bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis
Authors: Martínez-Alonso Montserrat , Carles-Lavila Misericòrdia , Pérez-Lacasta Maria José , Pons-Rodríguez Anna , Garcia Montse , Rué Montserrat 
Published: October 2017

ObjectiveThe aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer.SettingScreening for breast cancer.InterventionDAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes.Eligible studiesWe included published original, non-pilot, studies that assess the effect of DAs for breast cancer screening. We excluded the studies that evaluated only participation intention or actual uptake. The studies’ risk of bias was assessed with the Cochrane Collaboration’s tool for RCTs and the National Institutes of Health Quality Assessment Tool for non-RCTs.Primary and secondary outcomesThe main outcome measures were informed choice, decisional conflict and/or confidence, and knowledge. Secondary outcomes were values, attitudes, uncertainty and intention to be screened.ResultsA total of 607 studies were identified, but only 3 RCTs and 1 before-after study were selected. The use of DAs increased the proportion of women making an informed decision by 14%, 95% CI (2% to 27%) and the proportion of women with adequate knowledge by 12%, 95% CI (7% to 16%). We observed heterogeneity among the studies in confidence in the decision. The meta-analysis of the RCTs showed a significant decrease in confidence in the decision and in intention to be screened.ConclusionsTools to aid decision making in screening for breast cancer improve knowledge and promote informed decision; however, we found divergent results on decisional conflict and confidence in the decision. Under the current paradigm change, which favours informed choice rather than maximising uptake, more research is necessary for the improvement of DAs.
Fabry disease due to D313Y and novel GLA mutations
Authors: Koulousios Konstantinos , Stylianou Konstantinos , Pateinakis Panagiotis , Zamanakou Maria , Loules Gedeon , Manou Eleni , Kyriklidou Parthena , Katsinas Christos , Ouzouni Alexandra , Kyriazis John , Speletas Matthaios , Germenis Anastasios E 
Published: October 2017

ObjectivesOur aim is to report four novel α-gal A gene (GLA) mutations resulting in Fabry disease (FD) and provide evidence of pathogenicity of the D313Y mutation regarding which contradictory data have been presented in the literature.Setting and participantsTwenty-five family members of nine unrelated patients with definite FD diagnosis, 10 clinically suspected cases and 18 members of their families were included in this polycentric cohort study.Primary and secondary outcome measuresGenotyping and measurement of lyso-Gb3was performed in all individuals. The α-Gal A activity was measured in all men as well as plasma and urine Gb3concentration in selected cases. Optical and electron microscopy was performed in kidney biopsies of selected patients. All the above were evaluated in parallel with the clinical data of the patients.ResultsFourteen new cases of FD were recognised, four of which were carrying already describedGLAmutations. Four novelGLAmutations, namely c.835C>T, c.280T>A, c.924A>C and c.511G>A, resulting in a classic FD phenotype were identified. Moreover, FD was definitely diagnosed in five patients carrying the D313Y mutation. Eight D313Y carriers were presenting signs of FD despite not fulfilling the criteria of the disease, two had no FD signs and two others were apparently healthy.ConclusionsFour novelGLApathogenic mutations are reported and evidence of pathogenicity of the D313Y mutation is provided. It seems that the D313Y mutation is related to a later-onset milder phenotype than the typical phenotype with normal lysoGb3concentration. Our study underlines the significance of family member genotyping and newborn screening to avoid misdiagnoses and crucial delays in diagnosis and treatment of the disease.
Hypothermic oxygenated machine perfusion (HOPE) for orthotopic liver transplantation of human liver allografts from extended criteria donors (ECD) in donation after brain death (DBD): a prospective multicentre randomised controlled trial (HOPE ECD-DBD)
Authors: Czigany Zoltan , Schöning Wenzel , Ulmer Tom Florian , Bednarsch Jan , Amygdalos Iakovos , Cramer Thorsten , Rogiers Xavier , Popescu Irinel , Botea Florin , Froněk Jiří , Kroy Daniela , Koch Alexander , Tacke Frank , Trautwein Christian , Tolba Rene H , Hein Marc , Koek Ger H , Dejong Cornelis H C , Neumann Ulf Peter , Lurje Georg 
Published: October 2017

IntroductionOrthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts. Hypothermic oxygenated machine perfusion (HOPE) has been successfully tested in preclinical experiments and in few clinical series of donation after cardiac death OLT.Methods and analysisHOPE ECD-DBD is an investigator-initiated, open-label, phase-II, prospective multicentre randomised controlled trial on the effects of HOPE on ECD allografts in donation after brain death (DBD) OLT. Human whole organ liver grafts will be submitted to 1–2 hours of HOPE (n=23) via the portal vein before implantation and are going to be compared with a control group (n=23) of patients transplanted after conventional cold storage. Primary (peak and Δ peak alanine aminotransferase within 7 days) and secondary (aspartate aminotransferase, bilirubin and international normalised ratio, postoperative complications, early allograft dysfunction, duration of hospital and intensive care unit stay, 1-year patient and graft survival) endpoints will be analysed within a 12-month follow-up. Extent of ischaemia–reperfusion (I/R) injury will be assessed using liver tissue, perfusate, bile and serum samples taken during the perioperative phase of OLT.Ethics and disseminationThe study was approved by the institutional review board of the RWTH Aachen University, Aachen, Germany (EK 049/17). The current paper represent the pre-results phase. First results are expected in 2018.Trial registration numberNCT03124641.
Effects of family planning factors on the awareness of sexual and reproductive healthcare rights among married women of reproductive age in China: a cross sectional study
Authors: Junqing Wu , Chuanning Yu , Yuyan Li 
Published: October 2017

ObjectivesAlthough family planning in China has changed gradually since 1994, there are few studies about family planning and women’s reproductive rights. The main objective of this study was to examine awareness of sexual and reproductive healthcare rights (SRHCRs), and learn how factors related to family planning influence awareness of SRHCRs among married women of reproductive age in China.Methods and participantsInner Mongolia, Chongqing, Guangdong and Henan were selected for the study, and a total of 2504 married women of reproductive age were recruited. A self-administered anonymous questionnaire was used to collect information on participants’ awareness of SRHCRs.ResultsThere were a total of 10 843 (≤6×2504) responses, with a response rate of 72.17% (10 843/15 024) on average among participants regarding SRHCRs (a multiple response set). The highest response rate was for choice (Right 3) (90.64%, 95% CI 89.47%, 91.81%), followed by privacy (Right 5) (86.11%, 95% CI 84.72%, 87.50%) and information (Right 1) (84.47%, 95% CI 83.02%, 85.93%). Only 43.39% (95% CI 41.40%, 45.38%) of participants gave responses to safety (Right 4). Participants without children showed more interest in Right 1, in access (Right 2) and in Right 4. Those who utilised tests for fetal sex determination paid more attention to Rights 2 and 4. Women who accepted informed choice were more likely to be aware of all six rights except for Right 3 and dignity (Right 6). Those individuals who were satisfied or very satisfied with comprehensive sexual and reproductive health counselling services were more likely to show interest in all six rights.ConclusionsAwareness of SRHCRs among reproductive aged women in China is still inadequate. Family planning service providers might strengthen the service awareness of sex and reproductive health rights according to the different needs of women.
Search for unpublished data by systematic reviewers: an audit
Authors: Ziai Hedyeh , Zhang Rujun , Chan An-Wen , Persaud Nav 
Published: October 2017

ObjectivesWe audited a selection of systematic reviews published in 2013 and reported on the proportion of reviews that researched for unpublished data, included unpublished data in analysis and assessed for publication bias.DesignAudit of systematic reviews.Data sourcesWe searched PubMed and Ovid MEDLINE In-Process & Other Non-Indexed Citations between 1 January 2013 and 31 December 2013 for the following journals:Journal of the American Medical Association,The British Medical Journal,Lancet,Annals of Internal Medicineand theCochrane Database of Systematic Reviews. We also searched the Cochrane Library and included 100 randomly selected Cochrane reviews.Eligibility criteriaSystematic reviews published in 2013 in the selected journals were included. Methodological reviews were excluded.Data extraction and synthesisTwo reviewers independently reviewed each included systematic review. The following data were extracted: whether the review searched for grey literature or unpublished data, the sources searched, whether unpublished data were included in analysis, whether publication bias was assessed and whether there was evidence of publication bias.Main findings203 reviews were included for analysis. 36% (73/203) of studies did not describe any attempt to obtain unpublished studies or to search grey literature. 89% (116/130) of studies that sought unpublished data found them. 33% (68/203) of studies included an assessment of publication bias, and 40% (27/68) of these found evidence of publication bias.ConclusionA significant fraction of systematic reviews included in our study did not search for unpublished data. Publication bias may be present in almost half the published systematic reviews that assessed for it. Exclusion of unpublished data may lead to biased estimates of efficacy or safety in systematic reviews.
Neurological outcome after minimal invasive coronary artery surgery (NOMICS): protocol for an observational prospective cohort study
Authors: Nijs Kristof , Vandenbrande Jeroen , Vaqueriza Fidel , Ory Jean-Paul , Yilmaz Alaaddin , Starinieri Pascal , Dubois Jasperina , Jamaer Luc , Arijs Ingrid , Stessel Björn 
Published: October 2017

IntroductionAdverse neurocognitive outcomes are still an important cause of morbidity and mortality after cardiac surgery. The most common neurocognitive disorders after conventional cardiac surgery are postoperative cognitive dysfunction (POCD), stroke and delirium. Minimal invasive cardiac procedures have recently been introduced into practice. Endoscopic coronary artery bypass grafting (Endo-CABG) is a minimal invasive cardiac procedure based on the conventional CABG procedure. Neurocognitive outcome after minimal invasive cardiac surgery, including Endo-CABG, has never been studied. Therefore, the main objective of this study is to examine neurocognitive outcome after Endo-CABG.Methods and analysisWe will perform a prospective observational cohort study including 150 patients. Patients are categorised into three groups: (1) patients undergoing Endo-CABG, (2) patients undergoing a percutaneous coronary intervention and (3) a healthy volunteer group. All patients in the Endo-CABG group will be treated following a uniform, standardised protocol. To assess neurocognitive outcome after surgery, a battery of six neurocognitive tests will be administered at baseline and at 3-month follow-up. In the Endo-CABG group, a neurological examination will be performed at baseline and postoperatively and delirium will be scored at the intensive care unit. Quality of life (QOL), anxiety and depression will be assessed at baseline and at 3-month follow-up. Satisfaction with Endo-CABG will be assessed at 3-month follow-up. Primary endpoints are the incidence of POCD, stroke and delirium after Endo-CABG. Secondary endpoints are QOL after Endo-CABG, patient satisfaction with Endo-CABG and the incidence of anxiety and depression after Endo-CABG.Ethics and disseminationThe neurological outcome after minimal invasive coronary artery surgery study has received approval of the Jessa Hospital ethics board. It is estimated that the trial will be executed from December 2016 to January 2018, including enrolment and follow-up. Analysis of data, followed by publication of the results, is expected in 2018.Trial registration numberNCT02979782.
Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies
Authors: Wray Faye , Clarke David 
Published: October 2017

ObjectiveTo review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech.DesignSystematic review and thematic synthesis.MethodWe included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis.ResultsThirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life.ConclusionsUnderstanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties.
Prospective Investigation of Pesticide Applicators’ Health (PIPAH) study: a cohort study of professional pesticide users in Great Britain
Authors: Harding Anne-Helen , Fox David , Chen Yiqun , Pearce Neil , Fishwick David , Frost Gillian 
Published: October 2017

PurposeThe purpose of the study is to monitor the exposure and health of workers in Great Britain who use pesticides as a part of their job, and to gain a better understanding of the relationship between long-term exposure to pesticides and health.ParticipantsStudy participants are professional pesticide users who are certified in the safe use of pesticides or who were born before 1965 and apply pesticides under ‘grandfather rights’. Overall response rate was 20%; participants are mostly male (98%) and the average age is 54 years, ranging from 17 to over 80 years.Findings to dateParticipants have completed a baseline general questionnaire and three follow-up questionnaires on the use of pesticides. These data will enable investigations into the relationship between occupational pesticide exposure and health outcomes taking into account non-occupational confounding factors.Future plansThere is no set end date for data collection. Recruitment into the cohort will continue, and for the foreseeable future there will be annual pesticide use questionnaires and five yearly follow-up general questionnaires.The intention is to validate the pesticide use questionnaire, and to develop a crop/job exposure matrix (C/JEM) which can be updated regularly. This C/JEM will be able to look at general categories of pesticide, such as insecticides, structurally related pesticides, such as organochlorines, or individual active ingredients. Data collected on use of personal protective equipment and method of application will provide information on how potential exposure to pesticide during application may have been modified. The study will be able to estimate changes in individual pesticide use over time, and to examine the associations between pesticide use and both baseline and long-term health outcomes.The cohort members will be linked to national databases for notification of hospital episode statistics, cancer incidence and mortality for follow-up of health outcomes.
Impact of an inpatient electronic prescribing system on prescribing error causation: a qualitative evaluation in an English hospital
Authors: Puaar Seetal Jheeta , Franklin Bryony Dean 
Published: October 2017

BackgroundFew studies have applied a systems approach to understanding the causes of specific prescribing errors in the context of hospital electronic prescribing (EP). A comprehensive understanding of underlying causes is essential for developing effective interventions to improve prescribing safety. Our objectives were to explore prescribers’ perspectives of the causes of errors occurring with EP and to make recommendations to maximise benefits and minimise risks.MethodsWe studied a large hospital using inpatient EP. From April to June 2016, semistructured interviews were conducted with purposively sampled prescribers involved with a prescribing error. Interviews explored prescribers’ perceived causes of the error and views about EP; they were audio-recorded and transcribed verbatim. Data were thematically analysed against a framework based on Reason’s accident causation model, with a focus on identifying latent conditions.ResultsTwenty-five interviews explored causes of 32 errors. Slips and rule-based mistakes were the most common active failures. Error causation was multifactorial; environmental, individual, team, task and technology error-producing conditions were all influenced by EP. There were three broad groups of latent conditions: the EP system’s functionality and design; the organisation’s decisions around EP implementation and use; and prescribing behaviours in the context of EP.ConclusionsErrors were associated with the design of EP itself and its integration within the healthcare environment. Findings suggest that EP vendors should focus on revolutionising interface design and usability issues, bearing in mind the wider healthcare context in which such software is used. Healthcare organisations should draw upon human factors principles when implementing EP. Consideration of work environment, infrastructure, training, prescribing responsibilities and behaviours should be considered to address local issues identified.
Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis
Authors: Bahin Farzan F , Heitman Steven J , Rasouli Khalid N , Mahajan Hema , McLeod Duncan , Lee Eric Y T , Williams Stephen J , Bourke Michael J 
Published: October 2017

ObjectiveTo compare the cost-effectiveness of endoscopic submucosal dissection (ESD) and wide-field endoscopic mucosal resection (WF-EMR) for removing large sessile and laterally spreading colorectal lesions (LSLs) >20 mm.DesignAn incremental cost-effectiveness analysis using a decision tree model was performed over an 18-month time horizon. The following strategies were compared: WF-EMR, universal ESD (U-ESD) and selective ESD (S-ESD) for lesions highly suspicious for containing submucosal invasive cancer (SMIC), with WF-EMR used for the remainder. Data from a large Western cohort and the literature were used to inform the model. Effectiveness was defined as the number of surgeries avoided per 1000 cases. Incremental costs per surgery avoided are presented. Sensitivity and scenario analyses were performed.Results1723 lesions among 1765 patients were analysed. The prevalence of SMIC and low-risk-SMIC was 8.2% and 3.1%, respectively. Endoscopic lesion assessment for SMIC had a sensitivity and specificity of 34.9% and 98.4%, respectively. S-ESD was the least expensive strategy and was also more effective than WF-EMR by preventing 19 additional surgeries per 1000 cases. 43 ESD procedures would be required in an S-ESD strategy. U-ESD would prevent another 13 surgeries compared with S-ESD, at an incremental cost per surgery avoided of US$210 112. U-ESD was only cost-effective among higher risk rectal lesions.ConclusionS-ESD is the preferred treatment strategy. However, only 43 ESDs are required per 1000 LSLs. U-ESD cannot be justified beyond high-risk rectal lesions. WF-EMR remains an effective and safe treatment option for most LSLs.Trial registration numberNCT02000141.
Firearms training: what is actually taught?
Authors: Hemenway David , Rausher Steven , Violano Pina , Raybould Toby A , Barber Catherine W 
Published: October 2017

IntroductionFirearm safety instructors and public health professionals are natural allies in the quest to prevent firearm injuries. We audited basic firearm classes to provide information that can help familiarise public health professionals and others with the content covered.MethodsWith the advice of expert instructors, we created an audit form. Volunteers audited 20 basic firearm classes in seven north-eastern states.ResultsAll trainers covered a wide variety of safety issues. Some specific basics were covered in 90+% of the classes, including how to safely load/unload a gun, keeping your finger off the trigger until ready to shoot, and being aware of your target and what is behind it. In 50%–75% of the classes, the trainer covered topics such as operating a safety, clearing jams and cartridge malfunctions, and recommended storing guns unloaded and locked when not in use. Few instructors covered firearm suicide prevention (10%) or domestic violence (10%). Most encouraged gun ownership, gun carrying, gun use in self-defence and membership in a gun rights group.DiscussionFrom a public health standpoint, we would like to see more instructors covering topics such as firearm suicide and alternatives to gun use in self-defence, and to recommend safer storage of firearms.