bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of xylometazoline in hospitalised infants: is it safe? A retrospective cohort study
Authors: van Stralen Karlijn J , van Tol Joyce E , de Wildt Saskia N , Becker Matthijs L , van Houten Marlies A 
Published: September 2022

ObjectiveWhen infants suffer from nasal congestion, xylometazoline spray or drops can be effective to facilitate breathing and drinking. However, case reports on side effects have resulted in international warnings regarding use of xylometazoline in infants. Nevertheless, the incidence of these side effects in hospitalised infants is unknown.DesignRetrospective cohort study.SettingTeaching hospital between 2017 and 2021.PatientsInfants under 2 years of age.ExposureReceiving either saline-only (unlimited frequency, concentration 0.9%) or in combination with xylometazoline (maximum three times daily, concentration 0.025%).Main outcome measuresPredefined potential side effects (events), including among others apnoea, nausea, bradycardia, cyanosis and nosebleeds, were extracted from patient records, and the probability to be caused by saline only or xylometazoline–saline was determined using the ADR Probability Scale.ResultsWe included 898 admitted children during 1285 treatment episodes who received saline with or without xylometazoline. 26 events occurred in the saline-only group (incidence 20.0/100 treatment episodes), and 117 events occurred in the xylometazoline saline group (incidence of 10.5/100 treatment episodes), which was significantly lower (OR 0.47 95% CI 0.29 to 0.75, p=0.002). No definite linked or life-threatening events were found. Three nosebleeds had a probable link to the use of xylometazoline–saline, and all other events could only possibly be linked to saline-only or xylometazoline saline use. The incidence of all events was higher in the saline-only group as compared with the xylometazoline saline group, except nausea, which had a similar occurrence (p=0.65). Results were very similar across (gestational) age groups, gender and reasons for admission.ConclusionThe use of low-dose xylometazoline seems to be safe in hospitalised infants.
Long-term quality of life, work limitation, physical activity, economic cost and disease burden following ACL and meniscal injury: a systematic review and meta-analysis for the OPTIKNEE consensus
Authors: Filbay Stephanie Rose , Skou Søren T , Bullock Garrett S , Le Christina Y , Räisänen Anu M , Toomey Clodagh , Ezzat Allison M , Hayden Alix , Culvenor Adam G , Whittaker Jackie L , Roos Ewa M , Crossley Kay M , Juhl Carsten Bogh , Emery Carolyn 
Published: September 2022

ObjectiveDetermine the long-term health-related quality-of-life (HRQoL), work limitation, physical activity, health/economic cost and disease burden of traumatic ACL and/or meniscal injury. Findings will inform OPTIKNEE evidence-based consensus recommendations.DesignRandom-effects meta-analysis evaluated HRQoL (SF-36/SF-12/VR-12 Physical Component Scores (PCS) and Mental Component Scores (MCS), EuroQol-5D (EQ-5D)) stratified by time postinjury, and pooled mean differences (95% CI) between ACL-injured and uninjured controls. Other outcomes were synthesised descriptively. Risk-of-bias (RoB) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation) were assessed.Data sourcesMEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched inception: 22 November 2021.EligibilityStudies reporting HRQoL, work limitations, physical activity levels, health/economic costs or disease burden, ≥2 years post-ACL and/or meniscal injury.ResultsFifty studies were included (10 high-RoB, 28 susceptible-to-some-bias and 12 low-RoB). Meta-analysis (27 studies, very low certainty of evidence) estimated a pooled mean (95% CI) PCS of 52.4 (51.4 to 53.4) and MCS of 54.0 (53.0 to 55.0) 2–14 years post-ACL injury. Pooled PCS scores were worse >10 years (50.8 (48.7 to 52.9)) compared with 2–5 years (53.9 (53.1 to 54.7)) postinjury. Excluding high-RoB studies, PCS scores were worse in ACL-injured compared with uninjured controls (−1.5 (−2.9 to –0.1)). Six studies (low certainty of evidence) informed a pooled EQ-5D score of 0.83 (0.81 to 0.84). Some individuals experienced prolonged work absenteeism and modified activities ≥2 years post-ACL injury. ACL injury was associated with significant direct and indirect costs, and early ACL reconstruction may be less cost-effective than rehabilitation. Only three studies evaluated meniscal injury outcomes (all evaluated HRQoL).ConclusionThere is a very-low certainty of evidence that PCS scores ≥2 years post-ACL injury are worse than uninjured controls and decline over time, whereas MCS scores remain high. ACL injury can result in prolonged work absenteeism and high health/economic costs. Further studies are needed to determine the long-term burden of traumatic meniscal injury.
Trends in adherence to recommended physical activity and its effects on cardiometabolic markers in US adults with pre-diabetes
Authors: Qu Xiaolin , Chen Kun , Chen Jigang , Zhang Junhui 
Published: September 2022

IntroductionThis study aimed to examine the trends in adherence to Physical Activity Guidelines for Americans (PAG) as well as the association between them and cardiometabolic risk factors among US adults with pre-diabetes.Research design and methodsThis study included 6734 participants who were diagnosed with pre-diabetes from the National Health and Nutrition Examination Survey 2007–2008 to 2017–2018. The logistic regression model and linear regression model were used to test the trends in adherence to PAG. The multivariable linear regression model was used to examine the association between adherence to PAG and cardiometabolic risk factors.ResultsThe rate of adherence to the PAG for aerobic physical activity was not significantly changed (64.1% in 2007–2008 to 66.4% in 2017–2018, p=0.599). The sedentary time changed significantly (5.6, 6.8, and 6.0 hours in 2007–2008, 2013–2014, and 2017–2018, respectively; p<0.001). Adherence to the PAG was significantly associated with levels of waist circumference, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglycerides, insulin, 2-hour postload plasma glucose, and measurements of insulin resistance (homeostatic model assessment for insulin resistance (HOMA-IR)) and β-cell function (homeostasis model assessment of β-cell function (HOMA-β)). There was a significant relationship between sedentary time and levels of waist circumference, BMI, HDL-C, insulin, 2-hour postload glucose, HOMA-IR, and HOMA-β. The associations of adherence to the PAG and sedentary time with the levels of systolic and diastolic blood pressures and hemoglobin A1c were not significant.ConclusionsAdherence to PAG for aerobic activity did not change significantly among US adults with pre-diabetes. The time spent on sedentary behavior peaked in 2013–2014 and then decreased afterward. Adhering to the PAG for aerobic activity and reducing sedentary time significantly improved cardiometabolic health among adults with pre-diabetes.
Burden and treatment of chronic obstructive pulmonary disease among people using illicit opioids: matched cohort study in England
Authors: Lewer Dan , Cox Sharon , Hurst John R , Padmanathan Prianka , Petersen Irene , Quint Jennifer K 
Published: September 2022

ObjectiveTo understand the burden of chronic obstructive pulmonary disease among people who use illicit opioids such as heroin, and evaluate inequalities in treatment.DesignCohort study.SettingPatients registered at primary care practices in England.Participants106 789 patients in the Clinical Practice Research Datalink with illicit opioid use recorded between 2001 and 2018, and a subcohort of 3903 patients with a diagnosis of chronic obstructive pulmonary disease. For both cohorts, the study sampled a comparison group with no history of illicit opioids that was matched by age, sex, and general practice.Main outcome measuresIn the base cohort: diagnosis of chronic obstructive pulmonary disease and death due to the disease. In the subcohort: five treatments (influenza vaccine, pneumococcal vaccine, pulmonary rehabilitation, bronchodilators or corticosteroids, and smoking cessation support) and exacerbations requiring hospital admission.Results680 of 106 789 participants died due to chronic obstructive pulmonary disease, representing 5.1% of all cause deaths. Illicit opioid use was associated with 14.59 times (95% confidence interval 12.28 to 17.33) the risk of death related to chronic obstructive pulmonary disease, and 5.89 times (5.62 to 6.18) the risk of a diagnosis of the disease. Among patients with a new diagnosis, comorbid illicit opioid use was associated with current smoking, underweight, worse lung function, and more severe breathlessness. After adjusting for these differences, illicit opioids were associated with 1.96 times (1.82 to 2.12) times the risk of exacerbations requiring hospital admission, but not associated with a substantially different probability of the five treatments.ConclusionsDeath due to chronic obstructive pulmonary disease is about 15 times more common among people who use illicit opioids than the general population. This inequality does not appear to be explained by differences in treatment, but late diagnosis of the disease among people who use illicit opioids might contribute.
Patient and public involvement in the development of clinical practice guidelines: a scoping review
Authors: Bryant Elizabeth Ann , Scott Anna Mae , Greenwood Hannah , Thomas Rae 
Published: September 2022

ObjectivesOrganisations that develop clinical practice guidelines (CPGs) encourage involvement of patients and the publics in their development, however, there are no standard methodologies for doing so. To examine how CPGs report patient and public involvement (PPI), we conducted a scoping review of the evidence addressing the following four questions: (1) who are the patients and publics involved in developing the CPG?; (2) from where and how are the patients and publics recruited?; (3) at what stage in the CPG development process are the patients and publics involved? and (4) how do the patients and publics contribute their views? We also extracted data on the use of PPI reporting checklists by the included studies.DesignWe used the methodology developed by Arksey and O’Malley and refined by the Joanna Briggs Institute. We searched PubMed, Embase, CINAHL and PsycINFO, websites of national guideline bodies from the UK, Canada, Australia and the USA, and conducted a forward citation search. No language, date or participant demographics restrictions were applied. Data were synthesised narratively.ResultsWe included 47 studies addressing 1 or more of the 4 questions. All included studies reported who the patient and publics involved (PPI members) were, and several studies reported PPI members from different groups. Patients were reported in 43/47 studies, advocates were reported in 22/47 studies, patients and advocates reported in 17/47 studies, and general public reported in 2/47 studies. Thirty-four studies reported from where the patients and publics were recruited, with patient groups being the most common (20/34). Stage of involvement was reported by 42/47 studies, most commonly at question identification (26/42) and draft review (18/42) stages. Forty-two studies reported how the patients contributed, most commonly via group meetings (18/42) or individual interviews. Ten studies cited or used a reporting checklist to report findings.ConclusionsOur scoping review has revealed knowledge gaps to inform future research in several ways: replication, terminology and inclusion. First, no standard approach to PPI in CPG development could be inferred from the research. Second, inconsistent terminology to describe patients and publics reduces clarity around which patients and publics have been involved in developing CPGs. Finally, the under-representation of research describing PPI in the development of screening, as opposed to treatment, CPGs warrants further attention.
Medical service utilisation and direct medical cost of depression: a cross-sectional analysis of urban medical claims data from China
Authors: Ding Ruoxi , Zhu Dawei , Wang Yanshang , Yong Ma , Shi Xuefeng , He Ping 
Published: September 2022

ObjectivesDepression is becoming a growing cause of disability, suicides and disease burden. It incurred substantial costs to societies all over the world. Estimating the medical costs of depression will provide implications for related policies and interventions. However, there is scarce of evidence on the economic costs of depression in China. The aim of this study is to assess depression-related medical service utilisation, the direct medical costs of depression and potential associated factors.SettingsThis study used data that comprised 5% random sample of claims data from China’s Urban Basic Medical Insurance between January 2013 and December 2016. Beneficiaries’ demographic information, diagnoses and cost of outpatient and inpatient services were recorded in the data set.Participants26 123 patients with depression were identified as the study population in this study.Primary and secondary outcome measuresThe information on health service utilisation and cost was extracted based on the condition that depression was claimed as the index disease.ResultsFrom 2013 to 2016, weighted average annual total medical cost of depression in urban China was RMB2706.92, and the annual out-of-pocket cost was RMB786.4. The annual total medical cost of depression among urban residents in China was estimated to be 4.4 billion RMB (95% CI 4.15 to 4.67) (US$ 0.70, 95% CI 0.66 to 0.74). Nearly 65% of medical costs (RMB 1795.7 or US$ 285.0) were accounted by inpatient expenditure, and tertiary hospitals were the main provider of depression treatment. Depression-related medical care utilisation and direct costs were associated with gender, age, insurance status, severity of depression and diagnosis. Medication costs and medical service contributed to 41.7% and 56.6% of the average depression-related medical costs.ConclusionDepression poses a considerable burden on both the health system and the individual in urban China. Specific policies to strengthen the mental health resources in primary and secondary hospitals are in urgent need, and effective treatment strategies are important to prevent a progression and recurrence of depression, as well as an increase in medical cost.
Development, implementation and validation of resource-stratified guidelines in low-income and middle-income countries: a scoping review protocol
Authors: Griswold Dylan , Venturini Sara , Carney Nancy , Rubiano Andres M , Hutchinson Peter John , Kolias Angelos G 
Published: September 2022

IntroductionNearly every field of medicine has some form of clinical practice guidelines. However, only within the past 5–10 years has the medical community acknowledged the need for well-developed guidelines tailored to the local healthcare needs and the resources available. In most low-income and middle-income countries (LMICs), healthcare workers depend on guidelines developed in high-income countries (HICs), yet many interventions validated in a HIC are ineffective when implemented in an LMIC. The variation in infrastructure, medical personnel, technology and environmental conditions exhibited in LMICs relative to HICs necessitates a careful appraisal of the evidence base used in clinical guideline recommendations. This review aims to map the use of resource-stratified guidelines across all fields of medicine. The review seeks to answer three questions for the identified guidelines: (1) what was the method of development, (2) have they been implemented and, if so, (3) have they been validated.MethodsThe search strategy will aim to locate studies from inception to November 2021. An initial limited search of PubMed and Scopus was undertaken to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles were used to develop a full search strategy for PubMed and Scopus. This scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Data to be extracted from each study will include population characteristics of both developers and intended implementation population, medical specialty, validation status, method of guideline development, whether the study is consensus or evidence-based in addition to a summary of recommendations for practice.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal.
Psychiatric treatment conducted via telemedicine versus in-person consultations in mood, anxiety and personality disorders: a protocol for a systematic review and meta-analysis
Authors: Shaker Ali Abbas , Austin Stephen F , Sørensen John Aasted , Storebø Ole Jakob , Simonsen Erik 
Published: September 2022

IntroductionMajor advancements in technology have led to considerations how telemedicine (TM) and other technology platforms can be meaningfully integrated in treatment for psychiatric disorders. The COVID-19 pandemic has placed a further focus on use of TM in psychiatry. Despite the widespread use of TM, little is known about its effect compared with traditional in-person (IP) consultation. The objective of this systematic review is to examine if individual psychiatric outpatient interventions for adults using TM are comparable to IP in terms of (1) psychopathology outcomes, (2) levels of patient satisfaction, (3) working alliance and (4) dropout from treatment.Methods and analysisThis review will only include randomised controlled trials for adult participants with mood disorders, anxiety or personality disorders. The primary outcome is psychopathology, and secondary outcomes include patient satisfaction, treatment alliance and dropout rate. Systematic searches were conducted in MEDLINE, APA PsycINFO, Embase, Web of Science and CINAHL. The inverse-variance method will be used to conduct the meta-analysis. Effect sizes will be calculated as standardised mean difference (Hedges’ g) for the primary outcome, mean difference for patient satisfaction and working alliance, and risk ratio for the dropout rate. Effect sizes will be supplemented with 95% CI. We will calculate the I² statistic to quantify heterogeneity and Chi-square statistic (χ²) to test for heterogeneity for the primary outcome. Potential clinical and methodological heterogeneity moderators will be assessed in subgroup and sensitivity analysis. The risk of bias will be assessed by Cochrane Risk of Bias Tool V.2, and confidence in cumulative evidence will be assessed by Grading of Recommendations Assessment, Development and Evaluation.Ethics and disseminationNo ethical approval is required for this systematic review protocol. Data sets will be deposited in the Zenodo repository. The findings of this study will be published in a peer-review scientific journal.PROSPERO registration numberCRD42021256357.
National priority setting partnership using a Delphi consensus process to develop neonatal research questions suitable for practice-changing randomised trials in the United Kingdom
Authors: Evans Katie , Battersby Cheryl , Boardman James P , Boyle Elaine M , Carroll William D , Dinwiddy Kate , Dorling Jon , Gallagher Katie , Hardy Pollyanna , Johnston Emma , Mactier Helen , Marcroft Claire , Webbe James , Gale Chris 
Published: September 2022

IntroductionMethodologically robust clinical trials are required to improve neonatal care and reduce unwanted variations in practice. Previous neonatal research prioritisation processes have identified important research themes rather than specific research questions amenable to clinical trials. Practice-changing trials require well-defined research questions, commonly organised using the Population, Intervention, Comparison, Outcome (PICO) structure. By narrowing the scope of research priorities to those which can be answered in clinical trials and by involving a wide range of different stakeholders, we aim to provide a robust and transparent process to identify and prioritise research questions answerable within the National Healthcare System to inform future practice-changing clinical trials.Methods and analysisA steering group comprising parents, doctors, nurses, allied health professionals, researchers and representatives from key organisations (Neonatal Society, British Association of Perinatal Medicine, Neonatal Nurses Association and Royal College of Paediatrics and Child Health) was identified to oversee this project. We will invite submissions of research questions formatted using the PICO structure from the following stakeholder groups using an online questionnaire: parents, patients, healthcare professionals and academic researchers. Unanswered, non-duplicate research questions will be entered into a three-round eDelphi survey of all stakeholder groups. Research questions will be ranked by mean aggregate scores.Ethics and disseminationThe final list of prioritised research questions will be disseminated through traditional academic channels, directly to key stakeholder groups through representative organisations and on social media. The outcome of the project will be shared with key research organisations such as the National Institute for Health Research. Research ethics committee approval is not required.
How do care environments shape healthcare? A synthesis of qualitative studies among healthcare workers during the COVID-19 pandemic
Authors: Harrison Mia , Rhodes Tim , Lancaster Kari 
Published: September 2022

ObjectiveTo investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic.DesignCritical interpretive synthesis (CIS) of qualitative research.ParticipantsStudies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic.Results134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments.ConclusionsThe findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.