bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food choices: concordance in Australian children aged 11–12 years and their parents
Authors: Vivarini Prudence , Kerr Jessica A , Clifford Susan A , Grobler Anneke C , Jansen Pauline W , Mensah Fiona K , Baur Louise A , Gibbons Kay , Wake Melissa 
Published: July 2019

ObjectivesSnack foods—typically high in salt, sugar, fat and/or energy—are likely important to the obesity epidemic. In the context of a population-based health assessment involving parent–child dyads at child age 11–12 years, we report cross-generational concordance in intake at a controlled snack food observation.DesignCross-sectional study (Child Health CheckPoint), nested within the Longitudinal Study of Australian Children.SettingAssessment centres in seven Australian cities, February 2015–March 2016.ParticipantsOf all participating CheckPoint families (n=1874), 1299 children (50.3% girls) and 1274 parents (85.9% mothers) with snack data were included. Survey weights and methods were applied to account for the clustered multistage sample design.Outcome measuresPartway through the 3.5-hour assessment, parents and children attendedFood Stopseparately for a timed 15 min ‘snack break’. One of four standardised box size/content combinations was randomly provided to all participants on any given day. Total food mass, energy, nutrients and sodium consumed was measured to the nearest 1 g. Pearson’s correlation coefficients and adjusted multivariable linear regression models assessed parent–child concordance in each variable.ResultsChildren consumed less grams (151 g [SD 80] vs 165 g [SD 79]) but more energy (1393 kJ [SD 537] vs 1290 kJ [SD 658]) than parents. Parent–child concordance coefficients were small, ranging from 0.07 for sodium intake to 0.17 for carbohydrate intake. Compared with children with parents’ energy intake on the 10th centile, children whose parents were on the 90th centile ate on average 227 kJ more. If extrapolated to one similar unsupervised snack on a daily basis, this equates to an additional 83 050 kJ per year, which could have a cumulative impact on additional body fat.ConclusionsAlthough modest at an individual level, this measured parent-child concordance in unsupervised daily snack situations could account for substantial annual population differences in energy, fat and sodium intake for children aged 11–12 years.Trial registration numberISRCTN12538380.
Retinal microvasculature: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Authors: Dascalu Julian , Liu Mengjiao , Lycett Kate , Grobler Anneke C , He Mingguang , Burgner David P , Wong Tien Yin , Wake Melissa 
Published: July 2019

ObjectivesTo describe distributions and concordance of retinal microvasculature measurements in a population-based sample of Australian parent–child dyads at child age 11–12 years.DesignCross-sectional Child Health CheckPoint study, between waves 6 and 7 of the national population-based Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven Australian cities, February 2015–March 2016.ParticipantsOf the 1874 participating families, 1288 children (51% girls) and 1264 parents (87% mothers, mean age 43.7) were analysed. Diabetic participants and non-biological pairs were excluded from concordance analyses.Outcome measuresRetinal photographs were taken by non-mydriatic fundus camera. Trained graders scored vascular calibre using semi-automated software, yielding estimates of central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) and arteriolar–venular ratio (AVR). Pearson’s correlation coefficients and multivariable linear regression models assessed parent–child concordance. Survey weights and methods accounted for LSAC’s complex sampling, stratification and clustering within postcodes.ResultsMean (SD) of CRAE and CRVE were larger in children (159.5 (11.8) and 231.1 (16.5) μm, respectively) than parents (151.5 (14.0) and 220.6 (19.0) μm), yielding similar AVR (children 0.69 (0.05), parents 0.69 (0.06)). Correlation coefficients for parent–child pairs were 0.22 (95% CI 0.16 to 0.27) for CRAE, 0.23 (95% CI 0.17 to 0.28) for CRVE and 0.18 (95% CI 0.13 to 0.24) for AVR. Mother–child and father–child values were similar (0.20 and 0.32 for CRAE, 0.22 and 0.29 for CRVE, respectively). Relationships attenuated slightly on adjustment for age, sex, blood pressure, diabetes and body mass index. Percentiles and concordance are presented for the whole sample and by sex.ConclusionsArteriolar and venular calibre were similar to previously documented measures in midlife adult and late childhood populations. Population parent–child concordance values align with moderate polygenic heritability reported in smaller studies.
Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents
Authors: Smith Julia , Wang Jing , Grobler Anneke C , Lange Katherine , Clifford Susan A , Wake Melissa 
Published: July 2019

ObjectivesTo describe the epidemiology and parent-child concordance of hearing, speech reception, vocabulary and language in Australian parent-child dyads at child age 11 to 12 years.DesignPopulation-based cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children.SettingAssessment centres in seven Australian cities and eight regional towns or home visits around Australia, February 2015 to March 2016.ParticipantsOf all participating CheckPoint families (n=1874), 1516 children (50% female) and 1520 parents (87% mothers, mean age 43.8 years) undertook at least one of four measurements of hearing and language.Outcome measuresHearing threshold (better ear mean of 1, 2 and 4 kHz) from pure-tone audiometry, speech reception threshold, receptive vocabulary, expressive and receptive languages using a sentence repetition task. Parent-child concordance was examined using Pearson’s correlation coefficients and adjusted linear regression models. Survey weights and methods accounted for Longitudinal Study of Australian Children’s complex sampling and stratification.ResultsChildren had a similar speech reception threshold to parents (children mean −14.3, SD 2.4; parents −14.9, SD 3.2 dB) but better hearing acuity (children 8.3, SD 6.3; parents 13.4, SD 7.0 decibels hearing level). Standardised sentence repetition scores were similar (children 9.8, SD 2.9; parents 9.1, SD 3.3) but, as expected, parents had superior receptive vocabularies. Parent-child correlations were higher for the cognitively-based language measures (vocabulary 0.31, 95% CI 0.26 to 0.36; sentence repetition 0.29, 95% CI 0.24 to 0.34) than the auditory measures (hearing 0.18, 95% CI 0.13 to 0.23; speech reception threshold 0.18, 95% CI 0.13 to 0.22). Mother-child and father-child concordances were similar for all measures.ConclusionsWe provide population reference values for multiple measures spanning auditory and verbal communication systems in children and mid-life adults. Concordance values aligned with previous twin studies and offspring studies in adults, in keeping with polygenic heritability that is modest for audition but around 60% for language by late childhood.
Long-term observational approach in women with histological diagnosis of cervical low-grade squamous intraepithelial lesion: an Italian multicentric retrospective cohort study
Authors: Ciavattini Andrea , Serri Matteo , Di Giuseppe Jacopo , Liverani Carlo Antonio , Gardella Barbara , Papiccio Maria , Delli Carpini Giovanni , Morini Stefano , Clemente Nicolò , Sopracordevole Francesco 
Published: July 2019

ObjectiveTo evaluate the risk of progression to high-grade squamous intraepithelial lesion (HSIL) (CIN2-3) or invasive cancer in women with histopathological diagnosis of low-grade squamous intraepithelial lesion (LSIL) (CIN1), managed in a long-term observational approach up to 5 years.DesignRetrospective cohort study.SettingFour tertiary referral hospital.Participants434 women with adequate colposcopy and complete colposcopic charts were included in the present analysis. Women with glandular lesions on the referral cytology or previous diagnosis of cervical dysplasia or invasive cervical cancer or with synchronous vaginal, or with HIV infection or immunodepression were excluded.Primary and secondary outcome measuresThe main study outcome was the rate of progression to histopathological HSIL (CIN2-3) or invasive cancer at any time during 5 years of follow-up. The possible risk factors were also evaluated. As secondary outcome, we analysed the possible risk factors at the 24-month evaluation for histopathological HSIL (CIN2-3) or invasive cancer progression between 2 and 5 years from initial diagnosis.ResultsA progression to histopathological HSIL (CIN2-3) was found in a total of 32 (7.4%) cases during 5 years of follow-up. A histopathological diagnosis of HSIL (CIN3) was found in four patients (0.9%) and no case of invasive cancer was detected. High-grade cytology at inclusion and the presence of a positive high-risk human papillomavirus (HR-HPV) DNA test at 2 years from inclusion maintained a significant correlation with the risk of histopathological progression to HSIL (CIN2-3).ConclusionsThe results of our study showed a low rate (7.4%) of histopathological progression to HSIL (CIN2-3) in women with LSIL (CIN1) diagnosis during long-term follow-up up to 5 years. In case of positive HR-HPV DNA test at the 2 years evaluation an excisional treatment could be the preferred choice to prevent progression to HSIL (CIN2-3) in the following years, preferring a continuation of follow-up in case of HR-HPV DNA negative result.
Building patient capacity to participate in care during hospitalisation: a scoping review
Authors: Goodridge Donna , McDonald Meghan , New Lucia , Scharf Murray , Harrison Elizabeth , Rotter Thomas , Watson Erin , Henry Chrysanthus , Penz Erika D 
Published: July 2019

ObjectivesTo map the existing literature and describe interventions aimed at building the capacity of patients to participate in care during hospitalisation by: (1) describing and categorising the aspects of care targeted by these interventions and (2) identifying the behaviour change techniques (BCTs) used in these interventions. A patient representative participated in all aspects of this project.DesignScoping review.Data sourcesMEDLINE, Embase and CINAHL (Inception −2017).Study selectionStudies reporting primary research studies on building the capacity of hospitalised adult patients to participate in care which described or included one or more structured or systematic interventions and described the outcomes for at least the key stakeholder group were included.Data extractionTitle and abstract screening and full text screening were conducted by pairs of trained reviewers. One reviewer extracted data, which were verified by a second reviewer. Interventions were classified according to seven aspects of care relevant to hospital settings. BCTs identified in the articles were assigned through consensus of three reviewers.ResultsDatabase searches yielded a total 9899 articles, resulting in 87 articles that met the inclusion criteria. Interventions directed at building patient capacity to participate in care while hospitalised were categorised as those related to improving: patient safety (20.9%); care coordination (5.7%); effective treatment (5.7%) and/or patient-centred care using: bedside nursing handovers (5.7%); communication (29.1%); care planning (14%) or the care environment (19.8%). The majority of studies reported one or more positive outcomes from the defined intervention. Adding new elements (objects) to the environment and restructuring the social and/or physical environment were the most frequently identified BCTs.ConclusionsThe majority of studies to build capacity for participation in care report one or more positive outcomes, although a more comprehensive analysis is warranted.
Exploratory qualitative study to understand the underlying motivations and strategies of the private for-profit healthcare sector in urban Bangladesh
Authors: Adams Alayne Mary , Ahmed Rushdia , Shuvo Tanzir Ahmed , Yusuf Sifat Shahana , Akhter Sadika , Anwar Iqbal 
Published: July 2019

ObjectivesThis paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access.MethodsThis exploratory qualitative study was conducted in Dhaka, Sylhet and Khulna City Corporations. Data collection methods included key informant interviews (20) with government and private sector leaders, in-depth interviews (30) with clinic owners, managers and providers and exit interviews (30) with healthcare clients.ResultsProfit generation is a driving force behind entry into the private healthcare business and the provision of services. However, non-financial motivations are also emphasised such as aspirations to serve the disadvantaged, personal ambition, desire for greater social status, obligations to continue family business and adverse family events.The discussion of private sector motivations and strategies is framed using the Business Policy Model. This model is comprised of three components:products and services, and efforts to make these attractive including patient-friendly discounts and service-packages, and building ‘good’ doctor-patient relationships;the market environment, cultivated using medical brokers and referral fees to bring in fresh clientele, and receipt of pharmaceutical incentives; and finally,organisational capabilities, in this case overcoming human resource shortages by relying on medical staff from the public sector, consultant specialists, on-call and less experienced doctors in training, unqualified nursing staff and referring complicated cases to public facilities.ConclusionsIn the context of low public sector capacity and growing healthcare demands in urban Bangladesh, private for-profit engagement is critical to achieving universal health coverage (UHC). Given the informality of the sector, the nascent state of healthcare financing, and a weak regulatory framework, the process of engagement must be gradual. Further research is needed to explore how engagement in UHC can be enabled while maintaining profitability. Incentives that support private sector efforts to improve quality, affordability and accountability are a first step in building this relationship.
How do surgeons’ trade-off between patient outcomes and risk of complications in total knee arthroplasty? a discrete choice experiment in Australia
Authors: Szawlowski Sandie , Choong Peter F M , Li Jinhu , Nelson Elizabeth , Nikpour Mandana , Scott Anthony , Sundararajan Vijaya , Dowsey Michelle M 
Published: July 2019

ObjectiveTo measure the trade-off between risk of complications versus patient improvement in pain and function in orthopaedic surgeons’ decisions about whether to undertake total knee arthroplasty (TKA).MethodsA discrete choice experiment asking surgeons to make choices between experimentally-designed scenarios describing different levels of operative risk and dimensions of pain and physical function. Variation in preferences and trade-offs according to surgeon-specific characteristics were also examined.ResultsThe experiment was completed by a representative sample of 333 orthopaedic surgeons (n=333): median age 52 years, 94% male, 91% fully qualified. Orthopaedic surgeons were willing to accept substantial increases in absolute risk associated with TKA surgery for greater improvements in a patient’s pain and function. The maximum risk surgeons were willing to accept was 40% for reoperation and 102% for the need to seek further treatment from a general practitioner or specialist in return for a change from postoperative severe night-time pain at baseline to no night-time pain at 12 months. With a few exceptions, surgeon-specific characteristics were not associated with how much risk a surgeon is willing to accept in a patient undergoing TKA.ConclusionThis is the first study to quantify risk-benefit trade-offs among orthopaedic surgeons performing TKA, using a discrete choice experiment. This study provides insight into the risk tolerance of surgeons.
Screening a nation for hepatitis C virus elimination: a cross-sectional study on prevalence of hepatitis C and associated risk factors in the Rwandan general population
Authors: Umutesi Justine , Liu Carol Yingkai , Penkunas Michael J , Makuza Jean Damascene , Ntihabose Corneille K , Umuraza Sabine , Niyikora Julienne , Serumondo Janvier , Gupta Neil , Nsanzimana Sabin 
Published: July 2019

ObjectivesWe analysed data collected during programmatic screening activities conducted in 2017 to describe hepatitis C virus (HCV) seroprevalence in the general population and identify associated factors.DesignWe analysed data collected between June and September 2017. For both seroprevalence and viraemia, variations across demographic and geographic factors were assessed and multivariate regression models were fit to identify factors independently associated with each marker. Geospatial data were examined for visualisation.SettingHCV screening was organised within each of the 30 districts in Rwanda. One designated location in each district was selected as the screening site and screening took place for 1 week at each site.ParticipantsThis study included 124 223 male and female volunteers. Anti-HCV-positive individuals were followed up with HCV RNA viral load (VL) testing for infection confirmation.Main outcome measuresTwo markers were examined: the presence of HCV antibodies and HCV RNA VL.ResultsAmong 124 223 individuals screened, 11 003 (8.86%, 95% CIs: 8.70% to 9.02%) were positive for anti-HCV. Anti-HCV prevalence varied by age with the oldest age group (>55 year olds) having a prevalence of 16.46% (95% CIs: 16.14% to 16.80%) and the youngest age group (<25 year olds) having a prevalence of 2.20% (95% CIs: 1.93% to 2.50%) (crude OR=8.78). After adjustment for covariates, an association remained between anti-HCV prevalence and age (p<0.001), province (p<0.001) and socioeconomic status (p<0.001). Of the 3771 anti-HCV-positive individuals who had an available HCV RNA VL result, 2099 (55.66%, 95% CI: 54.06% to 57.25%) had a detectable HCV RNA VL. Age was also associated with HCV viraemia (p<0.001).ConclusionResults suggest that over 55% of individuals who screened positive for HCV-antibodies were chronically infected. Targeted screening for HCV among older individuals is recommended, given the association between age and infection. Further geographical hotspots of HCV infection can also inform targeted screening as Rwanda moves towards HCV elimination.
Assessing the safety and pharmacokinetics of the monoclonal antibodies, VRC07-523LS and PGT121 in HIV negative women in South Africa: study protocol for the CAPRISA 012A randomised controlled phase I trial
Authors: Mahomed Sharana , Garrett Nigel , Capparelli Edmund , Baxter Cheryl , Zuma Nonhlanhla Yende , Gengiah Tanuja , Archary Derseree , Moore Penny , Samsunder Natasha , Barouch Dan H , Mascola John , Ledgerwood Julie , Morris Lynn , Abdool Karim Salim 
Published: July 2019

IntroductionDespite extensive prevention campaigns and scale-up of antiretroviral therapy, HIV incidence among young women in southern Africa remains high. While the development of an efficacious vaccine remains a challenge, the discovery of broadly neutralising monoclonal antibodies (mAbs) has created the opportunity to explore passive immunisation as a long-acting injectable HIV prevention strategy. The purpose of this trial is to provide safety, pharmacokinetic (PK) and functional activity data of VRC07-523LS and PGT121 when administered subcutaneously (SC) to young South African women. Going forward, the aim is to select the ideal dose and/or monoclonal antibody for co-formulation and testing with CAP256-VRC26.25LS, a potent monoclonal antibody against subtype C virus, in an efficacy trial.Methods and analysisCAPRISA 012A is a randomised, double blinded, placebo-controlled phase I trial to assess the safety and PK profile of two mAbs, VRC07-523LS and PGT121 administered SC to 35 young HIV negative women at low risk for HIV infection. Women will be randomised into seven groups of five participants each. In each group, women will be randomised (4:1) to the active intervention, VRC07-523LS and/or PGT121, or placebo. Participants will be followed up for 24 weeks after the administration of the last dose of study product with a total study duration of 72 weeks. Safety in the study will be assessed by the number and percentage of reactogenicity and adverse events experienced by participants and the relatedness to study product. The PK study design was based on preliminary PK data for VRC07-523LS and PGT121.Ethics and disseminationEthical approval has been granted by the South African Health Products Regulatory Authority and by the University of KwaZulu-Natal Biomedical Research Ethics Committee. Results will be presented at international conferences and published in academic peer-reviewed journals. Trial results will be uploaded on the clinical trial registry.Trial registration numberPACTR201808919297244; Pre-results.
Bioactive adrenomedullin, proenkephalin A and clinical outcomes in an acute heart failure setting
Authors: Molvin John , Jujic Amra , Navarin Silvia , Melander Olle , Zoccoli Giada , Hartmann Oliver , Bergmann Andreas , Struck Joachim , Bachus Erasmus , Di Somma Salvatore , Magnusson Martin 
Published: July 2019

ObjectivesIn an acute heart failure (AHF) setting, proenkephalin A 119–159 (penKid) has emerged as a promising prognostic marker for predicting worsening renal function (WRF), while bioactive adrenomedullin (bio-ADM) has been proposed as a potential marker for congestion. We examined the diagnostic value of bio-ADM in congestion and penKid in WRF and investigated the prognostic value of bio-ADM and penKid regarding mortality, rehospitalisation and length of hospital stay in two separate European AHF cohorts.MethodsBio-ADM and penKid were measured in 530 subjects hospitalised for AHF in two cohorts: Swedish HeArt and bRain failure inVESTigation trial (HARVEST-Malmö) (n=322, 30.1% female; mean age 75.1+11.1 years; 12 months follow-up) and Italian GREAT Network Rome study (n=208, 54.8% female; mean age 78.5+9.9 years; no follow-up available).ResultsPenKid was associated with WRF (area under the curve (AUC) 0.65, p<0.001). In multivariable logistic regression analysis of the pooled cohort, penKid showed an independent association with WRF (adjusted OR (aOR) 1.74, p=0.004). Bio-ADM was associated with peripheral oedema (AUC 0.71, p<0.001), which proved to be independent after adjustment (aOR 2.30, p<0.001). PenKid was predictive of in-hospital mortality (OR 2.24, p<0.001). In HARVEST-Malmö, both penKid and bio-ADM were predictive of 1-year mortality (aOR 1.34, p=0.038 and aOR 1.39, p=0.030). Furthermore, bio-ADM was associated with rehospitalisation (aOR 1.25, p=0.007) and length of hospital stay (β=0.702, p=0.005).ConclusionIn two different European AHF cohorts, bio-ADM and penKid perform as suitable biomarkers for early detection of congestion severity and WRF occurrence, respectively, and are associated with pertinent clinical outcomes.