bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological distress and associated factors among healthcare professionals in Ethiopia during the COVID-19 pandemic: a cross-sectional study
Authors: Demilew Demeke , Angaw Dessie Abebaw , Getnet Berhanie , Tesfaye Bizuneh , Atnafu Asmamaw , Andualem Zewudu , Kerebih Habtamu 
Published: July 2022

ObjectivesThe objective of the study was to assess psychological distress (depression, anxiety and stress) and associated factors among healthcare professionals working at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.DesignInstitution-based cross-sectional study.SettingThis study was conducted at the University of Gondar Comprehensive Specialized Hospital.ParticipantsStudy participants were healthcare professionals from University of Gondar Comprehensive Specialized Hospital. They were selected for the study using a stratified sampling technique.MeasurementData were collected using a self-administered questionnaire. The 21-item Depression, Anxiety and Stress Scale was used to assess the depression, anxiety and stress levels. Descriptive and analytical statistics were used to present the findings. To determine the predictor variables for depression, anxiety and stress, a binary logistic regression model was fitted. Finally, variables with p value <0.05 in the final model were declared as significantly associated with psychological distress.ResultAlmost half (49.5) of the participants have psychological distress. The prevalence of depression, anxiety and stress during the COVID-19 pandemic among healthcare workers was 167 (42.7%), 201 (51.4%) and 242 (61.9%), respectively. In multivariable analysis, respondents found in the ages between 35 and 44; unmarried marital status; educational status with specialty, subspecialty and PhD holders; anaesthesia professionals; and healthcare professionals with known medical illness were significantly associated with depression. Unmarried marital status, anaesthesia professional, laboratory technologist and living with family were significantly associated with anxiety. Unmarried marital status; educational status with specialty, subspecialty and PhD holders; and anaesthesia professional were also statistically significant with stress.Conclusion and recommendationThe prevalence of depression, anxiety and stress during the COVID-19 pandemic among the Gondar University healthcare professionals was high. This could contribute to implementation of mitigation measures in a standardised and sustainable manner and emphasis should be given to this aspect of health even for future similar and unanticipated events.
Embryo selection through non-invasive preimplantation genetic testing with cell-free DNA in spent culture media: a protocol for a multicentre, double-blind, randomised controlled trial
Authors: Huang Jin , Li Rong , Zeng Lin , Hu Liang , Shi Juanzi , Cai Liyi , Yao Bing , Wang Xiu-Xia , Xu Yanwen , Yao Yuanqing , Wang Yan , Zhao Junzhao , Guan Yichun , Qian Weiping , Hao Guimin , Lu Sijia , Liu Ping , Qiao Jie 
Published: July 2022

IntroductionMorphological evaluation is used to select embryos for in vitro fertilisation. However, it does not fully reflect the implantation potential. Preimplantation genetic testing for aneuploidies (PGT-A) can detect embryonic aneuploidy, but biopsy procedure is invasive. Currently, a non-invasive PGT (ni-PGT) approach using spent medium is being evaluated. However, the clinical benefit of ni-PGT has not been clearly demonstrated. A multicentre randomised trial is needed to verify whether ni-PGT can be an new effective tool for evaluating embryos.Methods and analysisOverall, 1148 couples aged 35~42 (women) receiving in vitro fertilization–intracytoplasmic sperm injection are planned to be enrolled. Couples will be digitally randomised to (1) ni-PGT and (2) conventional morphology groups at a 1:1 treatment ratio. The primary outcome will be the ongoing pregnancy rate related to the first transfer cycle within 6 months after oocyte retrieval.Ethics and disseminationThe study protocol is approved by the Ethics Committee of Peking University Third Hospital and the participating hospitals. The results will be disseminated through international conferences and scientific journals.Trial registration numberNCT04339166.
Association between incident falls and subsequent fractures in patients attending the fracture liaison service after an index fracture: a 3-year prospective observational cohort study
Authors: Vranken Lisanne , Wyers Caroline E , Van der Velde Robert Y , Janzing Heinrich M J , Kaarsemakers Sjoerd , Driessen Johanna , Eisman John , Center Jacqueline R , Nguyen Tuan V , Tran Thach , Bliuc Dana , Geusens Piet , van den Bergh Joop P 
Published: July 2022

ObjectivesTo evaluate the risk of subsequent fractures in patients who attended the Fracture Liaison Service (FLS), with and without incident falls after the index fracture.DesignA 3-year prospective observational cohort study.SettingAn outpatient FLS in the Netherlands.ParticipantsPatients aged 50+ years with a recent clinical fracture.Outcome measuresIncident falls and subsequent fractures.ResultsThe study included 488 patients (71.9% women, mean age: 64.6±8.6 years). During the 3-year follow-up, 959 falls had been ascertained in 296 patients (60.7%) (ie, fallers), and 60 subsequent fractures were ascertained in 53 patients (10.9%). Of the fractures, 47 (78.3%) were fall related, of which 25 (53.2%) were sustained at the first fall incident at a median of 34 weeks. An incident fall was associated with an approximately 9-fold (HR: 8.6, 95% CI 3.1 to 23.8) increase in the risk of subsequent fractures.ConclusionThese data suggest that subsequent fractures among patients on treatment prescribed in an FLS setting are common, and that an incident fall is a strong predictor of subsequent fracture risk. Immediate attention for fall risk could be beneficial in an FLS model of care.Trial registration numberNL45707.072.13.
Impact of alcohol drinking and tobacco smoking on the drug-resistance of newly diagnosed tuberculosis: a retrospective cohort study in Shandong, China, during 2004–2020
Authors: Song Wan-mei , Li Shi-jin , Liu Jin-yue , Fu Qi , Xu Ting-ting , Tao Ning Ning , Zhang Qian-yun , Liu Si-qi , An Qi-qi , Zhu Xue-han , Liu Yao , Yu Chun-bao , Li Yi-fan , Dong Jihua , Li Huai-chen 
Published: July 2022

ObjectivesTo investigate the independent and collective impact of alcohol drinking and tobacco smoking on the drug-resistance of newly diagnosed tuberculosis (TB).DesignThis was a retrospective cohort study.SettingShandong, China.ParticipantsPatients with newly diagnosed TB from 1 January 2004 to 31 December 2020 were collected. Exclusive criteria: retreated cases; extrapulmonary tuberculosis; without information on drug susceptibility testing results, smoking or drinking habits; bacteriological identification as non-tuberculous mycobacteria.Primary and secondary outcome measuresPatients were classified into four groups including smokers only (G1), drinker only (G2), smoker +drinker (G3), non-smoker +non-drinker group (G0). We described the drug-resistant profiles, clinical factors and calculated the ORs of different drug-resistance among G1, G2, G3, compared with G0 through univariate and multivariate logistics regression models.ResultsOf the 7996 TB cases enrolled, the proportions of G1, G2, G3 and G0 were 8.25%, 3.89%, 16.46% and 71.40%, respectively. The rates of drug-resistant (DR)-TB, mono-resistant TB, multidrug resistant (MDR)-TB, polydrug resistant TB in G1, G2, G3 and G0 were 19.24%/16.4%/17.33%/19.08%, 11.52%/8.68%/10.94%/11.63%, 3.03%/2.57%/2.96%/3.66% and 4.70%/4.82%/3.34%/ 4.08%, respectively. G3 had a higher risk of MDR1: isoniazid +rifampin (adjusted OR (aOR)=1.91, 95% CI: 1.036 to 3.532), but had a lower risk of DR-TB (aOR=0.84, 95% CI: 0.71 to 0.99), rifampin-related resistance (aOR=0.68, 95% CI: 0.49 to 0.93), streptomycin-related resistance (aOR=0.82, 95% CI: 0.68 to 0.99), ethambutol-related resistance (aOR=0.57, 95% CI: 0.34 to 0.95), MDR3: isoniazid +rifampin+streptomycin (aOR=0.41, 95% CI: 0.19 to 0.85), any isoniazid +streptomycin resistance (aOR=0.85, 95% CI: 0.71 to 1.00). However, there were no significant differences between G1 and G0, G2 and G0 in all drug-resistant subtypes. Those patients with cavity had a higher risk of DR-TB among G3 (OR=1.35, 95% CI: 1.01 to 1.81).ConclusionAlthough we did not found an independent impact of alcohol drinking or tobacco smoking on TB drug-resistance, respectively, these two habits had a combined effect on TB drug-resistance.
Impact of a phone call with a medical student/general practitioner team on morbidity of chronic patients during the first French COVID-19 lockdown (COVIQuest): a cluster randomised trial
Authors: Dibao-Dina Clarisse , Léger Julie , Ettori-Ajasse Isabelle , Boivin Estelle , Chambe Juliette , Abou-Mrad-Fricquegnon Karim , Sun Sophie , Jego Maeva , Motte Baptiste , Chiron Benoit , Sidorkiewicz Stéphanie , Khau Cam-Anh , Bouchez Tiphanie , Ghali Maria , Bruel Sébastien , Lebeau Jean-Pierre , Camus Vincent , El-Hage Wissam , Angoulvant Denis , Caille Agnès , Guillon-Grammatico Leslie , Laurent Emeline , Saint-Lary Olivier , Boussageon Rémy , Pouchain Denis , Giraudeau Bruno 
Published: July 2022

ObjectivesThe first COVID-19 lockdown led to a significantly reduced access to healthcare, which may have increased decompensations in frail patients with chronic diseases, especially older patients living with a chronic cardiovascular disease (CVD) or a mental health disorder (MHD). The objective of COVIQuest was to evaluate whether a general practitioner (GP)-initiated phone call to patients with CVD and MHD during the COVID-19 lockdown could reduce the number of hospitalisation(s) over a 1-month period.DesignThis is a cluster randomised controlled trial. Clusters were GPs from eight French regions.ParticipantsPatients ≥70 years old with chronic CVD (COVIQuest_CV subtrial) or ≥18 years old with MHD (COVIQuest_MH subtrial).InterventionsA standardised GP-initiated phone call aiming to evaluate patients’ need for urgent healthcare, with a control group benefiting from usual care (ie, the contact with the GP was by the patient’s initiative).Main outcome measuresHospital admission within 1 month after the phone call.ResultsIn the COVIQuest_CV subtrial, 131 GPs and 1834 patients were included in the intervention group and 136 GPs and 1510 patients were allocated to the control group. Overall, 65 (3.54%) patients were hospitalised in the intervention group vs 69 (4.57%) in the control group (OR 0.82, 95% CI 0.56 to 1.20; risk difference −0.77, 95% CI −2.28 to 0.74). In the COVIQuest_MH subtrial, 136 GPs and 832 patients were included in the intervention group and 131 GPs and 548 patients were allocated to the control group. Overall, 27 (3.25%) patients were hospitalised in the intervention group vs 12 (2.19%) in the control group (OR 1.52, 95% CI 0.82 to 2.81; risk difference 1.38, 95% CI 0.06 to 2.70).ConclusionA GP-initiated phone call may have been associated with more hospitalisations within 1 month for patients with MHD, but results lack robustness and significance depending on the statistical approach used.Trial registration numberNCT04359875.
Doctor! Did you Google my symptoms? A qualitative study of patient perceptions of doctors’ point-of-care information seeking
Authors: Tranter Isaac , van Driel Mieke L , Mitchell Ben 
Published: July 2022

ObjectiveTo explore patient perceptions regarding doctors’ information seeking during consultations.Design and settingQualitative interviews with participants from six general practice waiting rooms in South East Queensland, Australia. Participants were asked about their experiences and opinions, and to comment on short videos of simulated consultations in which a doctor sought information. The interviews were analysed through a process of iterative thematic analysis using the framework of Braun and Clarke.ParticipantsThe 16 participants were purposively sampled including 5 men and 11 women from a diverse range of educational and age groups.ResultsHow a doctor’s need to look up information impacted patient impressions of competence and trust was an overarching theme. The four dominant themes include: the trust a patient has in the doctor before the consultation, whether the doctor is expected to know the answer to a question without searching, has the doctor added value to the consultation by searching and the consultation skills used in the process.ConclusionsPatient trust is fundamental to positive perceptions of general practitioners’ information seeking at the point-of-care. Communication is key to building this trust. Understanding the patient’s agenda, listening, assessing thoroughly and being honest and transparent about the need to seek information all contribute to a positive experience.
Forecasting models for leprosy cases: a scoping review protocol
Authors: Oliveira Ascef Bruna , de Oliveira Gustavo Laine Araújo , Ribeiro Filha Coriolano Carmelita , De Oliveira Junior Haliton Alves 
Published: July 2022

IntroductionLeprosy is a neglected tropical disease caused by Mycobacterium leprae that mainly affects the skin, the peripheral nerves, the mucosa of the upper respiratory tract and the eyes. Mathematical models and statistical methodologies could play an important role in decision-making and help maintain the gains in elimination programmes. Various models for predicting leprosy cases have been reported in the literature, but they have different settings and distinct approaches to predicting the cases. This study describes the protocol for a scoping review to identify and synthesise information from studies using models to forecast leprosy cases.Methods and analysisA scoping review methodology will be applied following the Joanna Briggs Institute methodology for scoping reviews and will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. We will perform a systematic search from when each database started until April 2022 and we will include the following electronic databases: MEDLINE via PubMed, Embase, Cochrane Library and Latin American and Caribbean Health Science Literature Database. Data will be extracted and recorded on a calibrated predefined data form and will be presented in a tabular form accompanied by a descriptive summary. The Prediction Model Study Risk of Bias Assessment Tool (PROBAST) will be used.Ethics and disseminationNo ethical approval is required for this study. This scoping review will identify and map the methodological and other characteristics of modelling studies predicting leprosy cases. We hope that the review will contribute to scientific knowledge in this area and act as a basis for researchers designing and conducting leprosy models. This information can also be used to enhance national surveillance systems and to target specific policies. The protocol and consequent publications of this scoping review will be disseminated through peer-reviewed publications and policy briefs.Systematic review registrationThis scoping review was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/W9375).
Body mass index trajectories and mortality in community-dwelling older adults: population-based cohort study
Authors: Pai Hari , Gulliford Martin C 
Published: July 2022

ObjectiveBoth low and high body mass index (BMI) have been associated with greater mortality in older adults. This study aimed to evaluate the trajectory of BMI in the final years of life.MethodsA population-based cohort study was conducted including community-dwelling adults in the English Longitudinal Study of Ageing between 1998 and 2012. BMI was evaluated in relation to age and years before death. Number of long-term conditions, cigarette smoking and socioeconomic position were evaluated as effect modifiers.ResultsData were analysed for 16 924 participants with 31 857 BMI records; mean age at study starts, 61.6 (SD 10.9) years; mean BMI, 27.5 (4.7) Kg/m2. There were 3686 participants (4794 BMI records) who died and 13 238 participants (27 063 BMI records) who were alive at last follow-up. Mean BMI increased with age to 60–69 years but then declined, but the age-related decline was more rapid in decedents. From 4 to 7 years before death or end of study, adjusted mean BMI was 0.87 (95% CI 0.50 to 1.24) Kg/m2 lower for male decedents than survivors and 1.02 (0.56 to 1.47) lower in women; and from 3 to 0 years before death, BMI was 1.39 (0.98 to 1.80) Kg/m2 lower in male decedents and 2.12 (1.60 to 2.64) lower in female decedents. Multiple long-term conditions and lower socioeconomic position were associated with higher peak BMI and greater BMI decline; current smoking was associated with lower BMI and greater BMI decline.ConclusionsIn community-dwelling older adults, mean BMI enters an accelerating decline from up to 8 years before death. Multiple long-term conditions, smoking and lower socioeconomic position are associated with BMI decline.
Contrast conservation measures during the global iohexol contrast shortage crisis did not affect stroke thrombectomy outcomes
Authors: Almallouhi Eyad , Sattur Mithun , Lajthia Orgest , Kicielinski Kimberly P , Holmstedt Christine , Lena Jonathan R , Al Kasab Sami , Spiotta Alejandro M 
Published: July 2022

BackgroundThe current global shortage in iohexol contrast material (Omnipaque) used in performing CT-based triage images and mechanical thrombectomy (MT) represents a challenge to the healthcare system. A study was undertaken to assess the safety and feasibility of implementing protocol-based changes in pre-MT and MT workflow at a comprehensive stroke center.MethodsA retrospective cohort study was undertaken of all patients with stroke who underwent MT during a 3-week period before implementing the contrast shortage protocol and for 3 weeks while implementing the protocol. The contrast shortage protocol included not performing perfusion images for MT selection and using diluted iohexol (50% contrast mixed with 50% heparinized saline) during the MT procedure. Procedural variables were compared between the two groups.ResultsA total of 27 patients underwent MT during the study period, 12 pre-contrast shortage and 15 post-contrast shortage. The average contrast volume used during the MT procedure was reduced from 83 mL to 68 mL after implementing the contrast shortage protocol (p=0.04). No difference was noted in the rate of successful reperfusion (11/15 vs 10/12), average time to recanalization (21 vs 23 min), average radiation dose (1143 vs 1117mGy) and time under fluoroscopy (20.7 vs 20.5 min) in the pre- and post-contrast shortage groups. A favorable discharge outcome was observed in 3/12 patients and 4/15 patients in the pre- and post-shortage periods, respectively (p=0.92).ConclusionsModifying stroke workflow to adapt to the current global shortage in iohexol is feasible. Using diluted iohexol (50% contrast mixed with 50% heparinized saline) did not affect MT outcomes.
CLinical Assessment of WEB device in Ruptured aneurYSms (CLARYS): 12-month angiographic results of a multicenter study
Authors: Spelle Laurent , Herbreteau Denis , Caroff Jildaz , Barreau Xavier , Ferré Jean-Christophe , Fiehler Jens , Januel Anne-Christine , Costalat Vincent , Liebig Thomas , Bourcier Romain , Möhlenbruch Markus A , Berkefeld Joachim , Weber Werner , Mihalea Cristian , Ikka Léon , Ozanne Augustin , Cognard Christophe , Narata Ana Paula , Bibi Richard Edwige , Gauvrit Jean-Yves , Raoult Hélène , Velasco Stéphane , Buhk Jan-Hendrik , Chalumeau Vanessa , Bester Maxim , Desal Hubert , du Mesnil de Rochemont Richard , Bohner Georg , Fischer Sebastian , Gallas Sophie , Biondi Alessandra , Grimaldi Lamiae , Moret Jacques , Byrne James , Pierot Laurent 
Published: July 2022

BackgroundThe CLinical Assessment of WEB device in Ruptured aneurYSms (CLARYS) study has shown that the endovascular treatment of ruptured bifurcation aneurysms with the Woven EndoBridge (WEB) is safe and effective and provides protection against rebleeding at 1 month and 1 year. The 12-month angiographic follow-up is an important endpoint of the study.MethodsThe CLARYS study is a prospective multicenter study conducted in 13 European centers. The study enrolled 60 patients with 60 ruptured aneurysms of the anterior and posterior circulation. The study was conducted with an independent assessment of safety outcomes and imaging.ResultsSixty patients with 60 ruptured bifurcation aneurysms to be treated with the WEB were included. Fifty-three aneurysms (88.3%) had a broad base with a dome to neck ratio <2 (mean 1.6). Of these, 46 patients were evaluated by an independent core laboratory with follow-up imaging performed at 12 months or before eventual retreatment. At 1 year, 19/46 aneurysms (41.3%) were completely occluded (Raymond–Roy grade I), 21/46 (45.7%) had a residual neck and 6/46 (13.0%) had residual aneurysm filling. Adequate occlusion was reported in 40/46 (87%) aneurysms. Six patients underwent target aneurysm retreatment.ConclusionsThe CLARYS study has previously shown that the use of the WEB in the endovascular treatment of ruptured bifurcation aneurysms provides effective protection against rebleeding with a good safety profile. The angiographic occlusion rates at 1 year reported here are comparable to those already seen in previous multicenter studies which primarily included unruptured aneurysms.
In-stent restenosis after vertebral artery origin stenosis stenting: a nomogram for risk assessment
Authors: Yang Kun , Fang Shiyuan , Zhang Xiao , Wang Tao , Feng Yiding , Jiao Liqun , Yan Yuxiang 
Published: July 2022

ObjectiveTo propose a nomogram for individual risk assessment of in-stent restenosis (ISR) after vertebral artery origin stenosis (VAOS) stenting.MethodsWe included 793 patients with VAOS treated with stenting from October 2006 to May 2013, with a median follow-up of 27.8 months. Cox regression and the least absolute shrinkage and selection operator (LASSO) regression were adopted for variable selection. The nomogram was formulated and validated by concordance indexes (C-indexes) and calibration curves. An in-stent restenosis risk table (ISR-RT) was subsequently generated for risk stratification. Differences between low-, intermediate-, and high-risk levels were shown by Kaplan-Meier curves and compared by log-rank test.ResultsThe training and validation set included 594 and 199 patients, with a mean ISR rate of 37.2% and 35.2%, respectively. Stent type (HR=1.64, 95% CI 1.26 to 2.14), stent diameter (HR=2.48, 95% CI 1.77 to 3.48), history of peripheral vascular disease (HR=2.17, 95% CI 1.17 to 4.00), history of transit ischemic attack (HR=1.45, 95% CI 1.05 to 2.14), and left-side involvement (HR=1.33, 95% CI 1.04 to 1.69) were included in the nomogram. The C-indexes at 6 and 12 months were 0.650 and 0.611 in the training set, and 0.713 and 0.603 in the validation set, respectively. Compared with low-risk patients, the intermediate- and high-level group had 1.46 (95% CI 1.05 to 2.04; p=0.0235) and 2.28 (95% CI 1.64 to 3.17; p<0.0001) higher chances of developing ISR in 2 years, respectively.ConclusionsA nomogram and a risk evaluation table were developed with good predictive ability for in-stent restenosis among patients with VAOS, which could serve as a practical approach for individualized risk evaluation.