bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-sectional analysis of pharmaceutical payments to Japanese board-certified gastroenterologists between 2016 and 2019
Authors: Murayama Anju , Kamamoto Sae , Kawashima Moe , Saito Hiroaki , Yamashita Erika , Tanimoto Tetsuya , Ozaki Akihiko 
Published: April 2023

ObjectivesLimited evidence is available regarding the financial relationships between gastroenterologists and pharmaceutical companies in Japan. This study analysed the magnitude, prevalence and trends of personal payments made by major pharmaceutical companies to board-certified gastroenterologists in Japan in recent years.DesignCross-sectional analysisSetting and participantsUsing payment data publicly disclosed by 92 major pharmaceutical companies, this study examined the non-research payments made to all board-certified gastroenterologists by the Japanese Society of Gastroenterology.Primary and secondary outcome measuresThe primary outcomes were payment amounts, the prevalence of gastroenterologists receiving payments, yearly trends in per-gastroenterologist payment values and the number of gastroenterologists with payments. Additionally, we evaluated the differences in payments among influential gastroenterologists, including clinical practice guideline authors, society board member gastroenterologists and other general gastroenterologists.ResultsApproximately 52.8% of all board-certified gastroenterologists received a total of US$89 151 253, entailing 134 249 payment contracts as the reimbursement for lecturing, consulting and writing, from 84 pharmaceutical companies between 2016 and 2019. The average and median payments per gastroenterologist were US$7670 (SD: US$26 842) and US$1533 (IQR: US$582–US$4781), respectively. The payment value per gastroenterologist did not significantly change during the study period, while the number of gastroenterologists with payments decreased by −1.01% (95% CI: −1.61% to −0.40%, p<0.001) annually. Board member gastroenterologists (median: US$132 777) and the guideline authoring gastroenterologists (median: US$106 069) received 29.9 times and 17.3 times higher payments, respectively, than general gastroenterologists (median: US$284).ConclusionMost gastroenterologists received personal payments from pharmaceutical companies, but only very few influential gastroenterologists with authority accepted substantial amounts in Japan. There should be transparent and rigorous management strategies for financial conflicts of interest among gastroenterologists working in influential positions.
Dismantling cognitive–behavioural therapy components for attention-deficit hyperactivity disorder in adolescents and adults: protocol for a network meta-analysis
Authors: Hamatani Sayo , Matsumoto Kazuki , Kunisato Yoshihiko , Okawa Sho , Yamashita Masatoshi , Mizuno Yoshifumi 
Published: April 2023

IntroductionCognitive–behavioural therapy (CBT) consists of multiple treatment techniques for each treatment model and is tailored to the patient’s characteristics. Randomised controlled trials (RCTs) have reported that CBT is effective for attention-deficit/hyperactivity disorder (ADHD); however, which CBT components are effective is unknown. In order to provide the best treatment technique, it is important to know which therapeutic component or combination thereof is more effective and what the specific effect size is.Methods and analysisWe will perform component network meta-analysis (cNMA). The search will include studies published from database inception up to 31 March 2022, in English. The electronic databases of MEDLINE (via PubMed), EMBASE, PsycINFO, ClinicalTrials.gov and Cochrane Library will be searched. We will systematically identify all RCTs in the treatment of ADHD between the ages of 10 and 60 years, comparing interventions composed of various CBT components with controlled interventions. We will perform pairwise and network meta-analysis with random effects to estimate summary ORs and standardised mean differences. We will assess the risk of bias in selected studies using the Cochrane risk of bias tool.Ethics and disseminationSince we will review published papers, ethical approval is not required. The results from this cNMA will provide a panorama of the CBT-based ADHD studies. The results of this study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42022323898.
Effect of school-based nutrition interventions among primary school children in sub-Saharan Africa: a systematic review protocol
Authors: Osei Angela Nyamekye , Djekic-Ivankovic Marija , Larson Charles P , Agbemafle Isaac , Jaeger-McEnroe Emily , Agbozo Faith 
Published: April 2023

IntroductionPreadolescents are passing through an intensive growth and development period that will benefit from healthy eating practices. For those attending school, school environments offer several potential benefits and have been demonstrated to influence the quality of dietary intakes and consequentially, nutritional status of school-aged children (SAC). Considering the amount of time children spend in school and the enormous potential of evidence-based interventions, the purpose of this review is to critically appraise peer-reviewed literature addressing the impact of school-based interventions on the nutritional status of SAC aged 6–12 years in sub-Saharan Africa.Methods and analysisA systematic search will be conducted in the following databases and online search records: Medline, CINAHL, Web of Science, Embase, Global health, Global Index Medicus, Cochrane library, Hinari and Google Scholar using search terms and keywords codeveloped with two librarians. An additional search will also be conducted from the reference list of identified literature. Search results of titles and abstracts will be initially screened for eligibility criteria by two independent reviewers and where there is disagreement, a third reviewer will be consulted. Articles meeting these criteria will then undergo a full-text review for the eligibility and exclusion criteria. The Joanna Briggs Institute critical appraisal tool will be used to assess the risk of bias. Data from articles meeting all study criteria will be extracted, analysed and synthesised. A meta-analysis will also be conducted if sufficient data are available.Ethics and disseminationThis systematic review is limited to publicly accessible data bases not requiring prior ethical approval to access. The results of the systematic review will be disseminated through publications in peer-reviewed journals as well as conference and stakeholder presentations.PROSPERO registration numberCRD42022334829.
Experiences of Undergraduate Medical, Nursing Students and Faculty regarding Flipped Classroom: A Mixed Method Study at Private Medical University in Pakistan
Authors: Sultan Amber Shamim , Ali Rahila , Zahid Nida , Akbar Rozmeen , Ali Mehdia , Fatima Sadia , Ghias Kulsoom , Martins Russell , Tariq Muhammad , Ajani Khairulnissa 
Published: April 2023

The ‘flipped classroom (FCR)’ is a teaching pedagogy where students are actively involved in the learning process. It reduces passivity, enables students to become active learners through reasoning and concept application and facilitates student interaction with their peers and instructors. This instructional approach enhances retention and decreases distraction by engaging students.ObjectivesThe purpose of this study was to train the faculty of the medical college and school of nursing in developing FCRs as an innovative teaching and learning strategy, to facilitate them in conducting flipped sessions for their students and to explore the experiences of medical, nursing students along with faculty members regarding the FCR they had attended and conducted.SettingPrivate medical college.ParticipantsA total of 442 students from medical college and school of nursing and midwifery participated in the evaluation survey with a female to male ratio of 339:103. Students who attended the flipped class sessions were included in the study sample. Students who did not complete the forms were excluded from the study. Nine faculty members who attended the workshop, agreed to facilitate the FCR session were invited to participate in the focus group discussion.ResultsBoth medical and nursing students found FCR format stimulating. A significantly higher proportion of medical students (73%) found the FCR more engaging and interesting than a traditional lecture as compared with nursing students (59%) (p=0.009). Similarly, 73% of medical students believed the learning objectives of both the non-face-to-face and face-to-face sessions were shared with them as compared with the 62% of nursing students who believed the same (p=0.002). A significantly higher proportion of medical (76%) versus nursing (61%) students found the FCR format more useful for application of their theoretical knowledge into clinical practice (p=0.030).ConclusionStudents found the FCR more engaging and interesting in terms of applying theoretical knowledge into practice. Similarly, faculty found this strategy as effective but challenging in terms of involving and engaging students in the learning process. It is recommended to conduct more FCR sessions for an interactive and student-centred learning, but proper planning of the session and using variety of technological tools to engage learners is a key to success.
Flash glucose monitoring in young people with type 1 diabetes—a qualitative study of young people, parents and health professionals: ‘It makes life much easier’
Authors: Beasant Lucy , Cullen Freyja , Thomas Elizabeth , Kandiyali Rebecca , Shield Julian P H , Mcgregor David , West Nicol , Ingram Jenny 
Published: April 2023

ObjectivesFlash glucose monitoring for patients with T1 diabetes avoids frequent painful finger-prick testing, thus potentially improving frequency of glucose self-monitoring. Our study aimed to explore experiences of young people using Freestyle Libre sensors and their parents, and to identify benefits and challenges to National Health Service (NHS) staff of its adoption in their care provision.ParticipantsYoung people with T1 diabetes, their parents and healthcare professionals were interviewed between February and December 2021. Participants were recruited via social media and through NHS diabetes clinic staff.DesignSemistructured interviews were conducted online and analysed using thematic methods. Staff themes were mapped onto normalisation process theory (NPT) constructs.ResultsThirty-four participants were interviewed: 10 young people, 14 parents and 10 healthcare professionals. Young people reported that life was much easier since changing to flash glucose monitoring, increasing confidence and independence to manage their condition. Parents’ quality of life improved and they appreciated access to real-time data. Using the NPT concepts to understand how technology was integrated into routine care proved useful; health professionals were very enthusiastic about flash glucose monitoring and coped with the extra data load to facilitate more tailored patient support within and between clinic visits.ConclusionThis technology empowers young people and their parents to understand their diabetes adherence more completely; to feel more confident about adjusting their own care between clinic appointments; and provides an improved interactive experience in clinic. Healthcare teams appear committed to delivering improving technologies, acknowledging the challenge for them to assimilate new information required to provide expert advice.
Prediction models for the survival in patients with intestinal-type gastric adenocarcinoma: a retrospective cohort study based on the SEER database
Authors: Hong Jiawen , Cheng Yinfei , Gu Xiaodan , Xu Weibing 
Published: April 2023

ObjectiveTo explore the influencing factors of survival in intestinal-type gastric adenocarcinoma (IGA) and set up prediction model for the prediction of survival of patients diagnosed with IGA.DesignA retrospective cohort study.Setting and participantsA total of 2232 patients with IGA who came from the Surveillance, Epidemiology, and End Results database.Primary and secondary outcome measuresPatients’ overall survival (OS) rate and cancer-specific survival (CSS) at the end of follow-up.ResultsOf the total population, 25.72% survived, 54.93% died of IGA and 19.35% died of other causes. The median survival time of patients was 25 months. The result showed that age, race, stage group, T stage, N stage, M stage, grade, tumour size, radiotherapy, number of lymph nodes removed and gastrectomy were independent prognostic factors of OS risk for patients with IGA; age, race, race, stage group, T stage, N stage, M stage, grade, radiotherapy and gastrectomy were associated with CSS risk for patients with IGA. In view of these prognostic factors, we developed two prediction models for predicting the OS and CSS risk for patients with IGA separately. For the developed OS-related prediction model, the C-index was 0.750 (95% CI: 0.740 to 0.760) in the training set, corresponding to 0.753 (95% CI: 0.736 to 0.770) in the testing set. Likewise, for the developed CSS-related prediction model, the C-index was 0.781 (95% CI: 0.770 to 0.793) in the training set, corresponding to 0.785 (95% CI: 0.766 to 0.803) in the testing set. The calibration curves of the training set and testing set revealed a good agreement between model predictions in the 1-year, 3-year and 5-year survival for patients with IGA and actual observations.ConclusionCombining demographic and clinicopathological features, two prediction models were developed to predict the risk of OS and CSS in patients with IGA, respectively. Both models have good predictive performance.
Signs and symptoms of acute pulmonary embolism and their predictive value for all-cause hospital death in respect of severity of the disease, age, sex and body mass index: retrospective analysis of the Regional PE Registry (REPER)
Authors: Ružičić Dušan Predrag , Dzudovic Boris , Matijasevic Jovan , Benic Marija , Salinger Sonja , Kos Ljiljana , Kovacevic-Preradovic Tamara , Mitevska Irena , Neskovic Aleksandar , Bozovic Bjanka , Bulatovic Nebojsa , Miloradovic Vladimir , Djuric Ivica , Obradovic Slobodan 
Published: April 2023

BackgroundThe incidence of the signs and symptoms of acute pulmonary embolism (PE) according to mortality risk, age and sex has been partly explored.Patients and methodsA total of 1242 patients diagnosed with acute PE and included in the Regional Pulmonary Embolism Registry were enrolled in the study. Patients were classified as low risk, intermediate risk or high risk according to the European Society of Cardiology mortality risk model. The incidence of the signs and symptoms of acute PE at presentation with respect to sex, age, and PE severity was investigated.ResultsThe incidence of haemoptysis was higher in younger men with intermediate-risk (11.7% vs 7.5% vs 5.9% vs 2.3%; p=0.01) and high-risk PE (13.8% vs 2.5% vs 0.0% vs 3.1%; p=0.031) than in older men and women. The frequency of symptomatic deep vein thrombosis was not significantly different between subgroups. Older women with low-risk PE presented with chest pain less commonly (35.8% vs 55.8% vs 48.8% vs 51.9%, respectively; p=0.023) than men and younger women. However, younger women had a higher incidence of chest pain in the lower-risk PE group than in the intermediate-risk and high-risk PE subgroups (51.9%, 31.4% and 27.8%, respectively; p=0.001). The incidence of dyspnoea (except in older men), syncope and tachycardia increased with the risk of PE in all subgroups (p<0.01). In the low-risk PE group, syncope was present more often in older men and women than in younger patients (15.5% vs 11.3% vs 4.5% vs 4.5%; p=0.009). The incidence of pneumonia was higher in younger men with low-risk PE (31.8% vs<16% in the other subgroups, p<0.001).ConclusionHaemoptysis and pneumonia are prominent features of acute PE in younger men, whereas older patients more frequently have syncope with low-risk PE. Dyspnoea, syncope and tachycardia are symptoms of high-risk PE irrespective of sex and age.
Impact of delayed screening invitations on screen-detected and interval cancers in the Dutch colorectal cancer screening programme: individual-level data analysis
Authors: Toes-Zoutendijk Esther , de Jonge Lucie , van Iersel Carola Adriana , Spaander Manon C W , van Vuuren Anneke J , van Kemenade Folkert , Ramakers Christian R , Dekker Evelien , Nagetaal Iris D , van Leerdam Monique E , Lansdorp-Vogelaar Iris 
Published: April 2023

ObjectiveTo assess the impact of delayed invitation on screen-detected and interval colorectal cancers (CRC) within a faecal immunochemical testing (FIT)-based CRC screening programme.DesignAll individuals that participated in 2017 and 2018 with a negative FIT and were eligible for CRC screening in 2019 and 2020 were included using individual-level data. Multivariable logistic regression analyses were used to assess the association between either the different time periods (ie, ‘before’, ‘during’ and ‘after’ the first COVID-19 wave) or the invitation interval on screen-detected and interval CRCs.ResultsPositive predictive value for advanced neoplasia (AN) was slightly lowerduring(OR=0.91) andafter(OR=0.95) the first COVID-19 wave, but no significant difference was observed for the different invitation intervals. Out of all individuals that previously tested negative, 84 (0.004%) had an interval CRC beyond the 24 months since their last invitation. The time period of invitation as well as the extended invitation interval was not associated with detection rates for AN and interval CRC rate.ConclusionThe impact of the first COVID-19 wave on screening yield was modest. A very small proportion of the FIT negatives had an interval CRC possibly due to an extended interval, which potentially could have been prevented if they had received the invitation earlier. Nonetheless, no increase in interval CRC rate was observed, indicating that an extended invitation interval up to 30 months had no negative impact on the performance of the CRC screening programme and a modest extension of the invitation interval seems an appropriate intervention.
Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer
Authors: Raisi-Estabragh Zahra , Cooper Jackie , McCracken Celeste , Crosbie Emma J , Walter Fiona M , Manisty Charlotte H , Robson John , Mamas Mamas A , Harvey Nicholas C , Neubauer Stefan , Petersen Steffen E 
Published: April 2023

ObjectivesTo evaluate incident cardiovascular outcomes and imaging phenotypes in UK Biobank participants with previous cancer.MethodsCancer and cardiovascular disease (CVD) diagnoses were ascertained using health record linkage. Participants with cancer history (breast, lung, prostate, colorectal, uterus, haematological) were propensity matched on vascular risk factors to non-cancer controls. Competing risk regression was used to calculate subdistribution HRs (SHRs) for associations of cancer history with incident CVD (ischaemic heart disease (IHD), non-ischaemic cardiomyopathy (NICM), heart failure (HF), atrial fibrillation/flutter, stroke, pericarditis, venous thromboembolism (VTE)) and mortality outcomes (any CVD, IHD, HF/NICM, stroke, hypertensive disease) over 11.8±1.7 years of prospective follow-up. Linear regression was used to assess associations of cancer history with left ventricular (LV) and left atrial metrics.ResultsWe studied 18 714 participants (67% women, age: 62 (IQR: 57–66) years, 97% white ethnicities) with cancer history, including 1354 individuals with cardiovascular magnetic resonance. Participants with cancer had high burden of vascular risk factors and prevalent CVDs. Haematological cancer was associated with increased risk of all incident CVDs considered (SHRs: 1.92–3.56), larger chamber volumes, lower ejection fractions, and poorer LV strain. Breast cancer was associated with increased risk of selected CVDs (NICM, HF, pericarditis and VTE; SHRs: 1.34–2.03), HF/NICM death, hypertensive disease death, lower LV ejection fraction, and lower LV global function index. Lung cancer was associated with increased risk of pericarditis, HF, and CVD death. Prostate cancer was linked to increased VTE risk.ConclusionsCancer history is linked to increased risk of incident CVDs and adverse cardiac remodelling independent of shared vascular risk factors.
Intratumoral tertiary lymphoid structure (TLS) maturation is influenced by draining lymph nodes of lung cancer
Authors: He Miao , He Qihua , Cai Xiuyu , Liu Jun , Deng Hongshen , Li Feng , Zhong Ran , Lu Yi , Peng Haoxin , Wu Xiangrong , Chen Zisheng , Lao Shen , Li Caichen , Li Jianfu , He Jianxing , Liang Wenhua 
Published: April 2023

BackgroundTertiary lymphoid structure (TLS) is an organized infiltration of immune cells, showing features of germinal center (GC) commonly seen in secondary lymphoid organs. However, its relationship with tumor-draining lymph nodes (TDLNs) has not been studied and we hypothesized that TDLN may influence maturation of intratumoral TLS in non-small cell lung cancer (NSCLC).MethodsTissue slides of 616 patients that had undergone surgeries were examined. Cox proportional hazard regression model was used to assess risk factors of patients’ survival, and logistic regression model was used for their relationship with TLS. Single-cell RNA-sequencing (scRNA-seq) was employed to explore transcriptomic features of TDLNs. Immunohistochemistry, multiplex immunofluorescence and flow cytometry were performed to analyze cellular composition. Cellular components of NSCLC samples from The Cancer Genome Atlas database were inferred with Microenvironment Cell Populations-counter (MCP-counter) method. Murine NSCLC models were used to dissect underlying mechanisms for relationship between TDLN and TLS maturation.ResultsWhile GC+TLS was associated with better prognosis, GC−TLS was not. TDLN metastasis reduced the prognostic relevance of TLS, and was associated with less GC formation. Primary tumor sites showed reduced B cell infiltration in TDLN-positive patients, and scRNA-seq revealed diminished memory B cell formation in tumor-invaded TDLNs, together with an emphasis on weakened interferon (IFN)-γ response. Murine NSCLC models revealed that IFN-γ signaling is involved in memory B cell differentiation in TDLNs and GC formation in primary tumors.ConclusionsOur research emphasizes the influence of TDLN on intratumoral TLS maturation and suggests a role of memory B cells and IFN-γ signaling in this communication.