bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective review of tertiary and neurosyphilis cases in Alberta, 1973–2017
Authors: Landry Takaaki , Smyczek Petra , Cooper Ryan , Gratrix Jennifer , Bertholet Lindsay , Read Ron , Romanowski Barbara , Singh Ameeta E 
Published: June 2019

ObjectivesTo review the notification rate and characteristics of tertiary and neurosyphilis cases in Alberta, Canada in the postantibiotic era.MethodsA retrospective review of all neurosyphilis and tertiary syphilis cases reported in Alberta from 1973 to March 2017 was undertaken and cases classified into early neurosyphilis, late neurosyphilis and cardiovascular (CV) syphilis. Variables collected included demographics, sexual partners, HIV status, clinical parameters, symptoms and treatment and distributions were compared between early versus late neurosyphilis and asymptomatic versus symptomatic cases (stratified by early versus late stage). Data were analysed using IBM SPSS Statistics V.19.0.Results254 cases were identified; 251 were neurosyphilis and 3 were CV. No cases of gummatous syphilis were reported. Early neurosyphilis accounted for 52.4% (n=133) and 46.1% (n=117) were late neurosyphilis cases; one (0.4%) case with unknown duration. Three outbreaks of infectious syphilis were identified during the study period and a concurrent rise in both early and late neurosyphilis was observed during the outbreak periods. The most common manifestation of symptomatic neurosyphilis was ocular involvement which was more likely in early neurosyphilis. Relative to late neurosyphilis cases, early neurosyphilis cases were more likely to be younger, Caucasian, born in Canada, HIV positive and reporting same sex partners.ConclusionsOur review of tertiary and neurosyphilis cases found that early and late neurosyphilis cases continue to occur in the context of cycling syphilis outbreaks. CV syphilis cases were extremely rare. Ongoing identification of new cases of syphilis and clinical evaluation of cases for complications continues to be important in the context of global resurgence of syphilis.
Post-colonoscopy colorectal cancers identified by probabilistic and deterministic linkage: results in an Australian prospective cohort
Authors: Subramaniam Kavitha , Ang P W , Neeman Teresa , Fadia Mitali , Taupin Doug 
Published: June 2019

ObjectivePost-colonoscopy colorectal cancers (PCCRCs) are recognised as a critical quality indicator. Benchmarking of PCCRC rate has been hampered by the strong influence of different definitions and methodologies. We adopted a rigorous methodology with high-detail individual data to determine PCCRC rates in a prospective cohort representing a single jurisdiction.SettingWe performed a cohort study of individuals who underwent colonoscopy between 2001 and 2008 at a single centre serving Australian Capital Territory (ACT) and enclaving New South Wales (NSW) region. These individuals were linked to subsequent colorectal cancer (CRC) diagnosis, within 5 years of a negative colonoscopy, through regional cancer registries and hospital records using probabilistic and deterministic record linkage. All cases were verified by pathology review. Predictors of PCCRCs were extracted.Participants7818 individuals had a colonoscopy in the cohort. Linkage to cancer registries detected 384 and 98 CRCs for notification dates of 2001–2013 (ACT) and 2001–2010 (NSW). A further 55 CRCs were identified from a search of electronic medical records using International Classification of Diseases-10 diagnosis codes. After verification and exclusions, 385/537 CRCs (58% male) were included.Primary outcome measurePCCRC rates.ResultsThere were 15 PCCRCs in our cohort. The PCCRC incidence rate was 0.384/1000 person-years and the 5-year PCCRC risk was estimated as 0.192% (95% CI 0.095 to 0.289). The index colonoscopy prior to PCCRC was more likely to show diverticulosis (p=0.017 for association, OR 3.56, p=0.014) and have poor bowel preparation (p=0.017 for association, OR 4.19, p=0.009).ConclusionIn this population-based cohort study, the PCCRC incidence rate was 0.384/1000 person-years and the 5-year PCCRC risk was 0.192%. These data show the ‘real world’ accuracy of colonoscopy for CRC exclusion.
Strategies to evaluate healthcare provider trainings in shared decision-making (SDM): a systematic review of evaluation studies
Authors: Müller Evamaria , Strukava Alena , Scholl Isabelle , Härter Martin , Diouf Ndeye Thiab , Légaré France , Buchholz Angela 
Published: June 2019

Design and objectivesWe performed a systematic review of studies evaluating healthcare provider (HCP) trainings in shared decision-making (SDM) to analyse their evaluation strategies.Setting and participantsHCP trainings in SDM from all healthcare settings.MethodsWe searched scientific databases (Medline, PsycInfo, CINAHL), performed reference and citation tracking, contacted experts in the field and scanned the Canadian inventory of SDM training programmes for healthcare professionals. We included articles reporting data of summative evaluations of HCP trainings in SDM. Two reviewers screened records, assessed full-text articles, performed data extraction and assessed study quality with the integrated quality criteria for review of multiple study designs (ICROMS) tool. Analysis of evaluation strategies included data source use, use of unpublished or published measures and coverage of Kirkpatrick’s evaluation levels. An evaluation framework based on Kirkpatrick’s evaluation levels and the Quadruple Aim framework was used to categorise identified evaluation outcomes.ResultsOut of 7234 records, we included 41 articles reporting on 30 studies: cluster-randomised (n=8) and randomised (n=9) controlled trials, controlled (n=1) and non-controlled (n=7) before-after studies, mixed-methods (n=1), qualitative (n=1) and post-test (n=3) studies. Most studies were conducted in the USA (n=9), Germany (n=8) or Canada (n=7) and evaluated physician trainings (n=25). Eleven articles met ICROMS quality criteria. Almost all studies (n=27) employed HCP-reported outcomes for training evaluation and most (n=19) additionally used patient-reported (n=12), observer-rated (n=10), standardised patient-reported (n=2) outcomes or training process and healthcare data (n=10). Most studies employed a mix of unpublished and published measures (n=17) and covered two (n=12) or three (n=10) Kirkpatrick’s levels. Identified evaluation outcomes covered all categories of the proposed framework.ConclusionsStrategies to evaluate HCP trainings in SDM varied largely. The proposed evaluation framework maybe useful to structure future evaluation studies, but international agreement on a core set of outcomes is needed to improve evidence.PROSPERO registration numberCRD42016041623.
Is urinary excretion of plasminogen associated with development of pre-eclampsia? An observational, explorative case–control study
Authors: Nielsen Lise H , Kronborg Camilla , Vittinghus Erik , Kitlen Gitte , Jensen Boye L , Knudsen Ulla B , Ovesen Per G 
Published: June 2019

ObjectivesPre-eclampsia (PE) is characterised by renal glomerular endotheliosis and injury to the glomerular filtration barrier with proteinuria. Patients with PE display aberrant filtration of the plasma proenzyme plasminogen which is activated, in the tubular fluid, to plasmin. Plasmin may activate the epithelial sodium channel and cause impaired sodium excretion and contribute to hypertension. An explorative study was conducted to test the association between urinary total plasminogen/plasmin and the development of PE. A positive association was hypothesised.DesignAn observational, explorative, nested case–control study of healthy pregnant women.SettingsA Danish County hospital. Samples were collected between 2001 and 2004.Participants1631 healthy pregnant women participated. Urine samples were collected longitudinally six times during pregnancy. 30 developed PE (cases) and were compared with 146 randomly selected healthy pregnant women (controls).Primary outcomeThe association between total plasminogen/plasmin excreted in the urine and PE development is expressed by ORs. Total urinary excretion of plasminogen/plasmin was defined by the urine plasminogen-plasmin/creatinine ratio.Secondary outcomeThe association between urine (u)-albumin/creatinine ratio, u-aldosterone/creatinine ratio and PE development is expressed by ORs. The correlation between urinary (u-) plasmin and u-aldosterone concentration is expressed as a correlation coefficient.ResultsThe development of PE in late pregnancy was associated with increased levels of the urine plasminogen-plasmin/creatinine ratio (OR=2.35; 95% CI: 1.12 to 4.93; p<0.05).U-aldosterone/creatinine ratio did not predict PE at any time. U-albumin/creatinine ratio was positively associated with the development of PE from gestational week 33 (OR=14.04; 95% CI: 2.56 to 76.97; p<0.01) and in week 33–35 (OR=14.15; 95% CI: 3.44 to 58.09; p<0.001) and after gestational week 36, respectively.ConclusionAberrant filtration of plasminogen may contribute to the pathophysiological features of impaired sodium excretion and hypertension associated with PE late in pregnancy. However, increased urinary albumin levels reveal stronger associations with PE development compared with urinary plasminogen levels.
One- and two-year visual outcomes from the Moorfields age-related macular degeneration database: a retrospective cohort study and an open science resource
Authors: Fasler Katrin , Moraes Gabriella , Wagner Siegfried , Kortuem Karsten U , Chopra Reena , Faes Livia , Preston Gabriella , Pontikos Nikolas , Fu Dun Jack , Patel Praveen , Tufail Adnan , Lee Aaron Y , Balaskas Konstantinos , Keane Pearse A 
Published: June 2019

ObjectivesTo analyse treatment outcomes and share clinical data from a large, single-centre, well-curated database (8174 eyes/6664 patients with 120 756 single entries) of patients with neovascular age-related macular degeneration (AMD) treated with anti-vascular endothelial growth factor (VEGF). By making our depersonalised raw data openly available, we aim to stimulate further research in AMD, as well as set a precedent for future work in this area.SettingRetrospective, comparative, non-randomised electronic medical record (EMR) database cohort study of the UK Moorfields AMD database with data extracted between 2008 and 2018.ParticipantsIncluding one eye per patient, 3357 eyes/patients (61% female). Extraction criteria were ≥1 ranibizumab or aflibercept injection, entry of ‘AMD’ in the diagnosis field of the EMR and a minimum of 1 year of follow-up. Exclusion criteria were unknown date of first injection and treatment outside of routine clinical care at Moorfields before the first recorded injection in the database.Main outcome measuresPrimary outcome measure was change in VA at 1 and 2 years from baseline as measured in Early Treatment Diabetic Retinopathy Study letters. Secondary outcomes were the number of injections and predictive factors for VA gain.ResultsMean VA gain at 1 year and 2 years were +5.5 (95% CI 5.0 to 6.0) and +4.9 (95% CI 4.2 to 5.6) letters, respectively. Fifty-four per cent of eyes gained ≥5 letters at 2 years, 63% had stable VA (±≤14 letters), 44% of eyes maintained good VA (≥70 letters). Patients received a mean of 7.7 (95% CI 7.6 to 7.8) injections during year 1 and 13.0 (95% CI 12.8 to 13.2) injections over 2 years. Younger age, lower baseline VA and more injections were associated with higher VA gain at 2 years.ConclusionThis study benchmarks high quality EMR study results of real life AMD treatment and promotes open science in clinical AMD research by making the underlying data publicly available.
What are young Indians saying about mental health? A content analysis of blogs on the It’s Ok To Talk website
Authors: Gonsalves Pattie Pramila , Hodgson Eleanor Sara , Michelson Daniel , Pal Sweta , Naslund John , Sharma Rhea , Patel Vikram 
Published: June 2019

ObjectivesThis study used thematic content analysis to examine submissions to a youth mental health website,www.itsoktotalk.in, in India.SettingWe considered submissions made to the It’s OK to Talk web platform during the first year of its operation (April 2017–March 2018), focusing specifically on website users based in India.ParticipantsWe analysed 37 submissions by 33 authors aged 19–31 years (mean age 22 years) from seven Indian cities (New Delhi, Lucknow, Bengaluru, Mumbai, Pune, Hyderabad and Haryana). Eligible submissions were English-language first-person accounts of self-identified mental health problems, submitted in any media format for online publication by authors aged 18 years or older and who were based in India. Eight study participants were additionally involved in a focus group who contributed to the coding process and preparation of the final manuscript.ResultsFour themes were identified: (1) living through difficulties; (2) mental health in context; (3) managing one’s mental health and (4) breaking stigma and sharing hope. Overall, the participants expressed significant feelings of distress and hopelessness as a result of their mental health problems; many described the context of their difficulties as resulting from personal histories or wider societal factors; a general lack of understanding about mental health; and widespread stigma and other negative attitudes. Most participants expressed a desire to overcome mental health prejudice and discrimination.ConclusionsPersonal narratives offer a window into young people’s self-identified priorities and challenges related to mental health problems and recovery. Such insights can inform antistigma initiatives and other public awareness activities around youth mental health.
Predictors of late presentation to renal dialysis: a cohort study of linked primary and secondary care records in East London
Authors: Olaitan Ademola , Ashman Neil , Homer Kate , Hull Sally 
Published: June 2019

ObjectivesThe outcomes and experience of care for patients who start renal replacement therapy (RRT) in an unplanned manner are worse than for those who have planned care. The objective of this study was to examine the primary care predictors of unplanned starts to RRT.DesignRetrospective cohort study with linked primary care and hospital data.Setting128 general practices in East London with a combined population of 1 043 346 people.Participants999 consecutive patients starting dialysis at Barts Health National Health Service Trust between September 2014 and August 2017.Primary outcome measuresUnplanned versus a planned start to dialysis among the cohort of 389 patients with a linked primary care record. An unplanned start to dialysis is defined as receiving nephrology care in the low clearance clinic (or equivalent) for less than 90 days. A planned start is defined as access to pre-dialysis counselling and care for at least 90 days prior to commencing dialysis.ResultsThe adjusted logistic regression analysis showed that the most important modifiable risk factors for unplanned dialysis were the absence of a chronic kidney disease (CKD) code in the general practice (GP) record (OR 8.02, 95% CI 3.65 to 17.63) and the absence of prescribed lipid lowering medication (OR 2.37, 95% CI 1.05 to 5.34). Other contributing factors included male gender and a greater number of long-term conditions.ConclusionsImproving CKD coding in primary care and the additional review and clinical scrutiny associated with this may contribute to a further reduction in unplanned RRT rates.
Cross-sectional study about the use of telemedicine for type 2 diabetes mellitus management in Spain: patient’s perspective. The EnREDa2 Study
Authors: Rodríguez-Fortúnez Patricia , Franch-Nadal Josep , Fornos-Pérez José A , Martínez-Martínez Fernando , de Paz Hector David , Orera-Peña María Luisa 
Published: June 2019

ObjectivesThe usefulness of telemedicine (TM) in type 2 diabetes mellitus (T2DM) has been discussed in recent years. The aim of this study is to describe patients’ perceptions about TM and to identify preferences on TM resources, in Spain.DesignAn observational, cross-sectional study was conducted using a structured questionnaire.Participants1036 patients with T2DM accepted to participate in the study (response rate: 68%).ResultsBlood glucose values were recorded by 85.9% of the patients while data such as lifestyle habits were only recorded by 14.4% of the patients. Previous experience in TM was reported by 9.8% of the patients, out of which 70.5% were satisfied with its service and 73.5% considered that the use of TM had optimised their T2DM management. However, most of these patients noted aspects to be improved such as user-friendliness (81.4%), interaction with the medical team (78.4%) and time required for recording/transferring data (78.4%). Experienced patients had better perception about TM usefulness than naïve patients for all listed aspects (p<0.05). Among naïve patients, 38.2% expressed their willingness to participate in TM programmes, but only 4.7% were invited to do so. Patients considered that physicians’ (77.5%) and pharmacists’ (75.5%) encouragement can boost the use of TM.ConclusionsIn Spain, nearly 10% of patients with T2DM have experience with TM and it is well accepted, especially one based on glucometers. Nevertheless, in order to promote TM use, easier and time-saving programmes for patient-physician interaction should be optimised.
Randomised controlled trial (RCT) study design for a large-scale municipal fall prevention exercise programme in community-living older women: study protocol for the Kuopio Fall Prevention Study (KFPS)
Authors: Vilpunaho Tommi , Kröger Heikki , Honkanen Risto , Koivumaa-Honkanen Heli , Sirola Joonas , Kuvaja-Köllner Virpi , Sund Reijo , Rikkonen Toni 
Published: June 2019

IntroductionFalls are a substantial health problem in seniors, causing fractures and being the leading cause of fatal injuries. The benefits of physical activity in fall prevention have been shown in randomised controlled trials (RCTs) in small cohorts (eg, ≤200 persons), but there is a gap between the known health effects of exercise and the large-scale implementation of effective activity in communities. Mental health and subjective well-being (SWB) should also be studied since they are strongly related to healthy ageing. Thus far, the proven efficacy of communal strategies to reduce falls and improve healthy ageing is sparse.Methods and analysisIn 2016, a 2-year RCT was launched in Kuopio, Finland to estimate the efficacy of a large, population-based, fall prevention exercise programme in community-living older women (born 1932–1945). Both the intervention and control group (n=457+457) receive health education. The intervention group is also offered free 6-month supervised training courses (weekly gym training and Taiji sessions), followed by a free 6-month unsupervised use of exercise facilities, as well as unsupervised low-cost exercise is also offered for another 12 months. During the whole 24-month follow-up, controls are free to pursue all their normal physical activities. Both study groups undergo the study measurements three times. Outcome measures include recording of falls, injuries, bone mineral density, changes in health and functional status and cognitive performance, deaths and SWB. Finally, the cost-effectiveness and cost–utility analysis will be conducted from the societal view. The main analyses comparing outcomes between study groups will be conducted using the intention to treat principle.Ethics and disseminationThe study has been reviewed and approved by the Research Ethics Committee of the Hospital District of North Savo. All regulations and measures of ethics and confidentiality are handled in accordance with the Declaration of Helsinki.Trial registration numberNCT02665169; Pre-results.
Integrating the prevention and control of rheumatic heart disease into country health systems: a systematic review protocol
Authors: Abrams Jessica , Watkins David , Abdullahi Leila H , Engel Mark E , Zuhlke Liesl J 
Published: June 2019

IntroductionRheumatic heart disease (RHD) is a preventable chronic condition affecting the valves of the heart. RHD prevention and care programmes have historically originated in more developed countries, implemented in a targeted (or vertical) manner and evaluated using non-controlled approaches. Taking a broad view of the integration of RHD activities within the whole system is critical for health planning in low-income regions with a high burden of RHD and less robust health systems. Therefore, we propose to conduct a systematic review to assess RHD programme models in order to gain a better understanding of the extent of integration within relevant health systems.Methods and analysisA predefined search strategy will be used to search for relevant articles published in English from January 1990 to December 2017. Electronic databases PubMed, Scopus, Web of Science, Africa Wide, CINAHL, Cochrane Central Register of Controlled Trials, Google Scholar and Global Index Medicus will be searched, as well as reference lists of relevant articles published. A standardised data extraction form will be used to obtain information for analysis from the included studies. The quality, reliability and risk of bias of included studies will be assessed using design-specific criteria. Programme integration will be analysed according to stewardship and governance, financing, planning, service delivery, monitoring and evaluation, and demand generation. Programme inputs, outputs and impact will also be described.Ethics and disseminationNo ethical approval is required. Findings will be disseminated in a peer-review journal in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.PROSPERO registration numberCRD42017076307
Does attendance of a prenatal education course reduce rates of caesarean section on maternal request? A questionnaire study in a tertiary women hospital in Shanghai, China
Authors: Gao Yifei , Tang Yunhui , Tong Mancy , Du Yan , Chen Qi 
Published: June 2019

ObjectiveCaesarean section rates have significantly increased worldwide. China has a caesarean rate of 46%, with a moderate contribution of caesarean section on maternal request. In this study, we investigated the association between maternal characteristics, attendance at a prenatal education course and caesarean section on maternal request.DesignQuestionnaire study.SettingTertiary hospital in China.Sample564 questionnaires.MethodsOn postpartum day 42, questionnaire data were collected. Data including age, parity, gravida, delivery mode, educational level, residence status, living condition and attendance of prenatal education course were analysed.Primary and secondary outcome measuresFactors associated with caesarean section on maternal request.Results46% of women were delivered by caesarean section on maternal request. Maternal age and residence status were all significantly associated with having a caesarean section on maternal request. The OR of an increase in caesarean section on maternal request in women over 30 years was 2.42 (95%confidence limits 1.597 to 3.666), compared with women under 30 years. 75% more women who resided in Shanghai had caesarean section on maternal request, compared with women who resided outside of Shanghai. However, there was a significant reduction (35%) in the number of caesarean sections on maternal request in women who attended a prenatal education course (p=0.029). There was no significant association between attendance of a prenatal education course and the other maternal characteristics studied.ConclusionMaternal age is associated with an increased risk of caesarean section on maternal request. For women of all age, attendance of a prenatal education course significantly reduced the rate of caesarean section on maternal request. Our data suggest that promotion of a prenatal education course is an important tool in China to reduce the rate of caesarean section.