bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explaining regional variations in colon cancer survival in Ontario, Canada: a population-based retrospective cohort study
Authors: Webber Colleen , Brundage Michael , Hanna Timothy P , Booth Christopher M , Kennedy Erin , Kong Weidong , Peng Yingwei , Whitehead Marlo , Groome Patti A 
Published: September 2022

ObjectivesRegional variation in cancer survival is an important health system performance measurement. We evaluated if regional variation in colon cancer survival may be driven by differences in the patient population, their health and healthcare utilisation, and/or cancer care delivery.DesignPopulation-based retrospective cohort study using routinely collected linked health administrative data.SettingOntario, Canada.ParticipantsPatients with colon cancer diagnosed between 1 January 2009 and 31 December 2012.OutcomeCancer-specific survival was compared across the province’s 14 health regions. Using accelerated failure time models, we assessed whether regional survival variations were mediated through differences in case mix, including age, sex, comorbidities, stage at diagnosis and colon subsite, potential marginalisation and/or prediagnosis healthcare.ResultsThe study population included 16 895 patients with colon cancer. There was statistically significant regional variation in cancer-specific survival. Three regions had cancer-specific survival that was between 30% (95% CI 1.03 to 1.65) and 39% (95% CI 1.13 to 1.71) longer and one region had cancer-specific survival that was 26% shorter (95% CI 0.58 to 0.93) than the reference region. For three of these regions, case mix explained between 26% and 56% of the survival variation. Further adjustment for rurality explained 22% of the remaining survival variation in one region. Adjustment for continuity of primary care and the diagnostic interval length explained 10% and 11% of the remaining survival variation in two other regions. Socioeconomic marginalisation, recent immigration and colonoscopy history did not explain colon cancer survival variation.ConclusionsCase mix accounted for much of the regional variation in colon cancer survival, indicating that efforts to monitor the quality of cancer care through survival metrics should consider case mix when reporting regional survival differences. Future work should repeat this approach in other settings and other cancer sites considering a broad range of potential mediators.
Understanding resilience among transition-age youth with serious mental illness: protocol for a scoping review
Authors: Nesbitt Amy E , Sabiston Catherine M , deJonge Melissa L , Barbic Skye Pamela , Kozloff Nicole , Nalder Emily Joan 
Published: September 2022

IntroductionTransition-age youth (16–29 years old) are disproportionately affected by the onset, impact and burden of serious mental illness (SMI; for example, depression, bipolar disorder, schizophrenia spectrum disorders). Emerging evidence has increasingly highlighted the concept of resilience in mental health promotion and treatment approaches for this population. A comprehensive synthesis of existing evidence is needed to enhance conceptual clarity in this area, identify knowledge gaps, and inform future research and practice. As such, the present scoping review is guided by the following questions: How has resilience been conceptualised and operationalised in the transition-age youth mental health literature? What factors influence resilience among transition-age youth with SMI, and what outcomes have been studied within the context of transition-age youth’s mental health recovery?Methods and analysisThe present protocol will follow six key stages, in accordance with Arksey and O’Malley’s (2005) established scoping review methodology and recent iterations of this framework, and has been registered with Open Science Framework (https://osf.io/rzfc5). The protocol and review process will be carried out by a multidisciplinary team in consultation with community stakeholders. A comprehensive search strategy will be conducted across multiple electronic databases to identify relevant empirical literature. Included sources will address the population of transition-age youth (16–29 years) diagnosed with SMI, the concept of resilience (in any context) and will report original research written in English. Data screening and extraction will be completed by at least two independent reviewers. Following meta-narrative review and qualitative content analyses, findings will be synthesised as a descriptive overview with tabular and graphical summaries.Ethics and disseminationUniversity of Toronto Health Sciences Research Ethics Board approval was obtained to complete the community stakeholder consultation stage of this review. Results will be disseminated through conference presentations, publications, and user-friendly reports and graphics.
Benefits of heart failure-specific pharmacotherapy in frail hospitalised patients: a cross-sectional study
Authors: Sharma Yogesh , Horwood Chris , Hakendorf Paul , Thompson Campbell 
Published: September 2022

ObjectivesUp to 50% of heart failure (HF) patients may be frail and have worse clinical outcomes than non-frail patients. The benefits of HF-specific pharmacotherapy (beta-blockers, ACE-inhibitors/angiotensin-receptor-blockers and mineralocorticoid-receptor-antagonist) in this population are unclear. This study explored whether HF-specific pharmacotherapy improves outcomes in frail hospitalised HF patients.DesignObservational, multicentre, cross-sectional study.SettingsTertiary care hospitals.ParticipantsOne thousand four hundred and six hospitalised frail HF patients admitted between 1 January 2013 and 31 December 2020.MeasuresThe Hospital Frailty Risk Score (HFRS) determined frailty status and patients with HFRS ≥5 were classified as frail. The primary outcomes included the days alive and out of hospital (DAOH) at 90 days following discharge, 30-day and 180-day mortality, length of hospital stay (LOS) and 30-day readmissions. Propensity score matching (PSM) compared clinical outcomes depending on the receipt of HF-specific pharmacotherapy.ResultsOf 5734 HF patients admitted over a period of 8 years, 1406 (24.5%) were identified as frail according to the HFRS and were included in this study. Of 1406 frail HF patients, 1025 (72.9%) received HF-specific pharmacotherapy compared with 381 (27.1%) who did not receive any of these medications. Frail HF patients who did not receive HF-specific pharmacotherapy were significantly older, with higher creatinine and brain natriuretic peptide but with lower haemoglobin and albumin levels (p<0.05) when compared with those frail patients who received HF medications. After PSM frail patients on treatment were more likely to have an increased DAOH (coefficient 16.18, 95% CI 6.32 to 26.04, p=0.001) than those who were not on treatment. Both 30-day (OR 0.30, 95% CI 0.23 to 0.39, p<0.001) and 180-day mortality (OR 0.43, 95% CI 0.33 to 0.54, p<0.001) were significantly lower in frail patients on HF treatment but, there were no significant differences in LOS and 30-day readmissions (p>0.05).ConclusionThis study found an association between the use of HF-specific pharmacotherapy and improved clinical outcomes in frail HF hospitalised patients when compared to those who were not on treatment.Trial registration numberANZCTRN383195.
Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review
Authors: Martins Maristela Santini , Lourenção Daniela Campos de Andrade , Pimentel Rafael Rodrigo da Silva , de Oliveira Janine Melo , Manganoti Letícia Tuany de Carvalho Nogueira , Modesto Roberto Chrispim , Silva Maiquele Sirlei dos Santos , dos Santos Marcelo José 
Published: September 2022

ObjectiveTo map the recommendations for hospitalised patient safety in the context of the COVID-19 pandemic.DesignScoping review using the method recommended by the Joanna Briggs Institute.Data sourcesDatabases: Medline, SCOPUS, EMBASE, ScienceDirect, LILACS, CINAHL and IBECS; grey literature platform: Google Scholar; and 11 official websites of leading healthcare institutions were searched on 27 April 2021 and updated on 11 April 2022.Eligibility criteriaWe included documents that present recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic, published in any language, from 2020 onwards.Data extraction and synthesisData extraction was performed in pairs with consensus rounds. A descriptive analysis was carried out to present the main characteristics of the articles. Qualitative data from the extraction of recommendations were analysed through content analysis.ResultsOne hundred and twenty-five documents were included. Most papers were identified as expert consensus (n=56, 44.8%). Forty-six recommendations were identified for the safety of hospitalised patients: 17 relating to the reorganisation of health services related to the flow of patients, the management of human and material resources and the reorganisation of the hospital environment; 11 on the approach to the airways and the prevention of the spread of aerosols; 11 related to sanitary and hygiene issues; 4 about proper use of personal protective equipment and 3 for effective communication.ConclusionsThe recommendations mapped in this scoping review present the best practices produced so far and serve as a basis for planning and implementing good practices to ensure safe hospital care, during and after COVID-19. The engagement of everyone involved in the care of hospitalised patients is essential to consolidate the mapped recommendations and provide dignified, safe and quality care.
Patient-related factors associated with superficial surgical site infection and progression to a periprosthetic joint infection after elective primary total joint arthroplasty: a single-centre, retrospective study in Sweden
Authors: Eriksson Hannah K , Lazarinis Stergios 
Published: September 2022

ObjectivesSuperficial surgical site infection (SSSI) may increase the risk of serious complications such as periprosthetic joint infection (PJI). This study aims to identify patient-related risk factors associated with SSSI and investigate their correlation with the progression of PJI.DesignIn this retrospective study, 1191 elective hip and knee prostheses were included. Patients were interviewed 3–5 months after surgery to answer questions about the postoperative period. Patient records were reviewed to determine whether there had been any documentation of wound-healing difficulties or whether antibiotics were prescribed to treat an infection related to arthroplasty surgery.SettingUppsala University Hospital, patients treated between November 2008 and December 2012.ParticipantsThe study population comprised 433 knees and 758 hips.Outcome measuresWe studied patient-related risk factors (joint, age, sex, the American Society of Anesthesiologists (ASA) classification, body mass index (BMI), smoking, diabetes and rheumatic disease) to determine whether they were associated with (1) SSSI and (2) the progress from SSSI to PJI.Results84 (7%) patients of the total cohort developed SSSI. This infection progressed to a PJI in 24 (29%) of the patients. Factors with increased adjusted risk ratios (aRRs) for SSSIs were knee surgery (1.7; 95% CI: 1.1 to 2.7), age≥65 years (1.7; 95% CI: 1.1 to 2.8), BMI≥30 (1.9; 95% CI: 1.0 to 3.4) and ASA classification≥3 (1.7; 95% CI: 1.0 to 2.9). ASA classification≥3 was the only factor showing a significant progression from SSSI to PJI (aRR=3.3; 95% CI: 1.0 to 10.3).ConclusionsThe risk of progressing from an SSSI to a PJI is high. Older patients, patients with obesity, and those with a high ASA classification considered for elective total knee arthroplasty seem to have an increased risk of developing SSSI. Patients with a high ASA classification seem to have an increased risk of progressing from SSSI to PJI.
Age-dependent and sex-dependent differences in mortality from influenza-associated cardiovascular diseases among older adults in Shanghai, China: a population-based study
Authors: Jin Shan , Jiang Chenyan , Xia Tian , Gu Zhen , Yu Huiting , Li Jing , Zheng Yaxu , Pan Hao , Qiao Jiaying , Cai Renzhi , Wu Huanyu , Wang Chunfang 
Published: September 2022

ObjectivesInfluenza epidemics lead to substantial morbidity and mortality among older adults. This study aimed to analyse and assess the age-specific and sex-specific differences in mortality rates for cardiovascular disease (CVD) associated with influenza in older adults.DesignWe obtained weekly data on mortality from CVD in adults≥60 years, categorised into five age groups. We used a quasi-Poisson model and adjusted for long-term and seasonal trends and absolute humidity as confounding factors. The male-to-female ratio (M/F ratio) was an indicator for assessing sex differences.SettingShanghai, China.ParticipantWe analysed 440 107 CVD deaths in adults aged ≥60 years, including 44 913 cases positive for influenza and 1 927 487 outpatient visits for influenza-like illness from 2010 to 2019.Main outcome measuresAge-specific and sex-specific excess CVD mortality rates in older adults for various combinations of CVDs and influenza viruses.ResultsVariations were observed in the excess mortality from CVD, ischaemic heart disease (IHD) and stroke depending on the influenza types/subtypes in different age and sex categories. The ≥85 years group had the highest excess mortality rates per 100 000 persons for CVD, IHD and stroke, while influenza A (H3N2) virus accounted for the highest mortality from CVD, IHD and stroke in people aged ≥65 years. Older men had a significantly lower influenza-associated IHD mortality rate than women, with an M/F ratio of 0.77 (p<0.05).ConclusionsExcess mortality rates for CVDs associated with influenza increased with age in older adults. The risk for influenza-associated IHD mortality was significantly higher in older women than men. Our findings will help implement targeted health strategies, including the promotion of influenza vaccination and early therapeutic intervention for the older population with CVD, to curb the influenza burden effectively.
Protocol of an iterative qualitative study to develop a molecular testing decision aid for shared decision-making in patients with lung cancer after surgery
Authors: Wei Xing , Liu Yangjun , Yu Hongfan , Dai Wei , Yang Ding , Zhang Kunpeng , Sun Jing , Xu Wei , Gong Ruoyan , Yu Qingsong , Pu Yang , Wang Yaqin , Liao Jia , Mu Yunfei , Zhang Yuanqiang , Feng Wenhong , Pan Qi , Li Qiang , Shi Qiuling 
Published: September 2022

IntroductionAlthough molecular testing is crucial for many patients with lung cancer, the decision to carry out molecular testing is not easy to make in actual clinical scenarios. Using a specific decision aid (DA) to conduct shared decision-making (SDM) may help ameliorate this problem. However, no DA currently exists for lung cancer molecular testing (DA_LCMT). We aim to develop an evidence-based, iteratively refined DA, which may facilitate SDM and improve the quality of SDM.Methods and analysisAfter considering the Ottawa Decision Support Framework, International Patient Decision Aid Standards and Food and Drug Administration guidance about methods to identify what is important to patients, semistructured interviews with qualitative research methods will be used to generate the decision-making needs of patients with lung cancer diagnosed with lung adenocarcinoma by intraoperative frozen pathological sections. Input will be provided by patients and other stakeholders, including thoracic surgeons, nurses, hospital administrators, molecular testing company staff and insurance company staff. Then, a modified Delphi method will be used to develop the DA_LCMT V.1.0 (DA_LCMT 1.0). Structured interviews with qualitative research methods will be used in the cognitive debriefing (alpha tests) and field testing (beta tests) to revise and improve the DA_LCMT from version 1.0 to the final version, version 3.0. Descriptive statistics will be used to summarise the baseline characteristics of the patients and other stakeholders. Qualitative data will be analysed using the three steps of grounded theory: generate a codebook, update the codebook and create a comprehensive list of related items.Ethics and disseminationEthics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital approved this study. This protocol is based on the latest version 1.0, dated 31 October 2021. The study was also approved by the Ethics Committees of The Third People’s Hospital of Chengdu, Zigong First People’s Hospital and Jiangyou People’s Hospital. The results of this study will be presented at medical conferences and published in peer-reviewed journals.Trial registration numberNCT05191485.
Assessing the outcomes and experiences of care from the perspective of people living with chronic conditions, to support countries in developing people-centred policies and practices: study protocol of the International Survey of People Living with Chronic Conditions (PaRIS survey)
Authors: de Boer Dolf , van den Berg Michael , Ballester Marta , Bloemeke Janika , Boerma Wienke , de Bienassis Katherine , Groenewegen Peter , Groene Oliver , Kendir Candan , Klazinga Niek , Porter Ian , Sunol Rosa , Thomas Laura , Valderas Jose Maria , Williams Rachel , Rijken Mieke 
Published: September 2022

IntroductionIn view of growing populations with chronic conditions, many countries are redesigning their health systems. However, little information is available about how health systems perform from the perspective of people living with chronic conditions. The Organisation for Economic Co-operation and Development (OECD) Member States therefore mandated the OECD to initiate the International Survey of People Living with Chronic Conditions (PaRIS survey), which aims to provide insight in outcomes and experiences of care as reported by people living with chronic conditions. The PaRIS-SUR consortium has been tasked by the OECD to support the development and implementation of the survey.Methods and analysisAs primary care services play a pivotal role in the management of chronic conditions, the PaRIS survey will be implemented in the primary care setting. Data will be collected with a survey among users of primary care services aged 45 years or older, of whom many have chronic conditions. An additional survey is conducted among their primary care providers. The nested study design will allow analysis of the patient-reported data in relation to characteristics of and care provided by primary care providers within and across countries. In 2022, the survey will be tested in a Field Trial in participating countries. Data for cross-country comparison will be collected by the Main Survey in 2023.Ethics and disseminationInformed consent will be obtained from primary care providers and service users. National Project Managers search ethical approval of the survey in their country, if required. Reporting by the OECD will focus on questions for international comparison. A secured information technology platform will be developed for participants and stakeholders in countries to receive feedback and answer their own questions. Findings will also be disseminated through an international OECD flagship report, conferences, scientific papers and policy briefs, to inform strategies to improve care for people living with chronic conditions throughout the world.
Peripartum care of persons with obesity: a scoping review of recommendations and practical tools for implementation
Authors: Kominiarek Michelle A , Cassimatis Irina , Peace Jack , Premkumar Ashish , Toledo Paloma , O'Dwyer Linda 
Published: September 2022

ObjectiveDespite the growing prevalence of obesity among reproductive aged persons in the USA, evidence-based guidelines for peripartum care are lacking. The objective of this scoping review is to identify obesity-related recommendations for peripartum care, evaluate grades of evidence for each recommendation, and identify practical tools (eg, checklists, toolkits, care pathways and bundles) to support their implementation in clinical practice.Data sourcesWe searched MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov from inception to December 2020 for eligible studies addressing peripartum care in persons with obesity.Study eligibility criteriaInclusion criteria were published evidence-rated recommendations and practical tools for peripartum care of persons with obesity.Study appraisal and synthesis methodsPairs of independent reviewers extracted data (source, publication year, content and number of recommendations, level and grade of evidence, description of tool) and identified similarities and differences among the articles.ResultsOf 18 315 screened articles, 18 were included including 7 articles with evidence-rated recommendations and 11 practical tools (3 checklists, 3 guidelines, 1 care bundle, 1 flowchart, 1 care pathway, 1 care map and 1 protocol). Thirteen of 39 evidence-rated recommendations were based on expert opinion. Recommendations related to surgical antibiotic prophylaxis and subcutaneous tissue closure at caesarean delivery received the highest grade of evidence. Some of the practical tools included a checklist from the USA regarding anticoagulation after caesarean delivery (evidence-supported recommendation), a bundle for surgical site infections after caesarean delivery in Australia (evidence did not support recommendation) and a checklist with content for several aspects of peripartum care from Canada (evidence supported seven of nine definitive recommendations).ConclusionThe recommendations for peripartum care for persons with obesity are based on limited evidence and few practical tools for implementation exist. Future work should focus on developing practical tools based on high-quality studies.