bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the incidence of bleeding in patients prescribed rivaroxaban for the treatment and prevention of deep vein thrombosis and pulmonary embolism in UK secondary care: an observational cohort study
Authors: Evans Alison , Davies Miranda , Osborne Vicki , Roy Debabrata , Shakir Saad 
Published: November 2020

ObjectivesTo evaluate the short-term (12 weeks) safety and utilisation of rivaroxaban prescribed to new-user adult patients for the treatment of deep vein thrombosis and pulmonary embolism and for the prevention of recurrent deep vein thrombosis and pulmonary embolism in a secondary care setting in England and Wales.DesignAn observational cohort study using the technique of Specialist Cohort Event Monitoring.SettingThe Rivaroxaban Observational Safety Evaluation study was conducted across 87 participating National Health Service secondary care trusts in England and Wales.Participants1532 patients treated with rivaroxaban for the prevention and treatment of deep vein thrombosis/pulmonary embolism from September 2013 to January 2016.InterventionsNon-interventional postauthorisation safety study of rivaroxaban.Primary and secondary outcome measures(1) Risk of major bleeding in gastrointestinal, intracranial, and urogenital sites and (2) risk of all major and clinically relevant non-major bleeds.ResultsOf a total of 4846 patients enrolled in the study from September 2013 to January 2016, 1532 were treated with rivaroxaban for the prevention and treatment of deep vein thrombosis/pulmonary embolism. The median age of the deep vein thrombosis/pulmonary embolism cohort was 63 years, and 54.6% were men. The risk of major bleeding within the gastrointestinal, urogenital and intracranial primary sites was 0.7% (n=11), 0.3% (n=5) and 0.1% (n=1), respectively. The risk of major bleeding in all sites was 1.5% (n=23) at a rate of 8.3 events per 100 patient-years.ConclusionsIn terms of the primary outcome risk of major bleeding in gastrointestinal, intracranial and urogenital sites, the risk estimates in the population using rivaroxaban for deep vein thrombosis/pulmonary embolism were low (<1%) and consistent with the risk estimated from clinical trial data and in routine clinical practice.Trial registration numbersClinicalTrials.gov Registry (NCT01871194); ENCePP Registry (EUPAS3979).
Puff or pass: do social media and social interactions influence smoking behaviour of university students? A cross-sectional mixed methods study from Dhaka, Bangladesh
Authors: Roby Naym Uddin , Hasan M Tasdik , Hossain Sahadat , Christopher Enryka , Ahmed Md Kapil , Chowdhury Ariful Bari , Hasan Shahriar , Ashraf Fatema 
Published: November 2020

ObjectiveTo determine whether the odds of being a smoker differ based on social media use and social interactions among urban university students in Bangladesh.HypothesisSocial media use and social interactions influence the smoking behaviour of Bangladeshi university students, particularly in starting and maintaining cigarette smoking.Design and settingA cross-sectional study using mixed methods on 600 student smokers and non-smokers recruited from two public and two private universities in Dhaka, Bangladesh, a lower middle-income country with limited resources. Exclusion criteria were those who did not use any form of social media and PhD students.ResultsOdds of smoking were significantly higher for those who socialised more than 4 hours/day (p<0.05; OR 1.75; 95% CI 1.12 to 2.75) and typically at night (p<0.05; OR 2.80; 95% CI 1.95 to 4.00). Odds of smoking were also higher for those who liked (p<0.05; OR 4.85; 95% CI 3.32 to 7.11), shared (p<0.05; OR 20.50; 95% CI 13.02 to 32.26) and followed (p<0.05; OR 2.88; 95% CI 1.36 to 6.11) tobacco-related content on social media. Qualitative analysis resulted in emergent themes of smokers imitating tobacco-related photos or videos seen on social media and peers as an influence for smoking initiation.ConclusionThis study suggests social media and social interactions may influence smoking behaviour in university students in Dhaka, Bangladesh. Future research should continue to investigate the roles social media and social interaction have on smoking in order to explore social media-based smoking cessation interventions or dissemination of smoking health hazards through social media.
‘10% of your medical students will cause 90% of your problems’: a prospective correlational study
Authors: Sawdon Marina , McLachlan JC 
Published: November 2020

ObjectivesOur aim was to explore the relationship between medical student Conscientiousness Index scores and indicators of later clinical performance held in the UK Medical Education Database (UKMED). Objectives were to determine whether conscientiousness in first-year and second-year medical students predicts later performance in medical school and in early practice. Policy implications would permit targeted remediation where necessary or aid in selection.DesignA prospective correlational study.SettingA single UK medical school and early years of practice, 2005–2018.ParticipantsThe data were obtained from the UKMED on 858 students. Full outcome data was available for variable numbers of participants, as described in the text.Main outcome measuresScores on the UK Foundation Programme Office’s Situational Judgement Test (SJT) and Educational Performance Measure (EPM), the Prescribing Safety Assessment (PSA) and Annual Review of Competency Progression (ARCP) outcomes.ResultsLinear regression analysis shows Conscientiousness Index scores significantly correlate with pregraduate and postgraduate performance variables: SJT scores (R=0.373, R2=0.139, B=0.066, p<0.001, n=539); PSA scores (R=0.249, R2=0.062, B=0.343, p<0.001, n=462); EPM decile scores for the first (lowest) decile are significantly lower than the remaining 90% (p=0.003, n=539), as are PSA scores (p<0.001, n=463), and ARCP year 2 scores (p=0.019, n=517). The OR that students in the first decile fail to achieve the optimum ARCP outcome is 1.6126 (CI: 1.1400 to 2.2809, p=0.0069, n=618).ConclusionsConscientiousness Index scores in years 1 and 2 of medical school have predictive value for later performance in knowledge, skills and clinical practice. This trait could be used either for selection or for targeted remediation to avoid potential problems in the future.
Effects of exergames training on postural balance in patients who had a chronic stroke: study protocol for a randomised controlled trial
Authors: Bessa Nathalia Priscilla Oliveira Silva , Lima Filho Bartolomeu Fagundes de , Medeiros Candice Simões Pimenta de , Ribeiro Tatiana Souza , Campos Tânia Fernandes , Cavalcanti Fabrícia Azevêdo da Costa 
Published: November 2020

IntroductionExergames training, as an additional therapy to standard care, has been widely used for motor recovery after patients who had a stroke, and it is a valuable and positive tool in the rehabilitation of this population. This study describes a single-blind randomised clinical trial that will aim to investigate the effects of exergames training on postural balance in patients with chronic stroke.Methods and analysisForty-two individuals with chronic stroke (>6 months), aged 20–75 years, will be randomised into two groups: the experimental group, which will be subjected to an exergames protocol, and control group, which will undergo a kinesiotherapy protocol. Both protocols are based on postural balance. The intervention will consist of 40-minute sessions two times per week for 10 consecutive weeks. The volunteers will be evaluated before the treatment, at the end of the interventions and 8 weeks thereafter. The primary outcome will be postural balance (Berg Balance Scale, Functional Reach Test, Timed Up and Go test and Centre of Pressure variables) and secondary outcomes will include gait (6 m timed walk and Kinovea Software), cortical activation patterns (electroencephalography Emotiv EPOC), functional independence (Functional Independence Measure), quality of life (Stroke-Specific Quality of Life Scale) and motivation (Intrinsic Motivation Inventory).Ethics and disseminationThis protocol was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (number 3.434.350). The results of the study will be disseminated to participants through social networks and will be submitted to a peer-reviewed journal and scientific meetings.Trial registration numberBrazilian Registry of Clinical Trials (RBR-78v9hx).
End-stage renal disease as a risk factor for epiglottitis: a population-based cohort study in Taiwan
Authors: Tsai Yao-Te , Tsai Ming-Shao , Hsu Cheng-Ming , Fang Ku-Hao , Huang Ethan I , Liu Chia-Yen , Lin Meng-Hung , Yang Yao-Hsu , Lee Yi-Chan , Chang Geng-He 
Published: November 2020

ObjectivesPatients with uremia are prone to infection; however, end-stage renal disease (ESRD) as a risk factor for acute epiglottitis warrants study. We investigated the risk of severe epiglottitis requiring hospitalisation in patients with ESRD.SettingWe conducted a retrospective matched cohort study by using the claims data of Taiwan’s National Health Insurance Research Database.ParticipantsWe identified an ESRD cohort with 87 908 patients newly diagnosed in 2000–2013 and underwent dialysis. The non-ESRD cohort comprised patients who had not received a diagnosis of ESRD, and they were matches to the ESRD cohort (1:1) by sex, age, residence urbanisation level, monthly income, and diabetes and hypertension status.Primary and secondary outcome measuresThe cumulative incidence of epiglottitis at the end of 2013 was analysed with Kaplan-Meier methods and log-rank tests. The HR of epiglottitis was calculated using the Cox proportional hazards model after adjustment for confounding factors.ResultsThe overall epiglottitis incidence rate was 94% greater in the ESRD cohort than in the non-ESRD cohort (10.3 vs 5.3 cases per 100 000 person-years, p=0.002), with an adjusted HR of 1.89 (95% CI: 1.23 to 2.91, p=0.004). In the log-rank analysis, compared with the non-ESRD group, the epiglottitis cumulative incidence was significantly higher in the ESRD group (p=0.003). Epiglottitis did not exhibit an association with higher rates of airway interventions, intensive care unit admissions or longer hospitalisation in patients with ESRD than in controls.ConclusionsThis nationwide matched cohort study indicated that ESRD patients should be monitored for the risk of severe epiglottitis requiring hospitalisation.
Co-production of an educational package for the universal human papillomavirus (HPV) vaccination programme tailored for schools with low uptake: a participatory study protocol
Authors: Fisher Harriet , Audrey Suzanne , Chantler Tracey , Finn Adam , Letley Louise , Mounier-Jack Sandra , Thomas Clare , Yates Julie , Hickman Matthew 
Published: November 2020

AimTo co-produce with young people an educational package about the human papillomavirus (HPV) vaccine that is tailored to increase vaccine uptake in schools and populations with lower uptake.IntroductionPersistent infection with HPV can result in cancers affecting men and especially women. From September 2019, the English-schools-based HPV vaccination programme was expanded to include young men (in addition to young women) aged 12–13 years. Some young people attending schools with lower uptake of the vaccine have unmet information needs. We hypothesise that mechanisms to address information needs and increase young people’s autonomy in consent procedures will result in higher uptake.Methods and analysisThe Medical Research Council’s framework for development and evaluation of complex interventions will inform intervention development. Recruitment of young people aged 12–15 years and key stakeholders (National Health Service commissioners, school staff, immunisation nurses and youth workers/practitioners) will be facilitated through existing links with healthcare organisations, schools and youth organisations in areas with lower uptake of the HPV vaccination programme. The proposed research will comprise three phases: (1) a rapid review of adolescent immunisation materials and preliminary qualitative interviews with young people and key stakeholders, (2) theory development and co-production of HPV vaccine communication materials through an iterative process with young people and (iii) testing delivery mechanisms and acceptability of the educational package in four schools with lower uptake.Ethics and disseminationThe University of Bristol’s Faculty of Health Sciences and London School of Hygiene and Tropical Medicine's Research Ethics Committees provided approvals for the study. A dissemination event for young people and key stakeholders and webinar with the National Immunisation Network will be organised. The study findings will be published in peer-reviewed journals and presented at conferences. Recommendations for a future larger scale study will be made.
Retrospective cohort study of health service use for cardiovascular disease among adults with and without a record of injury hospital admission
Authors: Randall Sean M , Wood Fiona M , Fear Mark W , Boyd James , Rea Suzanne , Duke Janine M 
Published: November 2020

ObjectiveTo quantify postinjury cardiovascular-related health service use experienced by mid to older aged adults hospitalised for injury, compared with uninjured adults. Additionally, to explore the effect of beta-blocker medications on postinjury cardiovascular hospitalisations among injury patients, given the potential cardioprotective effects of beta blockers.DesignA retrospective cohort study using linked administrative and survey data.ParticipantsRecords of 35 026 injured and 60 823 uninjured matched adults aged over 45 from New South Wales, Australia, who completed the 45 and up survey.Primary and secondary outcome measuresAdmission rates and cumulative lengths of stay for cardiovascular hospitalisations, and prescription rates for cardiovascular medications. Negative binomial and Cox proportional hazards regression modelling were used to generate incident rate ratios (IRRs) and HR.ResultsCompared with the uninjured, those with injury had a 19% higher adjusted rate of postinjury cardiovascular admissions (IRR 1.19, 95% CI 1.14 to 1.25), spent 40% longer in hospital for ardiovascular disease (IRR 1.40, 95% CI 1.26 to 1.57) and had slightly higher cardiovascular prescription rates (IRR 1.04, 95% CI 1.02 to 1.06), during study follow-up. Those in the injury cohort that used beta blockers both prior to and after injury (continuous) appeared to have reduced need for post-injury cardiovascular hospitalisation (IRR 1.09, 95% CI 1.17 to 1.42) compared with those commencing on beta blockers after injury (after 30 days: IRR 1.69, 95% CI 1.37 to 2.08).ConclusionsApparent increased postinjury hospitalisation rates and prolonged length of stay related to cardiovascular disease suggest that injury patients may require clinical support for an extended period after injury. Additionally, injury patients who were on continuous beta blocker treatment appeared to have lower need for post-injury cardiovascular hospitalisations. However, the data do not allow us to draw clear conclusions and further clinical research is required.
Modelling geographical accessibility to support disaster response and rehabilitation of a healthcare system: an impact analysis of Cyclones Idai and Kenneth in Mozambique
Authors: Hierink Fleur , Rodrigues Nelson , Muñiz Maria , Panciera Rocco , Ray Nicolas 
Published: November 2020

ObjectivesModelling and assessing the loss of geographical accessibility is key to support disaster response and rehabilitation of the healthcare system. The aim of this study was therefore to estimate postdisaster travel times to functional health facilities and analyse losses in accessibility coverage after Cyclones Idai and Kenneth in Mozambique in 2019.SettingWe modelled travel time of vulnerable population to the nearest functional health facility in two cyclone-affected regions in Mozambique. Modelling was done using AccessMod V.5.6.30, where roads, rivers, lakes, flood extent, topography and land cover datasets were overlaid with health facility coordinates and high-resolution population data to obtain accessibility coverage estimates under different travel scenarios.Outcome measuresTravel time to functional health facilities and accessibility coverage estimates were used to identify spatial differences between predisaster and postdisaster geographical accessibility.ResultsWe found that accessibility coverage decreased in the cyclone-affected districts, as a result of reduced travel speeds, barriers to movement, road constraints and non-functional health facilities. In Idai-affected districts, accessibility coverage decreased from 78.8% to 52.5%, implying that 136 941 children under 5 years of age were no longer able to reach the nearest facility within 2 hours travel time. In Kenneth-affected districts, accessibility coverage decreased from 82.2% to 71.5%, corresponding to 14 330 children under 5 years of age having to travel >2 hours to reach the nearest facility. Damage to transport networks and reduced travel speeds resulted in the most substantial accessibility coverage losses in both Idai-affected and Kenneth-affected districts.ConclusionsPostdisaster accessibility modelling can increase our understanding of spatial differences in geographical access to care in the direct aftermath of a disaster and can inform targeting and prioritisation of limited resources. Our results reflect opportunities for integrating accessibility modelling in early disaster response, and to inform discussions on health system recovery, mitigation and preparedness.
Clinical communication in inflammatory bowel disease: a systematic literature review protocol
Authors: Karimi Neda , Moore Alison Rotha , Lukin Annabelle , Kanazaki Ria , Williams Astrid-Jane , Connor Susan 
Published: November 2020

IntroductionEvidence regarding effective communication between clinicians and patients with inflammatory bowel disease (IBD) is limited. Studies that investigate clinical communication in IBD are much fewer in number than studies that investigate the perceptions of patients and clinicians about communication in clinical encounters. The current review aims to identify, organise and summarise systematically what is currently known about (1) the characteristics of interactions between clinicians who manage IBD and patients with IBD, and (2) how clinical discussion affects health outcomes in IBD.Methods and analysisScopus, PubMed, Embase, Communication Abstracts, Health & Society, Linguistics and Language Behavior Abstracts and PsycINFO will be systematically searched for studies that investigate the characteristics of IBD clinical interactions during recorded consultations, from earliest available dates within each database to May 2020. A specifically developed quality assessment tool, grounded in linguistic theory, will be used to critically assess the evidence. In addition, a data extraction template will be developed and utilised to provide a description of the characteristics of IBD clinical communication as well as an estimation of its effect on health outcomes in a narrative synthesis.Ethics and disseminationEthical review and approval is not required for this systematic review as no primary data will be collected. The results will be published in peer-reviewed journals and presented at academic conferences.PROSPERO registration numberInternational Prospective Register of Systematic Reviews (PROSPERO) on 28 April 2020 (registration number: CRD42020169657).
Defining timeliness in care for patients with lung cancer: protocol for a scoping review
Authors: Ansar Adnan , Lewis Virginia , McDonald Christine Faye , Liu Chaojie , Rahman Aziz 
Published: November 2020

IntroductionCancer is the second leading cause of death worldwide, and lung cancer is the single leading cause of cancer mortality worldwide. Early diagnosis of lung cancer is the key to better prognosis and longer survival. While there are substantial literature reporting delays in cancer diagnosis, there is a lack of consensus in the definitions and terms used to describe ‘delay’ in the treatment pathway. The aim of this scoping review is to identify and critically synthesise the operational definitions and terminologies used to describe the timely initiation of care and consequent treatments over the care pathway for patients with lung cancer. This scoping review will also compare how timeliness was operationalised in Western and Asian countries.Methods and analysisThe scoping review will use the methodology described by Arksey and O’Malley and endorsed by the Joanna Briggs Institute. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases will be searched. Grey literature sources and the reference lists of key studies will be used to identify additional relevant studies. The scoping review will include all studies, irrespective of study methodology and quality. Two reviewers will independently screen all titles and abstracts to identify eligible studies for inclusion. The full texts of identified studies will be further examined and charted using a data extraction form. A narrative synthesis will be performed to assess and categorise available definitions of timeliness.Ethics and disseminationEthical approval is not needed as this scoping review will be reviewing already published articles. The results produced from this review will be submitted to a scientific peer-reviewed journal for publication and will be presented at scientific meetings.
Impact of SARS-CoV-2 (COVID-19) on pregnancy: a systematic review and meta-analysis protocol
Authors: Medeiros Kleyton Santos , Sarmento Ayane Cristine Alves , Martins Erico Silva , Costa Ana Paula Ferreira , Eleutério Jr José , Gonçalves Ana Katherine 
Published: November 2020

IntroductionThe COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been growing at an accelerating rate, and has become a public health emergency. Pregnant women and their fetuses are susceptible to viral infection, and outcomes in this population need to be investigated.Methods and analysisPubMed, Web of Science, Embase, CINAHAL, Latin American and Caribbean Health Sciences Literature, clinicaltrials.gov, SCOPUS, Google Scholar and Cochrane Central Controlled Trials Registry will be searched for observational studies (cohort and control cases) published from December 2019 to present. This systematic review and meta-analysis will include studies of pregnant women at any gestational stage diagnosed with COVID-19. The primary outcomes will be maternal and foetal morbidity and mortality. Three independent reviewers will select the studies and extract data from the original publications. The risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies. To evaluate the strength of evidence from the included data, we will use Grading of Recommendation Assessment, Development, and Evaluation method. Data synthesis will be performed using Review Manager software V.5.2.3. To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous.Ethics and disseminationThis study will be a review of the published data, and thus it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberPROSPERO 2020: CRD42020181519.