bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of surgical treatment for anorectal melanoma: a propensity score-matched analysis of the Surveillance, Epidemiology, and End Results programme data
Authors: Lei Xiao , Qingqing Luo , Weijie Yuan , Li Peng , Huang Changhao , Kexun Yu , Zihua Chen 
Published: May 2022

ObjectiveAnorectal melanoma (AM) is a rare but aggressive tumour with limited information in the existing literature. This study aimed to assess the effect of surgical treatment for AM and predict the prognosis of affected patients.DesignA retrospective cohort study.SettingData of patients diagnosed with AM between 1975 and 2016 in the USA were collected from the Surveillance, Epidemiology, and End Results (SEER) database.ParticipantsThis study enrolled a total of 795 patients with AM from the SEER database and the validation cohort comprised 40 patients with AM enrolled from Chinese institutes.Primary and secondary outcome measuresOverall survival (OS) and AM-specific survival (AM-SS).ResultsA total of 795 patients with AM diagnosed between 1975 and 2016 were enrolled in this study. Data over the past four decades showed a trend of increase in incidence rate. A nomogram based on a multivariate Cox regression model was generated to predict AM-SS. The C-index of the nomogram was 0.74 (95% CI 0.71 to 0.77) on internal verification. In the validation cohort, the C-index of the nomogram was 0.72 (95% CI 0.68 to 0.76). The results of propensity score matching (PSM) analysis showed that patients who underwent surgical treatment achieved significant survival (OS: log-rank=17.41, p<0.001; AM-SS: log-rank=14.55, p<0.001). Patients who underwent surgery were stratified into local and extended surgery subgroups. AM-SS and OS were also compared after PSM, but the results were not significantly different between the two surgery subgroups (all p>0.05).ConclusionsThe nomogram based on the analysis of SEER data showed good performance in predicting OS and AM-SS. Patients with AM can benefit from surgery; however, extensive surgery and appendectomy may not improve AM-SS or OS.
Risk factors of COVID-19 vertical transmission among pregnant and non-pregnant Filipinos in Metro Manila: a multicentre cohort study protocol
Authors: Llamas-Clark Erlidia F , Singson Rebecca B , Heralde Francisco M , Lumandas Mayan U , Villanueva-Uy Maria Esterlita T , Cagayan Maria Stephanie Fay S , Regencia Zypher Jude G , Baja Emmanuel S 
Published: May 2022

IntroductionThe novel (COVID-19 was first reported to have originated in Wuhan, China, in December 2019. This new strain, SARS‐CoV‐2, has spread rapidly worldwide, prompting the WHO to declare the COVID-19 outbreak a global pandemic. The main objective of this cohort study is to determine the risk factors of COVID-19, the modes of COVID-19 vertical transmission, and the maternal and fetal outcomes among non-pregnant and pregnant women and their fetuses.Methods and analysisThis is a multicentre epidemiological study that will involve a prospective cohort. COVID-19 status among consulting non-pregnant and pregnant women in public hospitals in Manila, Philippines, will be determined and monitored for 6–12 months. Swab specimens from the nasopharynx, cervix, rectum, amniotic fluid, placenta, cord blood and breastmilk will be collected during consult and admission for reverse transcription-PCR (RT-PCR) testing. Blood will be collected during the postdelivery period to monitor the women and their neonates for any undue development and determine the antibody development to indicate an infective or non-infective state. Evidence of vertical transmission will be explored with the presence or absence of the virus using the maternal and fetal neonatal RT-PCR and lateral flow antibody status. Descriptive and inferential statistics will be done, including the associations between exposures and risk factors, description of clinical characteristics, and the COVID-19 status of the participants.Ethics and disseminationThe Single Joint Research Ethics Board of the Department of Health has approved this protocol (SJREB 2020-30). The study results will be disseminated through conference presentations, peer-reviewed articles, and various stakeholder public forums and activities.
Impact of trends and gender disparity in obesity on future type 2 diabetes in Turkey: a mathematical modelling analysis
Authors: Anakök Gül Anil , Awad Susanne F , Çağlayan Çiğdem , Huangfu Peijue , Abu-Raddad Laith J , Unal Belgin , Critchley Julia Alison 
Published: May 2022

BackgroundUsing a previously developed and validated mathematical model, we predicted future prevalence of type 2 diabetes mellitus (T2DM) and major modifiable risk factors (obesity, physical inactivity and smoking) stratified by age and sex in Turkey up to the year 2050.MethodsOur deterministic compartmental model fitted nationally representative demographic and risk factor data simultaneously for Turkish adults (aged 20–79) between 1997 and 2017, then estimated future trends. Our novel approach explored the impact of future obesity trends on these projections, specifically modelling (1) a gradual fall in obesity in women after the year 2020 until it equalled the age-specific levels seen in men and (2) cessation of the rise in obesity after 2020.ResultsT2DM prevalence is projected to rise from an estimated 14.0% (95% uncertainty interval (UI) 12.8% to 16.0%) in 2020 to 18.4% (95% UI 16.9% to 20.9%) by 2050; 19.7% in women and 17.2% in men by 2050; reflecting high levels of obesity (39.7% for women and 22.0% for men in 2050). Overall, T2DM prevalence could be reduced by about 4% if obesity stopped rising after 2020 or by 12% (22% in women) if obesity prevalence among women could be lowered to equal that of men. The higher age-specific obesity prevalence among women resulted in 2 076 040 additional women developing T2DM by the year 2050.ConclusionT2DM is common in Turkey and will remain so. Interventions and policies targeting the high burden of obesity (and low physical activity levels), particularly in women, could significantly impact future disease burdens.
Psychometric properties of the French and English short form of the Protective Behavioural Strategies for Marijuana Scale in Canadian university students
Authors: Côté José , Cossette Sylvie , Auger Patricia , Page Gabrielle , Coronado-Montoya Stephanie , Fontaine Guillaume , Chicoine Gabrielle , Rouleau Geneviève , Genest Christine , Lapierre Judith , Pedersen Eric R , Jutras-Aswad Didier 
Published: May 2022

BackgroundThe Protective Behavioural Strategies for Marijuana (PBSM-17) scale serves to identify and measure strategies employed by young adults before, during or after cannabis use. After the adaptation and translation of the PBSM-17 into French, a methodological study was conducted to evaluate the psychometric properties of this French version (FV) and of the original English version (EV) in a sample of bilingual Canadian university students.MethodsA total of 211 cannabis users (mean age=22.1 years) completed a sociodemographic questionnaire, a question on frequency of cannabis use (four categories: 1–3 times a month, once a week, more than once a week, everyday) and both versions (FV and EV) of the PBSM-17.ResultsBoth versions had similar internal reliability (α=0.91; α=0.88). The one-factor solution explained 36.46% of the variance for the FV and 42.26% for the EV. As hypothesised, greater use of protective behavioural strategies was related to lower frequency of cannabis use. One-way ANOVA test results revealed a statistically significant difference in use of strategies by frequency of cannabis use for both the FV (F(3, 207)=27.38, p<0.001) and EV (F(3, 207)=29.32, p<0.001). Post hoc comparisons showed that everyday users employed fewer strategies on average than lower-frequency users.ConclusionThe FV and EV of the PBSM-17 demonstrated satisfactory psychometric properties. The proposed FV of the PBSM-17 is a reliable instrument that could be used for research and clinical purposes. Protective behavioural strategies can serve as indicator of lower-risk cannabis use and could be targeted in prevention interventions.
Vaccine hesitancy and HPV vaccine uptake among male and female youth in Switzerland: a cross-sectional study
Authors: Kiener Laura M , Schwendener Corina L , Jafflin Kristen , Meier Audrey , Reber Noah , Schärli Maurer Susanna , Muggli Franco , Gültekin Nejla , Huber Benedikt M , Merten Sonja , Deml Michael J , Tarr Philip E 
Published: May 2022

ObjectivesIdentifying factors associated with human papillomavirus (HPV) vaccine uptake is essential for designing successful vaccination programmes. We aimed to examine the association between vaccine hesitancy (VH) and HPV vaccine uptake among male and female youth in Switzerland.DesignWith a cross-sectional study, an interview-based questionnaire was used to collect information on sociodemographic factors, vaccination records and to measure the prevalence of VH using the Youth Attitudes about Vaccines scale (YAV-5), a modified version of the Parent Attitudes about Childhood Vaccinations survey instrument.Setting and participantsEligible male and female participants, 15–26 years of age, were recruited through physicians’ offices and military enlistment in all three language regions of Switzerland. Of 1001 participants, we included 674 participants with a vaccination record available (415 males and 259 females) in this study.Primary and secondary outcome measuresThe outcome was uptake for HPV vaccine (having received ≥1 dose of HPV vaccine). Covariates were VH, sex, age and other sociodemographics.Results151 (58%) female and 64 (15%) male participants received ≥1 dose of HPV vaccine. 81 (31%) female and 92 (22%) male participants were VH (YAV-5-Score >50). The odds for being unvaccinated were higher for VH women than non-VH women, adjusted OR=4.90 (95% CI 2.53 to 9.50), but similar among VH and non-VH men, OR=1.90 (95% CI 0.84 to 4.31). The odds for being unvaccinated were lower for younger men (born on or after 1 July 2002) than older men (born before 1 July 2002), OR=0.34 (95% CI 0.14 to 0.81), but we found no association between age and vaccine uptake for female youth, OR=0.97 (95% CI 0.48 to 1.97).ConclusionsVH was associated with lower HPV vaccine uptake in female youth but not male youth in our study population in Switzerland. Our findings suggest that issues other than VH contribute to HPV underimmunisation in male youth in Switzerland.
Tuberculosis treatment management in primary healthcare sectors: a mixed-methods study investigating delivery status and barriers from organisational and patient perspectives
Authors: Zhou Jiani , Pu Jie , Wang Qingya , Zhang Rui , Liu Shili , Wang Geng , Zhang Ting , Chen Yong , Xing Wei , Liu Jiaqing , Hu Daiyu , Li Ying 
Published: May 2022

ObjectiveTuberculosis (TB) treatment management services (TTMSs) are crucial for improving patient treatment adherence. Under the TB integrated control model in China, healthcare workers (HCWs) in the primary healthcare (PHC) sectors are responsible for TTMS delivery. This mixed-method study aimed to explore the status of and barriers to TTMS delivery faced by HCWs in PHC sectors from the health organisational and patient perspectives.DesignWe completed a questionnaire survey of 261 TB healthcare workers (TB HCWs) and 459 patients with TB in the PHC sector and conducted 20 semistructured interviews with health organisational leaders, TB HCWs and patients with TB. SPSS V.22.0 and the framework approach were used for data analysis.SettingPHC sectors in Southwest China.ResultsOur results showed that TTMS delivery rate by HCWs in PHC sectors was <90% (88.4%) on average, and the delivery rates of intensive and continuation phase directly observed therapy (DOT) were only 54.7% and 53.0%, respectively. HCWs with high work satisfaction and junior titles were more likely to deliver first-time home visits and DOT services. Our results suggest that barriers to TTMS delivery at the organisational level include limited patient-centred approaches, inadequate resources and incentives, insufficient training, poor cross-sectional coordination, and strict performance assessment. At the patient level, barriers include low socioeconomic status, poor health literacy and TB-related social stigma.ConclusionTTMSs in Southwest China still need further improvement, and this study highlighted specific barriers to TTMS delivery in the PHC sector. Comprehensive measures are urgently needed to address these barriers at the organisational and patient levels to promote TB control in Southwest China.
Longitudinal costs and health service utilisation associated with primary care reforms in Ontario: a retrospective cohort study protocol
Authors: Aubrey-Bassler Kris , Laberge Maude , Knight John , Etchegary Cheryl , Rayner Jennifer , Tranmer Joan , Hogg William , Gao Zhiwei , Lukewich Julia , Breton Mylaine , Ryan Ashley 
Published: May 2022

IntroductionOver the last 20 years, the Canadian province of Ontario implemented several new models of primary care focusing on changes to physician remuneration, clinics led by nurse practitioners and the introduction of interprofessional primary care teams. Health outcome and cost evaluations of these models thus far have been mostly cross-sectional and in some cases results from these studies were conflicting. The aim of this population-based study is to investigate short, medium and long-term effectiveness of these reforms over the past 15–20 years.Methods and analysisThis is the protocol for a retrospective cohort study including fee-for-service (FFS) and community health centre cohorts (control cohorts) or patients who switched from either being unattached or from FFS to a new practice model (eg, capitation, enhanced FFS, team, nurse practitioner-led) from 1997 to 2020. The primary outcome is total healthcare costs and secondary outcomes are primary care costs, other (non-primary care) health costs, hospitalisations, length of stay, emergency department visits, accessibility and mortality. A combination of hard and propensity matching will be used where relevant. Outcomes will be adjusted for demographic and health factors and measured annually. Interrupted time series models will be used where data permits and difference-in-differences methods will be used otherwise.Ethics and disseminationEthics approval has been received from Queens University and Memorial University. The dissemination plan includes conference presentations, papers, brief evidence summaries targeted at select audiences and knowledge brokering sessions with key stakeholders.
Meta-analysis of the robustness of COVID-19 diagnostic kit performance during the early pandemic
Authors: Shanmugam Chandrakumar , Behring Michael , Luthra Vishwas , Leal Sixto M , Varambally Sooryanarayana , Netto George J , Manne Upender 
Published: May 2022

BackgroundAccurate detection of SARS-CoV-2 is necessary to mitigate the COVID-19 pandemic. However, the test reagents and assay platforms are varied and may not be sufficiently robust to diagnose COVID-19.MethodsWe reviewed 85 studies (21 530 patients), published from five regions of the world, to highlight issues involved in the diagnosis of COVID-19 in the early phase of the pandemic. All relevant articles, published up to 31 May 2020, in PubMed, BioRiXv, MedRiXv and Google Scholar, were included. We evaluated the qualitative (9749 patients) and quantitative (10 355 patients) performance of RT-PCR and serologic diagnostic tests for real-world samples, and assessed the concordance (5538 patients) between test performance in meta-analyses. Synthesis of results was done using random effects modelling and bias was evaluated according to QUADAS-2 guidelines.ResultsThe RT-PCR tests exhibited heterogeneity in the primers and reagents used. Of 1957 positive RT-PCR COVID-19 participants, 1585 had positive serum antibody (IgM±IgG) tests (sensitivity 0.81, 95% CI 0.66 to 0.90). While 3509 of 3581 participants RT-PCR negative for COVID-19 were found negative by serology testing (specificity 0.98, 95% CI 0.94 to 0.99). The chemiluminescent immunoassay exhibited the highest sensitivity, followed by ELISA and lateral flow immunoassays. Serology tests had higher sensitivity and specificity for laboratory approval than for real-world reporting data.DiscussionThe robustness of the assays/platforms is influenced by variability in sampling and reagents. Serological testing complements and may minimise false negative RT-PCR results. Lack of standardised assay protocols in the early phase of pandemic might have contributed to the spread of COVID-19.
Validation of a patient-reported measure of social support provided by nurses in breast cancer care (SuPP-N): based on a cross-sectional patient survey in 83 German hospitals
Authors: Lubasch Johanna Sophie , Lee Susan , Wirtz Markus Antonius , Pfaff Holger , Ansmann Lena 
Published: May 2022

ObjectivesTo validate the patient-reported measure of Social Support Perceived by Patients Scale-Nurses (SuPP-N).Design/settingA secondary data analysis based on a cross-sectional breast cancer patient survey in 83 German hospitals. Patients were asked to give written informed consent before they were discharged. If they agreed to participate, the questionnaire was sent via mail to their home address after discharge.ParticipantsOf 5583 eligible patients, 4841 consented to participate in the study and 4217 returned completed questionnaires (response rate: 75.5 %). For the data analysis n=3954 respondents were included. On average, participants were 60 years old and mostly in cancer stages I and II.Primary and secondary outcome measuresPerceived social support was assessed with a three-item patient-reported scale (SuPP-N). Convergent validity and criterion-related validity were tested using the following constructs: trust in nurses, trust in the treatment team (Wake Forest Physician Trust Scale, adapted), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire), processes organisation, availability of nurses.ResultsThe structural equation model (SEM) assuming a one-dimensional structure of the instrument showed acceptable goodness of fit (root mean square error of approximation=0.04, Comparative Fit Index=0.96 and Tucker-Lewis Index=0.96; factor loadings ≥0.83). Hypothesis–consistent correlations with trust in nurses (beta=0.615; p<0.01) and trust in the treatment team (beta=0.264; p<0.01) proved convergent validity. Criterion-related validity was proved by its association with patients’ quality of life (beta=−0.138; p<0.01), processes organisation (beta=−0.107; p<0.01) and the availability of nurses (beta=0.654; p<0.01).ConclusionThe results of the SEM identify potential important factors to foster social support by nurses in cancer care. In patient surveys, the SuPP-N can be used efficiently to measure patient-reported social support provided by nurses. The use of the scale can contribute to gain a better understanding of the relevance of social support provided by nurses for patients and to detect possible deficits and derive measures with the aim of improving the patient–nurse interaction.
Mediating role of social capital in the association between socioeconomic status and childcare practices in rural Malawi: a cross-sectional study
Authors: Choi Suhyoon , Kiriya Junko , Shibanuma Akira , Jimba Masamine 
Published: May 2022

ObjectivesChildcare practices determine the child nutritional outcomes, but resources for good practices are unequally distributed across socioeconomic status (SES). This study first examined the associations between social capital and childcare practices separately across SES groups. It then investigated the mediation effect of social capital between SES and childcare practices.DesignThis cross-sectional study used the Short Version of the Adapted Social Capital Assessment Tool to measure structural social capital (group membership, social support and citizenship activities) and cognitive social capital of mothers. Data were analysed using multilevel logistic regressions with random intercepts and mediation modellings.SettingRural Lilongwe, Malawi.ParticipantsA total of 320 mothers with a child aged between 12 months and 23 months.Primary outcome measuresChildcare practice outcomes included were minimum dietary diversity, handwashing and complete vaccination.ResultsAmong structural social capital dimensions, social support was found to be positively associated with minimum dietary diversity (adjusted OR (AOR)=1.44, 95% CI 1.22 to 1.71; p<0.001) and handwashing for all mothers (AOR=1.42, 95% CI 1.23 to 1.64; p<0.001). In the subgroup analysis, the higher SES group had higher odds of meeting the minimum dietary diversity (AOR=1.63, 95% CI 1.18 to 2.26; p=0.01) and handwashing with increased social support (AOR=1.53, 95% CI 1.13 to 2.08; p=0.01) than the lower SES. The mediation effect of social support accounted for 27.3% of the total effect between SES and minimum dietary diversity. Cognitive social capital was negatively associated with vaccination for the lower SES group (AOR=0.07, 95% CI 0.01 to 0.68; p=0.03).ConclusionsTo improve feeding and handwashing practices and to reduce health inequalities in rural Malawi, governments and organisations should consider promoting the value of social support and health. Future research is needed to explain the negative association between cognitive social capital and vaccination among the lower SES group.
Association between symptoms and risk of non-ST segment elevation myocardial infarction according to age and sex in patients admitted to the emergency department with suspected acute coronary syndrome: a single-centre retrospective cohort study
Authors: Steiro Ole-Thomas , Aakre Kristin Moberg , Tjora Hilde Lunde , Bjørneklett Rune Oskar , Skadberg Øyvind , Bonarjee Vernon Vijay Singha , Mjelva Øistein Rønneberg , Omland Torbjorn , Vikenes Kjell , Langørgen Jørund 
Published: May 2022

ObjectivesEvaluate the association between symptoms and risk of non-ST segment elevation myocardial infarction (NSTEMI) in patients admitted to an emergency department with suspected acute coronary syndrome based on sex and age.DesignPost hoc analysis of a prospective observational study conducted between September 2015 and May 2019.SettingUniversity hospital in Norway.Participants1506 participants >18 years of age (39.6% women and 31.0% 70 years of age or older).FindingsThe OR for NSTEMI was 9.4 if pain radiated to both arms, 3.0 if exertional chest pain was present during the last week and 2.9 if pain occurred during activity. Men had significantly lower OR compared with women if pain was dependent of position, respiration or palpation (OR 0.17 vs 0.53, p value for interaction 0.047). Patients <70 years had higher predictive value than older patients if they reported exertional chest pain the last week (OR 4.08 vs 1.81, 95%, p value for interaction 0.025) and lower if pain radiated to the left arm (OR 0.73 vs 1.67, p value for interaction 0.045).ConclusionsChest pain with radiation to both arms, exertional chest pain during the last week and pain during activity had the strongest predictive value for NSTEMI. The differences in symptom presentation and risk of NSTEMI between sex and age groups were small.Trial registration numberWESTCOR study ClinicalTrials.gov (NCT02620202).