bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of body indices and risk of mortality in patients with type 2 diabetes
Authors: Li Chia-Ing , Liu Chiu-Shong , Lin Chih-Hsueh , Yang Shing-Yu , Li Tsai-Chung , Lin Cheng-Chieh 
Published: August 2023

IntroductionA body shape index (ABSI) is independently associated with mortality in general population, but studies on the predictability of ABSI in the risk of mortality in patients with type 2 diabetes (T2D) are limited. We aimed to examine the independent and joint association of ABSI, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body roundness index (BRI) with mortality in patients with T2D.Research design and methodsThe study included 11 872 patients (46.5% women) aged 30 years and older and who took part in diabetes care management program of a medical center in Taiwan. Body indices were evaluated by anthropometric measurements at baseline between 2001 and 2016, and their death status was followed up through 2021. Multivariate Cox regression models were used to assess the effect of body indices on mortality.ResultsDuring a mean follow-up of 10.2 years, 560 cardiovascular disease (CVD) deaths and 3043 deaths were recorded. For ABSI, WC, WHR, WHtR and BRI, all-cause mortality rates were statistically significantly greater in Q4 versus Q2. For BMI and WHtR, all-cause mortality rates were also statistically significantly greater in Q1 versus Q2. The combination of BMI and ABSI exhibited a superiority in identifying risks of all-cause mortality and CVD mortality (HRs: 1.45 and 1.37, both p<0.01).ConclusionsCombined use of ABSI and BMI can contribute to the significant explanation of the variation in death risk in comparison with the independent use of BMI or other indices.
Feasibility and acceptability of Saheli, a WhatsApp Chatbot, on COVID-19 vaccination among pregnant and breastfeeding women in rural North India
Authors: El Ayadi Alison M , Singh Pushpendra , Duggal Mona , Kumar Vijay , Kaur Jasmeet , Sharma Preetika , Vosburg Kathryn Bradford , Diamond-Smith Nadia G 
Published: August 2023

IntroductionPregnant and breastfeeding women are priority targets for COVID-19 vaccination due to adverse maternal and fetal consequences of perinatal COVID-19 infection and the opportunity for protecting infants through maternal antibodies. Saheli (‘female friend’) is a WhatsApp-deployed chatbot providing evidence-based guidance on COVID-19 for pregnant and breastfeeding women.ObjectivesTo understand the feasibility and acceptability of Saheli and its impact on COVID-19 vaccination.MethodsWe pilot-tested Saheli among pregnant and breastfeeding participants of pre-existing WhatsApp educational groups led by a community-based non-governmental organisation in Haryana, India from January to March 2022 using a pre/post design.Results829 unique participants completed precommunity surveys or postcommunity surveys; 238 completed both. 829 individuals used Saheli, including 88% postintervention survey participants. Users reported Saheli was easy to engage with (79%), easy to understand (91%), quick (83%) and met their information needs (97%). 89% indicated it improved their COVID-19 knowledge a lot, 72% recommended it to others and 88% shared chatbot-derived information with others. Most participants received ≥1 COVID-19 vaccine (86% vs 88%, preintervention to postintervention); full vaccination was 55% and 61%, respectively. Vaccination over time increased marginally for ≥1 dose (OR 1.15, 95% CI 0.99 to 1.36) and significantly for 2 doses (OR 1.21, 95% CI 1.09 to 1.34), and increases were significant among pregnant (≥1 dose) and breastfeeding participants (2 doses). Vaccine hesitancy was low. Chatbot use was high, yet individual chatbot engagement did not alter COVID-19 vaccination.ConclusionChatbots are a promising health education strategy due to high acceptability and deployment potential. Interpreting community chatbot impact must acknowledge the co-occurring constellation of multilevel interventions, community and pandemic factors.
Systematic literature review of the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries
Authors: Brown Cyan Brittany , McDermott Lisa 
Published: August 2023

ObjectiveGlobally, 5 billion people lack access to safe surgery and annually, only 6% of surgeries occur in low-income countries. Surgical frugal innovations can reduce cost and optimise the function for the context; however, there is limited evidence about what enables success.DesignA systematic literature review (SLR) was performed to understand the barriers and facilitators of frugal innovation for surgical care in low-income and middle-income countries (LMICs).Data sourcesWeb of Science, PubMed, Embase at Ovid, Google Scholar and EThOs were searched.Eligibility criteria for selecting studiesInclusion criteria were original research in English containing a frugal surgical innovation. Research must be focused on LMICs. Studies were excluded if the content was not focused on LMICs or did not pertain to barriers and facilitators. 26 studies from 2006 to 2021 were included. The GRADE tool was used to assess overall review quality.ResultsResults were analysed using the modified consolidated framework for implementation research. The lack of formal evidence regarding frugal innovation in LMICs was the most reported barrier. The adaptability of frugal innovations to the context was the most reported facilitator. The limitations of this study were that most frugal innovations are not included in formal literature and that only English studies were included.ConclusionFrugal surgical innovations that are highly adaptable to the local context hold significant potential to scale and positively affect healthcare access and outcomes. Furthermore, supporting formal research about frugal innovations is important when aiming to innovate for health equity.
Prevalence of MRI lesions in men responding to a GP-led invitation for a prostate health check: a prospective cohort study
Authors: Moore Caroline M , Frangou Elena , McCartan Neil , Santaolalla Aida , Kopcke Douglas , Brembilla Giorgio , Hadley Joanna , Giganti Francesco , Marsden Teresa , Van Hemelrijck Mieke , Gong Fiona , Freeman Alex , Haider Aiman , Tuck Steve , Pashayan Nora , Callender Thomas , Green Saran , Brown Louise C , Punwani Shonit , Emberton Mark 
Published: August 2023

ObjectiveIn men with a raised prostate-specific antigen (PSA), MRI increases the detection of clinically significant cancer and reduces overdiagnosis, with fewer biopsies. MRI as a screening tool has not been assessed independently of PSA in a formal screening study. We report a systematic community-based assessment of the prevalence of prostate MRI lesions in an age-selected population.Methods and analysisMen aged 50–75 were identified from participating general practice (GP) practices and randomly selected for invitation to a screening MRI and PSA. Men with a positive MRI or a raised PSA density (≥0.12 ng/mL2) were recommended for standard National Health Service (NHS) prostate cancer assessment.ResultsEight GP practices sent invitations to 2096 men. 457 men (22%) responded and 303 completed both screening tests. Older white men were most likely to respond to the invitation, with black men having 20% of the acceptance rate of white men.One in six men (48/303 men, 16%) had a positive screening MRI, and an additional 1 in 20 men (16/303, 5%) had a raised PSA density alone. After NHS assessment, 29 men (9.6%) were diagnosed with clinically significant cancer and 3 men (1%) with clinically insignificant cancer.Two in three men with a positive MRI, and more than half of men with clinically significant disease had a PSA <3 ng/mL.ConclusionsProstate MRI may have value in screening independently of PSA. These data will allow modelling of the use of MRI as a primary screening tool to inform larger prostate cancer screening studies.Trial registration numberNCT04063566.
Study protocol for the ‘preventing functional decline in acutely hospitalised older patients (PREV_FUNC)’ study: effects of two multicomponent exercise programmes on physical function – a three-armed randomised controlled trial
Authors: Welmer Anna-Karin , Sandberg Linda , Sandlund Christina , Björck Caroline , Hagströmer Maria , Hamilton Julia , Helgstrand Gunilla , Lindgren Charlotte , Nordstrand Linda , Sandstedt Petter , Kivipelto Miia , Boström Anne-Marie 
Published: August 2023

IntroductionAcutely hospitalised older patients often live with frailty and have an increased risk of impaired physical function. Previous studies suggest that exercise might mitigate the risk of physical impairment; however, further research is needed to compare the effect of different types of exercise interventions. In this paper, we report a protocol for a trial that aims to examine (1) if multicomponent exercise interventions (interventions that include both mobility and strengthening exercises) have effects on physical function compared with usual care in older adults and (2) if a comprehensive multicomponent exercise programme is more effective than a simple multicomponent exercise programme that only include walking and sit-to-stand exercises.Methods and analysisThis is a three-armed randomised controlled trial, with two intervention groups (comprehensive and simple exercise programme) and a control group receiving usual care. We will include 320 participants aged ≥75 years from geriatric medical departments of four hospitals in Stockholm, Sweden. Assessments will be conducted at hospital admission, discharge and 3 months thereafter concerning physical function (primary outcome), activities of daily living, health-related quality of life, sarcopenia and falls. The number of readmissions will be registered up to 1 year after discharge. Data will be analysed with linear mixed effects models, according to the intention-to-treat approach.Ethics and disseminationEthical approval for this trial has been granted by the Swedish Ethical Review Authority (approval number 2022-03032-01). Data collection will consider the information requirement, the requirement of consent, confidentiality obligations and the utilisation requirement. Trial findings will be disseminated through multiple channels, including scientific publications and conferences, and workshops with healthcare professionals and the public.Trial registration numberNCT05366075
Effects of sleep duration, perceived organisational support and personal resilience on anxiety in non-hospitalised residents during the COVID-19 pandemic: a survey study in Ningbo, China
Authors: Zhang Yiqing , Ma Jingjing , Xu Qihang , Rong Yuezheng , Lu Shunshun , Wang Zhengzheng 
Published: August 2023

ObjectiveThis study assessed the association between sleep duration, perceived organisational support (POS), personal resilience and anxiety among non-hospitalised residents during the COVID-19 pandemic in Ningbo, China.MethodsIn this cross-sectional study, an online survey was conducted from 27 January 2023 to 5 February 2023, involving non-hospitalised residents over 14 years old in Ningbo. We received 1938 valid responses. The study used the General Demographic Characteristics Scale, the Generalised Anxiety Disorder Scale, Brief Resilient Coping Scale and the POS questionnaire.ResultsAmong the 1938 valid questionnaires, 1068 (55.1%) participants reported anxiety. Multivariate logistic regression analysis revealed that high organisational support (β=–0.34, adjusted OR (aOR) 0.71, 95% CI 0.51 to 0.98, p=0.038), moderate resilience (β=–0.26, aOR 0.77, 95% CI 0.63 to 0.95, p=0.013), high resilience (β=–0.67, aOR 0.51, 95% CI 0.36 to 0.73, p<0.001) and sleep duration of ≥7 hours (β=–1.00, aOR 0.37, 95% CI 0.28 to 0.49, p<0.001) were significantly associated with anxiety. Participant characteristics were not associated with anxiety.ConclusionsDuring the COVID-19 pandemic, organisational support, personal resilience and adequate sleep duration were associated with anxiety among non-hospitalised residents. These findings highlight the importance of increasing organisational support, implementing interventions that promote resilience and stress management, ensuring sufficient rest and sleep duration, and helping residents better manage anxiety.
Use of artificial intelligence in the detection of primary prostate cancer in multiparametric MRI with its clinical outcomes: a protocol for a systematic review and meta-analysis
Authors: Thomas Maya , Murali Sanjana , Simpson Benjamin Scott S , Freeman Alex , Kirkham Alex , Kelly Daniel , Whitaker Hayley C , Zhao Yi , Emberton Mark , Norris Joseph M 
Published: August 2023

IntroductionMultiparametric MRI (mpMRI) has transformed the prostate cancer diagnostic pathway, allowing for improved risk stratification and more targeted subsequent management. However, concerns exist over the interobserver variability of images and the applicability of this model long term, especially considering the current shortage of radiologists and the growing ageing population. Artificial intelligence (AI) is being integrated into clinical practice to support diagnostic and therapeutic imaging analysis to overcome these concerns. The following report details a protocol for a systematic review and meta-analysis investigating the accuracy of AI in predicting primary prostate cancer on mpMRI.Methods and analysisA systematic search will be performed using PubMed, MEDLINE, Embase and Cochrane databases. All relevant articles published between January 2016 and February 2023 will be eligible for inclusion. To be included, articles must use AI to study MRI prostate images to detect prostate cancer. All included articles will be in full-text, reporting original data and written in English. The protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist. The QUADAS-2 score will assess the quality and risk of bias across selected studies.Ethics and disseminationEthical approval will not be required for this systematic review. Findings will be disseminated through peer-reviewed publications and presentations at both national and international conferences.PROSPERO registration numberCRD42021293745.
Decision Aids in the ICU: a scoping review
Authors: Lei Yuling , Zhou Qi , Tao Yuexian 
Published: August 2023

ObjectiveThe purpose of this scoping review was to synthesise the effectiveness and acceptability of decision aids for critically ill patients and family members in the intensive care unit (ICU).MethodsA systematic search of four electronic databases and grey literature was undertaken to identify relevant studies on the application of decision aids in the ICU, without publication date restriction, through March 2023. The methodological framework proposed by Arksey and O’Malley was used to guide the scoping review.ResultsFourteen papers were ultimately included in this review. However, only nine decision aids were available, and it is noteworthy that many of these studies focused on the iterative development and testing of individual decision aids. Among the included studies, 92% (n=13) were developed in North America, with a primary focus on goals of care and life-sustaining treatments. The summary of the effect of decision aid application revealed that the most common indicators were the level of knowledge and code status, and some promising signals disappeared in randomised trials.ConclusionsThe complexity of treatment decisions in the ICU exceeds the current capabilities of existing decision aids. There is a clear gap in decision aids that are tailored to different cultural contexts, highlighting the need to expand the scope of their application. In addition, rigorous quality control is very important for randomised controlled trial, and indicators for assessing the effectiveness of decision aids need to be further clarified.
Knowledge support for optimising antibiotic prescribing for common infections in general practices: evaluation of the effectiveness of periodic feedback, decision support during consultations and peer comparisons in a cluster randomised trial (BRIT2) – study protocol
Authors: van Staa Tjeerd , Sharma Anita , Palin Victoria , Fahmi Ali , Cant Harriet , Zhong Xiaomin , Jury Francine , Gold Natalie , Welfare William , Ashcroft Darren , Tsang Jung Yin , Elliott Rachel Ann , Sutton Christopher , Armitage Chris , Couch Philip , Moulton Georgina , Tempest Edward , Buchan Iain Edward 
Published: August 2023

IntroductionThis project applies a Learning Healthcare System (LHS) approach to antibiotic prescribing for common infections in primary care. The approach involves iterations of data analysis, feedback to clinicians and implementation of quality improvement activities by the clinicians. The main research question is, can a knowledge support system (KSS) intervention within an LHS implementation improve antibiotic prescribing without increasing the risk of complications?Methods and analysisA pragmatic cluster randomised controlled trial will be conducted, with randomisation of at least 112 general practices in North-West England. General practices participating in the trial will be randomised to the following interventions: periodic practice-level and individual prescriber feedback using dashboards; or the same dashboards plus a KSS. Data from large databases of healthcare records are used to characterise heterogeneity in antibiotic uses, and to calculate risk scores for clinical outcomes and for the effectiveness of different treatment strategies. The results provide the baseline content for the dashboards and KSS. The KSS comprises a display within the electronic health record used during the consultation; the prescriber (general practitioner or allied health professional) will answer standard questions about the patient’s presentation and will then be presented with information (eg, patient’s risk of complications from the infection) to guide decision making. The KSS can generate information sheets for patients, conveyed by the clinicians during consultations. The primary outcome is the practice-level rate of antibiotic prescribing (per 1000 patients) with secondary safety outcomes. The data from practices participating in the trial and the dashboard infrastructure will be held within regional shared care record systems of the National Health Service in the UK.Ethics and disseminationApproved by National Health Service Ethics Committee IRAS 290050. The research results will be published in peer-reviewed journals and also disseminated to participating clinical staff and policy and guideline developers.Trial registration numberISRCTN16230629.
Role of fatty liver in the epidemic of advanced chronic liver disease among people with HIV: protocol for the Canadian LIVEHIV multicentre prospective cohort
Authors: Cinque Felice , Saeed Sahar , Kablawi Dana , Ramos Ballesteros Luz , Elgretli Wesal , Moodie Erica E M , Price Colleen , Monteith Ken , Cooper Curtis , Walmsley Sharon L , Pick Neora , Murray Melanie C M , Cox Joseph , Kronfli Nadine , Costiniuk Cecilia T , de Pokomandy Alexandra , Routy Jean-Pierre , Lebouché Bertrand , Klein Marina B , Sebastiani Giada 
Published: August 2023

IntroductionAdvanced chronic liver disease (ACLD) is a major cause of death for people with HIV (PWH). While viral hepatitis coinfections are largely responsible for this trend, metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging concern for PWH. We aimed to assess the contribution of MASLD to incident ACLD in PWH.Methods and analysisThis multicentre prospective observational cohort study will enrol 968 consecutive HIV monoinfected patients from four Canadian sites, excluding subjects with alcohol abuse, liver disease other than MASLD, or ACLD at baseline. Participants will be followed annually for 4 years by clinical evaluation, questionnaires, laboratory testing and Fibroscan to measure liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). The primary outcome will be incidence of ACLD, defined as LSM>10 kPa, by MASLD status, defined as CAP≥285 dB/m with at least one metabolic abnormality, and to develop a score to classify PWH according to their risk of ACLD. Secondary outcomes will include health-related quality of life (HRQoL) and healthcare resource usage. Kaplan-Meier survival method and Cox proportional hazards regression will calculate the incidence and predictors of ACLD, respectively. Propensity score methods and marginal structural models will account for time-varying exposures. We will split the cohort into a training set (to develop the risk score) and a validation set (for validation of the score). HRQoL scores and healthcare resource usage will be compared by MASLD status using generalised linear mixed effects model.Ethics and disseminationThis protocol has been approved by the ethics committees of all participating institutions. Written informed consent will be obtained from all study participants. The results of this study will be shared through scientific publications and public presentations to advocate for the inclusion of PWH in clinical trials of MASLD-targeted therapies and case-finding of ACLD in PWH.
Anti-β2GPI-domain I antibody is associated with extra-criteria manifestations in a large prospective antiphospholipid syndrome cohort in China
Authors: Zhou Yangzhong , Hu Chaojun , Qi Wanting , Long Yin , Huang Can , Wang Qian , Tian Xinping , Zhao Jiuliang , Li Mengtao , Zeng Xiaofeng 
Published: August 2023

BackgroundAnti-β2GPI-domain I (β2GPI-DI) antibody is pathogenic in patients with antiphospholipid syndrome (APS), but its additional clinical associations and diagnostic value are controversial.MethodsA total of 378 patients were included, of which 119 patients diagnosed with primary APS, 50 with APS secondary to SLE (SAPS group), 209 with SLE without APS (SLE group). Serum anti-β2GPI-DI IgG was measured using chemiluminescent immunoassay. Extra-criteria manifestations were analysed, including thrombocytopenia, autoimmune haemolytic anaemia, valvular lesions, APS nephropathy and non-vascular neurological manifestations.ResultsIn 169 patients with APS, 55 (32.5%) were positive for anti-β2GPI-DI IgG, accounting for 77.5% of those with anti-β2GPI IgG positivity. It is shown that 96.4% of those with anti-β2GPI-DI IgG also showed triple positivity in classic antiphospholipid antibodies (aPLs). The positivity of anti-β2GPI-DI IgG was significantly associated with recurrent thrombosis before APS diagnosis (p=0.015), microvascular thrombosis (p=0.038), but not with pregnancy morbidity (PM). Notably, patients with extra-criteria manifestations showed significantly higher positivity (p=0.001) and titres (p<0.001) in anti-β2GPI-DI IgG, especially for thrombocytopenia and APS nephropathy. In multivariable analysis, anti-β2GPI-DI IgG positivity (OR 2.94, 95% CI 1.29 to 6.70), secondary APS, arterial hypertension and Coombs’ test positivity independently predicted extra-criteria manifestations (C-index 0.83, 95% CI 0.77 to 0.90). After a median follow-up of 25 months, patients with anti-β2GPI-DI IgG also showed a tendency of more extra-criteria events, but not thrombotic events. Anti-β2GPI-DI was positive among 8.1% of the SLE controls, and showed high specificity (91.9%) in diagnosing SAPS among patients with SLE as compared with classic aPLs.ConclusionAnti-β2GPI-DI IgG was associated with extra-criteria manifestations in patients with APS. Further studies are warranted to validate its predictive values and potential role in daily practice.
Spin-0 bosons near rotating stars
Authors: Pinho E. O. , Barros C. C. 
Published: August 2023

AbstractIn this work we study the effects of rotating stars on the behavior of bosons close to their surfaces. For this task, metrics determined by the rotation of these stars will be taken into account. We will consider the Klein–Gordon equation in the Hartle–Thorne metric and in the one proposed by Berti et al. by considering some kinds of stars. Pions and Higgs bosons will be investigated as examples. By solving the equations, the main effect that may be observed is a rotational phase,$$\delta _R$$δR, that depends on the angular momentum of the star,J, in the wave function of the boson. Corrections of higher orders inJare also investigated.