bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study
Authors: Wang Haoyu , Liu Aihua , Zhao Tong , Gong Xun , Pang Tianxiao , Zhou Yingying , Xiao Yue , Yan Yumeng , Fan Chenling , Teng Weiping , Lai Yaxin , Shan Zhongyan 
Published: September 2017

ObjectivesOur study aimed to distinguish the ability of anthropometric indices to assess the risk of metabolic syndrome (MetS).DesignProspective cohort study.SettingShenyang, China.ParticipantsA total of 379 residents aged between 40 and 65 were enrolled. 253 of them were free of MetS and had been followed up for 4.5 years.MethodsAt baseline, all the participants underwent a thorough medical examination. A variety of anthropometric parameters were measured and calculated, including waist circumference (WC), body mass index (BMI), a body shape index (ABSI), abdominal volume index (AVI), body adiposity index, body roundness index, conicity index, waist-to-hip ratio and visceral adiposity index (VAI). After 4.5 year follow-up, we re-examined whether participants were suffering from MetS. A receiver operating characteristic (ROC) curve was applied to examine the potential of the above indices to identify the status and risk of MetS.OutcomesOccurrence of MetS.ResultsAt baseline, 33.2% participants suffered from MetS. All of the anthropometric indices showed clinical significance, and VAI was superior to the other indices as it was found to have the largest area under the ROC curve. After a 4.5 year follow-up, 37.8% of men and 23.9% of women developed MetS. ROC curve analysis suggested that baseline BMI was the strongest predictor of MetS for men (0.77 (0.68–0.85)), and AVI was the strongest for women (0.72 (0.64–0.79)). However, no significant difference was observed between WC and both indices. In contrast, the baseline ABSI did not predict MetS in both genders.ConclusionsThe present study indicated that these different indices derived from anthropometric parameters have different discriminatory abilities for MetS. Although WC did not have the largest area under the ROC curve for diagnosing and predicting MetS, it may remain a better index of MetS status and risk because of its simplicity and wide use.
A cross-sectional study in a tertiary care hospital in China: noise or silence in the operating room
Authors: Wang Xiaoxiao , Zeng Lin , Li Gang , Xu Mao , Wei Bin , Li Yan , Li Nan , Tao Liyuan , Zhang Hua , Guo Xiangyang , Zhao Yiming 
Published: September 2017

ObjectivesThis study aims to provide a comprehensive description of noise levels in operating rooms (ORs) in a tertiary care hospital in China. Additionally, the study aims to examine the deviation in noise levels from international and internal standards as well as the differences in noise levels by category of surgery and day of the week.MethodsWe monitored noise levels in 23 ORs in a tertiary care hospital in China between August 2015 and March 2016. Dosimeters were used to determine noise levels. The noise data collected in the dosimeter were downloaded to an IBM computer for subsequent analysis. One-way analysis of variance and Student’s t-test were used to examine the differences in noise levels.ResultsThe noise level in the ORs ranged between 59.2 and 72.3 dB(A), with 100% of the measurements exceeding the recommended hospital noise standards. There was substantial similarity in noise levels from Monday to Friday (F=1.404, p=0.234), with a range between 63.7 and 64.5 dB(A). The difference in noise levels by category of surgery was significant (F=3.381, p<0.001). The results of the post hoc analysis suggested that ophthalmic surgery had significantly higher noise levels than otolaryngological surgery or general surgery.ConclusionsOphthalmic surgery had significantly higher noise levels than otolaryngological or general surgeries. High noise levels were identified in all evaluated ORs during weekdays, and these levels consistently exceeded the currently accepted standards. These findings warrant further investigation to determine the harmful effects of noise on both patients and staff in ORs.￼￼
Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): study protocol
Authors: Rose Louise , Agar Meera , Burry Lisa D , Campbell Noll , Clarke Mike , Lee Jacques , Siddiqi Najma , Page Valerie J 
Published: September 2017

IntroductionDelirium is a common, serious and potentially preventable condition with devastating impact on the quality of life prompting a proliferation of interventional trials. Core outcome sets aim to standardise outcome reporting by identifying outcomes perceived fundamental for measurement in trials of a specific interest area. Our aim is to develop international consensus on two core outcome sets for trials of interventions to prevent and/or treat delirium, irrespective of study population. We aim to identify additional core outcomes specific to the critically ill, acutely hospitalised patients, palliative care and older adults.Methods and analysisWe will conduct a systematic review of published and ongoing delirium trials (1980 onwards) and one-on-one interviews of patients who have experienced delirium and family members. These data will inform Delphi round 1 of a two-stage consensus process. In round 2, we will provide participants their own response, summarised group responses and those of patient/family participants for rescoring. We will randomise participants to receive feedback as proportion scoring the outcome as critical or as group mean responses. We will hold a consensus meeting using nominal group technique to finalise outcomes for inclusion. We will repeat the Delphi process and consensus meeting to select measures for each core outcome. We will recruit 240 Delphi participants giving us 80% power to detect a 1.0–1.5 point (9-point scale) difference by feedback method between rounds. We will analyse differences for subsequent scores, magnitude of opinion change, items retained and level of agreement.Ethics and disseminationWe are obtaining research ethics approvals according to local governance. Participation will be voluntary and data deidentified. Support from three international delirium organisations will be instrumental in dissemination and core outcome set uptake. We will disseminate through peer-reviewed open access publications and present at conferences selected to reach a wide range of knowledge users.
Assessing the extent of drug interactions among patients with multimorbidity in primary and secondary care in the West Midlands (UK): a study protocol for the Mixed Methods Multimorbidity Study (MiMMS)
Authors: Backman Ruth , Weber Philip , Turner Alice M , Lee Mark , Litchfield Ian 
Published: September 2017

IntroductionThe numbers of patients with three or more chronic conditions (multimorbidity) are increasing, and will rise to 2.9 million by 2018 in the UK alone. Currently in the UK, conditions are mainly managed using over 250 sets of single-condition guidance, which has the potential to generate conflicting recommendations for lifestyle and concurrent medication for individual patients with more than one condition. To address some of these issues, we are developing a new computer-based tool to help manage these patients more effectively. For this tool to be applicable and relevant to current practice, we must first better understand how existing patients with multimorbidity are being managed, particularly relating to concerns over prescribing and potential polypharmacy.Methods and analysisUp to four secondary care centres, two community pharmacies and between four and eight primary care centres in the West Midlands will be recruited. Interviewees will be purposively sampled from these sites, up to a maximum of 30. In this mixed methods study, we will perform a dual framework analysis on the qualitative data; the first analysis will use the Theoretical Domains Framework to assess barriers and enablers for healthcare professionals around the management of multimorbid patients; the second analysis will use Normalisation Process Theory to understand how interventions are currently being successfully implemented in both settings. We will also extract quantitative anonymised patient data from primary care to determine the extent of polypharmacy currently present for patients with multimorbidity in the West Midlands.DiscussionWe aim to combine these data so that we can build a useful, fully implementable tool which addresses the barriers most amenable to change within both primary and secondary care contexts.Ethics and disseminationFavourable ethical approval has been granted by The University of Birmingham Research Ethics Committee (ERN_16–0074) on 17 May 2016. Our work will be disseminated through peer-reviewed literature, trade journals and conferences. We will also use the dedicated web page hosted by the University to serve as a central point of contact and as a repository of our findings. We aim to produce a minimum of three articles from this work to contribute to the international scientific literature.Protocol registration numberNIHR Clinical Research Network Portfolio Registration CPMS ID 30613.
Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials
Authors: Scott Alexander J , Webb Thomas L , Rowse Georgina 
Published: September 2017

IntroductionSleep and mental health go hand-in-hand, with many, if not all, mental health problems being associated with problems sleeping. Although sleep has been traditionally conceptualised as a secondary consequence of mental health problems, contemporary views prescribe a more influential, causal role of sleep in the formation and maintenance of mental health problems. One way to evaluate this assertion is to examine the extent to which interventions that improve sleep also improve mental health.Method and analysisRandomised controlled trials (RCTs) describing the effects of interventions designed to improve sleep on mental health will be identified via a systematic search of four bibliographic databases (in addition to a search for unpublished literature). Hedges’gand associated 95% CIs will be computed from means and SDs where possible. Following this, meta-analysis will be used to synthesise the effect sizes from the primary studies and investigate the impact of variables that could potentially moderate the effects. The Jadad scale for reporting RCTs will be used to assess study quality and publication bias will be assessed via visual inspection of a funnel plot and Egger’s test alongside Orwin’s fail-safen. Finally, mediation analysis will be used to investigate the extent to which changes in outcomes relating to mental health can be attributed to changes in sleep quality.Ethics and disseminationThis study requires no ethical approval. The findings will be submitted for publication in a peer-reviewed journal and promoted to relevant stakeholders.PROSPERO registration numberCRD42017055450.
Disability acquisition and mental health: effect modification by demographic and socioeconomic characteristics using data from an Australian longitudinal study
Authors: Aitken Zoe , Simpson Julie Anne , Bentley Rebecca , Kavanagh Anne Marie 
Published: September 2017

ObjectivesThere is evidence of a causal relationship between disability acquisition and poor mental health, but the substantial heterogeneity in the magnitude of the effect is poorly understood and may be aetiologically informative. This study aimed to identify demographic and socioeconomic factors that modify the effect of disability acquisition on mental health.Design and settingThe Household, Income and Labour Dynamics in Australia Survey is a nationally representative longitudinal survey of Australian households that has been conducted annually since 2001. Four waves of data were included in this analysis, from 2011 to 2014.ParticipantsIndividuals who acquired a disability (n=387) were compared with those who remained disability-free in all four waves (n=7936).Primary outcome measureMental health was measured using the mental health subscale of the Short Form 36 (SF-36) general health questionnaire, which measures symptoms of depression, anxiety and psychological well-being.MethodsLinear regression models were fitted to estimate the effect of disability acquisition on mental health, testing for effect modification by key demographic and socioeconomic characteristics. To maximise causal inference, we used a propensity score approach with inverse probability of treatment weighting to control for confounding and multiple imputation using chained equations to assess the impact of missing data.ResultsOn average, disability acquisition was associated with a 5-point decline in mental health score (estimated mean difference: −5.1, 95% CI −7.2 to –3.0). There was strong evidence that income and relationship status modified the effect, with more detrimental effects in the lowest (−12.5, 95% CI −18.5 to –6.5) compared with highest income quintile (−1.1, 95% CI –4.9 to 2.7) and for people not in a relationship (−8.8, 95% CI −12.9 to –4.8) compared with those who were (−3.7, 95% CI −6.1 to –1.4).ConclusionsOur results suggest that the detrimental effect of disability acquisition on mental health is substantially greater for socioeconomic disadvantaged individuals.
Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care: study protocol for a cluster randomised controlled trial
Authors: Liang Jenifer , Abramson Michael J , Zwar Nicholas , Russell Grant , Holland Anne E , Bonevski Billie , Mahal Ajay , Hecke Benjamin van , Phillips Kirsten , Eustace Paula , Paul Eldho , Petrie Kate , Wilson Sally , George Johnson 
Published: September 2017

IntroductionUp to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings.Methods and analysisA cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS — Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George’s Respiratory Questionnaire score of patients with COPD at 6 months from baseline.Ethics and disseminationThis project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018 – 2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time.Trial registration numberACTRN12614001155684; Pre-results.
Diagnostic validity of early-onset obsessive-compulsive disorder in the Danish Psychiatric Central Register: findings from a cohort sample
Authors: Nissen Judith , Powell Shelagh , Koch Susanne V , Crowley James J , Matthiesen Manuel , Grice Dorothy E , Thomsen Per H , Parner E 
Published: September 2017

ObjectivesEmploying national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR).DesignReview of patient journals selected randomly through the DPCR.MethodOne hundred cases of OCD were randomly selected from DPCR. Using a predefined coding scheme based on the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), experienced research nurse or child and adolescent psychiatrists assessed each journal to determine the presence/absence of OCD diagnostic criteria. The detailed assessments were reviewed by two senior child and adolescent psychiatrists to determine if diagnostic criteria were met.Primary outcome measurementsPositive predictive value (PPV) was used as the primary outcome measurement.ResultsA total of 3462 children/adolescents received an OCD diagnosis as the main diagnosis between 1 January 1995 and 31 December 2015. The average age at diagnosis was 13.21±2.89 years. The most frequent registered OCD subcode was the combined diagnosis DF42.2. Of the 100 cases we examined, 35 had at least one registered comorbidity. For OCD, the PPV was good (PPV 0.85). Excluding journals with insufficient information, the PPV was 0.96. For the subcode F42.2 the PPV was 0.77. The inter-rater reliability was 0.94. The presence of the CYBOCS in the journal significantly increased the PPV for the OCD diagnosis altogether and for the subcode DF42.2.ConclusionThe validity and reliability of International Classification of Disease 10th revision codes for OCD in the DPCR is generally high. The subcodes for predominant obsessions/predominant compulsions are less certain and should be used with caution. The results apply for both children and adolescents and for both older and more recent cases. Altogether, the study suggests that there is a high validity of the OCD diagnosis in the Danish National Registers.
Impact of oral self-care on incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 study
Authors: Bando Shino , Tomata Yasutake , Aida Jun , Sugiyama Kemmyo , Sugawara Yumi , Tsuji Ichiro 
Published: September 2017

ObjectivesTo assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss.DesignA 5.7-year prospective cohort study.SettingOhsaki City, Japan.Participants12 370 community-dwelling individuals aged 65 years and older.Primary outcome measuresIncident functional disability (new long-term care insurance certification).ResultsThe 5.7-year incidence rate of disability was 18.8%. In comparison with participants who had ≥20 teeth, the HRs (95% CIs) for incident functional disability among participants who had 10–19 and 0–9 teeth were 1.15 (1.01–1.30) and 1.20 (1.07–1.34), respectively (p trend<0.05). However, the corresponding values for those who brushed their teeth ≥2 times per day were not significantly higher in the ‘10–19 teeth’ and ‘0–9 teeth’ groups (HRs (95% CI) 1.05 (0.91–1.21) for participants with 10–19 teeth, and 1.09 (0.96–1.23) for participants with 0–9 teeth), although HRs for those who brushed their teeth <2 times per day were significantly higher (HRs (95% CI) 1.32 (1.12–1.55) for participants with 10–19 teeth, and 1.33 (1.17–1.51) for participants with 0–9 teeth). Such a negating association was not observed for other forms of oral self-care.ConclusionsTooth brushing may partially negate the increased risk of incident functional disability associated with having fewer remaining teeth.
British Thoracic Society quality standards for home oxygen use in adults
Authors: Suntharalingam Jay , Wilkinson Tom , Annandale Joseph , Davey Claire , Fielding Rhea , Freeman Daryl , Gibbons Michael , Hardinge Maxine , Hippolyte Sabrine , Knowles Vikki , Lee Cassandra , MacNee William , Pollington Jacqueline , Vora Vandana , Watts Trefor , Wijesinghe Meme 
Published: September 2017

IntroductionThe purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for home oxygen provision in the UK, together with measurable markers of good practice. Quality statements are based on the British Thoracic Society (BTS) Guideline for Home Oxygen Use in Adults.MethodsDevelopment of BTS Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards.Results10 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for home oxygen use, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare.DiscussionBTS Quality Standards for home oxygen use in adults form a key part of the range of supporting materials that the society produces to assist in the dissemination and implementation of a guideline’s recommendations.
Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure
Authors: Wu Tianzhou , Li Jiang , Shao Li , Xin Jiaojiao , Jiang Longyan , Zhou Qian , Shi Dongyan , Jiang Jing , Sun Suwan , Jin Linfeng , Ye Ping , Yang Lingling , Lu Yinyun , Li Tan , Huang Jianrong , Xu Xiaowei , Chen Jiajia , Hao Shaorui , Chen Yuemei , Xin Shaojie , Gao Zhiliang , Duan Zhongping , Han Tao , Wang Yuming , Gan Jianhe , Feng Tingting , Pan Chen , Chen Yongping , Li Hai , Huang Yan , Xie Qing , Lin Shumei , Li Lanjuan , Li Jun 
Published: September 2017

ObjectiveThe definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients.DesignThe clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria.ResultsOf the patients assessed using the Chronic Liver Failure Consortium criteria with the exception of cirrhosis, 391 patients with ACLF were identified: 92 with non-cirrhotic HBV-ACLF, 271 with cirrhotic HBV-ACLF and 28 with ACLF with cirrhosis caused by non-HBV aetiologies (non-HBV-ACLF). The short-term (28/90 days) mortality of the patients with HBV-ACLF were significantly higher than those of the patients with non-HBV-ACLF. Total bilirubin (TB) ≥12 mg/dL and an international normalised ratio (INR) ≥1.5 was proposed as an additional diagnostic indicator of HBV-ACLF, and 19.3% of patients with an HBV aetiology were additionally diagnosed with ACLF. The new prognostic score (0.741×INR+0.523×HBV-SOFA+0.026×age+0.003×TB) for short-term mortality was superior to five other scores based on both discovery and external validation studies.ConclusionsRegardless of the presence of cirrhosis, patients with CHB, TB ≥12 mg/dL and INR ≥1.5 should be diagnosed with ACLF. The new criteria diagnosed nearly 20% more patients with an HBV aetiology with ACLF, thus increasing their opportunity to receive timely intensive management.