bluuebunny/crossref_metadata_2025_split huggingface dataset:
Body composition: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Authors: Clifford Susan A , Gillespie Alanna N , Olds Timothy , Grobler Anneke C , Wake Melissa 
Published: July 2019

ObjectivesOverweight and obesity remain at historically high levels, cluster within families and are established risk factors for multiple diseases. We describe the epidemiology and cross-generational concordance of body composition among Australian children aged 11–12 years and their parents.DesignThe population-based cross-sectional Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven major Australian cities and eight regional cities, or home visits; February 2015–March 2016.ParticipantsOf all participating CheckPoint families (n=1874), body composition data were available for 1872 children (49% girls) and 1852 parents (mean age 43.7 years; 88% mothers), including 1830 biological parent-child pairs.MeasuresHeight, weight, body mass index (BMI), waist circumference and waist-to-height ratio for all participants; body fat and fat-free mass by four-limb bioimpedence analysis (BIA) at assessment centres, or body fat percentage by two-limb BIA at home visits.Analysis:parent-child concordance was assessed using (i) Pearson’s correlation coefficients, and (ii) partial correlation coefficients adjusted for age, sex and socioeconomic disadvantage. Survey weights and methods accounted for LSAC’s complex sample design.Results20.7% of children were overweight and 6.2% obese, as were 33.5% and 31.6% of parents. Boys and girls showed similar distributions for all body composition measures but, despite similar BMI and waist-to-height ratio, mothers had higher proportions of total and truncal fat than fathers. Parent-child partial correlations were greatest for height (0.37, 95% CI 0.33 to 0.42). Other anthropometric and fat/lean measures showed strikingly similar partial correlations, ranging from 0.25 (95% CI 0.20 to 0.29) for waist circumference to 0.30 (95% CI 0.25 to 0.34) for fat-free percentage. Whole-sample and sex-specific percentile values are provided for all measures.ConclusionsExcess adiposity remains prevalent in Australian children and parents. Moderate cross-generational concordance across all measures of leanness and adiposity is already evident by late childhood.
(Un)Spoken realities of living with axial spondyloarthritis: a qualitative study focused on couple experiences
Authors: Raybone Kerry , Family Hannah , Sengupta Raj , Jordan Abbie 
Published: July 2019

ObjectiveAxial spondyloarthritis is a long-term rheumatic condition. The symptoms, including pain, can impact on the daily life routines and psychological well-being of individuals that are diagnosed with axial spondyloarthritis (axSpA). Partners are often a main source of support for individuals who manage a long-term condition and they can also be affected by the illness experience, often themselves reporting elevated levels of emotional distress. Few qualitative studies have explored the impact of axSpA on partner relationships. This study addresses the social context of axSpA by investigating the experiences for both individuals with axSpA and their partners.DesignSemistructured individual telephone interviews analysed using thematic analysis at a dyadic partner level.SettingParticipants were recruited from the social media pages of a UK-based axSpA-specific charity.ParticipantsNine heterosexual partner dyads (23–65 years), who were currently cohabiting, comprising nine individuals diagnosed with axSpA (n=6 females) and nine partners (n=3 females).ResultsThree themes ‘Perceived relational closeness’, ‘Playing third wheel to axSpA’ and ‘Tensions surrounding a carer-type role’ were identified. The findings illustrate how living with axSpA can influence closeness between partners and dominate daily decisions, particularly surrounding leisure activities. Partners commonly adopted a carer-type role, despite many individuals with axSpA expressing desire for a greater sense of autonomy.ConclusionsThis study provides an important insight into the lived experiences of both individuals with axSpA and their partners. Findings highlight the social context of managing a long-term condition and suggest the need for including partners within consultations, and the need for support provision for partners.
Updating EuroSCORE by including emotional, behavioural, social and functional factors to the risk assessment of patients undergoing cardiac surgery: a study protocol
Authors: Cromhout Pernille Fevejle , Berg Selina Kikkenborg , Moons Philip , Damgaard Sune , Nashef Samer , Thygesen Lau Caspar 
Published: July 2019

IntroductionConventional risk assessment in cardiac surgery focus on medical and physiological factors and have been developed to predict mortality. Other relevant risk factors associated with increased risk of poor outcomes are not included. Adding non-medical variables as potential prognostic factors to risk assessments direct attention away from specific diagnoses towards a more holistic view of the patients and their predicament. The aim of this paper is to describe the method and analysis plan for the development and validation of a prognostic screening tool as a supplement to the European System for Cardiac Operative Risk Evaluation (EuroSCORE) to predict mortality, readmissions and prolonged length of admission in patients within 90 days after cardiac surgery, as individual outcomes.Methods and analysisThe development of a prognostic screening tool with inclusion of emotional, behavioural, social and functional factors complementing risk assessment by EuroSCORE will adopt the methods recommended by the PROGnosis RESearch Strategy Group and report using the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis statement. In the development stage, we will use data derived from three datasets comprising 1143, 3347 and 982 patients for a prospective cohort study of patients undergoing cardiac surgery, respectively. We will construct logistic regression models to predict mortality, prolonged length of admission and 90-day readmissions. In the validation stage, we will use data from a separate sample of 333 patients planned to undergo cardiac surgery to assess the performance of the developed prognostic model. We will produce validation plots showing the overall performance, area under the curve statistic for discrimination and the calibration slope and intercept.Ethics and disseminationThe study will follow the requirements from the Ethical Committee System ensuring voluntary participation in accordance with the Helsinki declarations. Data will be filed in accordance with the requirements of the Danish Data Protection Agency.
Comparison of surgical strategies in patients with spontaneous intracerebral haemorrhage: a protocol for a network meta-analysis
Authors: Yu Zhiyuan , Zheng Jun , Ma Lu , Guo Rui , You Chao , Li Hao 
Published: July 2019

IntroductionSpontaneous intracerebral haemorrhage (sICH) is a severe stroke subtype. The effective therapies for patients with sICH are still unclear, and the role of surgical treatment in sICH management is still controversial. Although some large trials did not show that surgery could benefit patients with sICH, some other studies suggested that some specific surgical strategies can have potential benefits to these patients. For a better understanding of the surgical treatment in patients with sICH, it is necessary to conduct a network meta-analysis to compare the effects of medical treatment and different surgical methods comprehensively.Methods and analysisThis protocol has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Related studies until August 2018 will be searched in the following databases: PubMed, Embase, Scopus, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang. Randomised controlled trials and non-randomised prospective studies comparing at least two different interventions in patients with sICH will be included. Quality assessment will be conducted using Cochrane Collaboration’s tool or Newcastle-Ottawa Scale based on their study designs. The primary outcome will be functional outcome and the secondary outcome will be mortality. Pairwise and network meta-analysis will be conducted using STATA V.14 (StataCorp, College Station, Texas, USA). Mean ranks and the surface under the cumulative ranking curve will be used to evaluate every intervention. Statistical inconsistency assessment, subgroup analysis, sensitivity analysis and publication bias assessment will be performed.Ethics and disseminationEthics approval is not necessary because this study will be based on publications. The results of this study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018112239
Trajectories of sickness absence among salaried workers: evidence from the WORKss cohort in Catalonia (Spain), 2012-2014
Authors: Ubalde-Lopez Monica , Hernando-Rodriguez Julio C , Benavides Fernando G , Serra Laura 
Published: July 2019

ObjectivesSickness absence (SA) is a widely studied integrated measure of health status. To better understand how SA behaves over time (SA trajectory) a longitudinal and individual-centred approach will allow identifying groups of individuals who share common characteristics. The aim of this study was to identify and describe SA trajectories and to assess employment conditions and diagnosis groups as determinants.SettingWorking-life and sickness absence administrative records from a representative sample of affiliated with the Spanish Social Security system.Participants38 420 workers affiliated with the Spanish Social Security system, born 1949 to 1969 or 1970 to 1990, resident in Catalonia who had SA between 2012 and 2014 (75 212 episodes).ResultsWe identified three different SA trajectories in both birth cohorts for men and women: low-stable (86.2% to 90.8% of individuals), decreasing (4.4% to 5.9% of individuals) and increasing (4.1% to 8.7% of individuals) accumulated days of SA. The main characteristic of SA trajectories was the medical diagnosis group. The increasing SA trajectory had a higher proportion of workers with SA due to mental disorders compared with the other trajectories. The association analysis showed diagnosis group strongly related with all SA trajectories, particularly SA due to mental disorders showed the strongest association with the increasing trajectory among young men (adjusted OR (aOR): 42.40, 95% CI 17.03 to 105.57). Low salary levels exhibited a strong relationship with decreased accumulation of SA days over time for old women (aOR: 2.08, 95% CI 1.36 to 3.18) and men (aOR: 2.75, 95% CI 1.77 to 4.27). Unskilled manual occupations were associated with increasing trajectories among young women (aOR: 1.36, 95% CI 1.01 to 1.84). No significant differences were observed for other employment conditions across trajectories.ConclusionsWorkers with mental disorders are more likely to have increased days of SA, whereas low salary levels at later ages are related to a decrease in SA days over time. Special attention to preventing the course of mental disorders at young and middle age is warranted.
Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa
Authors: Amugsi Dickson Abanimi , Dimbuene Zacharie Tsala , Kyobutungi Catherine 
Published: July 2019

ObjectiveTo investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.DesignSecondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).SettingsGhana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).SubjectsWomen aged 15–49 years (n=64698).ResultsCompared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.ConclusionsOur analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.
Impact of Universal Credit in North East England: a qualitative study of claimants and support staff
Authors: Cheetham Mandy , Moffatt Suzanne , Addison Michelle , Wiseman Alice 
Published: July 2019

ObjectivesTo understand the impact of the roll-out of Universal Credit (UC) from the perspectives of claimants and staff supporting them in North East England.DesignQualitative study comprising interviews and focus groups.SettingGateshead and Newcastle, two localities in North East England characterised by high levels of socioeconomic deprivation, where the roll-out of UC started in 2017 as a new way to deliver welfare benefits for the UK working age population.Participants33 UC claimants with complex needs, disabilities and health conditions and 37 staff from local government, housing, voluntary and community sector organisations.ResultsParticipants’ accounts of the UC claims process and the consequences of managing on UC are reported; UC negatively impacts on material wellbeing, physical and mental health, social and family lives. UC claimants described the digital claims process as complicated, disorientating, impersonal, hostile and demeaning. Claimants reported being pushed into debt, rent arrears, housing insecurity, fuel and food poverty through UC. System failures, indifference and delays in receipt of UC entitlements exacerbated the difficulties of managing on a low income. The threat of punitive sanctions for failing to meet the enhanced conditionality requirements under UC added to claimant’s vulnerabilities and distress. Staff reported concerns for claimants and additional pressures on health services, local government and voluntary and community sector organisations as a result of UC.ConclusionsThe findings add considerable detail to emerging evidence of the deleterious effects of UC on vulnerable claimants’ health and wellbeing. Our evidence suggests that UC is undermining vulnerable claimants’ mental health, increasing the risk of poverty, hardship, destitution and suicidality. Major, evidence-informed revisions are required to improve the design and implementation of UC to prevent further adverse effects before large numbers of people move on to UC, as planned by the UK government.
One-year longitudinal study of psychological distress and self-assessed health in survivors of out-of-hospital cardiac arrest
Authors: Viktorisson Adam , Sunnerhagen Katharina S , Johansson Dongni , Herlitz Johan , Axelsson Åsa 
Published: July 2019

ObjectivesFew studies have investigated the psychological and health-related outcome after out-of-hospital cardiac arrest (OHCA) over time. This longitudinal study aims to evaluate psychological distress in terms of anxiety and depression, self-assessed health and predictors of these outcomes in survivors of OHCA, 3 and 12 months after resuscitation.MethodsRecruitment took place from 2008 to 2011 and survivors of OHCA were identified through the national Swedish Cardiopulmonary Resuscitation Registry. Inclusion criteria were age ≥18 years, survival ≥12 months and a Cerebral Performance Category score ≤2. Questionnaires containing the Hospital Anxiety and Depression Scale and European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) were administered at 3 and 12 months after the OHCA. Participants were also asked to report treatment-requiring comorbidities.ResultsOf 298 survivors, 85 (29%) were eligible for this study and 74 (25%) responded. Clinically relevant anxiety was reported by 22 survivors at 3 months and by 17 at 12 months, while clinical depression was reported by 10 at 3 months and 4 at 12 months. The mean EQ-5D-3L index value increased from 0.82 (±0.26) to 0.88 (±0.15) over time. There were significantly less symptoms of psychological distress (p=0.01) and better self-assessed health (p=0.003) at 12 months. Treatment-requiring comorbidity predicted anxiety (OR 4.07, p=0.04), while being female and young age predicted poor health (OR 6.33, p=0.04; OR 0.91, p=0.002) at 3 months. At 12 months, being female was linked to anxiety (OR 9.23, p=0.01) and depression (OR 14.78, p=0.002), while young age predicted poor health (OR 0.93, p=0.003).ConclusionThe level of psychological distress and self-assessed health improves among survivors of OHCA between 3 and 12 months after resuscitation. Higher levels of psychological distress can be expected among female survivors and those with comorbidity, while survivors of young age and who are female are at greater risk of poor health.
Trends in inequality in life expectancy at birth between 2004 and 2017 and projections for 2030 in Korea: multiyear cross-sectional differences by income from national health insurance data
Authors: Khang Young-Ho , Bahk Jinwook , Lim Dohee , Kang Hee-Yeon , Lim Hwa-Kyung , Kim Yeon-Yong , Park Jong Heon 
Published: July 2019

ObjectivesThe current status, time trends and future projections of a national health equity target are crucial elements of national health equity surveillance. This study examined time trends in inequality by income in life expectancy (LE) at birth between 2004 and 2017 and made future projections for the year 2030 in Korea.DesignUsing individually linked mortality data, time trends in inequality by income in LE at birth were examined. The LE projection was made with the Lee-Carter model.SettingTotal Korean population and death data derived from the National Health Information Database of the National Health Insurance Service.ParticipantsA total of 685 773 157 subjects and 3 486 893 deaths between 2004 and 2017 were analysed.Primary and secondary outcome measuresAnnual LE and the magnitude of inequality by income in LE between 2004 and 2030.ResultsInequality by income in LE among the total Korean population increased during the past 14 years, and this inequality is projected to become even greater in the future. In 2030, the magnitude of inequality by income in LE is projected to increase by 0.25 years in comparison to the magnitude in 2017. The increase in LE inequality was projected to be more prominent among women, with a projected 1.08 year increase in LE inequality between 2017 and 2030.ConclusionAggressive policies should be developed to close the increasing LE gap in Korea. LE inequalities by income should be considered as a measurable target for health equity in the process of establishing the National Health Plan 2030 in Korea.
Cancer chemotherapy: incidence and predictors of 30-day mortality
Authors: Dizdar Omer , Demir Metin , Bozbulut Utku Burak , Hayran Mutlu , Kars Ayse 
Published: July 2019

ObjectivesThirty-day mortality (30 DM) is a measure of quality of cancer treatment and the predictors for 30 DM are important to identify vulnerable patients who are least likely to benefit from chemotherapy. We assessed the incidence and potential predictors of 30 DM in patients receiving chemotherapy.MethodsAll patients who received chemotherapy within an 8-month period in our hospital were assessed. Baseline prechemotherapy clinical features, vital signs, Modified Early Warning Scores (MEWS) and laboratory tests were recorded. Potential predictors of 30 DM were evaluated using multivariate logistic regression analysis.ResultsAmong 4560 patients included, 77 patients (1.7%) died within 30 days of chemotherapy. Patients who died were older (62 vs 58, p=0.002), mostly males (61% vs 43%, p=0.006), had worse Eastern Cooperative Oncology Group performance scores (ECOG PS), and higher MEWS scores compared with those who survived. Multivariate analysis identified age ≥60 years (OR 2.2, 95% CI 1.2 to 4.1, p=0.01), male gender (OR 2.1, 95% CI 1.1 to 3.9, p=0.02), ECOG PS≥3 (OR 3.2, 95% CI 1.1 to 8.8, p=0.03), pulse rate ≥90 bpm (OR 3.8, 95% CI 2.0 to 7.0, p<0.01), systolic blood pressure <110 mm Hg (OR 2.1, 95% CI 1.1 to 4.1, p=0.02), body mass index <25 kg/m2(OR 2.1, 95% CI 1.1 to 3.8, p=0.02) and haemoglobin< 90 g/L (OR 14.2, 95% CI 4.3 to 46.6, p<0.01) to be associated with increased risk of 30 DM.ConclusionsAlong with well-known prognostic factors such as ECOG PS and disease stage, other simple and readily available parameters may predict early mortality after chemotherapy and produce a signal for the physicians to carefully reevaluate vulnerable patients before chemotherapy administration.
Quantitative estimation of thrombus-erythrocytes using MRI. A phantom study with clot analogs and analysis by statistic regression models
Authors: Janot Kevin , Oliveira Tiago Ribeiro , Fromont-Hankard Gaelle , Annan Mariam , Filipiak Isabelle , Barantin Laurent , Guibon Roseline , Duffy Sharon , Gilvarry Michael , Cottier Jean-Philippe , Narata Ana Paula 
Published: July 2019

BackgroundThrombus composition has the potential to affect acute ischemic stroke (AIS) treatment.ObjectiveTo evaluate in an in vitro test the correlation of clot composition, especially erythrocytes (red blood cells (RBCs)), with the variation of signal intensity ratio (SIR) obtained with MRI sequences used for AIS, and qualification of the susceptibility vessel sign effect using clot analogs.Materials and methodsNine ovine clots were fixed in a gelatin-manganese solution and studied by MRI (T2GE, T2-weighted gradient echo; SWI, susceptibility-weighted imaging; FLAIR, fluid attenuated inversion recovery). RBC concentration was estimated using regression models (SLR, single linear regression; MLR, multiple linear regression; RF, random Forest; and ANN, artificial neural networking), which combined the SIR–histology relationship of three MRI sequences.ResultsNegative correlation was found between SIR and RBC concentration. T2GE SWI could not statistically distinguish clots with RBC content >54% and <23%. SLR was applied only to FLAIR images since T2GE and SWI demonstrated signal saturation. All four regression models showed a correlation between MRI and histology: SLR=0.981; MLR=0.986; RF=0.994, and ANN=0.971. One unknown clot was studied and agreement between SIR and histological analyses was found in all models.ConclusionsWe presented a method to quantify RBC concentration in clot analogs, combining SWI, T2GE, and FLAIR. This in vitro study has some limitations, so clot collection after thrombectomy with simultaneous imaging analysis is necessary to validate this model.