bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of type 2 diabetes mellitus in women of childbearing age in Africa during 2000–2016: a systematic review and meta-analysis
Authors: Chivese Tawanda , Werfalli Mahmoud M , Magodoro Itai , Chinhoyi Rekai Lionel , Kengne A P , Norris Shane A , Levitt Naomi S 
Published: May 2019

ObjectivesThe aim of this research was to estimate the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), in African women of childbearing age.Study designSystematic review and meta-analysis of relevant African studies published from January 2000 to December 2016.Data sourcesWe searched several databases, including EMBASE, MEDLINE, CINAHL, grey literature and references of included studies.SettingStudies carried out in African communities or any population-based studies were included.ParticipantsWe included studies, carried out in Africa, with non-pregnant women of childbearing age. Studies must have been published between the years 2000 and 2016.OutcomesThe primary outcome was prevalent T2DM. The secondary outcomes were IFG and IGT.Data extraction and synthesisTwo reviewers independently extracted data and, using the adapted Hoy risk of bias tool, independently assessed for risk of bias. We used random-effects meta-analysis models to pool prevalence estimates across studies. We used Cochran’s Q statistic and the I2statistic to assess heterogeneity.ResultsA total of 39 studies from 27 countries were included, totaling 52 075 participants, of which 3813 had T2DM. The pooled prevalence of T2DM was 7.2% (95% CI 5.6% to 8.9%) overall and increased with age. The pooled prevalence was 6.0% (95% CI 4.2% to 8.2%) for impaired fasting glycemia while the prevalence of IGT ranged from 0.9% to 37.0% in women aged 15–24 and 45–54 years, respectively. Substantial heterogeneity across studies was not explained by major studies characteristics such as period of publication, rural/urban setting or whether a study was nationally representative or not.ConclusionThis review highlights the need for interventions to prevent and control diabetes in African women of childbearing age, in view of the significant prevalence of T2DM and prediabetes.PROSPERO registration numberCRD42015027635
Engaging high-risk groups in early lung cancer diagnosis: a qualitative study of symptom presentation and intervention preferences among the UK’s most deprived communities
Authors: McCutchan Grace , Hiscock Julia , Hood Kerenza , Murchie Peter , Neal Richard D , Newton Gareth , Thomas Sara , Thomas Ann Maria , Brain Kate 
Published: May 2019

ObjectivesPeople at high-risk for lung cancer—current/former smokers, aged 40+ years, with serious lung comorbidity (ie, chronic obstructive pulmonary disease) and living in highly deprived areas—are more likely to delay symptom presentation. This qualitative study aimed to understand the influences on early presentation with lung cancer symptoms in high-risk individuals and intervention preferences.MethodsSemi-structured qualitative interviews with 37 high-risk individuals (without a cancer diagnosis), identified through seven GP practices in socioeconomically deprived areas of England, Scotland and Wales (most deprived 20%). A symptom attribution task was used to explore lung symptom perception and help seeking, developed using Leventhal’s Common Sense Model. Four focus groups with 16 high-risk individuals and 12 local stakeholders (healthcare professionals and community partners) were conducted to explore preferences for an intervention to promote early lung cancer symptom presentation. Data were synthesised using Framework analysis.ResultsIndividual and area level indicators of deprivation confirmed that interview participants were highly deprived.Interviews.Preoccupation with managing ‘treatable’ short-term conditions (chest infections), led to avoidance of acting on ‘inevitable and incurable’ long-term conditions (lung cancer). Feeling judged and unworthy of medical help because of their perceived social standing or lifestyle deterred medical help seeking, particularly when difficult life circumstances and traumatic events led to tobacco and alcohol addiction.Focus groups. Participants recommended multifaceted interventions in community venues, with information about lung cancer symptoms and the benefits of early diagnosis, led by a trained and non-judgemental facilitator.ConclusionsThis study was novel in engaging a high-risk population to gain an in-depth understanding of the broader contextual influences on lung cancer symptom presentation. Perceived lack of health service entitlement and complex lives facilitated avoidance of recognising and presenting with lung cancer symptoms. Community-based interventions have the potential to empower disadvantaged populations to seek medical help for lung symptoms.
Designing and psychometric evaluation of Stretching Exercise Influencing Scale (SEIS)
Authors: Delshad Mohammad Hossien , Tavafian Sedigheh Sadat , Kazemnejad Anoshirvan 
Published: May 2019

ObjectiveThe lack of reliable and valid tools for assessing the factors that influence stretching exercises (SEs) among Iranian office employees is obvious. This study aimed to design and evaluate psychometric properties of this instrument.DesignCross-sectional study of psychometric properties.SettingData were gathered from May to September 2017.ParticipantsParticipants were 420 office employees who were working in 10 health centres affiliated to the Shahid Beheshti University of Medical Sciences in Tehran, Iran.Primary outcome measuresThe instrument was designed on the basis of the constructs of the health promotion model (HPM) and extant literature. Exploratory factor analysis (EFA), Cronbach’s α and intraclass correlation coefficient (ICC) were employed to check the scale’s psychometric properties.ResultsIn total, 420 questionnaires were completed. The mean age of the office employees was 37.1±8.03 years. Among the 86 items, 77 items had significant item-to-total correlations (p<0.05). The results showed good internal consistency and reliability for the whole questionnaire and each domain. EFA results confirmed 53.32% of the total variance of the items yielded in 11 subscales. The ICC was acceptable (0.78, 95% CI 0.70 to 0.88).ConclusionsThe Stretching Exercise Influencing Scale (SEIS) can be a reliable and valid instrument for measuring the factors that influence SEs among office employees.Trial registrationIRCT20160824295512N1
Risk stratification model for in-hospital death in patients undergoing percutaneous coronary intervention: a nationwide retrospective cohort study in Japan
Authors: Inohara Taku , Kohsaka Shun , Yamaji Kyohei , Ishii Hideki , Amano Tetsuya , Uemura Shiro , Kadota Kazushige , Kumamaru Hiraku , Miyata Hiroaki , Nakamura Masato 
Published: May 2019

ObjectivesTo provide an accurate adjustment for mortality in a benchmark, developing a risk prediction model from its own dataset is mandatory. We aimed to develop and validate a risk model predicting in-hospital mortality in a broad spectrum of Japanese patients after percutaneous coronary intervention (PCI).DesignA retrospective cohort study was conducted.SettingThe Japanese-PCI (J-PCI) registry includes a nationally representative retrospective sample of patients who underwent PCI and covers approximately 88% of all PCIs in Japan.ParticipantsOverall, 669 181 patients who underwent PCI between January 2014 and December 2016 in 1018 institutes.Main outcome measuresIn-hospital death.ResultsThe study population (n=669 181; mean (SD) age, 70.1(11.0) years; women, 24.0%) was divided into two groups: 50% of the sample was used for model derivation (n=334 591), while the remaining 50% was used for model validation (n=334 590). Using the derivation cohort, both ‘full’ and ‘preprocedure’ risk models were developed using logistic regression analysis. Using the validation cohort, the developed risk models were internally validated. The in-hospital mortality rate was 0.7%. The preprocedure model included age, sex, clinical presentation, previous PCI, previous coronary artery bypass grafting, hypertension, dyslipidaemia, smoking, renal dysfunction, dialysis, peripheral vascular disease, previous heart failure and cardiogenic shock. Angiographic information, such as the number of diseased vessel and location of the target lesion, was also included in the full model. Both models performed well in the entire validation cohort (C-indexes: 0.929 and 0.926 for full and preprocedure models, respectively) and among prespecified subgroups with good calibration, although both models underestimated the risk of mortality in high-risk patients with the elective procedure.ConclusionsThese simple models from a nationwide J-PCI registry, which is easily applicable in clinical practice and readily available directly at the patients’ presentation, are valid tools for preprocedural risk stratification of patients undergoing PCI in contemporary Japanese practice.
Health promotion at the workplace setting: a protocol for a systematic review of effectiveness and sustainability of current practice in low-income and middle-income countries
Authors: Wanjau Mary Njeri , Zapata-Diomedi Belen , Veerman Lennert 
Published: May 2019

IntroductionLow-income and middle-income countries (LMICs) are experiencing a growing disease burden due to non-communicable diseases (NCDs). Changing behavioural practices, such as diets high in saturated fat, salt and sugar and sedentary lifestyles, have been associated with the increase in NCDs. Health promotion at the workplace setting is considered effective in the fight against NCDs and has been reported to yield numerous benefits. However, there is a need to generate evidence on the effectiveness and sustainability of workplace health promotion practice specific to LMICs. We aim to synthesise the current literature on workplace health promotion in LMICs focusing on interventions effectiveness and sustainability.Methods and analysisWe will conduct a systematic review of published studies from LMICs up to 31 March 2019. We will search the following databases: EMBASE, MEDLINE, PubMed, Web of Science, Scopus, ProQuest and CINAHL. Two reviewers will independently screen potential articles for inclusion and disagreements will be resolved by consensus. We will appraise the quality and risk of bias of included studies using two tools from the Cochrane handbook for systematic reviews of interventions. We will present a narrative overview and assessment of the body of evidence derived from the comprehensive review of the studies. The reported outcomes will be summarised by study design, duration, intensity/frequency of intervention delivery and by the six-priority health promotion action areas set out in the Ottawa Charter. We will conduct a thematic analysis to identify the focus areas of current interventions. This systematic review protocol has been prepared according to the Preferred Reporting Items for Systematic reviews and Meta- analyses for Protocols 2015 statement.Ethics and disseminationThis study does not require ethics approval. We will disseminate the results of this review through peer-reviewed publications and conference presentations.Trial registration numberCRD42018110853.
Development and validation of an emotional picture set of self-injury (EPSI) for borderline personality disorder: protocol for a validation study
Authors: Bachmann Katharina , Schulze Marcel , Sörös Peter , Schmahl Christian , Philipsen Alexandra 
Published: May 2019

IntroductionBorderline personality disorder (BPD) is a severe psychiatric disorder that is characterised by major problems in emotion regulation. Affected persons frequently engage in non-suicidal self-injury (NSSI) to regulate emotions. NSSI is associated with high emotionality in patients with BPD and it can be expected that stimuli depicting scenes of NSSI elicit an emotional response indicative of BPD. The present study protocol describes the development and validation of an emotional picture set of self-injury (EPSI) to advance future research on emotion regulation in BPD.Methods and analysisThe present validation study aims to develop and validate an emotional picture set relevant for BPD. Emotional responses to EPSI as well as to a neutral picture set will be investigated in a sample of 30 patients with BPD compared with 30 matched, healthy controls and to 30 matched depressive controls. Emotional responses will be assessed by heart rate variability, facial expression and Self-Assessment Manikin.Ethics and disseminationEthics approval was obtained by the medical ethics committee of the Carl-von-Ossietzky University of Oldenburg, Germany (registration: 2017–044). The results of the trial will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03149926; Pre-results.
Drugs targeting the JAK/STAT pathway for the treatment of immune-mediated inflammatory skin diseases: protocol for a scoping review
Authors: Gómez-García Francisco , Gómez-Arias Pedro Jesús , Hernandez Jorge , Montilla Ana María , Gay-Mimbrera Jesús , Aguilar-Luque Macarena , Viguera-Guerra Isabel , Velez García-Nieto Antonio , Isla-Tejera Beatriz , Ruano Juan 
Published: May 2019

IntroductionThe Janus kinase and Signal Transducer and Activator of Transcription protein (JAK/STAT) pathway is known to be involved in inflammatory and neoplastic skin diseases, like psoriasis, atopic dermatitis, alopecia areata, vitiligo and melanoma. Improved knowledge of the components of this pathway has allowed the development of drugs, which act by inhibiting the pathway, blocking specific components. This offers new therapeutic opportunities. Although evidence on the use of JAK/STAT blockades in dermatological diseases is growing, none have been approved for use in treating skin diseases. The aim of this study is to develop an a priori protocol to broadly review the available evidence on the use of drugs targeting the JAK/STAT pathway in the treatment of dermatological diseases.Methods and analysisFor the conduction of the scoping review protocol, we will employ an established scoping review methodology described in the Joanna Briggs Institute manual. This methodology outlines a five-stage approach: (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data and (5) collate, summarise and report the results, with an optional consultation exercise. Finally, we will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews to present the results.Ethics and disseminationSince this is a review of the literature, ethics approval is not indicated. We will disseminate the findings from this study in publications in peer-reviewed journals as well as presentations at relevant national and international conferences.
Personalised antiplatelet therapy based on pharmacogenomics in acute ischaemic minor stroke and transient ischaemic attack: study protocol for a randomised controlled trial
Authors: Zhang Xiao-Guang , Zhu Xiao-Qiong , Xue Jie , Li Zhi-Zhang , Jiang Hua-Yu , Hu Liang , Yue Yun-Hua 
Published: May 2019

IntroductionAntiplatelet therapy combining aspirin and clopidogrel is considered to be a key intervention for acute ischaemic minor stroke (AIMS) and transient ischaemic attack (TIA). However, the interindividual variability in response to clopidogrel resulting from the polymorphisms in clopidogrel metabolism-related genes has greatly limited its efficacy. To date, there are no reports on individualised antiplatelet therapy for AIMS and TIA based on the genetic testing and clinical features. Therefore, we conduct this randomised controlled trial to validate the hypothesis that the individualised antiplatelet therapy selected on the basis of a combination of genetic information and clinical features would lead to better clinical outcomes compared with the standard care based only on clinical features in patients with AIMS or TIA.Methods and analysisThis trial will recruit 2382 patients with AIMS or TIA who meet eligibility criteria. Patients are randomly assigned in a 1:1 ratio to pharmacogenetic group and standard group. Both groups receive a loading dose of 300 mg aspirin and 300 mg clopidogrel on day 1, followed by 100 mg aspirin per day on days 2–365. The P2Y12 receptor antagonist is selected by the clinician according to the genetic information and clinical features for pharmacogenetic group and clinical features for the standard group on days 2–21. The primary efficacy endpoint is a new stroke event (ischaemic or haemorrhagic) that happens within 1 year. The secondary efficacy endpoint is analysed as the individual or composite outcomes of the new clinical vascular event (ischaemic stroke, haemorrhagic stroke, myocardial infarction or vascular death). Baseline characteristics and outcomes after treatment will be evaluated.Ethics and disseminationThis protocol has been approved by the ethics committee of Yangpu Hospital, Tongji University School of Medicine (No. LL-2018-KY-012). We will submit the results of this trial for publication in a peer-reviewed journal.Trial registration numberChiCTR1800019911; Pre-results.
EPISYNC study: predictors of patient-ventilator asynchrony in a prospective cohort of patients under invasive mechanical ventilation - study protocol
Authors: Sousa Mayson Laercio de Araujo , Magrans Rudys , Hayashi Fátima K , Blanch Lluis , Kacmarek R M , Ferreira Juliana C 
Published: May 2019

IntroductionPatient-ventilator asynchrony is common during the entire period of invasive mechanical ventilation (MV) and is associated with worse clinical outcomes. However, risk factors associated with asynchrony are not completely understood. The main objectives of this study are to estimate the incidence of asynchrony during invasive MV and its association with respiratory mechanics and other baseline patient characteristics.Methods and analysisWe designed a prospective cohort study of patients admitted to the intensive care unit (ICU) of a university hospital. Inclusion criteria are adult patients under invasive MV initiated for less than 72 hours, and with expectation of remaining under MV for more than 24 hours. Exclusion criteria are high flow bronchopleural fistula, inability to measure respiratory mechanics and previous tracheostomy. Baseline assessment includes clinical characteristics of patients at ICU admission, including severity of illness, reason for initiation of MV, and measurement of static mechanics of the respiratory system. We will capture ventilator waveforms during the entire MV period that will be analysed with dedicated software (Better Care, Barcelona, Spain), which automatically identifies several types of asynchrony and calculates the asynchrony index (AI). We will use a linear regression model to identify risk factors associated with AI. To assess the relationship between survival and AI we will use Kaplan-Meier curves, log rank tests and Cox regression. The calculated sample size is 103 patients. The statistical analysis will be performed by the software R Programming (www.R-project.org) and will be considered statistically significant if the p value is less than 0.05.Ethics and disseminationThe study was approved by the Ethics Committee of Instituto do Coração, School of Medicine, University of São Paulo, Brazil, and informed consent was waived due to the observational nature of the study. We aim to disseminate the study findings through peer-reviewed publications and national and international conference presentations.Trial registration numberNCT02687802; Pre-results.
Primary care clinicians’ views of paediatric respiratory infection surveillance information to inform clinical decision-making: a qualitative study
Authors: Anderson Emma C , Kesten Joanna May , Lane Isabel , Hay Alastair D , Moss Timothy , Cabral Christie 
Published: May 2019

AimTo investigate primary care clinicians’ views of a prototype locally relevant, real-time viral surveillance system to assist diagnostic decision-making and antibiotic prescribing for paediatric respiratory tract infections (RTI). Clinicians’ perspectives on the content, anticipated use and impact were explored to inform intervention development.BackgroundChildren with RTIs are overprescribed antibiotics. Pressures on primary care and diagnostic uncertainty can lead to decisional biases towards prescribing. We hypothesise that real-time paediatric RTI surveillance data could reduce diagnostic uncertainty and help reduce unnecessary antibiotic prescribing.MethodologySemistructured one-to-one interviews with 21 clinicians from a range of urban general practitioner surgeries explored the clinical context and views of the prototype system. Transcripts were analysed using thematic analysis.ResultsThough clinicians self-identified as rational (not over)prescribers, cognitive biases influenced antibiotic prescribing decisions. Clinicians sought to avoid ‘anticipated regret’ around not prescribing for a child who then deteriorated. Clinicians were not aware of formal infection surveillance information sources (tending to assume many viruses are around), perceiving the information as novel and potentially useful. Perceptions of surveillance information as presented included: not relevant to decision-making/management; useful to confirm decisions post hoc; and increasing risks of missing sick children. Clinicians expressed wariness of using population-level data to influence individual patient decision-making and expressed preference for threat (high-risk) information identified by surveillance, rather than reassuring information about viral RTIs.ConclusionsMore work is needed to develop a surveillance intervention if it is to beneficially influence decision-making and antibiotic prescribing in primary care. Key challenges for developing interventions are how to address cognitive biases and how to communicate reassuring information to risk-oriented clinicians.
Neighbourhood disparities in the price of the cheapest cigarettes in the USA
Authors: Mills Sarah D , Golden Shelley D , Henriksen Lisa , Kong Amanda Y , Queen Tara L , Ribisl Kurt M 
Published: May 2019

BackgroundThere is evidence that the cheapest cigarettes cost even less in neighbourhoods with higher proportions of youth, racial/ethnic minorities and low-income residents. This study examined the relationship between the price of the cheapest cigarette pack and neighbourhood demographics in a representative sample of tobacco retailers in the USA.MethodsData collectors recorded the price of the cheapest cigarette pack (regardless of brand) in 2069 retailers in 2015. Multilevel linear modelling examined the relationship between price and store neighbourhood (census tract) characteristics, specifically median household income and percentage of youth, Black, Asian/Pacific Islander and Hispanic residents.ResultsAverage price for the cheapest pack was $5.17 (SD=1.73) and it was discounted in 19.7% of stores. The price was $0.04 less for each SD increase in the percentage of youth and $0.22 less in neighbourhoods with the lowest as compared with the highest median household incomes. Excluding excise taxes, the average price was $2.48 (SD=0.85), and associations with neighbourhood demographics were similar.ConclusionThe cheapest cigarettes cost significantly less in neighbourhoods with a greater percentage of youth and lower median household income. Non-tax mechanisms to increase price, such as minimum price laws and restrictions on discounts/coupons, may increase cheap cigarette prices.