bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of obesity and overweight in sub-Saharan Africa: a protocol for a systematic review and meta-analysis
Authors: Biadgilign Sibhatu , Mgutshini Tennyson , Haile Demewoz , Gebremichael Bereket , Moges Yonatan , Tilahun Kelemu 
Published: November 2017

IntroductionGlobally, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost and 3.8% of disability-adjusted life years in 2010. Despite the fact that obesity and overweight is a problem of high-income countries, low- and middle-income countries (LMICs), in particular urban settings of sub-Saharan African countries, face the challenge of an increasing trend. The aim of this systematic review and meta-analysis will be to determine the prevalence of obesity and overweight individuals in sub-Saharan Africa and to help guide policy planners in the decision-making process for the increase in non-communicable diseases in Africa.Methods and analysesA comprehensive systematic review and meta-analysis of published studies on the prevalence of obesity and overweight in sub-Saharan Africa will be conducted. A computerised internet search using Medline/PubMed, Google Scholar and EMBASE databases and reference lists of previous prevalence studies and detailed search strategy and cross-checking of reference lists of published peer-reviewed articles will be conducted to identify all epidemiological and/or clinical studies published in English and French. We will use the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement for reporting. The overall effect (pooled estimated effect size) of the prevalence of obesity and overweight will be analysed using the Der Simonian–Laird random effects meta-analysis (random effects model) and the obesity proportion (with 95% CI) will be measured.Ethics and disseminationThe underlying work is based on systematic reviews of published data and thus doed not require ethical review approval. The findings of the systematic review will be disseminated in different conferences and seminars and will be published in a reputable and refereed international peer-reviewed journal.PROSPERO registration numberCRD42017064942.
Monitoring of clinical strains and environmental fungal aerocontamination to prevent invasive aspergillosis infections in hospital during large deconstruction work: a protocol study
Authors: Loeffert Sophie Tiphaine , Melloul Elise , Dananché Cédric , Hénaff Laetitia , Bénet Thomas , Cassier Pierre , Dupont Damien , Guillot Jacques , Botterel Françoise , Wallon Martine , Gustin Marie-Paule , Vanhems Philippe 
Published: November 2017

IntroductionMonitoring fungal aerocontamination is an essential measure to prevent severe invasive aspergillosis (IA) infections in hospitals. One central block among 32 blocks of Edouard Herriot Hospital (EHH) was entirely demolished in 2015, while care activities continued in surrounding blocks. The main objective was to undertake broad environmental monitoring and clinical surveillance of IA cases to document fungal dispersion during major deconstruction work and to assess clinical risk.Methods and analysisA daily environmental survey of fungal loads was conducted in eight wards located near the demolition site. Air was collected inside and outside selected wards by agar impact samplers. Daily spore concentrations were monitored continuously by volumetric samplers at a flow rate of 10 L.min-1. Daily temperature, wind direction and speed as well as relative humidity were recorded by the French meteorological station Meteociel.Aspergillus fumigatusstrains stored will be genotyped by multiple-locus, variable-number, tandem-repeat analysis. Antifungal susceptibility will be assessed by E-test strips on Roswell Park Memorial Institute medium supplemented with agar. Ascertaining the adequacy of current environmental monitoring techniques in hospital is of growing importance, considering the rising impact of fungal infections and of curative antifungal costs. The present study could improve the daily management of IA risk during major deconstruction work and generate new data to ameliorate and redefine current guidelines.Ethics and disseminationThis study was approved by the clinical research and ethics committees of EHH.
Impact of US smoke-free air laws on restaurants and bars by employer size: a panel study
Authors: Shafer Paul 
Published: November 2017

ObjectivesThirty states have smoke-free air laws that ban smoking in restaurants and bars, covering nearly two-thirds of the US population. It is well established that these laws generally have a null or positive economic impact on restaurants and bars. However, all establishments in a geographic area are usually treated as a homogeneous group without considering the potential for differential effects by establishment characteristics. This study uses variation in smoke-free air laws over time to estimate their impact on employment in restaurants and bars with a focus on potential differences by employer size (number of employees). A two-pronged approach with a national-level and state-level analysis is used to take advantage of more granular data availability for a single state (North Carolina).DesignObservational study using panel data.Setting1) US, 2) North CarolinaInterventionsSmoke-free air laws.Outcome measuresState-level accommodation and food services employment for all 50 states and District of Columbia from 1990 through 2014 (Quarterly Census of Employment and Wages); county-level restaurant and bar employment in North Carolina from 2001 through 2014 (North Carolina Department of Commerce).ResultsThere is no evidence of a redistributive effect of smoke-free air laws on restaurant and bar employment by employer size.ConclusionThe lack of a redistributive effect is an important finding for policy-makers considering implementation or expansion of a smoke-free air law to protect employees and patrons from the dangers of exposure to secondhand smoke.
When has service provision for transient ischaemic attack improved enough? A discrete event simulation economic modelling study
Authors: Barton Pelham , Sheppard James P , Penaloza-Ramos Cristina M , Jowett Sue , Ford Gary A , Lasserson Daniel , Mant Jonathan , Mellor Ruth M , Quinn Tom , Rothwell Peter M , Sandler David , Sims Don , McManus Richard J 
Published: November 2017

ObjectivesThe aim of this study was to examine the impact of transient ischaemic attack (TIA) service modification in two hospitals on costs and clinical outcomes.DesignDiscrete event simulation model using data from routine electronic health records from 2011.ParticipantsPatients with suspected TIA were followed from symptom onset to presentation, referral to specialist clinics, treatment and subsequent stroke.InterventionsIncluded existing versus previous (less same day clinics) and hypothetical service reconfiguration (7-day service with less availability of clinics per day).Outcome measuresThe primary outcome of the model was the prevalence of major stroke after TIA. Secondary outcomes included service costs (including those of treating subsequent stroke) and time to treatment and attainment of national targets for service provision (proportion of high-risk patients (according to ABCD2score) seen within 24 hours).ResultsThe estimated costs of previous service provision for 490 patients (aged 74±12 years, 48.9% female and 23.6% high risk) per year at each site were £340 000 and £368 000, respectively. This resulted in 31% of high-risk patients seen within 24 hours of referral (47/150) with a median time from referral to clinic attendance/treatment of 1.15 days (IQR 0.93–2.88). The costs associated with the existing and hypothetical services decreased by £5000 at one site and increased £21 000 at the other site. Target attainment was improved to 79% (118/150). However, the median time to clinic attendance was only reduced to 0.85 days (IQR 0.17–0.99) and thus no appreciable impact on the modelled incidence of major stroke was observed (10.7 per year, 99% CI 10.5 to 10.9 (previous service) vs 10.6 per year, 99% CI 10.4 to 10.8 (existing service)).ConclusionsReconfiguration of services for TIA is effective at increasing target attainment, but in services which are already working efficiently (treating patients within 1–2 days), it has little estimated impact on clinical outcomes and increased investment may not be worthwhile.
The impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission of HIV on the uptake of maternal antiretroviral therapy among HIV-seropositive pregnant women in sub-Saharan Africa: a systematic review and meta-analysis
Authors: Takah Noah F , Kennedy Iain T R , Johnman Cathy 
Published: November 2017

ObjectivesTo identify the approaches that are used in improving on male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV and their impact on the uptake maternal antiretroviral therapy (ART) in sub-Saharan Africa (SSA).SettingThis was a systematic review and meta-analysis of published studies carried out in SSA at all levels of healthcare (primary, secondary, tertiary and community).ParticipantsThe participants of the studies included were HIV-positive pregnant women and breastfeeding mothers with their male partners. Studies were included if they were conducted in SSA and mentioned an approach used in improving male partner involvement with data on the impact on the uptake of maternal ART uptake.OutcomesIn the protocol, maternal ART uptake, infant prophylaxis, safe infant feeding options, condom use and family planning were envisaged. However, only maternal ART has been reported here due to limitations on the word count.ResultsFrom an initial 2316 non-duplicate articles, 17 articles were included in the systematic review and meta-analysis. In the combined model, the ORs for complex community interventions, enhanced psychosocial interventions, verbal encouragement and invitation letters were 4.22 (95% CI 2.27 to 7.77), 2.29 (95% CI 1.42 to 7.69), 2.39 (95% CI 1.26 to 4.53) and 1.21 (95% CI 0.89 to 1.63), respectively, whereas in the model using adjusted ORs, enhanced psychosocial interventions had a higher effect than any other intervention. The heterogeneity was moderate using adjusted ORs.ConclusionEnhanced psychosocial interventions and complex community interventions increase male partner involvement and the uptake of PMTCT services more than any other intervention. Invitation letters had no effect. More randomised trials and observational studies (that have adjusted for potential confounders) are needed in the future.PROSPERO registration number42016032673.
Is there an association between vitamin D status and risk of chronic low back pain? A nested case–control analysis in the Nord-Trøndelag Health Study
Authors: Heuch Ingrid , Heuch Ivar , Hagen Knut , Mai Xiao-Mei , Langhammer Arnulf , Zwart John-Anker 
Published: November 2017

ObjectivesTo explore potential associations between vitamin D status and risk of chronic low back pain (LBP) in a Norwegian cohort, and to investigate whether relationships depend on the season of blood sample collection.DesignA nested case–control study in a prospective data set.SettingThe Norwegian community-based Nord-Trøndelag Health Study (HUNT). Data were collected in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys.Main outcome measureChronic LBP, defined as LBP persisting at least 3 months continuously during the past year.ParticipantsAmong individuals aged 19–55 years without LBP in HUNT2, a data set was generated including 1685 cases with LBP in HUNT3 and 3137 controls without LBP.MethodsBlood samples from the participants collected in HUNT2 were analysed for serum 25-hydroxyvitamin D (25(OH)D) level. Associations with LBP in HUNT3 were evaluated by unconditional logistic regression analysis with adjustment for age, sex, work status, physical activity at work and in leisure time, education, smoking, and body mass index.ResultsNo association between vitamin D status and risk of chronic LBP was found in the total data set (OR per 10 nmol/L 25(OH)D=1.01, 95% CI 0.97 to 1.06) or in individuals with blood samples collected in summer/autumn (OR per 10 nmol/L 25(OH)D=0.99, 95% CI 0.93 to 1.06). For blood samples drawn in winter/spring, associations differed significantly between women and men (p=0.004). Among women a positive association was seen (OR per 10 nmol/L 25(OH)D=1.11, 95% CI 1.02 to 1.20), but among men no significant association was observed (OR per 10 nmol/L 25(OH)D=0.90, 95% CI 0.81 to 1.01).ConclusionsOverall, no association between vitamin D status and risk of LBP was demonstrated. The association suggested in women for the winter/spring season cannot be regarded as established.
Self-management of cardiac pain in women: an evidence map
Authors: Parry Monica , Bjørnnes Ann Kristin , Clarke Hance , Cooper Lynn , Gordon Allan , Harvey Paula , Lalloo Chitra , Leegaard Marit , LeFort Sandra , McFetridge-Durdle Judith , McGillion Michael , O’Keefe-McCarthy Sheila , Price Jennifer , Stinson Jennifer , Victor J Charles , Watt-Watson Judy 
Published: November 2017

ObjectiveTo describe the current evidence related to the self-management of cardiac pain in women using the process and methodology of evidence mapping.Design and settingLiterature search for studies that describe the self-management of cardiac pain in women greater than 18 years of age, managed in community, primary care or outpatient settings, published in English or a Scandinavian language between 1 January 1990 and 24 June 2016 using AMED, CINAHL, ERIC, EMBASE, MEDLINE, Proquest, PsychInfo, the Cochrane Library, Scopus, Swemed+, Web of Science, the Clinical Trials Registry, International Register of Controlled Trials, MetaRegister of Controlled Trials, theses and dissertations, published conference abstracts and relevant websites using GreyNet International, ISI proceedings, BIOSIS and Conference papers index. Two independent reviewers screened using predefined eligibility criteria. Included articles were classified according to study design, pain category, publication year, sample size, per cent women and mean age.InterventionsSelf-management interventions for cardiac pain or non-intervention studies that described views and perspectives of women who self-managed cardiac pain.Primary and secondary outcomes measuresOutcomes included those related to knowledge, self-efficacy, function and health-related quality of life.ResultsThe literature search identified 5940 unique articles, of which 220 were included in the evidence map. Only 22% (n=49) were intervention studies. Sixty-nine per cent (n=151) of the studies described cardiac pain related to obstructive coronary artery disease (CAD), 2% (n=5) non-obstructive CAD and 15% (n=34) postpercutaneous coronary intervention/cardiac surgery. Most were published after 2000, the median sample size was 90 with 25%–100% women and the mean age was 63 years.ConclusionsOur evidence map suggests that while much is known about the differing presentations of obstructive cardiac pain in middle-aged women, little research focused on young and old women, non-obstructive cardiac pain or self-management interventions to assist women to manage cardiac pain.PROSPERO registration numberCRD42016042806.
Lamin and the heart
Authors: Captur Gabriella , Arbustini Eloisa , Bonne Gisèle , Syrris Petros , Mills Kevin , Wahbi Karim , Mohiddin Saidi A , McKenna William J , Pettit Stephen , Ho Carolyn Y , Muchir Antoine , Gissen Paul , Elliott Perry M , Moon James C 
Published: November 2017

Lamins A and C are intermediate filament nuclear envelope proteins encoded by theLMNAgene. Mutations inLMNAcause autosomal dominant severe heart disease, accounting for 10% of dilated cardiomyopathy (DCM). Characterised by progressive conduction system disease, arrhythmia and systolic impairment, lamin A/C heart disease is more malignant than other common DCMs due to high event rates even when the left ventricular impairment is mild. It has several phenotypic mimics, but overall it is likely to be an under-recognised cause of DCM. In certain clinical scenarios, particularly familial DCM with early conduction disease, the pretest probability of finding anLMNAmutation may be quite high.Recognising lamin A/C heart disease is important because implantable cardioverter defibrillators need to be implanted early. Promising oral drug therapies are within reach thanks to research into the mitogen-activated protein kinase (MAPK) and affiliated pathways. Personalised heart failure therapy may soon become feasible forLMNA, alongside personalised risk stratification, as variant-related differences in phenotype severity and clinical course are being steadily elucidated.Genotyping and family screening are clinically important both to confirm and to excludeLMNAmutations, but it is the three-pronged integration of such genetic information with functional data from in vivo cardiomyocyte mechanics, and pathological data from microscopy of the nuclear envelope, that is properly reshaping ourLMNAknowledge base, one variant at a time. This review explains the biology of lamin A/C heart disease (genetics, structure and function of lamins), clinical presentation (diagnostic pointers, electrocardiographic and imaging features), aspects of screening and management, including current uncertainties, and future directions.
Heart rate at first postdischarge visit and outcomes in patients with heart failure
Authors: Kim Tae-Hun , Kim Hyungseop , Kim In-Cheol , Yoon Hyuck-Jun , Park Hyoung-Seob , Cho Yun-Kyeong , Nam Chang-Wook , Han Seongwook , Hur Seung-Ho , Kim Yoon-Nyun 
Published: November 2017

ObjectiveHeart rate control is important to prevent adverse outcomes in patients with heart failure (HF). However, postdischarge activity may worsen heart rate control, resulting in readmission. This study aimed to explore the implications of the heart rate differences between discharge and the first outpatient visit (D-O diff).MethodsWe retrospectively identified 458 patients (male: 46%; mean age: 72 years) discharged after HF. The heart rates at admission, discharge and first outpatient visit were analysed. The primary outcome was a composite of cardiovascular (CV) death and readmission of non-fatal myocardial infarction (MI), non-fatal stroke or non-fatal HF over a mean follow-up of 16 months.ResultsDuring follow-up, the clinical outcomes were noted in 223 patients (49%): HF, 199; stroke, 9; MI, 6; CV death, 9. The heart rate at the first outpatient visit (r=−0.311, P<0.001) and D-O diff (r=0.416, P<0.001) showed a better correlation with the time-to-clinical event than the heart rate at admission or discharge. The events group displayed a pronounced heart rate increase (13 beats/min) from discharge to the first outpatient visit compared with the event-free group (a decrease of 2 beats/min). A decrease less than −15 in the D-O diff showed a 4.5-fold risk of clinical outcomes during follow-up (P<0.001).ConclusionsA decreased D-O diff was related to the adverse outcomes of HF. The failure of heart rate control within more than 15 beats/min at the first outpatient visit was an independent factor for CV events.
Predicting how health behaviours contribute to the development of diseases within a military population in the Hungarian Defence Forces
Authors: Novák Attila , Hornyák B , Rázsó Zs , Szalánczi Sz , Juhász Zs , Sótér A , Nyakas Cs 
Published: November 2017

IntroductionRecent legislative amendments in Hungary have resulted in the possibility for early retirement being abolished in the Hungarian Defence Forces. The retirement age for professional soldiers has also increased to 65 years, thereby greatly increasing the average length of military service. This necessitates greater attention to the health and care of service personnel due to the increase of chronic non-communicable diseases with age. The aim of this research was to identify how health behaviours might potentially contribute to diseases in the Hungarian Defence Forces.MethodsAll members of the Hungarian Defence Forces undergoing health screenings between 2011 and 2015 were assessed. Health variables analysed were derived from the health screening data sheet which is collected from every member of the Hungarian Defence Forces undergoing a health screening since 2009. Items recorded were connected to health behaviour (physical activity, nutrition, smoking), subjective well-being (psychosomatic backache, fatigue and quality of waking up to describe the quality of sleep), sociodemographic data (age, gender) and the mental toughness quotient (MTQ). A logistic regression model was utilised to predict how health behaviour may affect the development of disease.ResultsFactors most associated with the development of disease included psychosomatic backache (P<0.000), age (P<0.001), frequency of undertaking sports (P<0.05), quality of sleeping and waking up (P<0.05) and the assessment of gender differences (P<0.05).ConclusionsExtension of the length of active service will result in an increased burden of disease for members of the Hungarian Defence Forces. This includes both physical and psychological morbidity that could potentially be obstacles for service personnel to perform their military duties. Health behaviours such as psychosomatic backache, the frequency of performing sports and sleep quality may predict the development of disease and should be explored in health screening consultations.
Could routine spirometry suggest sensitisation in the military medicine setting?
Authors: Cirillo Ignazio , Gallo F , Ciprandi G 
Published: November 2017

IntroductionProviding evidence of sensitisation is the formal requirement for allergy diagnosis. The aim of this study was to evaluate whether spirometry may be able to predict sensitisation in a representative cohort of Italian Navy military personnel.Methods2043 (1875 men, 168 women, mean age 28.35±11.6 years) Italian Navy military personnel were enrolled into this study. Spirometry and skin prick testing were performed to predict sensitisation.ResultsSensitisation, assessed by skin prick test, was documented in 658 (32.2%) subjects. Impaired forced expiratory flow at the 25% and 75% of the pulmonary volume (FEF25–75) as demonstrated on spirometry was detected in 82 subjects, of whom 69 were sensitised (P<0.0001). Impaired FEF25–75 was significantly associated with sensitisation (OR 7.43; 95% CI 4.04 to 14.66; P<0.0001).DiscussionThe findings of this study suggest that impaired FEF25–75 may predict sensitisation in this cohort of Italian Navy personnel. This outcome is relevant in the military medical setting, as it could allow early identification of subjects with subclinical asthma.