bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study
Authors: Killingmo Rikke Munk , Storheim Kjersti , van der Windt Danielle , Zolic-Karlsson Zinajda , Vigdal Ørjan Nesse , Kretz Lise , Småstuen Milada Cvancarova , Grotle Margreth 
Published: June 2022

ObjectivesTo describe healthcare utilization and estimate associated costs during 1 year of follow-up among older people seeking primary care due to a new episode back pain and to describe healthcare utilization across patients with different risk profiles stratified using the StarT Back Screening Tool (SBST).DesignProspective cohort study.Participants and settingA total of 452 people aged ≥55 years seeking Norwegian primary care with a new episode of back pain were included.Outcome measuresThe primary outcome of this study was total cost of healthcare utilization aggregated for 1 year of follow-up. Secondary outcomes included components of healthcare utilization aggregated for 1 year of follow-up. Healthcare utilization was self-reported and included: primary care consultations, medications, examinations, hospitalisation, rehabilitation stay, and operations. Costs were estimated based on unit costs collected from national pricelists. Healthcare utilization across patients with different SBST risk profiles was compared using Kruskal-Wallis test, post hoc Mann-Whitney U tests and Bonferroni adjustment.ResultsIn total, 438 patients were included in the analysis. Mean (BCa 95% CI) total cost per patient over 1 year was €825 (682-976). Median (BCa 95% CI) total cost was €364 (307-440). The largest cost category was primary care consultations, accounting for 56% of total costs. Imaging rate was 34%. The most commonly used medication was paracetamol (27%–35% of patients). Medium- and high-risk patients had a significantly higher degree of healthcare utilization compared with low-risk patients (p<0.030).ConclusionThis study estimated a 1 year mean and median cost of healthcare utilization of €825 and €364, respectively. Patients within the top 25th percentile accounted for 77% of all costs. Patients classified as medium risk and high risk had a significantly higher degree of healthcare utilization compared with patients classified as low risk.Trial registration numberClinicalTrials.govNCT04261309, results
Determinants of handwashing practice and its associated factors among mothers of under-5 children in Kolladiba town, Northwest Ethiopia: cross-sectional study
Authors: Wolde Maereg , Abate Meshehsa , Mandefro Gebremeskel , Beru Ezedin , Kassahun Aysheshim , Tesema Getayeneh Antehunegn 
Published: June 2022

PurposeHandwashing is a single most preventive measure for reducing the spread of contagious diseases. Mothers serve as the children’s nurses and poor practice of simple hygiene increases the risk of the spread of diseases to under-5 children.ObjectiveThis study aimed at investigating the proportion of handwashing practice at critical times and associated factors among mothers of under-5 children in Kolladiba town, Northwest Ethiopia.Design, Setting, participants and outcome measuresA community-based cross-sectional study design was carried out from 20 February 2020 to 12 March 2020, in Kolladiba town. A total of 334 mothers participated in this study. The study participants were selected using a systematic random sampling technique. Bivariable and multivariable binary logistic regression was employed. A p<0.05 was used to declare statically significant variables.ResultsThe proportion of good handwashing practice among mothers at critical times was 51.2% (95% CI 45.8% to 56.5%). In the multivariable binary logistic regression analysis, mothers who attained college and above (adjusted OR, AOR 4.93, 95% CI 1.28 to 19), knowledge of handwashing (AOR 1.26, 95% CI 1.11 to 1.42), husband working in governmental organisation (AOR 0.17, 95% CI 0.04 to 0.76), husband working at private organisation (AOR 0.16, 95% CI 0.04 to 0.75), mercantile husbands (AOR 0.09, 95% CI 0.02 to 0.37), tap water supply (AOR 0.26, 95% CI 0.07 to 0.93) and handwashing facility adjacent to latrine (AOR 6.17, 95% CI 2.02 to 18.8) were significant factors.ConclusionHandwashing practice in kolladiba town among mothers at critical times was found to be low. Higher educational status, knowledge about handwashing practice and availability of handwashing facilities near the latrine, tap water source and husband occupation were significant factors. Thus, health awareness shall be given on the importance of handwashing practice with a due emphasis on mothers who do not attain higher education, with lower knowledge, who have tap water, working husbands and who do not have handwashing facilities near the latrine.
Global prevalence, treatment and outcome of tuberculosis and COVID-19 coinfection: a systematic review and meta-analysis (from November 2019 to March 2021)
Authors: Wang Quan , Guo Shasha , Wei Xiaolin , Dong Quanfang , Xu Ning , Li Hui , Zhao Jie , Sun Qiang 
Published: June 2022

IntroductionThe COVID-19 outbreak poses a significant threat to the patients with tuberculosis (TB). TB and COVID-19 (TB–COVID) coinfection means the disease caused by both Mycobacterium tuberculosis and SARS-CoV-2 infection. Currently, the prevalence status, treatment and outcomes of the coinfection are poorly characterised. We aimed to systematically review the evidence on this topic and provide comprehensive information to guide the control and treatment of TB–COVID coinfection.MethodsAn extensive screening was conducted using six electronic databases to search eligible studies from 1 November 2019 to 19 March 2021. Prevalence rate, treatment and outcomes of TB–COVID coinfection were extracted. Random-effects models were used to calculate mean fatality rates of coinfection with 95% CIs. The risks of bias were assessed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Study Reporting Prevalence Data and JBI Critical Appraisal Checklist for Case Report. A meta-analysis was conducted for subgroups on in-hospital fatality rate.ResultsForty-two studies were included into the analysis (35 case reports and 7 retrospective cohort studies). Nineteen countries reported coinfected patients, including high and low TB prevalence countries. The only study revealing prevalence rate came from West Cape Province, South Africa (people aged above 20 years, 0.04% until 1 June 2020 and 0.06% until 9 June 2020). The treatment regimens for coinfected patients were highly heterogeneous. The mean overall and in-hospital fatality rates of coinfection were 13.9% (95% CI: 1.6% to 26.2%) and 17.5% (95% CI: 8.9% to 26.0%). The mean in-hospital fatality rates for high-income countries (Italy and Argentina) and low/middle-income countries (LMICs) (India, Philippines, South Africa) were 6.5% (95% CI: −0.8% to ~13.9%) and 22.5% (95% CI: 19.0% to ~26.0%).ConclusionTB–COVID coinfection is common globally, and the coinfected patients suffer from higher fatality risk than patients with normal COVID-19. Outcomes shared significant differences between high-income countries and LMICs.PROSPERO registration numberCRD42021253660.
Protocol for the development of a reporting guideline for causal and counterfactual prediction models in biomedicine
Authors: Xu Jie , Guo Yi , Wang Fei , Xu Hua , Lucero Robert , Bian Jiang , Prosperi Mattia 
Published: June 2022

IntroductionWhile there are guidelines for reporting on observational studies (eg, Strengthening the Reporting of Observational Studies in Epidemiology, Reporting of Studies Conducted Using Observational Routinely Collected Health Data Statement), estimation of causal effects from both observational data and randomised experiments (eg, A Guideline for Reporting Mediation Analyses of Randomised Trials and Observational Studies, Consolidated Standards of Reporting Trials, PATH) and on prediction modelling (eg, Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis), none is purposely made for deriving and validating models from observational data to predict counterfactuals for individuals on one or more possible interventions, on the basis of given (or inferred) causal structures. This paper describes methods and processes that will be used to develop a Reporting Guideline for Causal and Counterfactual Prediction Models (PRECOG).Methods and analysisPRECOG will be developed following published guidance from the Enhancing the Quality and Transparency of Health Research (EQUATOR) network and will comprise five stages. Stage 1 will be meetings of a working group every other week with rotating external advisors (active until stage 5). Stage 2 will comprise a systematic review of literature on counterfactual prediction modelling for biomedical sciences (registered in Prospective Register of Systematic Reviews). In stage 3, a computer-based, real-time Delphi survey will be performed to consolidate the PRECOG checklist, involving experts in causal inference, epidemiology, statistics, machine learning, informatics and protocols/standards. Stage 4 will involve the write-up of the PRECOG guideline based on the results from the prior stages. Stage 5 will seek the peer-reviewed publication of the guideline, the scoping/systematic review and dissemination.Ethics and disseminationThe study will follow the principles of the Declaration of Helsinki. The study has been registered in EQUATOR and approved by the University of Florida’s Institutional Review Board (#202200495). Informed consent will be obtained from the working groups and the Delphi survey participants. The dissemination of PRECOG and its products will be done through journal publications, conferences, websites and social media.
Development and validation of a multidimensional, culturally and socially inclusive Child Resilience Questionnaire (parent/caregiver report) to measure factors that support resilience: a community-based participatory research and psychometric testing study in Australia
Authors: Gartland Deirdre , Riggs Elisha , Giallo Rebecca , Glover Karen , Stowe Mardi , Mongta Sharon , Weetra Donna , Brown Stephanie Janne 
Published: June 2022

ObjectiveDevelop a comprehensive socially inclusive measure to assess child resilience factors.DesignA socioecological model of resilience, community-based participatory research methods and two rounds of psychometric testing created the Child Resilience Questionnaire (parent/caregiver report, child report, school report). The parent/caregiver report (CRQ-P/C) is the focus of this paper.SettingAustralia.ParticipantsCulturally and socially diverse parents/caregivers of children aged 5–12 years completed the CRQ-P/C in the pilot (n=489) and validation study (n=1114). Recruitment via a large tertiary hospital’s outpatient clinics, Aboriginal and refugee background communities (Aboriginal and bicultural researchers networks) and nested follow-up of mothers in a pregnancy cohort and a cohort of Aboriginal families.AnalysisExploratory and confirmatory factor analyses conducted to assess the structure and construct validity of CRQ-P/C subscales. Cronbach’s alpha used to assess internal consistency of subscales. Criterion validity assessed with the Strengths and Difficulties Questionnaire (SDQ) parent report.ResultsConceptually developed CRQ comprised 169 items in 19 subscales across five socioecological domains (self, family, friends, school and community). Two rounds of psychometric revision and community consultations created a CRQ-P/C with 43 items in 11 scales: self (positive self, positive future, managing emotions), family (connectedness, guidance, basic needs), school (teacher support, engagement, friends) and culture (connectedness, language). Excellent scale reliability (α=0.7–0.9), except basic needs scale (α=0.61) (where a highly endorsed item was retained for conceptual integrity). Criterion validity was supported: scales had low to moderate negative correlations with SDQ total difficulty score (Rs= -0.2/–0.5. p<0.001); children with emotion/behavioural difficulties had lower CRQ-P/C scores (β=−14.5, 95% CI −17.5 to −11.6, adjusted for gender).ConclusionThe CRQ-P/C is a new multidomain measure of factors supporting resilience in children. It has good psychometric properties and will have broad applications in clinical, educational and research settings. The tool also adds to the few culturally competent measures relevant to Aboriginal and refugee background communities.
Cannabis use among youth in Canada: a scoping review protocol
Authors: Kourgiantakis Toula , Edwards Travonne , Lee Eunjung , Logan Judith , Vicknarajah Ragave , Craig Shelley L , Simon-Tucker Monique , Williams Charmaine C 
Published: June 2022

IntroductionCanadian youth (aged 15–24) have the highest rates of cannabis use globally. There are increasing concerns about the adverse effects of cannabis use on youth physical and mental health. However, there are gaps in our understanding of risks and harms to youth. This scoping review will synthesise the literature related to youth cannabis use in Canada. We will examine the relationship between youth cannabis use and physical and mental health, and the relationship with use of other substances. We will also examine prevention strategies for youth cannabis use in Canada and how the literature addresses social determinants of health.Methods and analysisUsing a scoping review framework developed by Arksey and O’Malley, we will conduct our search in five academic databases: MEDLINE, Embase, APA PsycInfo, CINAHL and Web of Science’s Core Collection. We will include articles published between 2000 and 2021, and articles meeting the inclusion criteria will be charted to extract relevant themes and analysed using a qualitative thematic analysis approach.Ethics and disseminationThis review will provide relevant information about youth cannabis use and generate recommendations and gaps in the literature. Updated research will inform policies, public education strategies and evidence-based programming. Results will be disseminated through an infographic, peer-reviewed publication and presentation at a mental health and addiction conference. Ethics approval is not required for this scoping review.
UK endoscopy workload and workforce patterns: is there potential to increase capacity? A BSG analysis of the National Endoscopy Database
Authors: Beaton David , Sharp Linda , Trudgill Nigel John , Thoufeeq Mo , Nicholson Brian D , Rogers Peter , Docherty James , Penman Ian D , Rutter Matt 
Published: June 2022

BackgroundThe lack of comprehensive national data on endoscopy activity and workforce hampers strategic planning. The National Endoscopy Database (NED) provides a unique opportunity to address this in the UK. We evaluated NED to inform service planning, exploring opportunities to expand capacity to meet service demands.DesignData on all procedures between 1 March 2019 and 29 February 2020 were extracted from NED. Endoscopy activity and endoscopist workforce were analysed.Results1 639 640 procedures were analysed (oesophagogastroduodenoscopy (OGD) 693 663, colonoscopy 586 464, flexible sigmoidoscopy 335 439 and endoscopic retrograde cholangiopancreatography 23 074) from 407 sites by 4990 endoscopists. 89% of procedures were performed in NHS sites. 17% took place each weekday, 10% on Saturdays and 6% on Sundays. Training procedures accounted for 6% of total activity, over 99% of which took place in NHS sites. Median patient age was younger in the independent sector (IS) (51 vs 60 years, p<0.001). 74% of endoscopists were male. Gastroenterologists and surgeons each comprised one-third of the endoscopist workforce; non-medical endoscopists (NMEs) comprised 12% yet undertook 23% of procedures. Approximately half of endoscopists performing OGD (52%) or colonoscopies (48%) did not meet minimum annual procedure numbers.ConclusionThis comprehensive analysis reveals endoscopy workload and workforce patterns for the first time across both the NHS and the IS in all four UK nations. Half of all endoscopists perform fewer than the recommended minimum annual procedure numbers: a national strategy to address this, along with expansion of the NME workforce, would increase endoscopy capacity, which could be used to exploit latent weekend capacity.
Inhibition of the postsynaptic density protein 95 on the protective effect of Ang-(1-7)–Mas on cerebral ischaemia injury
Authors: Zhao Bingrui , Wang Zhe , Liang Xinyue , Wang Xiaoyan , Lin Kai , Yuan Lihua , Jiang Jing , Xu Cong , Zhang Daolai , Sun Yeying , Bian Weihua 
Published: June 2022

BackgroundPostsynaptic density protein-95 (PSD95) plays an important role in cerebral ischaemia injury, but its mechanism needs further research. This study aimed to explore the role of PSD95 in (Ang-(1-7))-Mas-mediated cerebral ischaemia protection and its regulatory mechanism.MethodsOxygen–glucose deprivation (OGD) neuron and rat middle cerebral artery occlusion (MCAO) models were used as in vitro and in vivo models, respectively. TAT-MAS9C was used to disrupt the interaction between PSD95 and Mas. The recombinant PSD95 adenovirus (Ad-PSD95) was used to overexpress PSD95 in neurons.ResultsResults showed that in OGD neurons, Ang-(1-7) could promote cell viability; reduce cell apoptosis; reduce the cell membrane localisation of Mas; upregulate the expression levels of pAKT, bcl-2 and I-κB; and downregulate the expression levels of Bax, pI-κB, tumour necrosis factor alpha and interleukin-1β. TAT-MAS9C could enhance the aforementioned effects of Ang-(1-7). However, the PSD95 overexpression inhibited the aforementioned effects of Ang-(1-7). In the MCAO rat model, the 2,3,5-triphenyltetrazolium chloride (TTC) staining showed that Ang-(1-7) reduced the infarct volume. The Morris water maze test showed that the number of crossings over the platform area in the Ang-(1-7) group was significantly increased. TAT-MAS9C could promote the protective effect of Ang-(1-7).ConclusionsResults suggested that PSD95 alleviated the activation of AKT and the inhibition of nuclear factor kappa B signalling pathway mediated by the Ang-(1-7)–Mas complex, thereby reducing neuronal activity, increasing apoptosis and inhibiting the Ang-(1-7)–Mas-mediated cerebral ischaemia protection.
Endovascular thrombectomy with or without intravenous alteplase for acute ischemic stroke due to large vessel occlusion: a systematic review and meta-analysis of randomized trials
Authors: Wang Xin , Ye Zhikang , Busse Jason W , Hill Michael D , Smith Eric E , Guyatt Gordon H , Prasad Kameshwar , Lindsay M Patrice , Yang Hui , Zhang Yi , Liu Ying , Tang Borui , Wang Xinrui , Wang Yushu , Couban Rachel J , An Zhuoling 
Published: June 2022

BackgroundAmong patients who had an ischaemic stroke presenting directly to a stroke centre where endovascular thrombectomy (EVT) is immediately available, there is uncertainty regarding the role of intravenous thrombolysis agents before or concurrently with EVT. To support a rapid guideline, we conducted a systematic review and meta-analysis to examine the impact of EVT alone versus EVT with intravenous alteplase in patients who had an acute ischaemic stroke due to large vessel occlusion.MethodsIn November 2021, we searched MEDLINE, Embase, PubMed, Cochrane, Web of Science, clincialtrials.gov and the ISRCTN registry for randomised controlled trials (RCTs) comparing EVT alone versus EVT with alteplase for acute ischaemic stroke. We conducted meta-analyses using fixed effects models and assessed the certainty of evidence using the GRADE approach.ResultsIn total 6 RCTs including 2334 participants were eligible. Low certainty evidence suggests that, compared with EVT and alteplase, there is possibly a small decrease in the proportion of patients independent with EVT alone (risk ratio (RR) 0.97, 95% CI 0.89 to 1.05; risk difference (RD) −1.5%; 95% CI −5.4% to 2.5%), and possibly a small increase in mortality with EVT alone (RR 1.07, 95% CI 0.88 to 1.29; RD 1.2%, 95% CI −2.0% to 4.9%) . Moderate certainty evidence suggests that there is probably a small decrease in symptomatic intracranial haemorrhage (sICH) with EVT alone (RR 0.75, 95% CI 0.52 to 1.07; RD −1.0%; 95%CI −1.8% to 0.27%).ConclusionsLow certainty evidence suggests that there is possibly a small decrease in the proportion of patients that achieve functional independence and a small increase in mortality with EVT alone. Moderate certainty evidence suggests that there is probably a small decrease in sICH with EVT alone. The accompanying guideline provides contextualised guidance based on this body of evidence.PROSPERO registration numberCRD42021249873.
What happens after they survive? The role of anticoagulants and antiplatelets in IVC injuries
Authors: Hynes Allyson M , Scantling Dane R , Murali Shyam , Bormann Bradford C , Paul Jasmeet S , Reilly Patrick M , Seamon Mark J , Martin Niels D 
Published: June 2022

BackgroundVenous thromboembolism (VTE) after an inferior vena cava (IVC) injury is a devastating complication. Current practice involves variable use of anticoagulation and antiplatelet (AC/AP) agents. We hypothesized that AC/AP can reduce the incidence of VTE and that delayed institution of AC/AP is associated with increased VTE events.MethodsWe retrospectively reviewed IVC injuries cared for at a large urban adult academic level 1 trauma center between January 1, 2008 and December 31, 2020, surviving 72 hours. Patient demographics, injury mechanism, surgical repair, type and timing of AC, and type and timing of VTE events were characterized. Postoperative AC status during hospital course before an acute VTE event was delineated by grouping patients into four categories: full, prophylactic, prophylactic with concomitant AP, and none. The primary outcome was the incidence of an acute VTE event. IVC ligation was excluded from analysis.ResultsOf the 76 patients sustaining an IVC injury, 26 were included. The incidence of a new deep vein thrombosis distal to the IVC injury and a new pulmonary embolism was 31% and 15%, respectively. The median onset of VTE was 5 days (IQR 1–11). Four received full AC, 10 received prophylactic AC with concomitant AP, 8 received prophylactic AC, and 4 received no AC/AP. New VTE events occurred in 0.0% of full, in 30.0% of prophylactic with concomitant AP, in 50.0% of prophylactic, and in 50.0% without AC/AP. There was no difference in baseline demographics, injury mechanisms, surgical interventions, and bleeding complications.DiscussionThis is the first study to suggest that delay and degree of antithrombotic initiation in an IVC-injured patient may be associated with an increase in VTE events. Consideration of therapy initiation should be performed on hemostatic stabilization. Future studies are necessary to characterize the optimal dosing and temporal timing of these therapies.Level of evidenceTherapeutic, level 3.