bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomedical authors’ awareness of publication ethics: an international survey
Authors: Schroter Sara , Roberts Jason , Loder Elizabeth , Penzien Donald B , Mahadeo Sarah , Houle Timothy T 
Published: November 2018

ObjectiveThe extent to which biomedical authors have received training in publication ethics, and their attitudes and opinions about the ethical aspects of specific behaviours, have been understudied. We sought to characterise the knowledge and attitudes of biomedical authors about common issues in publication ethics.DesignCross-sectional online survey.Setting and participantsCorresponding authors of research submissions to 20 journals.Main outcome measure(s)Perceived level of unethical behaviour (rated 0 to 10) presented in five vignettes containing key variables that were experimentally manipulated on entry to the survey and perceived level of knowledge of seven ethical topics related to publishing (prior publication, author omission, self-plagiarism, honorary authorship, conflicts of interest, image manipulation and plagiarism).Results4043/10 582 (38%) researchers responded. Respondents worked in 100 countries and reported varying levels of publishing experience. 67% (n=2700) had received some publication ethics training from a mentor, 41% (n=1677) a partial course, 28% (n=1130) a full course and 55% (n=2206) an online course; only a small proportion rated training received as excellent. There was a full range (0 to 10 points) in ratings of the extent of unethical behaviour within each vignette, illustrating a broad range of opinion about the ethical acceptability of the behaviours evaluated, but these opinions were little altered by the context in which it occurred. Participants reported substantial variability in their perceived knowledge of seven publication ethics topics; one-third perceived their knowledge to be less than ‘some knowledge’ for the sum of the seven ethical topics and only 9% perceived ‘substantial knowledge’ of all topics.ConclusionsWe found a large degree of variability in espoused training and perceived knowledge, and variability in views about how ethical or unethical scenarios were. Ethical standards need to be better articulated and taught to improve consistency of training across institutions and countries.
Surgical quality in organ procurement during day and night: an analysis of quality forms
Authors: de Boer Jacob , Van der Bogt Koen , Putter Hein , Ooms-de Vries Kirsten , Haase-Kromwijk Bernadette , Pol Robert , De Jonge Jeroen , Dejong Kees , Nijboer Mijntje , Van der Vliet Daan , Braat Dries 
Published: November 2018

ObjectivesTo analyse a potential association between surgical quality and time of day.DesignA retrospective analysis of complete sets of quality forms filled out by the procuring and accepting surgeon on organs from deceased donors.SettingProcurement procedures in the Netherlands are organised per region. All procedures are performed by an independent, dedicated procurement team that is associated with an academic medical centre in the region.ParticipantsIn 18 months’ time, 771 organs were accepted and procured in The Netherlands. Of these, 17 organs were declined before transport and therefore excluded. For the remaining 754 organs, 591 (78%) sets of forms were completed (procurement and transplantation). Baseline characteristics were comparable in both daytime and evening/night-time with the exception of height (p=0.003).Primary outcome measureAll complete sets of quality forms were retrospectively analysed for the primary outcome, procurement-related surgical injury. Organs were categorised based on the starting time of the procurement in either daytime (8:00–17:00) or evening/night-time (17:00–8:00).ResultsOut of 591 procured organs, 129 organs (22%) were procured during daytime and 462 organs (78%) during evening/night-time. The incidence of surgical injury was significantly lower during daytime; 22 organs (17%) compared with 126 organs (27%) procured during evening/night-time (p=0.016). This association persists when adjusted for confounders.ConclusionsThis study shows an increased incidence of procurement-related surgical injury in evening/night-time procedures as compared with daytime. Time of day might (in)directly influence surgical performance and should be considered a potential risk factor for injury in organ procurement procedures.
Using the extended self-regulatory model to characterise diabetes medication adherence: a cross-sectional study
Authors: Shiyanbola Olayinka O , Unni Elizabeth , Huang Yen-Ming , Lanier Cameron 
Published: November 2018

ObjectivesTo cluster the adherence behaviours of patients with type 2 diabetes based on their beliefs in medicines and illness perceptions and examine the psychosocial, clinical and sociodemographic characteristics of patient clusters.DesignCross-sectional study.SettingA face-to-face survey was administered to patients at two family medicine clinics in the Midwest, USA.ParticipantsOne hundred and seventy-four ≥20-year-old, English-speaking adult patients with type 2 diabetes who were prescribed at least one oral diabetes medicine daily were recruited using convenience sampling.Primary and secondary outcome measuresBeliefs in medicines and illness perceptions were assessed using the Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire, respectively. Self-reported medication adherence was assessed using the Morisky Medication Adherence Scale. Psychosocial correlates of adherence, health literacy and self-efficacy were measured using the Newest Vital Sign and the Self-efficacy for Appropriate Medication Use, respectively. Two-step cluster analysis was used to classify patients.ResultsParticipants’ mean age was 58.74 (SD=12.84). The majority were women (57.5%). Four clusters were formed (non-adherent clusters: ambivalent and sceptical; adherent clusters: indifferent and accepting). The ambivalent cluster (n=30, 17.2%) included low-adherent patients with high necessity beliefs, high concern beliefs and high illness perceptions. The sceptical cluster (n=53, 30.5%) included low adherent patients with low necessity beliefs but high concern beliefs and high illness perceptions. Both the accepting (n=40, 23.0%) and indifferent (n=51, 29.3%) clusters were composed of patients with high adherence. Significant differences between the ambivalent, sceptical, accepting and indifferent adherent clusters were based on self-efficacy, illness perception domains (treatment control and coherence) and haemoglobin A1c (p<0.01).ConclusionsPatients with diabetes in specific non-adherent and adherent clusters still have distinct beliefs as well as psychosocial characteristics that may help providers target tailored medication adherence interventions.
From embracing to managing risks
Authors: Keen Justin , Nicklin Emma , Wickramasekera Nyantara , Long Andrew , Randell Rebecca , Ginn Claire , McGinnis Elizabeth , Willis Sean , Whittle Jackie 
Published: November 2018

ObjectiveTo assess developments over time in the capture, curation and use of quality and safety information in managing hospital services.SettingFour acute National Health Service hospitals in England.Participants111.5 hours of observation of hospital board and directorate meetings, and 72 hours of ward observations. 86 interviews with board level and middle managers and with ward managers and staff.ResultsThere were substantial improvements in the quantity and quality of data produced for boards and middle managers between 2013 and 2016, starting from a low base. All four hospitals deployed data warehouses, repositories where datasets from otherwise disparate departmental systems could be managed. Three of them deployed real-time ward management systems, which were used extensively by nurses and other staff.ConclusionsThe findings, particularly relating to the deployment of real-time ward management systems, are a corrective to the many negative accounts of information technology implementations. The hospital information infrastructures were elements in a wider move, away from a reliance on individual professionals exercising judgements and towards team-based and data-driven approaches to the active management of risks. They were not, though, using their fine-grained data to develop ultrasafe working practices.
Associations of lifestyle and vascular risk factors with Alzheimer’s brain biomarker changes during middle age: a 3-year longitudinal study in the broader New York City area
Authors: Walters Michelle J , Sterling Joanna , Quinn Crystal , Ganzer Christine , Osorio Ricardo S , Andrews Randolph D , Matthews Dawn C , Vallabhajosula Shankar , de Leon Mony J , Isaacson Richard S , Mosconi Lisa 
Published: November 2018

ObjectiveTo investigate the associations between lifestyle and vascular risk factors and changes in Alzheimer’s disease (AD) biomarkers (beta-amyloid load via11C-PiB PET, glucose metabolism via18F-FDG PET and neurodegeneration via structural MRI) and global cognition in middle-aged asymptomatic participants at risk for AD.DesignProspective, longitudinal.SettingThe study was conducted at New York University Langone/Weill Cornell Medical Centres in New York City.ParticipantsSeventy cognitively normal participants from multiple community sources, aged 30–60 years with lifestyle measures (diet, intellectual activity and physical activity), vascular risk measures and two imaging biomarkers visits over at least 2 years, were included in the study.Outcome measuresWe examined MRI-based cortical thickness, fluoro-deoxy-glucose (FDG) glucose metabolism and PiB beta-amyloid in AD-vulnerable regions. A global cognitive z-score served as our summary cognition measure. We used regression change models to investigate the associations of clinical, lifestyle and vascular risk measures with changes in AD biomarkers and global cognition.ResultsDiet influenced changes in glucose metabolism, but not amyloid or cortical thickness changes. With and without accounting for demographic measures, vascular risk and baseline FDG measures, lower adherence to a Mediterranean-style diet was associated with faster rates of FDG decline in the posterior cingulate cortex (p≤0.05) and marginally in the frontal cortex (p=0.07).None of the other lifestyle variables or vascular measures showed associations with AD biomarker changes. Higher baseline plasma homocysteine was associated with faster rates of decline in global cognition, with and without accounting for lifestyle and biomarker measures (p=0.048). None of the lifestyle variables were associated with cognition.ConclusionsDiet influenced brain glucose metabolism in middle-aged participants, while plasma homocysteine explained variability in cognitive performance. These findings suggest that these modifiable risk factors affect AD risk through different pathways and support further investigation of risk reduction strategies in midlife.
Improving household surveys and use of data to address health inequities in three Asian cities: protocol for the Surveys for Urban Equity (SUE) mixed methods and feasibility study
Authors: Elsey Helen , Poudel Ak Narayan , Ensor Tim , Mirzoev Tolib , Newell James Nicholas , Hicks Joseph Paul , Cartwright Christopher , Wong David , Tait Caroline , Baral Sushil , Bhattarai Radheshyam , Khanal Sudeepa , Dhungel Rajeev , Gajurel Subash , Manandhar Shraddha , Mashreky Saidur , Ferdoush Junnatul , Huque Rumana , Ferdous Tarana , Nasreen Shammi , Van Minh Hoang , Duc Duong Minh , Ngoc Bao , Thomson Dana , Wallace Hilary 
Published: November 2018

IntroductionAs rapid urbanisation transforms the sociodemographic structures within cities, standard survey methods, which have remained unchanged for many years, under-represent the urban poorest. This leads to an overly positive picture of urban health, distorting appropriate allocation of resources between rural and urban and within urban areas. Here, we present a protocol for our study which (i) tests novel methods to improve representation of urban populations in household surveys and measure mental health and injuries, (ii) explores urban poverty and compares measures of poverty and ‘slumness’ and (iii) works with city authorities to understand, and potentially improve, utilisation of data on urban health for planning more equitable services.Methods and analysisWe will conduct household surveys in Kathmandu, Hanoi and Dhaka to test novel methods: (i) gridded population sampling; (ii) enumeration using open-access online maps and (iii) one-stage versus two-stage cluster sampling. We will test reliability of an observational tool to categorise neighbourhoods as slum areas. Within the survey, we will assess the appropriateness of a short set of questions to measure depression and injuries. Questionnaire data will also be used to compare asset-based, consumption-based and income-based measures of poverty. Participatory methods will identify perceptions of wealth in two communities in each city. The analysis will combine quantitative and qualitative findings to recommend appropriate measures of poverty in urban areas. We will conduct qualitative interviews and establish communities of practice with government staff in each city on use of data for planning. Framework approach will be used to analyse qualitative data allowing comparison across city settings.Ethics and disseminationEthical approvals have been granted by ethics committees from the UK, Nepal, Bangladesh and Vietnam. Findings will be disseminated through conference papers, peer-reviewed open access articles and workshops with policy-makers and survey experts in Kathmandu, Hanoi and Dhaka.
Study of Concussion in Rugby Union through MicroRNAs (SCRUM): a study protocol of a prospective, observational cohort study
Authors: Yakoub Kamal M , O’Halloran Patrick , Davies David J , Bentley Conor , Watson Callum N , Forcione Mario , Scarpa Ugo , Bishop Jonathan R B , Toman Emma , Hammond Douglas , Cross Matthew J , Stokes Keith A , Kemp Simon P T , Menon David K , Di Pietro Valentina , Belli Antonio 
Published: November 2018

IntroductionThe diagnosis of mild traumatic brain injury or sports-related concussion is a challenge for all clinicians, players, coaches and parents involved in contact sports. Currently, there is no validated objective biomarker available to assess the presence or severity of concussion in sport, and so it is necessary to rely on subjective measures like self-reporting of symptoms which depend on the cooperation of the athlete. There is a significant health risk associated with repetitive injury if the diagnosis is missed, and so there is great value in an objective biomarker to assist diagnostic and prognostic decisions.ObjectiveTo establish a panel of non-invasive MicroRNA biomarkers in urine and saliva for the rapid diagnosis of sports-related concussion and investigate the kinetics and clinical utility of these biomarkers in assisting diagnostic, prognostic and return-to-play decisions.Methods and analysisObservational, prospective, multicentre cohort study recruiting between the 2017–2018 and 2018–2019 Rugby Union seasons. Professional rugby players in the two highest tiers of senior professional domestic rugby competition in England will be recruited prospectively to the study. During the season, three groups will be identified: athletes entering the World Rugby Head Injury Assessment (HIA) protocol, uninjured control athletes and control athletes with musculoskeletal injuries. Saliva and urine will be collected from these athletes at multiple timepoints, coinciding with key times in the HIA protocol and return-to-play process.Ethics and disseminationEthics approval has been obtained. The compiled and analysed results will be presented at national and international conferences concerning the care of patients with traumatic brain injury. Results will also be submitted for peer review and publication in the subject journals/literature.
Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
Authors: van Leeuwen Kevin D B , Bohnen Arthur M , Jacobs Marloes L , van Der Lei Johan , Janssens Hein J E M , Koffeman Aafke R , Bindels Patrick J E , Bierma-Zeinstra Sita M A 
Published: November 2018

IntroductionGout is the most common inflammatory arthritis in the Dutch general practice population and is often managed with long-term uric acid lowering treatment. The clinical relevance of this treatment in preventing gout attacks is unclear.Primary research questionWhat is the frequency of self-reported gout attacks and what is the effect of allopurinol use in patients diagnosed with gout in general practice?Methods and analysisAdult patients with a diagnostic consultation code for gout in the year 2013, 2014 or 2015 will be invited to participate in this prospective observational cohort study. Patients with a limited life expectancy will be excluded. Baseline measurements will include blood pressure, body mass index and a blood sample (estimated glomerular filtration rate, serum uric acid, cholesterol (low-density lipoprotein (LDL) and high-density lipoprotein), glucose (fasting)). At the 2-year follow-up, patients will receive questionnaires every 3 months. The questionnaires at baseline, 12 months and 24 months assess the frequency of gout attacks, the presence of tophi, comorbidity, medication use, quality of life, diet and lifestyle. The questionnaires in between only assess the frequency of gout attacks and medication use for gout. Descriptive statistics will be used to calculate the mean frequency of self-reported gout attacks during the 2-year follow-up. The propensity score for each patient being offered allopurinol is estimated and used to match patients with and without allopurinol treatment. We will compare the frequency of gout attacks in these groups using multilevel Poisson regression analyses. With this type of analysis, we can calculate the corrected estimated effect of allopurinol on gout attack frequency.Ethics and disseminationThe research protocol was approved by the Medical Ethical Committee of the Erasmus Medical Centre in Rotterdam. The knowledge generated by this study will be transferred to the Dutch College of General Practitioners, conferences and to (inter)national peer-reviewed journals.Trial registration numberNTR6329; Pre-results.
How are risk ratios reported in orthopaedic surgery journals? A descriptive study of formats used to report absolute risks
Authors: Petrova Dafina , Joeris Alexander , Sánchez María-José , Salamanca-Fernández Elena , Garcia-Retamero Rocio 
Published: November 2018

PurposeThe numerical format in which risks are communicated can affect risk comprehension and perceptions of medical professionals. We investigated what numerical formats are used to report absolute risks in empirical articles, estimated the frequency of biasing formats and rated the quality of figures used to display the risks.DesignDescriptive study of reporting practices.MethodWe randomly sampled articles published in seven leading orthopaedic surgery journals during a period of 13 years. From these, we selected articles that reported group comparisons on a binary outcome (eg, revision rates in two groups) and recorded the numerical format used to communicate the absolute risks in the results section. The quality of figures was assessed according to published guidelines for transparent visual aids design.Outcome measuresPrevalence of information formats and quality of figures.ResultsThe final sample consisted of 507 articles, of which 14% reported level 1 evidence, 13% level 2 and 73% level 3 or lower. The majority of articles compared groups of different sizes (90%), reported both raw numbers and percentages (64%) and did not report the group sizes alongside (50%). Fifteen per cent of articles used two formats identified as biasing: only raw numbers (8%, ‘90 patients vs 100 patients’) or raw numbers reported alongside different group sizes (7%, ‘90 out of 340 patients vs 100 out of 490 patients’). The prevalence of these formats decreased in more recent publications. Figures (n=79) had on average two faults that could distort comprehension, and the majority were rated as biasing.ConclusionAuthors use a variety of formats to report absolute risks in scientific articles and are likely not aware of how some formats and graph design features can distort comprehension. Biases can be reduced if journals adopt guidelines for transparent risk communication but more research is needed into the effects of different formats.
Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs: an implementation and realist evaluation protocol
Authors: Hudon Catherine , Chouinard Maud-Christine , Aubrey-Bassler Kris , Burge Frederick , Doucet Shelley , Ramsden Vivian R , Brodeur Magaly , Bush Paula L , Couturier Yves , Dubois Marie-France , Guénette Line , Légare France , Morin Paul , Poder Thomas G , Poitras Marie-Ève , Roberge Pasquale , Valaitis Ruta , Bighead Shirley , Campbell Cameron , Couture Martine , Davis Breanna , Deschenes Élaine , Edwards Lynn , Gander Sarah , Gauthier Gilles , Gauthier Patricia , Gibson Richard J , Godbout Julie , Landry Geneviève , Longjohn Christine , Rabbitskin Norma , Roy Denis A , Roy Judy , Sabourin Véronique , Sampalli Tara , Saulnier Amanda , Spence Claude , Splane Jennifer , Warren Mike , Young Joanne , Pluye Pierre 
Published: November 2018

IntroductionSignificant evidence in the literature supports case management (CM) as an effective intervention to improve care for patients with complex healthcare needs. However, there is still little evidence about the facilitators and barriers to CM implementation in primary care setting. The three specific objectives of this study are to: (1) identify the facilitators and barriers of CM implementation in primary care clinics across Canada; (2) explain and understand the relationships between the actors, contextual factors, mechanisms and outcomes of the CM intervention; (3) identify the next steps towards CM spread in primary care across Canada.Methods and analysisWe will conduct a multiple-case embedded mixed methods study. CM will be implemented in 10 primary care clinics in five Canadian provinces. Three different units of analysis will be embedded to obtain an in-depth understanding of each case: the healthcare system (macro level), the CM intervention in the clinics (meso level) and the individual/patient (micro level). For each objective, the following strategy will be performed: (1) an implementation analysis, (2) a realist evaluation and (3) consensus building among stakeholders using the Technique for Research of Information by Animation of a Group of Experts method.Ethics and disseminationThis study, which received ethics approval, will provide innovative knowledge about facilitators and barriers to implementation of CM in different primary care jurisdictions and will explain how and why different mechanisms operate in different contexts to generate different outcomes among frequent users. Consensual and prioritised statements about next steps for spread of CM in primary care from the perspectives of all stakeholders will be provided. Our results will offer context-sensitive explanations that can better inform local practices and policies and contribute to improve the health of patients with complex healthcare needs who frequently use healthcare services. Ultimately, this will increase the performance of healthcare systems and specifically mitigate ineffective use and costs.