bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rationale and design of a statewide telestroke registry: Lone Star Stroke Consortium Telestroke Registry (LeSteR)
Authors: Astudillo Cesar , Ankrom Christy , Trevino Alyssa , Malazarte Rene M , Bambhroliya Arvind B , Savitz Sean , Topel Christopher H , Milling Truman J , Wu Tzu-Ching 
Published: September 2019

IntroductionThe Lone Star Stroke Consortium Telestroke Registry (LeSteR) currently consisting of 3 academic hub centres and 27 partner spokes is a statewide initiative organised by leading academic health centres in the State of Texas to understand practice patterns of acute stroke management via telestroke (TS) in Texas, a state with one of the largest rural populations in the USA.Methods and analysisAll patients who had presumed stroke for whom a TS consultation has been obtained in the network are entered into a web-based, Health Insurance Portability and Accountability Act-compliant database from September 2013 to present. Spokes were enrolled into LeSteR in a staggered approach in two data collection phases: a retrospective phase and a prospective phase. Basic clinical, demographic data and relevant time metrics are collected in the retrospective phase. Starting 1 September 2015, additional outcome data including 90-day modified Rankin score, readmission and 90-day disposition are obtained by a standard phone interview. From the registry initiation to 31 December 2017, there are 8089 patients who had suspected stroke in the registry. Over 60% of patients enrolled after 1 September 2015 have reported outcome data. Enrolment is still active for this registry.Ethics and disseminationLeSteR is a statewide TS registry organised by academic health centres that will provide significant insight regarding the impact of TS in the State of Texas. Findings from LeSteR will provide data that can be analysed to improve the allocation of healthcare resources using TS to treat stroke in a state with one of the largest rural populations.
Hospital Survey on Patient Safety Culture (HSPSC): a systematic review of the psychometric properties of 62 international studies
Authors: Waterson Patrick , Carman Eva-Maria , Manser Tanja , Hammer Antje 
Published: September 2019

ObjectiveTo carry out a systematic review of the psychometric properties of international studies that have used the Hospital Survey on Patient Safety Culture (HSPSC).DesignLiterature review and an analysis framework to review studies.SettingHospitals and other healthcare settings in North and South America, Europe, the Near East, the Middle East and the Far East.Data sourcesA total of 62 studies and 67 datasets made up of journal papers, book chapters and PhD theses were included in the review.Primary and secondary outcome measuresPsychometric properties (eg, internal consistency) and sample characteristics (eg, country of use, participant job roles and changes made to the original version of the HSPSC).ResultsJust over half (52%) of the studies in our sample reported internal reliabilities lower than 0.7 for at least six HSPSC dimensions. The dimensions ‘staffing’, ‘communication openness’, ‘non-punitive response to error’, ‘organisational learning’ and ‘overall perceptions of safety’ resulted in low internal consistencies in a majority of studies. The outcomes from assessing construct validity were reported in 60% of the studies. Most studies took place in a hospital setting (84%); the majority of survey participants (62%) were drawn from nursing and technical staff. Forty-two per cent of the studies did not state what modifications, if any, were made to the original US version of the instrument.ConclusionsWhile there is evidence of a growing worldwide trend in the use of the HSPSC, particularly within Europe and the Near/Middle East, our review underlines the need for caution in using the instrument. Future use of the HSPSC needs to be sensitive to the demands of care settings, the target population and other aspects of the national and local healthcare contexts. There is a need to develop guidelines covering procedures for using, adapting and translating the HSPSC, as well as reporting findings based on its use.
Intelligence in young adulthood and alcohol use disorders in a prospective cohort study of Danish men: the role of psychiatric disorders and parental psychiatric history
Authors: Just-Østergaard Emilie , Flensborg-Madsen Trine , Knop Joachim , Sørensen Holger Jelling , Becker Ulrik , Mortensen Erik Lykke 
Published: September 2019

ObjectivesThe aims were to estimate the association between intelligence measured in young adulthood and risk of alcohol use disorders (AUD) in men and to investigate the potential modification of this association by psychiatric disorders, parental AUD and parental psychiatric disorders.DesignProspective cohort study based on a linkage of intelligence test scores from draft board examinations and register data on AUD diagnoses during 36 years of follow-up.SettingDenmark.Participants3287 Danish men from the Copenhagen Perinatal Cohort (born 1959–1961) who appeared before the draft board at a mean age of 18.7 years.Primary outcome measureFirst registration with AUD during follow-up was the primary outcome. Information on AUD was based on diagnoses retrieved from national hospital and outpatient treatment registers, defined according to the International Classification of Diseases.Results361 (11.0%) men were registered with AUD during follow-up. Low intelligence scores were associated with increased odds of AUD adjusting for parental AUD, parental psychiatric disorders, maternal smoking during pregnancy, birth weight, maternal age at birth, parity and childhood socioeconomic position (OR per SD decrease in intelligence=1.69, 95% CI 1.49 to 1.92). Separate analyses indicated significant interaction (p<0.001) between intelligence and psychiatric disorders. The adjusted OR per SD decrease in intelligence score was 2.04 (95% CI 1.67 to 2.49) in men without other psychiatric disorders whereas the OR was 1.21 (95% CI 1.01 to 1.46) in men with other psychiatric disorders. No interaction was found between intelligence and parental AUD or between intelligence and parental psychiatric disorders.ConclusionsThe association between intelligence in young adulthood and AUD is modified by other psychiatric disorders as low intelligence is primarily a risk factor for men without other psychiatric disorders. Future studies should take other psychiatric disorders into account when investigating associations between intelligence and AUD.
Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: a prospective observational study
Authors: Quaglio Gianluca , Tognon Francesca , Finos Livio , Bome David , Sesay Santigie , Kebbie Atiba , Di Gennaro Francesco , Camara Bienvenu Salim , Marotta Claudia , Pisani Vincenzo , Bangura Zainab , Pizzol Damiano , Saracino Annalisa , Mazzucco Walter , Jones Susan , Putoto Giovanni 
Published: September 2019

ObjectivesTo assess the trends concerning utilisation of maternal and child health (MCH) services before, during and after the Ebola outbreak, quantifying the contribution of a reorganised referral system (RS).DesignA prospective observational study of MCH services.SettingPujehun district in Sierra Leone, 77 community health facilities and 1 hospital from 2012 to 2017.Main outcome measuresMCH utililization was evaluated by assessing: (1) institutional deliveries, Cesarean-sections, paediatric and maternity admissions and deaths, and major direct obstetric complications (MDOCs), at hospital level; (2) antenatal care (ANC) 1 and 4, institutional delivery and family planning, at community level. Contribution of a strengthened RS was also measured.ResultsAt hospital level, there is a significant difference between trends Ebola versus pre-Ebola for maternal admissions (7, 95% CI 4 to 11, p<0.001), MDOCs (4, 95% CI 1 to 7, p=0.006) and institutional deliveries (4, 95% CI 2 to 6, p=0.001). There is also a negative trend in the transition from Ebola to post-Ebola for maternal admissions (−7, 95% CI −10 to −4, p<0.001), MDOCs (−4, 95% CI −7 to −1, p=0.009) and institutional deliveries (−3, 95% CI −5 to −1, p=0.001). The differences between trends pre-Ebola versus post-Ebola are only significant for paediatric admissions (3, 95% CI 0 to 5, p=0.035). At community level, the difference between trends Ebola versus pre-Ebola and Ebola versus post-Ebola are not significant for any indicators. The differences between trends pre-Ebola versus post-Ebola show a negative difference for institutional deliveries (−7, 95% CI −10 to −4, p<0.001), ANC 1 (−6, 95% CI −10 to −3, p<0.001), ANC 4 (−8, 95% CI −11 to −5, p<0.001) and family planning (−85, 95% CI −119 to −51, p<0.001).ConclusionsA stronger health system compared with other districts in Sierra Leone and a strengthened RS enabled health facilities in Pujehun to maintain service provision and uptake during and after the Ebola epidemic.
Functional status and life satisfaction of patients with stable angina pectoris in Austria
Authors: Spinka Fabian , Aichinger Josef , Wallner Eva , Brecht Stephan , Rabold Thomas , Metzler Bernhard , Zweiker Robert , Lang Irene , Delle Karth Georg 
Published: September 2019

ObjectivesAlthough substantial progress in the treatment of stable angina pectoris (sAP) has been made, little is known about the functional status and quality of life (QoL) of patients in different healthcare systems.Design and methodsWe undertook a survey using the Seattle Angina Questionnaire (SAQ) (five domains scored form 0—worst assessment to 100—best assessment) to assess symptoms, QoL (including limitation of activities), demographics, geographic distribution and individual disease data in patients with stable coronary artery disease in Austrian cardiology practices.ResultsA total of 660 patients with sAP with a mean age of 69.2 years were included. SAQ scores were 67.5±24.4 for physical limitation, 65.5±26.6 for angina stability, 79.3±23.2 for angina frequency, 86.3±16.2 for treatment satisfaction and 63.7±24.2 for overall QoL. Multiple regression identified male gender, but also female gender, Eastern Austrian residence and high body mass index as predictive factors for SAQ scoring. A total of 35.6% of the patients reported at least one desirable activity that was limited through AP symptoms.ConclusionsActivity and QoL assessments are in accordance with published literature: The number and the diversity of desired activities indicate the need to focus on patient’s individual activity level to improve symptom management.
Childhood adversities and 5-HTTLPR polymorphism as risk factors of substance use disorders: retrospective case-control study in Murcia (Spain)
Authors: Navarro-Mateu Fernando , Quesada Mari Paz , Escámez Teresa , Alcaráz Mª José , Seiquer de la Peña Catherine , Salmerón Diego , Huerta José María , Vilagut Gemma , Chirlaque Maria Dolores , Navarro Carmen , Husky Mathilde , Kessler Ronald C , Alonso Jordi , Martínez Salvador 
Published: September 2019

ObjectiveTo explore the separate and joint associations of childhood adversities and 5-HTTLPR polymorphism as risk factors for substance use disorders among adults.DesignRetrospective case-control study.SettingCases from the substance unit and controls from a representative sample of the adult general population in the metropolitan area of Murcia (Spain).ParticipantsCases were defined as outpatients 18 years old or older currently in the treatment for alcohol, opioids or cocaine use disorders in the clinical unit. Controls were randomly selected among individuals without substance use disorders who participated in the Psychiatric Enquiry to General Population in Southeast Spain-Murcia (PEGASUS-Murcia) project, a cross-sectional study of a representative sample of the adult general population. In all, 142 cases and 531 controls were interviewed and a subsample of 114 cases (80.3%) and 329 controls (62%) provided a biological sample.ExposureA history of 12 childhood adversities, lifetime mental disorders and sociodemographic variables was assessed with the Composite International Diagnostic Interview (CIDI)version 3.0). Buccal swabs were obtained to genotype the 5-HTTLPR polymorphism with the biallelic and the triallelic classification.Main outcome and measureMultivariable logistic regression models were performed to estimate adjusted ORs and 95% CI.ResultsChildhood adversities were associated with an elevated risk of substance use disorders (OR=5.77, 95% CI 3.46 to 9.61). Homozygotes for the short allele of the 5-HTTLPR polymorphism also showed the elevated risk of substance use disorders for the biallelic and triallelic classification: (1.97 (1.10 to 3.55) and 2.01 (1.11 to 3.64), respectively). No evidence for gene × environment interactions was found.ConclusionsChildhood adversities and the 5-HTTLPR polymorphism are involved in the aetiology of substance use disorders though findings exploring the existence of a gene–environment interaction were inconclusive.
Rates of retention of persons with a mental health disorder in outpatient smoking cessation and reduction trials, and associated factors: protocol for a systematic review and meta-analysis
Authors: Metse Alexandra Patricia , Stockings Emily , Bailey Jacqueline , Regan Timothy , Bartlem Kate , Wolfenden Luke , Taylor Gemma , Wiggers John , Bowman Jenny 
Published: September 2019

IntroductionSmoking among persons with a mental health disorder is associated with inequitable health, social and economic burden. Randomised controlled trials (RCTs) are considered the gold standard design for the assessment of healthcare intervention efficacy/effectiveness. However, many RCTs of smoking interventions for persons with a mental health disorder lack rigour due to low participant retention. No systematic review has pooled retention rates in randomised trials of smoking interventions for persons with a mental health disorder or explored associated factors. The aims of the systematic review will therefore be to: (1) summarise overall rates of participant retention in smoking cessation and reduction trials involving persons with a mental health disorder (including for experimental and control groups separately) and (2) determine if retention rates vary according to participant, environmental, researcher and study factors.Methods and analysisPsycINFO, EMBASE, MEDLINE, CENTRAL and The Cochrane Tobacco Addiction Review Group Specialised Register will be searched for reports of RCTs of outpatient smoking cessation or reduction interventions for adults with a mental health disorder. The search terms will include MeSH terms and free text words, and there will be no language or date restrictions. All databases will be searched from inception to present. Data will be analysed using the Mantel-Haenszel fixed-effect model, and where substantial heterogeneity (I2>50%) is detected, DerSimonian & Laird inverse-variance random effects model. Pooled estimates and 95% CIs will be calculated for overall participant retention rates and for intervention and control trial arms separately. Associations between participant retention and participant, environmental, researcher and study factors will be assessed via subgroup analyses and, where sufficient data are obtained, meta-regression.Ethics and disseminationThis study does not require ethical approval. The findings of this review will be disseminated via publication in a peer-reviewed open access medical journal and presentations at international scientific meetings.
Zoledronate in the prevention of Paget’s (ZiPP): protocol for a randomised trial of genetic testing and targeted zoledronic acid therapy to preventSQSTM1-mediated Paget’s disease of bone
Authors: Cronin Owen , Forsyth Laura , Goodman Kirsteen , Lewis Steff C , Keerie Catriona , Walker Allan , Porteous Mary , Cetnarskyj Roseanne , Ranganath Lakshminarayan R , Selby Peter L , Hampson Geeta , Chandra Rama , Ho Shu , Tobias Jon H , Young-Min Steven , McKenna Malachi J , Crowley Rachel K , Fraser William D , Gennari Luigi , Nuti Ranuccio , Brandi Maria Luisa , Del Pino-Montes Javier , Devogelaer Jean-Pierre , Durnez Anne , Isaia Giancarlo , Di Stefano Marco , Guañabens Núria , Blanch Josep , Seibel Markus J , Walsh John P , Kotowicz Mark A , Nicholson Geoffrey C , Duncan Emma L , Major Gabor , Horne Anne , Gilchrist Nigel L , Boers Maarten , Murray Gordon D , Charnock Keith , Wilkinson Diana , Russell R Graham G , Ralston Stuart H 
Published: September 2019

IntroductionPaget’s disease of bone (PDB) is characterised by increased and disorganised bone remodelling affecting one or more skeletal sites. Complications include bone pain, deformity, deafness and pathological fractures. Mutations in sequestosome-1 (SQSTM1) are strongly associated with the development of PDB. Bisphosphonate therapy can improve bone pain in PDB, but there is no evidence that treatment alters the natural history of PDB or prevents complications. The Zoledronate in the Prevention of Paget’s disease trial (ZiPP) will determine if prophylactic therapy with the bisphosphonate zoledronic acid (ZA) can delay or prevent the development of PDB in people who carrySQSTM1mutations.Methods and analysisPeople with a family history of PDB aged >30 years who test positive forSQSTM1mutations are eligible to take part. At the baseline visit, participants will be screened for the presence of bone lesions by radionuclide bone scan. Biochemical markers of bone turnover will be measured and questionnaires completed to assess pain, health-related quality of life (HRQoL), anxiety and depression. Participants will be randomised to receive a single intravenous infusion of 5 mg ZA or placebo and followed up annually for between 4 and 8 years at which point baseline assessments will be repeated. The primary endpoint will be new bone lesions assessed by radionuclide bone scan. Secondary endpoints will include changes in biochemical markers of bone turnover, pain, HRQoL, anxiety, depression and PDB-related skeletal events.Ethics and disseminationThe study was approved by the Fife and Forth Valley Research Ethics Committee on 22 December 2008 (08/S0501/84). Following completion of the trial, a manuscript will be submitted to a peer-reviewed journal. The results of this trial will inform clinical practice by determining if early intervention with ZA in presymptomatic individuals withSQSTM1mutations can prevent or slow the development of bone lesions with an adverse event profile that is acceptable.Trial registration numberISRCTN11616770
Operative treatment of displaced midshaft clavicle fractures: has randomised control trial evidence changed practice patterns?
Authors: Schneider Prism , Bransford Richard , Harvey Edward , Agel Julie 
Published: September 2019

ObjectivesTo determine if level 1 evidence from a landmark trial changed practice patterns for treatment of patients with displaced midshaft clavicle fractures.DesignRetrospective cohort study.SettingTwo level 1 trauma centres.ParticipantsDisplaced midshaft clavicle fractures.Results686 patients met inclusion criteria. The pretrial cohort (n=108) was 68.5% male, with a mean age of 37.7 (±13.9) years. The post-trial cohort (n=578) was 76.1% male, with a mean age of 41.9 (±12.7) years. There was nearly a 10-fold increase in the patients treated with openreduction and internal fixation (ORIF) in the post-trial cohort (34.1%) compared with the pretrial cohort (3.7%) (p<0.001). Patients in the post-trial cohort were more likely to undergo ORIF if they were <40 years (OR=2.2; 95% CI 1.53 to 3.10), if their Injury Severity Score was >9 (OR=1.6; 95% CI 0.89 to 2.99) or if they were treated at a centre that participated in theCanadian Orthopaedic Trauma Society (COTS)trial (OR=5.2; 95% CI 3.31 to 8.21).ConclusionsThis study demonstrated a significant shift towards more frequentORIFfor displaced midshaft clavicle fractures following the COTS trial. Quantifying changes in practice pattern following publication of level 1 evidence is important to further our understanding of the impact largerandomisedclinical trailsare having on clinical practice.
Neonatal azithromycin administration to prevent infant mortality: study protocol for a randomised controlled trial
Authors: Sie Ali , Bountogo Mamadou , Nebie Eric , Ouattara Mamadou , Coulibaly Boubacar , Bagagnan Cheik , Zabre Pascal , Lebas Elodie , Brogdon Jessica , Godwin William W , Lin Ying , Porco Travis , Doan Thuy , Lietman Thomas M , Oldenburg Catherine E 
Published: September 2019

IntroductionBiannual mass azithromycin distribution to children aged 1–59 months has been shown to reduce all-cause mortality. Children under 28 days of age were not treated in studies evaluating mass azithromycin distribution for child mortality due to concerns related to infantile hypertrophic pyloric stenosis (IHPS). Here, we report the design of a randomised controlled trial to evaluate the efficacy and safety of administration of a single dose of oral azithromycin during the neonatal period.Methods and analysisTheNouveaux-nés et Azithromycine: une Innovation dans le Traitement des Enfants(NAITRE) study is a double-masked randomised placebo-controlled trial designed to evaluate the efficacy of a single dose of azithromycin (20 mg/kg) for the prevention of child mortality. Newborns (n=21 712) aged 8–27 days weighing at least 2500 g are 1:1 randomised to a single, directly observed, oral dose of azithromycin or matching placebo. Participants are followed weekly for 3 weeks after treatment to screen for adverse events, including IHPS. The primary outcome is all-cause mortality at the 6-month study visit.Ethics and disseminationThis study was approved by the Institutional Review Boards at the University of California, San Francisco in San Francisco, USA (Protocol #18-25027) and the Comité National d’Ethique pour la Recherche in Ouagadougou, Burkina Faso (Protocol #2018-10-123). The findings of this trial will be presented at local, regional and international meetings and published in open access peer-reviewed journals.Trial registration numberNCT03682653; Pre-results.
Intoxication in dogs and cats: a basic approach to decontamination
Authors: Humm Karen , Greensmith Tom 
Published: September 2019

Background: There are two types of intoxicated patient that present to veterinary practices: the asymptomatic patient with a known exposure and the patient with clinical signs that may (or may not) be due to a toxin or poison. Deciding when (or if) to treat these patients is often an inexact science and the decision must be made based on numerous risk factors, the owner's level of comfort with risk and any financial constraints.Aim of the article: This article is the first in a series of four and aims to provide a basic overview of the approach to decontamination of an asymptomatic patient presented with a known intoxication. It also outlines therapies that may be considered in both symptomatic and asymptomatic patients, and these will be discussed in more detail in future articles.