chisato , You San-Lin , Yuan Jian-Min , Shin Myung-Hee , Chen Yu , Pan Wen-Harn , Pednekar Mangesh S , Tsugane Shoichiro , Cai Hui , Xiang Yong-Bing , Ozasa Kotaro , Tomata Yasutake , Kanemura Seiki , Sugawara Yumi , Wada Keiko , Wang Renwei , Ahn Yoon-Ok , Yoo Keun-Young , Ahsan Habibul , Chia Kee Seng , Boffetta Paolo , Kang Daehee , Potter John D , Inoue Manami , Zheng Wei , Nan Hongmei 
Published: August 2019

ObjectiveTo study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations.DesignA pooled analysis of 15 population-based cohort studies.Setting and participants694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium.InterventionsNone.Main outcome measuresHRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality.ResultsA total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (ptrend=0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both ptrend<0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis).ConclusionHigher educational level was associated with substantially lower risk of death among Asian populations.
The joint effect of insomnia symptoms and lifestyle factors on risk of self-reported fibromyalgia in women: longitudinal data from the HUNT Study
Authors: Skarpsno Eivind Schjelderup , Nilsen Tom Ivar Lund , Sand Trond , Hagen Knut , Mork Paul Jarle 
Published: August 2019

ObjectivesTo investigate the association between insomnia symptoms and risk of self-reported fibromyalgia in women, and to explore whether leisure time physical activity and body mass index (BMI) modify this association.DesignProspective cohort study.SettingWe used longitudinal data from the Norwegian Nord-Trøndelag Health Study collected in 1995–1997 (baseline) and 2006–2008 (follow-up).ParticipantsA total of 14 172 women who reported to be free from fibromyalgia at baseline.Primary outcome measuresWe estimated adjusted risk ratios (RRs) with 95% CI for self-reported fibromyalgia at follow-up associated with baseline insomnia symptoms, leisure time physical activity and BMI.ResultsOverall, 466 incident cases of fibromyalgia were reported during the follow-up period of approximately 11 years, corresponding to a crude absolute risk (AR) of 3.3%. Compared with women without insomnia symptoms (crude AR=2.8%), women who reported one, two or three symptoms had RRs of fibromyalgia of 1.39 (95% CI: 1.08 to 1.80), 1.86 (95% CI: 1.33 to 2.59) and 2.66 (95% CI: 1.75 to 4.06), respectively. Compared with highly physically active women without insomnia symptoms (crude AR=2.7%), women with one or more insomnia symptoms had a RR of fibromyalgia of 1.90 (95% CI: 1.30 to 2.79) if they reported low physical activity and a RR of 1.55 (95% CI: 1.12 to 2.13) if they reported high physical activity. We found no synergistic effect between insomnia symptoms and BMI on risk of fibromyalgia; however, overweight and obese women with one or more insomnia symptoms had RRs of 2.35 (95% CI: 1.73 to 3.21) and 2.18 (95% CI: 1.42 to 3.35) compared with the reference group of normal weight women without insomnia symptoms (crude AR=2.3%).ConclusionsInsomnia symptoms are strongly and positively associated with risk of fibromyalgia in adult women. Leisure time physical activity may compensate for some of the adverse effect of insomnia symptoms on risk of fibromyalgia.
Phenylketonuria incidence in China between 2013 and 2017 based on data from the Chinese newborn screening information system: a descriptive study
Authors: Xiang Liangcheng , Tao Jing , Deng Kui , Li Xiaohong , Li Qi , Yuan Xuelian , Liang Juan , Yu Erling , Wang Meixian , Wang Huiqing , Liu Hanmin , Zhu Jun 
Published: August 2019

ObjectiveThis study examines the incidence and spatial clustering of phenylketonuria (PKU) in China between 2013 and 2017.MethodsData from the Chinese Newborn Screening Information System were analysed to assess PKU incidence with 95% CIs by province, region and disease severity. Spatial clustering of PKU cases was analysed using global and local spatial autocorrelation analysis in the geographic information system.ResultsThe database contained 4925 neonates with confirmed PKU during the study period, corresponding to an incidence of 6.28 (95% CI: 6.11 to 6.46) per 100 000 neonates screened. Incidence was highest in the provinces of Gansu, Ningxia and Qinghai, where it ranged from 19.00 to 28.63 per 100 000 neonates screened. Overall incidence was higher in the northern part of the country, where classical disease predominated, than in the southern part, where mild disease predominated. PKU cases clustered spatially (global Moran’s I=0.3603,Z=5.3097, p<0.001), and local spatial autocorrelation identified four northern provinces as high–high clusters (Gansu, Qinghai, Ningxia and Shanxi).ConclusionsChina shows an intermediate PKU incidence among countries, and incidence differs substantially among Chinese provinces and between northern and southern regions. Our results suggest the need to focus efforts on screening, diagnosing and treating PKU in high-incidence provinces.
Enriching medical trainees’ learning through practice: a video reflexive ethnography study protocol
Authors: Noble Christy , Billett Stephen , Hilder Joanne , Teodorczuk Andrew , Ajjawi Rola 
Published: August 2019

IntroductionSupporting medical students’ and junior doctors’ development in busy clinical settings is challenging. As opportunities for developing trainees, for example, traditional bedside teaching, are decreasing, teaching outside of clinical practice is increasing. However, evidence suggests that effective learning through practice arises via an interplay between, first, what experiences are afforded by clinical settings and, second, how trainees engage with these affordances. Many studies investigating clinician learning through practice focus on only one of these two factors. Yet, a well-recognised methodological challenge of enabling learners to articulate how and what they are learning through practice exists. We need, therefore, to understand how this relationship plays out in practice in ways that enrich learning.Methods and analysisThis protocol describes a video reflexive ethnographic approach to illuminate how learning through practice in hospital settings occurs and can be enriched. The study will be conducted in two phases. In phase I, senior clinicians from emergency medicine, medicine and surgical specialties will be interviewed about how they guide trainees’ learning through practice. These forms of guidance, analysed using the framework method, will inform phase II comprising observations of practice in: (1) emergency, (2) medical and (3) surgical departments. Video recorded episodes of clinicians’ guiding learning through practice will be shared and appraised in reflexive sessions with each clinical team. Relational interdependent learning theory informs the design and data analyses to elicit and evaluate strategies for guiding learning through practice.Ethics and disseminationEthical approval has been received from both healthcare and university settings. The findings should provide important insights for clinicians about workplace learning practices. Findings will be disseminated across the project phases and to diverse audiences—locally, nationally and internationally. The dissemination strategy will use seminars, grand rounds, conference presentations and academic papers to articulate practical, theoretical and methodological findings.
Tricuspid regurgitation severity after atrial septal defect closure or pulmonic valve replacement
Authors: Martin-Garcia Agustin C , Dimopoulos Konstantinos , Boutsikou Maria , Martin-Garcia Ana , Kempny Aleksander , Alonso-Gonzalez Rafael , Swan Lorna , Uebing Anselm , Babu-Narayan Sonya V , Sanchez Pedro Luis , Li Wei , Shore Darryl , Gatzoulis Michael A 
Published: August 2019

ObjectivesCardiac surgery or catheter interventions are nowadays commonly performed to reduce volume loading of the right ventricle in adults with congenital heart disease. However, little is known, on the effect of such procedures on pre-existing tricuspid regurgitation (TR). We assessed the potential reduction in the severity of TR after atrial septal defect (ASD) closure and pulmonic valve replacement (PVR).MethodsDemographics, clinical and echocardiographic characteristics of consecutive patients undergoing ASD closure or PVR between 2005 and 2014 at a single centre who had at least mild preoperative TR were collected and analysed.ResultsOverall, 162 patients (mean age at intervention 41.6±16.1 years, 38.3% male) were included: 101 after ASD closure (61 transcatheter vs 40 surgical) and 61 after PVR (3 transcatheter vs 58 surgical). Only 11.1% received concomitant tricuspid valve surgery (repair). There was significant reduction in the severity of TR in the overall population, from 38 (23.5%) patients having moderate or severe TR preoperatively to only 11 (6.8%) and 20 (12.3%) at 6 months and 12 months of follow-up, respectively (McNemar p<0.0001). There was a significant reduction in tricuspid valve annular diameter (p<0.0001), coaptation distance (p<0.0001) and systolic tenting area (p<0.0001). The reduction in TR was also observed in patients who did not have concomitant tricuspid valve (TV) repair (from 15.3% to 6.9% and 11.8% at 6 and 12 months, respectively, p<0.0001). On multivariable logistic regression including all univariable predictors of residual TR at 12 months, only RA area remained in the model (OR 1.2, 95% CI 1.04 to 1.37, p=0.01).ConclusionsASD closure and PVR are associated with a significant reduction in tricuspid regurgitation, even among patients who do not undergo concomitant tricuspid valve surgery.
National trends in endovascular therapy for acute ischemic stroke: utilization and outcomes
Authors: Stein Laura , Tuhrim Stanley , Fifi Johanna , Mocco J , Dhamoon Mandip 
Published: August 2019

ObjectiveFollowing widespread acceptance of endovascular therapy (ET) for large vessel occlusion stroke in 2015, we assessed nationwide utilization of revascularization for acute ischemic stroke (AIS).MethodsWe utilized the 2013–2016 Healthcare Cost and Utilization Project Nationwide Readmissions Database. We identified AIS admissions, treatment with intravenous thrombolysis (IVT), ET, and vascular risk factors using International Classification of Disease Clinical Modification codes. Main predictor of outcome was the time period of index admission (‘pre-endovascular era (pre-EA)’ January 2013–January 2015 and ‘endovascular era (EA)’ February 2015– December 2016). We calculated the proportion of AIS admissions in which, first, VT and second, ET was performed. Among patients treated with ET, we examined the association between era and discharge disposition, in-hospital mortality during index admission, and 30-day readmission.ResultsThere were 925 363 index AIS admissions before the EA and 857 347 during. A higher proportion of AIS patients received IVT (8.4% vs 7.8%) and ET (2.6% vs 1.3%) in the EA. Although length of stay (LOS) was shorter in the EA (5.70 vs 6.80 days), total charges were greater ($56 691 vs $53 878), and admissions were more often to a metropolitan hospital (65.2% vs 57.2%). Among those treated with ET, a smaller proportion received IVT (29.7% vs 44.9%), LOS was substantively shorter (9.75 vs 12.76 days), and patients had a lower odds of discharge home.ConclusionsThe utilization of ET has doubled in the EA but ET remains underutilized. ET is predominantly provided at metropolitan teaching hospitals and associated with higher charges despite shorter LOS and unchanged in-hospital mortality.
Police killings of Black people and rates of sexually transmitted infections: a cross-sectional analysis of 75 large US metropolitan areas, 2016
Authors: Ibragimov Umedjon , Beane Stephanie , Friedman Samuel R , Smith Justin C , Tempalski Barbara , Williams Leslie , Adimora Adaora A , Wingood Gina M , McKetta Sarah , Stall Ronald D , Cooper Hannah LF 
Published: August 2019

Objectives
Emerging literature shows that racialised police brutality, a form of structural racism, significantly affects health and well-being of racial/ethnic minorities in the USA. While public health research suggests that structural racism is a distal determinant of sexually transmitted infections (STIs) among Black people, no studies have empirically linked police violence to STIs. To address this gap, our study measures associations between police killings and rates of STIs among Black residents of US metropolitan statistical areas (MSAs).

Methods
This cross-sectional ecological analysis assessed associations between the number of Black people killed by police in 2015 and rates of primary and secondary syphilis, gonorrhoea and chlamydia per 100 000 Black residents of all ages in 2016 in 75 large MSAs. Multivariable models controlled for MSA-level demographic and socioeconomic characteristics, police expenditures, violent crime, arrest and incarceration rates, insurance rates and healthcare funding.

Results
In 2015, the median number of Black people killed by police per MSA was 1.0. In multivariable models, police killings were positively and significantly associated with syphilis and gonorrhoea rates among Black residents. Each additional police killing in 2015 was associated with syphilis rates that were 7.5% higher and gonorrhoea rates that were 4.0% higher in 2016.

Conclusions
Police killings of Black people may increase MSA-level risk of STI infections among Black residents. If future longitudinal analyses support these findings, efforts to reduce STIs among Black people should include reducing police brutality and addressing mechanisms linking this violence to STIs.
Alcohol and drug use, partner PrEP use and STI prevalence among people with HIV
Authors: Hojilla J Carlo , Marcus Julia , Volk Jonathan E , Leyden Wendy , Hare C Bradley , Hechter Rulin C , Edelman E Jennifer , Silverberg Michael , Satre Derek D 
Published: August 2019

Objectives
People with HIV (PWH) have a high burden of bacterial sexually transmitted infections (STIs). We examined the relationship of alcohol and drug use and partner pre-exposure prophylaxis (PrEP) use to STI prevalence in a cohort of PWH with a history of unhealthy alcohol use.

Methods
We analysed data from a primary care-based alcohol intervention study at Kaiser Permanente Northern California (KPNC). Participants were recruited between April 2013 and May 2015 and were followed for up to 24 months. We linked participant responses to questions from the 24 month follow-up interview, including alcohol and drug use and partner PrEP use, with STI test results (ie, syphilis, chlamydia, gonorrhoea) in the KPNC electronic health record. Prevalence ratios (PR) were estimated using Poisson models fitted with robust variance estimators to evaluate the association of substance use and partner use of PrEP with STIs.

Results
In the analytic sample (n=465), the median age was 52 years (IQR 45–59); 67% were white; 95% were men who have sex with men. Thirty-two per cent of participants had HIV-positive partners only; 31% had HIV-negative partners with at least one on PrEP in the previous year and 37% had HIV-negative partners without any on PrEP. Twenty-three per cent reported alcohol and drug use prior to sex in the last 6 months. Eight per cent of participants had an STI. Partner PrEP use (adjusted PR (aPR) 2.99 (95% CI 1.11 to 8.08)) was independently associated with higher STI prevalence. Participants who reported use of alcohol (aPR 1.53 (0.61 to 3.83)), drugs (aPR 1.97 (0.71 to 5.51)) or both (aPR 1.93 (0.75 to 4.97)) prior to sex had a higher STI prevalence.

Conclusions
The higher prevalence of STIs among PWH with unhealthy alcohol use who have partners on PrEP suggests that this subgroup may be a high-yield focus for targeted outreach, STI screening and sexual health counselling.
Long-Term Results of Surgically Treated Radial Polydactyly – An Outcome Correlation Study
Authors: Yeung Ching Man , Choi Alexander Kai Yiu , Tong Jennifer Wing Sze , Fok Winnie , Chan Yat Fai , Chow Yuk Yin 
Published: August 2019

Background: Thumb polydactyly is one of the commonest congenital hand differences. Traditional surgeon-based outcome scores capture outcomes mainly on bodily structure and function. Outcomes on the long-term well-being of the patients in the domains of activity and participation are not fully studied. Methods: Forty-eight thumbs in forty-five Chinese patients with radial polydactyly underwent surgical treatment at or before 3 years old were recruited. Mean follow-up was 11.6 years. Surgical outcomes were collected and compared to the normal opposite thumb. The results were compiled into the Japanese Society for Surgery of the Hand (JSSH) score, Cheng score and Tada score. Patients’ activity involving hands were assessed by both objective tools and patient-reported outcome measure while their health-related quality of life (HRQoL) was assessed by Patient- and Parent-reported Pediatric Quality of Life Inventory (PedsQL). Correlations between outcomes were analysed. Results: Overall, both parents and patients themselves reported good quality of life with mean score of 86.6% and 92.1% respectively in PedsQL. The combined surgical scores ranged from 52% good or excellent results using JSSH score to 100% good result using Cheng score. None of the outcomes on bodily structure and function showed positive correlation with patient’s well-being. Negative correlation was noted in total passive range of movement, active movement and Cheng score. All patients reported no activity restriction. Writing test did not show significant slowing. The operated hands had significantly poorer fine motor dexterity than normal. No significant correlation is noted between activity outcomes and PedsQL. Conclusions: Outcomes on bodily structure, function and activity showed little correlation with patients’ well-being after thumb polydactyly correction. It should be careful in using or analysing patient/parent-reported outcome measures on HRQoL as outcome assessment of surgical treatment of radial polydactyly.
Arthroscopic Thermal Shrinkage: A Novel Method for the Treatment of Chronic Volar Plate Instability at the Metacarpal Phalangeal Joint of the Thumb
Authors: Wong Yu Chung , Ho Pak Cheong 
Published: August 2019

Background: Chronic volar plate instability of the thumb metacarpal phalangeal joint (MCPJ) is a disabling clinical problem. Patients usually present with pain and disability in terms of reduction in pinch and grip power. Numerous surgical techniques have been described for the treatment of this condition. Here we describe a novel method for the treatment of this condition by thermal shrinkage of the volar plate via thumb MCPJ arthroscopy. Methods: A retrospective review of 8 patients with chronic thumb MCPJ volar plate instability treated with the novel technique of thermal shrinkage of the volar plate via thumb MCPJ arthroscopy. The primary outcome is maintenance of saggital plane stability at the thumb MCPJ. Secondary outcomes include pinch and grip power, The Disabilities of the Arm, Shoulder and Hand (DASH) Score and thumb MCPJ range of movement. The duration of follow up and complications were also reviewed. Results: The mean follow up period was 41.4 months (range, 2–134 months). One case had recurrence of instability requiring open volar plate capsulodesis. All other cases had their thumb hyperextensibility resolved and maintained throughout the entire follow up period, up to 134 months for the case with the longest duration of follow up. Conclusions: Preliminary results suggest this novel, minimally invasive technique for the treatment of thumb MCPJ volar plate instability is effective and the long term follow up results are durable.