bluuebunny/crossref_metadata_2025_split huggingface dataset:
The quality of antiretroviral medicines: an uncertain problem
Authors: Do Ngan Thi , Boupha Phonepasith , Newton Paul N , Caillet Céline 
Published: March 2023

ObjectivesSubstandard and falsified (SF) antiretrovirals (ARVs) risk poor outcomes and drug resistance, potentially affecting millions of people in need of treatment and prevention. We assessed the available evidence on SF ARV and related medical devices to discuss their potential public health impact.MethodsSearches were conducted in Embase, PubMed, Google, Google Scholar, Web of Science and websites with interest in ARV quality in English and French up to 30 November 2021. Publications reporting on the prevalence of SF ARV were assessed in a quantitative analysis using the Medicine Quality Assessment Reporting Guidelines (MEDQUARG).ResultsWe included 205 publications on SF ARV and 11 on SF medical devices. Nineteen prevalence surveys of SF ARV, published between 2003 and 2021, were included, with no surveys relevant to SF medical devices. The prevalence survey sample size ranged from 3 to 2630 samples (median (Q1–Q3): 16.0 (10.5–44.5); 3 (15.8%) used random outlet sampling methods. Of the 3713 samples included in the prevalence surveys, 1.4% (n=51) failed at least one test. Efavirenz, nevirapine and lamivudine-nevirapine-stavudine combination were the most surveyed ARV with failure frequencies of 3.6% (7/193), 2.6% (5/192) and 2.8% (5/177), respectively. The median (Q1%–Q3%) concordance with the MEDQUARG criteria was 42.3% (34.6%–55.8%).ConclusionThese results suggest that there are few data in the public domain of the quality of ARV in supply chains; the proportion of SF ARV is relatively low in comparison to other classes of essential medicines. Even a low proportion of the ARV supply chain being poor quality could make a large difference in the HIV/AIDS international landscape. The 95-95-95 target for 2026 and other international targets could be greatly hampered if even 1% of the millions of people taking ARV (for both prevention and prophylaxis) receive medicines that do not meet quality standards. More surveillance of SF ARV is needed to ensure issues are detected.
Appraisal of the causal effect of plasma caffeine on adiposity, type 2 diabetes, and cardiovascular disease: two sample mendelian randomisation study
Authors: Larsson Susanna C , Woolf Benjamin , Gill Dipender 
Published: March 2023

ObjectiveTo investigate the potential causal effects of long term plasma caffeine concentrations on adiposity, type 2 diabetes, and major cardiovascular diseases.DesignTwo sample mendelian randomisation study.SettingGenome-wide association study summary data for associations of two single nucleotide polymorphisms associated with plasma caffeine at the genome-wide significance threshold (rs2472297 near theCYP1A2gene and rs4410790 near theAHRgene) and their association with the outcomes.ParticipantsPrimarily individuals of European ancestry participating in cohorts contributing to genome-wide association study consortia.Main outcome measuresOutcomes studied were body mass index, whole body fat mass, whole body fat-free mass, type 2 diabetes, ischaemic heart disease, atrial fibrillation, heart failure, and stroke.ResultsHigher genetically predicted plasma caffeine concentrations were associated with lower body mass index (beta −0.08 standard deviation (SD) (95% confidence interval −0.10 to −0.06), where 1 SD equals about 4.8 kg/m2in body mass index, for every standard deviation increase in plasma caffeine) and whole body fat mass (beta −0.06 SD (−0.08 to −0.04), 1 SD equals about 9.5 kg; P<0.001) but not fat-free mass (beta −0.01 SD (−0.02 to −0.00), 1 SD equals about 11.5 kg; P=0.17). Higher genetically predicted plasma caffeine concentrations were associated with a lower risk of type 2 diabetes in two consortia (FinnGen and DIAMANTE), with a combined odds ratio of 0.81 ((95% confidence interval 0.74 to 0.89); P<0.001). Approximately half (43%; 95% confidence interval 30% to 61%) of the effect of caffeine on type 2 diabetes was estimated to be mediated through body mass index reduction. No strong associations were reported between genetically predicted plasma caffeine concentrations and a risk of any of the studied cardiovascular diseases.ConclusionsHigher plasma caffeine concentrations might reduce adiposity and risk of type 2 diabetes. Further clinical study is warranted to investigate the translational potential of these findings towards reducing the burden of metabolic disease.
Preoperative refraction, age and optical zone as predictors of optical and visual quality after advanced surface ablation in patients with high myopia: a cross-sectional study
Authors: Zhou Jiaqi , Xu Ye , Li Meiyan , Knorz Michael C , Zhou Xingtao 
Published: March 2023

ObjectiveTo investigate the factors associated with optical and visual quality of advanced surface ablation in high myopia.DesignA cross-sectional study of high myopic eyes treated with laser epithelial keratomileusis (LASEK)/epipolis laser in situ keratomileusis (Epi-LASIK).Setting6Eye and ENT Hospital of Fudan University in Shanghai.MethodsOne hundred and thirty-eight high myopic eyes (138 patients) (myopia −6 D or more) were examined more than 12 months after LASEK or Epi-LASIK with advanced surface ablation on the MEL 80 excimer laser (Zeiss AG, Jena, Germany). Refraction, higher order aberrations (HOAs) and contrast sensitivity before and after surgery were evaluated. Factors including preoperative refraction, age, gender, central corneal thickness, pupil size, optical diameter, ablation depth and flap creation method were analysed for association with postoperative high-order aberration, contrast and glare sensitivities, and different analytic diameters.ResultsHOAs increased significantly postoperatively (p<0.05), with the most significant change found in Z(spherical aberration). At a 5 mm analysis diameter, increased coma was associated with age; increased spherical aberration difference was associated with age, optical zone diameter and method of epithelial flap creation. At a 3 mm analysis diameter, none of the factors contributed to changes in HOAs. Higher preoperative refractive error was associated with decreased contrast and glare sensitivity at each spatial frequency.ConclusionA larger optical zone diameter design is recommended to achieve better visual quality in advanced surface ablation for high myopia correction. Age and preoperative refraction may help predict postoperative visual quality.
Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013
Authors: Oh Jiyoung , Moon Juyoung , Choi Jae Wook , Kim Kyunghee 
Published: March 2023

ObjectivesTo identify factors associated with the continuum of maternal, newborn and child health care in The Gambia.DesignA secondary statistical analysis using Demographic and Health Survey conducted in 2013.SettingThe Gambia.Participants1308 married women (or with a partner) whose most recent children were aged 12–23 months at the time of the survey.Outcome measuresThe main outcome was continuum of care for maternal, newborn and child health. The modified composite coverage index was calculated to express the completion level of continuum of care.ResultsThe following factors were associated with the continuum of maternal, newborn and child health care: women’s autonomy in decision-making of her own healthcare (β=0.063, p=0.015), having higher educated husbands (β=0.138, p<0.001), listening to the radio at least once a week (β=0.078, p=0.006), having a child with birth order less than 5 (β=0.069, p=0.037), initiating the first antenatal care within 16 weeks of pregnancy (β=0.170, p<0.001), having been informed of signs of pregnancy complications (β=0.057, p=0.029), living in rural areas (β=−0.107, p=0.006) and having higher burden due to distance to health facility (β=−0.100, p<0.001), with an explanatory power of 15.5% (R2=0.155).ConclusionsEfforts on future policies and programmes should focus on the concept of continuum of care considering the associated factors. In particular, more attention should be given to providing country-wide family planning and education to women, men and community members in The Gambia.
Is the time of calling helpful for differentiating transient ischaemic attack and stroke from mimics in primary care out-of-hours services? A cross-sectional study
Authors: Erkelens Daphne CA , Zwart Dorien L , van der Meer Gerben H , Wouters Loes TCM , De Groot Esther , Damoiseaux Roger AMJ , Hoes Arno W , Rutten Frans H 
Published: March 2023

ObjectivesTelephone triage of patients suspected of transient ischaemic attack (TIA) or stroke is challenging. Both TIA and stroke more likely occur during daytime, with a peak in the morning hours. Thus, the time of calling might be a helpful determinant during telephone triage. We assessed the time of calling in patients with stroke-like symptoms who called the out-of-hours services in primary care (OHS-PC), and evaluated whether the time of calling differed between patients with TIA or stroke compared with those with mimics.DesignCross-sectional study.SettingSix OHS-PC locations in the Netherlands.Participants1269 telephone triage recordings of patients calling the OHS-PC because of stroke-like symptoms. We collected information on patient characteristics, symptoms, time of calling and urgency allocation. The final diagnosis related to each triage call was based on letters from the neurologist (retrieved from the patient’s general practitioner).Primary and secondary outcome measuresThe primary outcome measures were the time of calling hourly and 4 hourly, and the risk of TIA or stroke/hour. The secondary outcome measure was the risk ratio of TIA or stroke in the morning (08:00—12:00h) versus other hours.ResultsMean age was 68.6 (SD±18.5) years, 56.9% were women and 50.0% had a TIA or stroke. The risk ratio of TIA or stroke among people calling with stroke-like symptoms between 08:00—12:00h versus other hours was 1.13 (95% CI 1.00 to 1.28, p=0.070). After correction for age and sex, the adjusted risk ratio was 0.94 (95% CI 0.80 to 1.10, p=0.434).ConclusionIn patients who called the OHS-PC because of stroke-like symptoms, the time of calling did not differ between patients with TIA or stroke and patients with mimics.Trial registration numberThe Netherlands National Trial Registry (NTR7331).
Risk of infections and cardiovascular and venous thromboembolic events associated with JAK inhibitors in rheumatoid arthritis: protocols of two systematic reviews and network meta-analyses
Authors: Alves Carlos , Penedones Ana , Mendes Diogo , Batel-Marques Francisco 
Published: March 2023

IntroductionJanus kinases (JAK) inhibitors demonstrated to be effective in the treatment of adult patients with moderate-to-severe active rheumatoid arthritis (RA) but have been associated with serious cardiovascular and serious events. Two systematic reviews and network meta-analyses will be carried aiming to compare the relative safety of the different JAK inhibitors with regard to the risk of (1) cardiovascular and thromboembolic events and (2) serious infections in patients with RA.Methods and analysisPUBMED, Embase, Cochrane Controlled Register of Trials and ClinicalTrials.gov will be searched in order to identify randomised controlled trials evaluating the efficacy and safety of JAK inhibitors in patients with RA. The following events will be assessed: (1) any cardiovascular event; major adverse cardiovascular events and venous thromboembolism and (2) any infection; serious infections; herpes zoster infection and tuberculosis. Search terms will comprise RA and drugs names, including the thesaurus terms and the International Nonproprietary Names. The assessment of the methodological quality of the included studies will be performed through the RoB 2 tool: a revised Cochrane risk of bias tool for randomised trials. Network meta-analyses will be performed using STATA V.13.0. For each outcome, treatments will be ranked according to the probability of being the safest (best) alternative using the surface under the cumulative ranking curve.Ethics and disseminationEthical approval is not required as no primary data are collected. This systematic review will be disseminated through peer-reviewed publications and at conference meetings.
Qualitative study of the roles of midwives in the provision of sexual and reproductive healthcare services in the Somaliland health system
Authors: Maregn Rahel Tesfa , Bourret Kirsty , Egal Jama Ali , Esse Amina , Mattison Cristina , Klingberg-Allvin Marie 
Published: March 2023

ObjectivesTo explore midwives’ perspectives in providing sexual reproductive healthcare services in the Somaliland health system.MethodsAn exploratory qualitative design using focus group discussions (n=6) was used. The study was conducted in the capital of Somaliland, Hargeisa, at six maternal and child healthcare centres that provide sexual and reproductive healthcare (SRH) services. Qualified midwives (n=44) who had been working in the maternal and child health centres for a minimum of 1 year were recruited to participate, and only one did not participate due to illness.ResultsThe results showed that Somaliland midwives face multiple challenges from a lack of formal arrangements, primarily written guidelines and policies, that explicitly define their role as healthcare professionals, which impact the quality of care they provide. They also reported feeling unsafe when practising according to their professional scope of practice due to challenging cultural norms, customary traditions and Somaliland’s legal system. Finally, the midwives called for support, including training, institutional protection and psychological support, to enhance their ability and fulfil their role in SRH services in Somaliland.ConclusionMidwives are essential to the provision of equitable SRH services to women and girls, yet are not fully supported by policies, laws or institutions, often living in fear of the consequences of their behaviours. Our research highlights the importance of understanding the context of Somaliland midwifery in order to better support the development of the midwifery workforce, stronger governance structures and midwifery leadership. Appropriately addressing these challenges faced by midwives can better sustain the profession and help to improve the quality of care provided to women and girls and ultimately enhance their reproductive health outcomes.
Methods for assessing guideline adherence for invasive procedures in the care of chronic coronary artery disease: a scoping review
Authors: Kentenich Hannah , Müller Dirk , Wein Bastian , Stock Stephanie , Seleznova Yana 
Published: March 2023

ObjectivesIn the care of coronary artery disease (CAD), evidence questions the adequate application of guidelines for cardiovascular procedures, particularly coronary angiographies (CA) and myocardial revascularisation. This review aims to examine how care providers’ guideline adherence for CA and myocardial revascularisation in the care of chronic CAD was assessed in the literature.DesignScoping review.Data sourcesPubMed and EMBASE were searched through in June 2021 (rerun in September 2022).Eligibility criteriaWe included studies assessing care providers’ adherence to evidence-based guidelines for CA or myocardial revascularisation in the care of chronic CAD. Studies had to list the evaluation of guideline adherence as study objective, describe the evaluation methods used and report the underlying guidelines and recommendations.Data extraction and synthesisTwo independent reviewers used standardised forms to extract study characteristics, methodological aspects such as data sources and variables, definitions of guideline adherence and quantification methods and the extent of guideline adherence. To elucidate the measurement of guideline adherence, the main steps were described.ResultsTwelve studies (311 869 participants) were included, which evaluated guideline adherence by (1) defining guideline adherence, (2) specifying the study population, (3) assigning (classes of) recommendations and (4) quantifying adherence. Thereby, primarily secondary data were used. Studies differed in their definitions of guideline adherence, where six studies each considered only recommendation class I/grade A/strong recommendations as adherent or additionally recommendation classes IIa/IIb. Furthermore, some of the studies reported a priori definitions and allocation rules for the assignment of recommendation classes. Guideline adherence results ranged from 10% for percutaneous coronary intervention with prior heart team discussion to 98% for coronary artery bypass grafting.ConclusionDue to remarkable inconsistencies in the assessment, a cautious interpretation of the guideline adherence results is required. Future efforts should endeavour to establish a consistent understanding of the concept of guideline adherence.
Acupuncture for Crohn’s disease: a protocol for systematic review and meta-analysis
Authors: Han Qiang , Liu Daming , Zhang Peng 
Published: March 2023

IntroductionCrohn’s disease (CD) is a chronic inflammatory bowel disease that seriously affects the quality of life. While conventional medicines are of limitations, acupuncture has been shown to be a promising therapy. While no systematic review related has been published, the present study aimed to evaluate the efficacy and safety of acupuncture for CD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from the establishment of the database until 31 December 2022. Randomised controlled trials evaluating the efficacy and safety of acupuncture/electroacupuncture on patients with CD, controlled by conventional therapies, were included. Outcomes include induction of clinical remission and response, maintenance of remission, and the incidence of adverse events. All articles will be screened and extracted by two reviewers independently. The risk of bias will be evaluated using the revised Cochrane Risk of Bias 2 tool. A fixed effect model or a random effects model will be used based on the assessment of heterogeneity. A subgroup analysis and sensitivity analysis will be carried out if necessary. Publication bias will be analysed, and the strength of the body of evidence for primary outcomes will be graded.Ethics and disseminationThere is no necessity for this study to acquire ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42022356967.
Reporting quality of abstracts from randomised controlled trials published in leading critical care nursing journals: a methodological quality review
Authors: Villa Michele , Le Pera Massimo , Cassina Tiziano , Bottega Michela 
Published: March 2023

ObjectivesTo evaluate the methodological quality of randomised controlled trial (RCT) abstracts in leading critical care nursing journals against the Consolidated Standards of Reporting Trials-Abstracts (CONSORT-A) checklist and to identify variables related with abstract reporting quality.DesignDescriptive methodological quality review.Data sourceWe searched the PubMed database and the websites of each included journal.Eligibility criteriaWe included RCT abstracts published between 2011 and 2021 in the first 11 Scopus-ranking (2021) critical care nursing journals that reported the results of RCTs in English that referred to the care of adult patients with acute/critical illness or their relatives and/or caregivers and conducted in ICUs.Data extraction and synthesisTwo independent investigators extracted the data using a prespecified 17-item checklist directly derived from CONSORT-A. For the primary outcome, each item was evaluated whether it was adequately reported or not and descriptive statistics were reported. An overall score was calculated by summing the results of all items and multivariate linear regression was conducted to detect potential predictors.ResultsSeventy-eight RCT abstracts were included in this review. The items with the highest CONSORT-A adherence were authors, objective, conclusion, participants, interventions and outcome. The randomisation item had the lowest CONSORT-A adherence, followed by trial registration, funding source, harms or side effects, recruitment, blinding and outcome results. The average CONSORT-A score was 8.5±1.5 points (of the maximum 17.5 points). Multivariate analysis indicated that the categorised word score and publication date were positively associated with the overall CONSORT-A score, while the first author’s country being in Asia was negatively associated with the overall CONSORT-A score.ConclusionsThe 78 RCT abstracts showed poor overall adherence to CONSORT-A. The results indicate that the methodological reporting quality of RCT abstracts in critical care nursing journals requires improvement to facilitate assessment of the applicability and relevance of the results reported.
Efficacy and safety of low dose intravenous cangrelor in a consecutive cohort of patients undergoing neuroendovascular procedures
Authors: Cagnazzo Federico , Radu Răzvan Alexandru , Derraz Imad , Lefevre Pierre Henri , Dargazanli Cyril , Machi Paolo , Morganti Riccardo , Gascou Gregory , Fendeleur Julien , Rapido Francesca , Costalat Vincent 
Published: March 2023

BackgroundCangrelor is an intravenous P2Y12 inhibitor with rapid onset and fast offset of antiplatelet action. Dose adjusted cangrelor based on platelet function testing is suggested to be advantageous for use during neuroendovascular procedures. In this study, we aimed to assess the efficacy and safety of this strategy.MethodsThis retrospective study included consecutive patients who received low dose intravenous cangrelor (5 µg/kg; infusion 1 µg/kg/min) for ruptured (RIA) and unruptured (UIA) intracranial aneurysms, and acute ischemic stroke (AIS). Indications were acute stenting or intraluminal thrombus. Outcomes were assessed at 24 hours by brain CT and CT angiography. The primary efficacy outcome was the rate of stent occlusion or persistent intraluminal thrombus. The primary safety outcome was the rate of major hemorrhages.Results101 patients (56 men; median age (IQR) 59 (51–70) years) received low dose cangrelor for acute stenting (79/101 (78%)) and intraprocedural thrombus (22/101 (22%)). Overall, 5 (4.9%) patients experienced stent occlusion within 24 hours (RIA 3/28; AIS 2/52). There were no cases of failure among UIA patients. Stent mis-opening (fish mouthing or stenosis >50%) was significantly associated with stent occlusion (P<0.001). The overall rate of major hemorrhage was 2% (2/101), which occurred in AIS patients. Platelet reactivity unit (PRU) values were lower in those presenting with major hemorrhage (PRU 4 (SD 1.4) vs PRU 60 (SD 63); P=0.043). Mortality rate after cangrelor related hemorrhage was 1%.ConclusionsLow dose cangrelor appears to be effective in preventing stent thrombosis and arterial patency with a low hemorrhagic risk.