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49 emner vises.
Haywood, K., Potter, R., Froud, R., Pearce, G., Box, B., Muldoon, L., Lipton, R., Petrou, S., Rendas-Baum, R., Logan, A.-M., Stewart, K., Underwood, M., Matharu, M., on behalf of the CHESS COSMIG group, Haywood, Underwood, Matharu, Davies, Potter, Petrou, Box, Pearce, Muldoon, Lipton, Jensen, Nichols, Patel, Stewart
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objective
Typically, migraine prevention trials focus on reducing migraine days. This narrow focus may not capture all that is important to people with migraine. Inconsistency in outcome selection across trials limits the potential for data pooling and evidence synthesis. In response, we describe the development of core outcome set for migraine (COSMIG).
Design
A two-stage approach sought to achieve international, multistakeholder consensus on both the core domain set and core measurement set. Following construction of a comprehensive list of outcomes, expert panellists (patients, healthcare professionals and researchers) completed a three-round electronic-Delphi study to support a reduction and prioritisation of core domains and outcomes. Participants in a consensus meeting finalised the core domains and methods of assessment. All stages were overseen by an international core team, including patient research partners.
Results
There was a good representation of patients (episodic migraine (n=34) and chronic migraine (n=42)) and healthcare professionals (n=33) with high response and retention rates. The initial list of domains and outcomes was reduced from >50 to 7 core domains for consideration in the consensus meeting, during which a 2-domain core outcome set was agreed.
Conclusion
International and multistakeholder consensus emerged to describe a two-domain core outcome set for reporting research on preventive interventions for chronic and episodic migraine: migraine-specific pain and migraine-specific quality of life. Intensity of migraine pain assessed with an 11-point Numerical Rating Scale and the frequency as the number of headache/migraine days over a specified time period. Migraine-specific quality of life assessed using the Migraine Functional Impact Questionnaire.
Læs mere Tjek på PubMedNunez, D., Martinez, P., Borghero, F., Campos, S., Martinez, V.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Introduction
The stigma towards mental disorders can limit the use and effectiveness of available mental health interventions for young people. We aim to systematically review effectiveness of interventions to reduce stigma towards mental disorders in young people, as evidence has not been recently and systematically synthesised on this topic.
Methods and analysis
We will conduct a systematic review and meta-analysis of randomised or controlled clinical trials of interventions to reduce stigma towards mental disorders in people aged 10–24 years. Studies involving a comparison group, post intervention and/or follow-up assessments of knowledge, attitudes and/or behaviours towards mental disorders (including help-seeking behaviours), will be included. The Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PubMed and PsycINFO databases will be searched, without time limits, for eligible studies in English or Spanish, and with results available. Databases will be searched from July 2020 to April 2021. The study selection process, the data extraction and the critical evaluation—with the Cochrane risk-of-bias tool—of included studies will be performed independently and in duplicate by teams of reviewers, with the assistance of a third party, until reaching a high degree of agreement. In the presence of substantial heterogeneity (I2 >75%), a narrative synthesis of the study results will be used. If feasible, we will also conduct a quality effects model for the statistical synthesis of results. If sufficient data are available, subgroup analyses will be performed to assess potential sources of heterogeneity. Doi plots and the Luis Furuya-Kanamori index will be used to assess publication bias. The Grades of Recommendation, Assessment, Development and Evaluation approach will be used to assess the confidence in the evidence reviewed.
Ethics and dissemination
Results are expected to be published in a peer-reviewed journal in the field of adolescent and/or youth mental health.
PROSPERO registration number
CRD42020210901.
Læs mere Tjek på PubMedMottram, R., Knerr, W. L., Gallacher, D., Fraser, H., Al-Khudairy, L., Ayorinde, A., Williamson, S., Nduka, C., Uthman, O. A., Johnson, S., Tsertsvadze, A., Stinton, C., Taylor-Phillips, S., Clarke, A.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objective
Attendance at population-based breast cancer (mammographic) screening varies. This comprehensive systematic review and meta-analysis assesses all identified patient-level factors associated with routine population breast screening attendance.
Design
CINAHL, Cochrane Library, Embase, Medline, OVID, PsycINFO and Web of Science were searched for studies of any design, published January 1987–June 2019, and reporting attendance in relation to at least one patient-level factor.
Data synthesis
Independent reviewers performed screening, data extraction and quality appraisal. OR and 95% CIs were calculated for attendance for each factor and random-effects meta-analysis was undertaken where possible.
Results
Of 19 776 studies, 335 were assessed at full text and 66 studies (n=22 150 922) were included. Risk of bias was generally low. In meta-analysis, increased attendance was associated with higher socioeconomic status (SES) (n=11 studies; OR 1.45, 95% CI: 1.20 to 1.75); higher income (n=5 studies; OR 1.96, 95% CI: 1.68 to 2.29); home ownership (n=3 studies; OR 2.16, 95% CI: 2.08 to 2.23); being non-immigrant (n=7 studies; OR 2.23, 95% CI: 2.00 to 2.48); being married/cohabiting (n=7 studies; OR 1.86, 95% CI: 1.58 to 2.19) and medium (vs low) level of education (n=6 studies; OR 1.24, 95% CI: 1.09 to 1.41). Women with previous false-positive results were less likely to reattend (n=6 studies; OR 0.77, 95% CI: 0.68 to 0.88). There were no differences by age group or by rural versus urban residence.
Conclusions
Attendance was lower in women with lower SES, those who were immigrants, non-homeowners and those with previous false-positive results. Variations in service delivery, screening programmes and study populations may influence findings. Our findings are of univariable associations. Underlying causes of lower uptake such as practical, physical, psychological or financial barriers should be investigated.
Trial registration number
CRD42016051597.
Læs mere Tjek på PubMedSmith, M. J., Njagi, E. N., Belot, A., Leyrat, C., Bonaventure, A., Benitez Majano, S., Rachet, B., Luque Fernandez, M. A.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objectives
We aimed to assess the association between multimorbidity and deprivation on short-term mortality among patients with diffuse large B-cell (DLBCL) and follicular lymphoma (FL) in England.
Setting
The association of multimorbidity and socioeconomic deprivation on survival among patients diagnosed with DLBCL and FL in England between 2005 and 2013. We linked the English population-based cancer registry with electronic health records databases and estimated adjusted mortality rate ratios by multimorbidity and deprivation status. Using flexible hazard-based regression models, we computed DLBCL and FL standardised mortality risk by deprivation and multimorbidity at 1 year.
Results
Overall, 41 422 patients aged 45–99 years were diagnosed with DLBCL or FL in England during 2005–2015. Most deprived patients with FL with multimorbidities had three times higher hazard of 1-year mortality (HR: 3.3, CI 2.48 to 4.28, p<0.001) than least deprived patients without comorbidity; among DLBCL, there was approximately twice the hazard (HR: 1.9, CI 1.70 to 2.07, p<0.001).
Conclusions
Multimorbidity, deprivation and their combination are strong and independent predictors of an increased short-term mortality risk among patients with DLBCL and FL in England. Public health measures targeting the reduction of multimorbidity among most deprived patients with DLBCL and FL are needed to reduce the short-term mortality gap.
Læs mere Tjek på PubMedSu, W., Zhu, J.-G., Zhao, X.-Q., Chen, H., Li, W.-P., Li, H.-W.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objectives
Serum calcium levels (sCa) were reported to be associated with risk of cardiovascular diseases. The aim of this study was to analyse the association between sCa and long-term mortality in patients with acute coronary syndrome (ACS).
Design
A retrospective observational cohort study.
Setting
Single-centre study with participants recruited from the local area.
Participants
A total of consecutive 13 772 patients with ACS were included in this analysis. Patients were divided based on their sCa profile (≤2.1 mmol/L, 2.1–2.2 mmol/L, 2.2–2.3 mmol/L, 2.3–2.4 mmol/L, 2.4–2.5 mmol/L,>2.5 mmol/L) and followed up for a median of 2.96 years (IQR 1.01–4.07).
Primary outcome
Long-term all-cause mortality.
Results
During a median follow-up period of 2.96 years, patients with sCa ≤2.1 mmol/L had the highest cumulative incidences of all-cause mortality (16.7%), whereas those with sCa 2.4–2.5 mmol/L had the lowest cumulative incidences of all-cause mortality (3.5%). After adjusting for potentially confounding variables, the Cox analysis revealed that compared with the reference group (sCa 2.4–2.5 mmol/L), all the other groups had higher mortality except for the sCa 2.3–2.4 mmol/L group (HR, 1.32, 95% CI 0.93 to 1.87). Restricted cubic splines showed that the relationship between sCa and all-cause mortality seemed to be U shaped. The optimal sCa cut-off point, 2.35 mmol/L, was determined based on the shape of restricted cubic splines.
Conclusions
Altered serum calcium homeostasis at admission independently predicts all-cause mortality in patients with ACS. In addition, a U-shaped relationship between sCa and all-cause mortality exists, and maintaining sCa at approximately 2.35 mmol/L may minimise the risk of mortality.
Læs mere Tjek på PubMedCreemers, J. H. A., Pawlitzky, I., Grosios, K., Gileadi, U., Middleton, M. R., Gerritsen, W. R., Mehra, N., Rivoltini, L., Walters, I., Figdor, C. G., Ottevanger, P. B., de Vries, I. J. M.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Introduction
The undiminished need for more effective cancer treatments stimulates the development of novel cancer immunotherapy candidates. The archetypical cancer immunotherapy would induce robust, targeted and long-lasting immune responses while simultaneously circumventing immunosuppression in the tumour microenvironment. For this purpose, we developed a novel immunomodulatory nanomedicine: PRECIOUS-01. As a PLGA-based nanocarrier, PRECIOUS-01 encapsulates a tumour antigen (NY-ESO-1) and an invariant natural killer T cell activator to target and augment specific antitumour immune responses in patients with NY-ESO-1-expressing advanced cancers.
Methods and analysis
This open-label, first-in-human, phase I dose-escalation trial investigates the safety, tolerability and immune-modulatory activity of increasing doses of PRECIOUS-01 administered intravenously in subjects with advanced NY-ESO-1-expressing solid tumours. A total of 15 subjects will receive three intravenous infusions of PRECIOUS-01 at a 3-weekly interval in three dose-finding cohorts. The trial follows a 3+3 design for the dose-escalation steps to establish a maximum tolerated dose (MTD) and/or recommended phase II dose (RP2D). Depending on the toxicity, the two highest dosing cohorts will be extended to delineate the immune-related parameters as a readout for pharmacodynamics. Subjects will be monitored for safety and the occurrence of dose-limiting toxicities. If the MTD is not reached in the planned dose-escalation cohorts, the RP2D will be based on the observed safety and immune-modulatory activity as a pharmacodynamic parameter supporting the RP2D. The preliminary efficacy will be evaluated as an exploratory endpoint using the best overall response rate, according to Response Evaluation Criteria in Solid Tumors V.1.1.
Ethics and dissemination
The Dutch competent authority (CCMO) reviewed the trial application and the medical research ethics committee (CMO Arnhem-Nijmegen) approved the trial under registration number NL72876.000.20. The results will be disseminated via (inter)national conferences and submitted for publication to a peer-reviewed journal.
Trial registration number
NCT04751786.
Læs mere Tjek på PubMedRoberts, K., Mills, N., Metcalfe, C., Lane, A., Clement, C., Hollingworth, W., Taylor, J., Holcombe, C., Skillman, J., Fairhurst, K., Whisker, L., Cutress, R., Thrush, S., Fairbrother, P., Potter, S.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Background
Implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure following mastectomy. IBBR techniques are evolving rapidly, with mesh-assisted subpectoral reconstruction becoming the standard of care and more recently, prepectoral techniques being introduced. These muscle-sparing techniques may reduce postoperative pain, avoid implant animation and improve cosmetic outcomes and have been widely adopted into practice. Although small observational studies have failed to demonstrate any differences in the clinical or patient-reported outcomes of prepectoral or subpectoral reconstruction, high-quality comparative evidence of clinical or cost-effectiveness is lacking. A well-designed, adequately powered randomised controlled trial (RCT) is needed to compare the techniques, but breast reconstruction RCTs are challenging. We, therefore, aim to undertake an external pilot RCT (Best-BRA) with an embedded QuinteT Recruitment Intervention (QRI) to determine the feasibility of undertaking a trial comparing prepectoral and subpectoral techniques.
Methods and analysis
Best-BRA is a pragmatic, two-arm, external pilot RCT with an embedded QRI and economic scoping for resource use. Women who require a mastectomy for either breast cancer or risk reduction, elect to have an IBBR and are considered suitable for both prepectoral and subpectoral reconstruction will be recruited and randomised 1:1 between the techniques.
The QRI will be implemented in two phases: phase 1, in which sources of recruitment difficulties are rapidly investigated to inform the delivery in phase 2 of tailored interventions to optimise recruitment of patients.
Primary outcomes will be (1) recruitment of patients, (2) adherence to trial allocation and (3) outcome completion rates. Outcomes will be reviewed at 12 months to determine the feasibility of a definitive trial.
Ethics and dissemination
The study has been approved by the National Health Service (NHS) Wales REC 6 (20/WA/0338). Findings will be presented at conferences and in peer-reviewed journals.
Trial registration number
ISRCTN10081873.
Læs mere Tjek på PubMedSantiago, A., Carre, A., Miranda, R., Lemogne, C., LeStrat, Y., Benyamina, A., Perney, P., Luquiens, A.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Introduction
Development of fully internet-based programs could provide a new avenue to improve access to healthcare for problem gamblers. In this project, we aim to assess the efficacy of a web-based cognitive intervention targeting inhibitory control among problem gamblers, using a randomised controlled design. As impaired inhibitory control is involved in self-regulation difficulties in behavioural addictions, it represents a particularly relevant cognitive process to target for an online psychological intervention.
Methods and analysis
This will be a single-blinded, randomised, comparative therapeutic web-based, controlled trial. Up to 200 non-treatment seeking adult problem gamblers with a Problem Gambling Severity Index-recent (PGSI-recent) score ≥5 will be included. The intervention will be a computerised cognitive training program targeting inhibitory skills. The comparator, an active control, will be a computerised neutral sensorial program. Both programs will be carried out under similar conditions: biweekly online training for 6 weeks and optional telephone support will be offered to patients for debriefing. The main objective of the study is to assess the clinical efficacy of the online cognitive training program at 6 weeks, measured with the PGSI-recent. The secondary objectives are to assess the efficacy on the gambling behaviour assessed by the account-based gambling data, on the self-reported gambling practice, and on the inhibition performance at the neuropsychological level at 6, 14 and 52 weeks. We will also assess the acceptability of this program and the preferred level of guidance. Data analysis will be in intention-to-treat.
Ethics and dissemination
This randomized controlled trial will be executed in compliance with the Helsinki Declaration, and was approved by the local ethics boards (Comité de Protection des Personnes) in October 2017. The findings will be published in peer-reviewed journals.
Trial registration number
NCT03673800.
Læs mere Tjek på PubMedAbelairas-Gomez, C., Martinez-Isasi, S., Barcala-Furelos, R., Varela-Casal, C., Carballo-Fazanes, A., Pichel-Lopez, M., Fernandez Mendez, F., Otero-Agra, M., Sanchez Santos, L., Rodriguez-Nunez, A.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objective
To compare the effectiveness of 4-month rolling-refreshers and annual retraining in basic life support (BLS) on a sample of schoolchildren.
Design
Prospective longitudinal trial.
Setting and participants
Four hundred and seventy-two schoolchildren (8–12 years old).
Interventions
Schoolchildren were instructed in BLS and then split into the following three groups: control group (CG), standard group (SG) and rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1) and 2 years later (T2). Moreover, CG did not receive any additional training; SG received one 50 min retraining session 1 year later; RRG participated in very brief (5 min) rolling-refreshers that were carried out every 4 months.
Primary and secondary outcomes
Hands-on skills of BLS sequence and cardiopulmonary resuscitation.
Results
BLS sequence performance was similar in all groups at T1, but SG and RRG followed the steps of the protocol in more proportion than CG at T2. When compared at T2, RRG showed higher proficiency than SG in checking safety, checking response, opening the airway and alerting emergency medical services. In addition, although the mean resuscitation quality was low in all groups, RRG participants reached a higher percentage of global quality cardiopulmonary resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7; RRG: 15.5±26.1 mm).
Conclusions
In 8-to-12-year-old schoolchildren, although annual 50 min retraining sessions help to maintain BLS performance, 4-month very brief rolling-refreshers were shown to be even more effective. Thus, we recommend implementing baseline BLS training at schools, with subsequently brief rolling-refreshers.
Læs mere Tjek på PubMedVerny, M.-A., Milenkovic, D., Macian, N., Pereira, B., Evrard, R., Gilcher, C., Steingass, C. B., Mosoni, P., Gladine, C., Monfoulet, L.-E., Schweiggert, R., Pickering, G., Morand, C.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Introduction
Although epidemiological studies associate the consumption of sugary beverages with adverse health effects, human experimental studies have demonstrated substantially different metabolic responses when 100% fruit juices are compared with artificial beverages. Fruit juices do not just provide sugars and associated calories, but they are also rich in bioactive compounds. Flavanones are bioactives specifically and abundantly found in citrus foods, with hesperidin as the major representative in sweet oranges. Flavanone intake has been associated with a lower incidence of mortality from cardiovascular disease (CVD). However, clinical evidence are too scarce to confirm the vasculoprotective effects of 100% orange juice (OJ) presumably mediated by flavanones and thereby do not allow firm conclusions to be drawn about their efficacy.
Methods and analysis
The HESPER-HEALTH study aims to assess the efficacy of OJ in improving vascular function and the contribution of hesperidin to these effects. This double-blind, randomised, controlled, crossover study will be carried out in 42 volunteers predisposed to CVD, based on age and on overweight. It includes three 6-week periods of consumption of 330 mL/d of OJ versus control drinks with and without hesperidin at a dose in agreement with a daily OJ serving (approx. 200–215 mg). The primary outcome is endothelial function, assessed by flow mediated dilation, with measurements performed at fasting and postprandially in response to a challenge meal. The secondary outcomes include bioavailability and metabolism of flavanones, changes in other markers of vascular function, systemic biomarkers of cardiovascular risk, endothelial dysfunction and inflammation, vitamin C and carotenoids status, anthropometry and body composition, gut microbiota composition, nutrigenomic response and in oxylipin profiling.
Ethics and dissemination
This ongoing study was approved by the Ethics committee Sud-Est III, Bron, France on 17 November 2020. The trial is registered on ClinicalTrials.gov. The results will be disseminated in peer-reviewed journals.
Trial registration number
NCT04731987; Pre-results.
Læs mere Tjek på PubMedPatel, S. R., Ormesher, D. C., Smith, S. R., Wong, K. H. F., Bevis, P., Bicknell, C. D., Boyle, J. R., Brennan, J. A., Campbell, B., Cook, A., Crosher, A. P., Duarte, R. V., Flett, M. M., Gamble, C., Jackson, R. J., Juszczak, M. T., Loftus, I. M., Nordon, I. M., Patel, J. V., Platt, K., Psarelli, E.-E., Rowlands, P. C., Smyth, J. V., Spachos, T., Taggart, L., Taylor, C., Vallabhaneni, S. R.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Introduction
In one-third of all abdominal aortic aneurysms (AAAs), the aneurysm neck is short (juxtarenal) or shows other adverse anatomical features rendering operations more complex, hazardous and expensive. Surgical options include open surgical repair and endovascular aneurysm repair (EVAR) techniques including fenestrated EVAR, EVAR with adjuncts (chimneys/endoanchors) and off-label standard EVAR. The aim of the UK COMPlex AneurySm Study (UK-COMPASS) is to answer the research question identified by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme: ‘What is the clinical and cost-effectiveness of strategies for the management of juxtarenal AAA, including fenestrated endovascular repair?’
Methods and analysis
UK-COMPASS is a cohort study comparing clinical and cost-effectiveness of different strategies used to manage complex AAAs with stratification of physiological fitness and anatomical complexity, with statistical correction for baseline risk and indication biases. There are two data streams. First, a stream of routinely collected data from Hospital Episode Statistics and National Vascular Registry (NVR). Preoperative CT scans of all patients who underwent elective AAA repair in England between 1 November 2017 and 31 October 2019 are subjected to Corelab analysis to accurately identify and include every complex aneurysm treated. Second, a site-reported data stream regarding quality of life and treatment costs from prospectively recruited patients across England. Site recruitment also includes patients with complex aneurysms larger than 55 mm diameter in whom an operation is deferred (medical management). The primary outcome measure is perioperative all-cause mortality. Follow-up will be to a median of 5 years.
Ethics and dissemination
The study has received full regulatory approvals from a Research Ethics Committee, the Confidentiality Advisory Group and the Health Research Authority. Data sharing agreements are in place with National Health Service Digital and the NVR. Dissemination will be via NIHR HTA reporting, peer-reviewed journals and conferences.
Trial registration number
ISRCTN85731188.
Læs mere Tjek på PubMedHuda, S., Whittam, D., Jackson, R., Karthikeayan, V., Kelly, P., Linaker, S., Mutch, K., Kneen, R., Woodhall, M., Murray, K., Hunt, D., Waters, P., Jacob, A.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objective
To identify factors predictive of relapse risk and disability in myelin oligodendrocyte glycoprotein associated disease (MOGAD).
Setting
Patients were seen by the neuromyelitis optica spectrum disorders (NMOSD) service in Liverpool, UK, a national referral centre for adult patients with MOGAD, NMOSD and related conditions.
Participants
Patients with MOGAD=76 from England, Northern Ireland and Scotland were included in this cohort study.
Results
Relapsing disease was observed in 55% (42/76) of cases. Steroid treatment >1 month (OR 0.2, 95% CI 0.05 to 0.80; p=0.022), transverse myelitis (TM) at first attack (OR 0.03, 95% CI 0.004 to 0.23; p=0.001) and male sex (OR 0.16, 95% CI 0.04 to 0.68; p=0.014) were associated with monophasic disease (area under the curve=0.85). Male sex (HR 0.46, 95% CI 0.24 to 0.89; p=0.011) and TM at disease onset (HR 0.42, 95% CI 0.22 to 0.82; p=0.011) were also associated with an increased latency to first relapse. 45% (32/71) of patients became MOG-antibody negative and in relapsing patients negative seroconversion was associated with a lower relapse risk (relative risk 0.11 95% CI 0.05 to 0.26; p<0.001). No specific factors were predictive of visual or overall disability.
Conclusions
Male patients with spinal cord involvement at disease onset have a lower risk of relapsing disease and longer latency to first relapse. Steroid treatment for at least 1 month at first attack was also associated with a monophasic disease course. MOG-antibody negative seroconversion was associated with a lower risk of relapse and may help inform treatment decisions and duration.
Læs mere Tjek på PubMedJaensson, M., Stenberg, E., Liang, Y., Nilsson, U., Dahlberg, K.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objectives
The aim was to psychometrically test and evaluate the Swedish functional health literacy scale and the Swedish communicative and critical health literacy scale in patients undergoing bariatric surgery.
Design
A prospective cross-sectional psychometric study.
Setting
Patients from three bariatric centres in Sweden were consecutively included in this study.
Participants
A total of 704 patients undergoing bariatric surgery filled in the questionnaires preoperatively. Inclusion criteria were scheduled for primary bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) and greater than 17 years, proficiency in Swedish.
Primary and secondary measures
Psychometric outcomes of the Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale.
Results
There was a higher proportion of females (74.4%, n=523) to males (25.6%, n=180). The mean age was 42 years (SD 11.5). Limited functional health literacy and limited communicative and critical health literacy (including both inadequate and problematic health literacy) was reported in 55% (n=390) and 40% (n=285), respectively. Cronbach alpha for the Swedish Functional Health Literacy scale was α=0.86 and for the Swedish Communicative and Critical Health Literacy scale, α=0.87. Construct validity showed weak to negative correlations between the Swedish Functional Health Literacy scale and income, education and SF-36/RAND36 summary scores. Confirmatory factor analysis showed a one-factor solution for the Swedish Functional Health Literacy scale and a two-factor solution for the Swedish Communicative and Critical Health Literacy scale.
Conclusions
The Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale are valid and reliable to use for patients undergoing bariatric surgery in a Swedish context. Measuring dimensions of health literacy can be used as a guide for the development of health literacy friendly patient information in patients undergoing bariatric surgery.
Læs mere Tjek på PubMedBretherton, C. P., Claireaux, H. A., Gower, J., Martin, S., Thornhill, A., Johnson, L., Silvester, L., Kearney, R. S., Baxter, M., Dixon, P., Giblin, V., Griffin, X. L., Eardley, W.
BMJ Open, 30.11.2021
Tilføjet 30.11.2021
Objective
To determine research priorities for the management of complex fractures, which represent the shared priorities of patients, their families, carers and healthcare professionals.
Design/setting
A national (UK) research priority setting partnership.
Participants
People who have experienced a complex fracture, their carers and relatives, and relevant healthcare professionals and clinical academics involved in treating patients with complex fractures. The scope includes open fractures, fractures to joints broken into multiple pieces, multiple concomitant fractures and fractures involving the pelvis and acetabulum.
Methods
A multiphase priority setting exercise was conducted in partnership with the James Lind Alliance over 21 months (October 2019 to June 2021). A national survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second national survey asked respondents to prioritise the research questions. A final shortlist of 18 questions was taken to a stakeholder workshop, where a consensus was reached on the top 10 priorities.
Results
A total of 532 uncertainties, submitted by 158 respondents (including 33 patients/carers) were received during the initial survey. These were refined into 58 unique indicative questions, of which all 58 were judged to be true uncertainties after review of the existing evidence. 136 people (including 56 patients/carers) responded to the interim prioritisation survey and 18 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions.
Conclusions
The top 10 research priorities for complex fracture include questions regarding rehabilitation, complications, psychological support and return to life-roles. These shared priorities will now be used to guide funders and teams wishing to research complex fractures over the coming decade.
Læs mere Tjek på PubMedZhang, S., Shi, Y., Liu, B., Wang, H., Zhao, X., Wang, X., Sun, T.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Objectives
The current study aimed to evaluate the status quo of perceived job demands and resources respectively among Chinese doctors, to examine the mediating role of work–family conflicts in the relationship between perceived job demands and various indicators of well-being, and to test the mediating role of psychological attachment in the relationship between perceived job resources and thriving at work among Chinese doctors.
Design
A cross-sectional online survey study.
Setting
Online questionnaires were administered across 30 provinces.
Participants
A total of 2617 doctors provided sufficiently complete responses to be used in the study.
Results
Perceived job demands (M=3.843, SD=0.791) of participants were positively associated with work–family conflicts (B=0.454, p<0.001) and negatively associated with job satisfaction (B=–0.065, p<0.001) and life satisfaction (B=–0.261, p<0.001). Work–family conflicts partially mediated the relationship between job demands and life satisfaction and fully mediated the relationship between job demands and job satisfaction. Perceived job resources (M=2.474, SD=0.740) among Chinese doctors were positively associated with psychological attachment (B=0.988, p<0.001) and thriving at work (B=0.582, p<0.001). Furthermore, psychological attachment partially mediated the relationship between perceived job resources and thriving at work.
Conclusion
Doctors in China with high-level job demands tended to exhibit increased work–family conflicts, which in turn threatened their job and life satisfaction. On the contrary, doctors with greater job resources were more likely to thrive at work by increasing their degree of psychological attachment. The current study suggested that Chinese health policymakers and hospital administrators should provide a work environment with a dynamic equilibrium between doctors’ job demands and resources.
Læs mere Tjek på PubMedAmigo, F., Dalmau-Bueno, A., Garcia-Altes, A.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Background
‘Weekend effect’ is a term used to describe the increased mortality associated with weekend emergency admissions to hospital, in contrast with admission on weekdays. The objective of the present study is to determine whether the weekend effect is present in hospitals in Catalonia.
Methods
We analysed all urgent admissions in Catalonia in 2018, for a group of pathologies. Two groups were defined (those admitted on a weekday and those admitted on a weekend). We obtained mortality at 3, 7, 15 and 30 days, and applied a proportions test to both groups. Additionally, we used Cox’s regression for mortality at 30 days, using the admission on a weekend as the exposition, adjusting by socioeconomic and clinical variables. We used the hospital discharge database and the Central Registry of the Insured Population.
Results
72 427 admissions for the selected pathologies during 2018 were found. No statistically significant differences in mortality at 30 days (p=0.524) or at 15 days (p=0.119) according to the day of admission were observed. However, significant differences were found in mortality at 7 days (p=0.025) and at 3 days (p=0.002). The hazard rate associated with the weekend was 1.13 (95% CI: 1.04 to 1.23). By contrast, the adjusted HR of the weekend interaction with time was 0.99 (95% CI: 0.99 to 1.00).
Conclusions
There is a weekend effect, but it is not constant in time. This could suggest the existence of dysfunctions in the quality of care during the weekend.
Læs mere Tjek på PubMedLu, S., Zhang, A. Y., Liu, T., Choy, J. C. P., Ma, M. S. L., Wong, G., Lum, T.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Objectives
To understand and assess the degree of personalisation of tailored activities for people with dementia (PWD); and to estimate the magnitude of the effects of levels of personalisation on reducing behavioural and psychological symptoms of dementia (BPSD), improving quality of life (QoL) and level of engagement.
Design
Systematic review with meta-analysis.
Data sources
ProQuest, PubMed, Ovid, Cochrane Library, Web of Science and CINAHL were searched from the start of indexing to May 2020.
Eligibility criteria
We included randomised controlled trials and quasi-experimental studies assessing the effects of tailored activities for people aged 60 years or older with dementia or cognitive impairment on the outcomes of BPSD, QoL, depression and level of engagement with control groups.
Data extraction and synthesis
Two researchers screened studies, extracted data and assessed risks of bias. A rating scheme to assess the degree of personalisation of tailored activities was developed to classify tailored activities into high/medium/low groups. Effect sizes were expressed using standardised mean differences at 95% Confidence Interval (CI). Subgroup analyses were conducted to assess whether the degree of personalisation of tailored activities affected outcomes of interest.
Results
Thirty-five studies covering 2390 participants from 16 countries/regions were identified. Studies with a high-level of personalisation interventions (n=8) had a significant and moderate effect on reducing BPSD (standardised mean differences, SMD=–0.52, p<0.05), followed by medium (n=6; SMD=–0.38, p=0.071) and low-level personalisation interventions (n=6; SMD=–0.15, p=0.076). Tailored activities with a high-level of personalisation had a moderate effect size on improving QoL (n=5; SMD=0.52, p<0.05), followed by a medium level (n=3; SMD=0.41, p<0.05) of personalisation.
Conclusions
To develop high-level tailored activities to reduce BPSD and improve QoL among PWD, we recommend applying comprehensive assessments to identify and address two or more PWD characteristics in designed tailored activities and allow modification of interventions to respond to changing PWD needs/circumstances.
PROSPERO registration number
CRD42020168556.
Læs mere Tjek på PubMedRasmussen, B., Hakonsen, S. J., Toft, B.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Introduction
Cardiac rehabilitation has become an integral part of secondary treatment of cardiovascular heart disease. Despite evidence demonstrating that cardiac rehabilitation improves prognoses, reduces disease progression and helps patients to find a new foothold in life, many patients do not enrol. Face-to-face interventions can encourage patients to enrol; however, it is unclear which strategies have been developed, how they are structured in a hospital context and whether they target the life-world of the patients. The objective of this scoping review is to map and evaluate the nature and characteristics of studies that have reported on face-to-face interventions to encourage patients to enrol in cardiac rehabilitation.
Methods and analysis
This review will be guided by the Joanna Briggs Institute Methodology for Scoping Reviews. A search strategy developed in cooperation with a research secretary will be applied in six databases including studies published from 2000 in English, Danish, Norwegian, Swedish and German with no restriction on publication type or study design. Studies involving adult patients with ischaemic heart disease or heart failure will be included. Studies providing the intervention after enrolment in cardiac rehabilitation will be excluded. Study selection will be performed independently by two reviewers. Data will be extracted by two reviewers using predefined data charting forms. The presentation of data will be a narrative summary of the characteristics and key findings to facilitate the integration of diverse evidence, and as we deem appropriate will be supported by a diagrammatic or tabular presentation.
Ethics and dissemination
This scoping review will use data from existing publications and does not require ethical approval. Results will be reported through publication in a scientific journal and presented on relevant conferences and disseminated as part of future workshops with professionals involved in communication with patients about enrolment in cardiac rehabilitation.
Læs mere Tjek på PubMedChen, T., Bachani, A. M., Li, Q.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Objectives
While appropriate child restraint use in motor vehicles can reduce the risk of injuries or deaths, few previous studies have assessed child restraint practice in China. We aim to describe the prevalence of child restraint use and investigate risk factors affecting child restraint practice in Shanghai, China.
Design and setting
A cross-sectional observational study was conducted near children’s hospitals, kindergartens, entertainment places and shopping malls in Shanghai, China.
Participants
Eight rounds of data were collected between October 2015 and April 2019 with a total sample size of 12 061 children.
Primary outcome measures
At each site, trained field workers observed and recorded child restraint use in all passing motor vehicles with at least one child passenger.
Results
The overall child safety restraint use rate was 6.42%. Child restraint use rate rose over time, from 5.12% in round 1% to 8.55% in round 8 (p<0.001). Results from the adjusted logistic regression model showed that children occupants with the following risk factors had a higher likelihood of child restraint use: children younger than 5 years compared with those aged 5–12 years (OR 2.12; 95% CI 1.78 to 2.53; p<0.001), sitting in rear seat compared with those in front seat (OR 31.80; 95% CI 4.45 to 227.14; p=0.001), children occupants observed near entertainment places (OR 2.34; 95% CI 1.67 to 3.28; p<0.001) or near shopping malls (OR 1.86; 95% CI 1.36 to 2.55; p<0.001) compared with those near children’s hospitals and transportation in the morning compared with afternoon (OR 1.30; 95% CI 1.04 to 1.62; p=0.021).
Conclusions
The overall child safety restraint use rate was low in Shanghai. Our findings may shed light on monitoring child restraint practice and have implications for intervention programmes for children occupants with the identified risk factors, which may help to promote child restraint use in motor vehicles and prevent road traffic injuries or deaths.
Læs mere Tjek på PubMedEvenson, K. R., Bellettiere, J., Cuthbertson, C. C., Di, C., Dushkes, R., Howard, A. G., Parada Jr., H., Schumacher, B. T., Shiroma, E. J., Wang, G., Lee, I.-M., LaCroix, A. Z.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Purpose
This paper describes the Women’s Health Accelerometry Collaboration, a consortium of two prospective cohort studies of women age 62 years or older, harmonised to explore the association of accelerometer-assessed physical activity and sedentary behaviour with cancer incidence and mortality.
Participants
A total of 23 443 women (age mean 73.4, SD 6.8) living in the USA and participating in an observational study were included; 17 061 from the Women’s Health Study (WHS) and 6382 from the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health (WHI/OPACH) Study.
Findings to date
Accelerometry, cancer outcomes and covariate harmonisation was conducted to align the two cohort studies. Physical activity and sedentary behaviour were measured using similar procedures with an ActiGraph GT3X+ accelerometer, worn at the hip for 1 week, during 2011–2014 for WHS and 2012–2014 for WHI/OPACH. Cancer outcomes were ascertained via ongoing surveillance using physician adjudicated cancer diagnosis. Relevant covariates were measured using questionnaire or physical assessments. Among 23 443 women who wore the accelerometer for at least 10 hours on a single day, 22 868 women wore the accelerometer at least 10 hours/day on ≥4 of 7 days. The analytical sample (n=22 852) averaged 4976 (SD 2669) steps/day and engaged in an average of 80.8 (SD 46.5) min/day of moderate-to-vigorous, 105.5 (SD 33.3) min/day of light high and 182.1 (SD 46.1) min/day of light low physical activity. A mean of 8.7 (SD 1.7) hours/day were spent in sedentary behaviour. Overall, 11.8% of the cohort had a cancer diagnosis (other than non-melanoma skin cancer) at the time of accelerometry measurement. During an average of 5.9 (SD 1.6) years of follow-up, 1378 cancer events among which 414 were fatal have occurred.
Future plans
Using the harmonised cohort, we will access ongoing cancer surveillance to quantify the associations of physical activity and sedentary behaviour with cancer incidence and mortality.
Læs mere Tjek på PubMedLugani, F., Angeletti, A., Ravani, P., Vivarelli, M., Colucci, M., Caridi, G., Verrina, E., Emma, F., Ghiggeri, G. M.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Introduction
Glucocorticoids induce remission in 90% of children with idiopathic nephrotic syndrome (INS). Some become steroid-dependent (SD) and require the addition of steroid sparing drugs such as calcineurin-inhibitors (CNI) or cyclophosphamide, to maintain remission. Considering the toxicity of these drugs, alternative interventions are needed for long-term treatment. The anti-CD20 antibody rituximab has shown promising steroid-sparing properties, with conflicting results in complicated forms of SD-INS. Mycophenolate mofetil (MMF) resulted effective in maintaining free-steroid remission, however, studies are limited to few uncontrolled trials with reported different dose of MMF.
Methods and analysis
This open-label, two-parallel-arm, superiority controlled randomised clinical trial will enrol children with SD-INS maintained in remission with oral glucocorticoids or CNI. Children and young adults will be randomised to either MMF (1.200 mg/m2) or rituximab (375 mg/m2) infusion. After enrolment, glucocorticoids will be tapered until complete withdrawal. We will enrol 160 children and young adults to detect as significant at the two-sided p value of 0.01 with a power >0.8 a reduction in the risk of 1-year relapse (primary end-point). As secondary endpoints, we will compare the amount of glucocorticoids required to maintain complete remission at 6 and 24 months.
Ethics and dissemination
The trial was approved by the local ethics boards (Comitato Etico Regione Liguria CER Liguria https://www.portalericerca-liguria.it/). We will publish the study results at international scientific meetings.
Trial registration numbers
NCT004585152.
Læs mere Tjek på PubMedLiu, Y., Li, J., Dou, Y., Ma, H.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Objective
The prevalence of type 2 diabetes mellitus (T2DM) and hypertension (HTN) has notably increased in recent years. However, there is little evidence from large-scale studies assessing the joint effect of T2DM and HTN on the risk of cardiovascular events in China. This study was performed to investigate the association of T2DM and HTN with the incidence of combined vascular events (VEs) and stroke in China.
Design
A retrospective cohort study.
Setting
Data were collected from the SuValue database which includes the electronic medical records of >90 million patients from 161 hospitals across 18 provinces in China.
Participants
Patients aged ≥18 with a diagnosis of T2DM and/or HTN were included. Non-T2DM and non-HTN patients were included in this study as controls.
Outcomes
Incidence of combined VEs and stroke during the study.
Results
In the current study, 8012 patients with T2DM, 9653 patients with HTN, 3592 patients with both T2DM and HTN and 10 561 patients without T2DM or HTN were included. T2DM was significantly associated with combined VE and stroke risk (HR 1.332, 95% CI 1.134 to 1.565 and HR 1.584, 95% CI 1.246 to 2.014, respectively). HTN was significantly associated with combined VE and stroke risk (HR 3.244, 95% CI 2.946 to 3.572 and HR 4.543, 95% CI 3.918 to 5.268, respectively). T2DM combined with HTN was significantly associated with combined VE and stroke risk (HR 3.002, 95% CI 2.577 to 3.497 and HR 4.151, 95% CI 3.346 to 5.149, respectively). HTN was associated with a higher combined VE and stroke risk than T2DM (HR 2.435, 95% CI 2.113 to 2.805 and HR 2.868, 95% CI 2.341 to 3.513, respectively).
Conclusion
T2DM and HTN were strongly associated with combined VE and stroke risk; however, the HTN-only group had a higher combined VE and stroke risk than the T2DM-only group.
Læs mere Tjek på PubMedNoyes, J., Roberts, G., Williams, G., Chess, J., Mc Laughlin, L.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Objectives
To explore how people with chronic kidney disease who are pre-dialysis, family members and healthcare professionals together navigate common shared decision-making processes and to assess how this impacts future treatment choice.
Design
Coproductive qualitative study, underpinned by the Making Good Decisions in Collaboration shared decision-model. Semistructured interviews with a purposive sample from February 2019 - January 2020. Interview data were analysed using framework analysis. Coproduction of logic models/roadmaps and recommendations.
Setting
Five Welsh kidney services.
Participants
95 participants (37 patients, 19 family members and 39 professionals); 44 people supported coproduction (18 patients, 8 family members and 18 professionals).
Findings
Shared decision-making was too generic and clinically focused and had little impact on people getting onto home dialysis. Preferences of where, when and how to implement shared decision-making varied widely. Apathy experienced by patients, caused by lack of symptoms, denial, social circumstances and health systems issues made future treatment discussions difficult. Families had unmet and unrecognised needs, which significantly influenced patient decisions. Protocols containing treatment hierarchies and standards were understood by professionals but not translated for patients and families. Variation in dialysis treatment was discussed to match individual lifestyles. Patients and professionals were, however, defaulting to the perceived simplest option. It was easy for patients to opt for hospital-based treatments by listing important but easily modifiable factors.
Conclusions
Shared decision-making processes need to be individually tailored with more attention on patients who could choose a home therapy but select a different option. There are critical points in the decision-making process where changes could benefit patients. Patients need to be better educated and their preconceived ideas and misconceptions gently challenged. Healthcare professionals need to update their knowledge in order to provide the best advice and guidance. There needs to be more awareness of the costs and benefits of the various treatment options when making decisions.
Læs mere Tjek på PubMedZhan, W., Zhu, J., Hua, X., Ye, J., Chen, Q., Zhang, J.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Objectives
To describe the epidemiology of uterine rupture in China from 2015 to 2016 and to build a prediction model for uterine rupture in women with a scarred uterus.
Setting
A multicentre cross-sectional survey conducted in 96 hospitals across China in 2015–2016.
Participants
Our survey initially included 77 789 birth records from hospitals with 1000 or more deliveries per year. We excluded 2567 births less than 24 gestational weeks or unknown and 1042 births with unknown status of uterine rupture, leaving 74 180 births for the final analysis.
Primary and secondary outcome measures
Complete and incomplete uterine rupture and the risk factors, and a prediction model for uterine rupture in women with scarred uterus (assigned each birth a weight based on the sampling frame).
Results
The weighted incidence of uterine rupture was 0.18% (95% CI 0.05% to 0.23%) in our study population during 2015 and 2016. The weighted incidence of uterine rupture in women with scarred and intact uterus was 0.79% (95% CI 0.63% to 0.91%) and 0.05% (95% CI 0.02% to 0.13%), respectively. Younger or older maternal age, prepregnancy diabetes, overweight or obesity, complications during pregnancy (hypertensive disorders in pregnancy and gestational diabetes), low education, repeat caesarean section (≥2), multiple abortions (≥2), assisted reproductive technology, placenta previa, induce labour, fetal malpresentation, multiple pregnancy, anaemia, high parity and antepartum stillbirth were associated with an increased risk of uterine rupture. The prediction model including eight variables (OR >1.5) yielded an area under the curve (AUC) of 0.812 (95% CI 0.793 to 0.836) in predicting uterine rupture in women with scarred uterus with sensitivity and specificity of 77.2% and 69.8%, respectively.
Conclusions
The incidence of uterine rupture was 0.18% in this population in 2015–2016. The predictive model based on eight easily available variables had a moderate predictive value in predicting uterine rupture in women with scarred uterus. Strategies based on predictions may be considered to further reduce the burden of uterine rupture in China.
Læs mere Tjek på PubMedDe Neubourg, D., Janssens, L., Verhaegen, I., Smits, E., Mol, B. W., Roelant, E.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Introduction
Tubal patency testing is an essential part in the fertility workup of many subfertile women. Hysterosalpingography (HSG) has long been the test of choice in many clinics. There is evidence from a large randomised multicentre trial and from a recent meta-analysis that women who had HSG using oil soluble contrast medium (OSCM) had higher rates of ongoing pregnancy compared with women who underwent this procedure using water contrast. However, the field is moving away from HSG and nowadays hysterosalpingo-foam sonography (Hyfosy) using ultrasound guidance is considered as the first line office tubal patency test. Therefore, a large multicentre randomised clinical trial (RCT) will be initiated to evaluate if flushing the fallopian tubes with OSCM after a normal Hyfosy showing at least one patent fallopian tube will increase the live birth rate as compared with no flushing.
Methods and analysis
We plan a multicentre two arm, 1:1 randomised, open-label pragmatic comparative trial in 12 Belgian centres. After informed consent, we will randomise infertile women between 18 and 40 years of age, undergoing Hyfosy as part of the fertility workup to Hyfosy with additional tubal flushing with OSCM versus Hyfosy without additional flushing. Infertility is defined as lack of conception despite 12 months of unprotected intercourse, or three cycles of donor insemination without pregnancy or three ovulatory ovulation induction cycles without pregnancy, all three in combination with at least one patent tube on Hyfosy. Primary endpoint will be live birth with conception within 6 months after randomisation.
Ethics and dissemination
Approval on 11 May 2021 by the Ethics Committee from ZNA Hospital Antwerp who was the central Ethics Committee for the Clinical Trial Regulation Pilot (Pilot 412) in the 12 centres. The findings from this RCT will be disseminated in peer-reviewed publications and presentations at scientific international meetings.
Trial registration numbers
EudraCT number: 2020-002135-30 and NCT04379973.
Læs mere Tjek på PubMedRenz, B. W., Adrion, C., Klinger, C., Ilmer, M., DHaese, J. G., Buhr, H.-J., Mansmann, U., Werner, J., PyloResPres Study Group
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Introduction
Partial pancreatoduodenectomy (PD) is the treatment of choice for various benign and malignant tumours of the pancreatic head or the periampullary region. For reconstruction of the gastrointestinal passage, two stomach-preserving PD variants exist: pylorus preservation PD (ppPD) or pylorus resection PD (prPD) with preservation of the stomach. In pancreatic surgery, delayed gastric emptying (DGE) remains a serious complication after PD with an incidence varying between 4.5% and 45%, potentially delaying hospital discharge or further treatment, for example, adjuvant chemotherapy. Evidence is lacking to assess, which variant of PD entails fewer postoperative DGE.
Methods and analysis
The protocol of a large-scale, multicentre, pragmatic, two-arm parallel-group, registry-based randomised controlled trial (rRCT) using a two-stage group-sequential design is presented. This patient-blind rRCT aims to demonstrate the superiority of prPD over ppPD with respect to the overall incidence of DGE within 30 days after index surgery in a German real-world setting. A total of 984 adults undergoing elective PD for any indication will be randomised in a 1:1 ratio. Patients will be recruited at about 30 hospitals being members of the StuDoQ|Pancreas registry established by the German Society of General and Visceral Surgery. The postoperative follow-up for each patient will be 30 days. The primary analysis will follow an intention-to-treat approach and applies a binary logistic random intercepts model. Secondary perioperative outcomes include overall severe morbidity (Clavien-Dindo classification), blood loss, 30-day all-cause mortality, postoperative hospital stay and operation time. Complication rates and adverse events will be closely monitored.
Ethics and dissemination
This protocol was approved by the leading ethics committee of the Medical Faculty of the Ludwig-Maximilians-Universität, Munich (reference number 19-221). The results will be published in a peer-reviewed journal and presented at international conferences. Study findings will also be disseminated via the website (http://www.dgav.de/studoq/pylorespres/).
Trial registration number
DRKS-ID: DRKS00018842.
Læs mere Tjek på PubMedLiu, X., Robbins, S., Wang, X., Virk, S., Schuck, K., Deveza, L. A., Oo, W. M., Carmichael, K., Antony, B., Eckstein, F., Wirth, W., Little, C., Linklater, J., Harris, A., Humphries, D., O'Connell, R., Heller, G., Buttel, T., Lohmander, S., Ding, C., Hunter, D. J.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Introduction
Knee osteoarthritis (KOA) is a highly prevalent disabling joint disease. Intra-articular stem cell therapy is increasingly being used for treating KOA with little high-quality evidence to support its use. The aim of this study is to investigate the efficacy, safety and cost-effectiveness of allogeneic mesenchymal stem cells (Cymerus MSCs) for treating symptomatic tibiofemoral KOA and improving knee structure over 24 months.
Methods and analysis
The Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis study is a phase III, multi-centre, parallel, superiority, randomised, double-blind, placebo-controlled trial, which will be conducted in Sydney and Hobart, Australia. 440 participants (220 per arm) aged over 40 years with painful KOA and mild to moderate structural change on X-ray (Kellgren and Lawrence grade 2 or 3) with medial minimum joint space width between 1 and 4 mm in the study knee will be recruited from the community and randomly allocated to receive either intra-articular MSCs or saline at baseline, week 3 and week 52. The coprimary outcomes will be the proportion of participants achieving patient-acceptable symptom state for knee pain at 24 months and quantitative central medial femorotibial compartment cartilage thickness change from baseline to 24 months. Main secondary outcomes include change in knee pain, Patient Global Assessment, physical function, quality of life and other structural changes. Additional data for cost-effectiveness analysis will also be recorded. Adverse events will be monitored throughout the study. The primary analysis will be conducted using modified intention-to-treat.
Ethics and dissemination
This protocol has been approved by The University of Sydney (USYD) Human Research Ethics Committee (HREC) #: 2020/119 and The University of Tasmania (UTAS) HREC #: H0021868. All participants will be required to provide informed consent. Dissemination will occur through conferences, social media, and scientific publications.
Trial registration numbers
Australian New Zealand Clinical Trials Registry (ACTRN12620000870954); U1111-1234-4897.
Læs mere Tjek på PubMedBelavy, D. L., Diwan, A. D., Ford, J., Miller, C. T., Hahne, A. J., Mundell, N., Tagliaferri, S., Bowe, S., Pedder, H., Saueressig, T., Zhao, X., Chen, X., Balasundaram, A. P., Arora, N. K., Owen, P. J.
BMJ Open, 29.11.2021
Tilføjet 30.11.2021
Introduction
Chronic low back pain disorders (CLBDs) present a substantial societal burden; however, optimal treatment remains debated. To date, pairwise and network meta-analyses have evaluated individual treatment modes, yet a comparison of a wide range of common treatments is required to evaluate their relative effectiveness. Using network meta-analysis, we aim to evaluate the effectiveness of treatments (acupuncture, education or advice, electrophysical agents, exercise, manual therapies/manipulation, massage, the McKenzie method, pharmacotherapy, psychological therapies, surgery, epidural injections, percutaneous treatments, traction, physical therapy, multidisciplinary pain management, placebo, ‘usual care’ and/or no treatment) on pain intensity, disability and/or mental health in patients with CLBDs.
Methods and analysis
Six electronic databases and reference lists of 285 prior systematic reviews were searched. Eligible studies will be randomised controlled/clinical trials (including cross-over and cluster designs) that examine individual treatments or treatment combinations in adult patients with CLBDs. Studies must be published in English, German or Chinese as a full-journal publication in a peer-reviewed journal. A narrative approach will be used to synthesise and report qualitative and quantitative data, and, where feasible, network meta-analyses will be performed. Reporting of the review will be informed by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, including the network meta-analysis extension (PRISMA-NMA). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for network meta-analysis will be implemented for assessing the quality of the findings.
Ethics and dissemination
Ethical approval is not required for this systematic review of the published data. Findings will be disseminated via peer-reviewed publication.
PROSPERO registration number
PROSPERO registration number CRD42020182039.
Læs mere Tjek på PubMedEeles, A. L., Burnett, A. C., Cheong, J. L., Aldis, A., Pallot, L., Polonidis, T., Rust, K., Hunt, R. W., Delany, C., Spittle, A. J., The Centre of Research Excellence in Newborn Medicine, Allen, McIntyre, Cheong, Doyle, Davis, Anderson, Spittle, Hunt, Thompson, Lee, Manley, Owen, Goldfeld, Roberts, Jacobs, Burnett, Dawson, Boland, Dalziel, Treyvaud, Thio, Aldis
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Objective
Neonatal conditions can have lifelong implications for the health and well-being of children and families. Traditionally, parents and patients have not been included in shaping the agenda for research and yet they are profoundly affected by the neonatal experience and its consequences. This study aimed to identify consensus research priorities among parents/patients of newborn medicine in Australia and New Zealand.
Design
Parents/patients with experience of neonatal care in Australia and New Zealand completed an online Delphi study to identify research priorities across four epochs (neonatal admission, early childhood, childhood/adolescence and adulthood). Parents/patients first generated key challenges in each of these epochs. Through inductive thematic analysis, recurring topics were identified and research questions generated. Parents/patients rated these questions in terms of priorities and a list of questions consistently rated as high priority was identified.
Participants
393 individuals participated, 388 parents whose children had received neonatal care and 5 adults who had received neonatal care themselves.
Results
Many research questions were identified as high-priority across the lifespan. These included how to best support parental mental health, relationships between parents and neonatal clinical staff (including involvement in care and communication), bonding and the parent–child relationship, improving neonatal medical care and addressing long-term impacts on child health and neurodevelopment.
Conclusions
Parents with experience of newborn medicine have strong, clear and recurring research priorities spanning neonatal care practices, psychological and other impacts on families, and impacts on child development. These findings should guide neonatal research efforts. In addition to generating new knowledge, improved translation of existing evidence to parents is also needed.
Læs mere Tjek på PubMedCai, Z., Xian, J., Araujo, C., Zhang, Z., Zhou, H., Peng, H., Sharma, M., Zhao, Y.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Objectives
This study aims to assess the independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs).
Design
A cross-sectional study was conducted.
Participants
There are 1481 high school students (49.9% boys) in this study, who were enrolled from one inner urban and two peri-urban schools in Chongqing, China.
Outcome measures
Academic grades were assessed based on the students’ self-reported grade ranking in the last cumulative examination.
Results
In IUHSSs and PUHSSs, high frequency of sugar-sweetened beverage consumption was unlikely to obtain high academic grades (OR 0.56, 95% CI 0.32 to 0.99 and 0.63, 95% CI 0.42 to 0.96), respectively). Among IUHSSs, meeting the recommendations for weekday screen time and egg consumption (OR 1.57, 95% CI 1.06 to 2.34 and 1.60, 95% CI 1.04 to 2.47, respectively) and high frequency of fruit consumption (1.67, 95% CI 1.11 to 2.50) were significantly associated with high academic grades; meeting the recommendation for weekday sleep duration was unlikely to obtain high academic grades (0.46, 95% CI 0.21 to 0.98). Among PUHSSs, meeting the recommendations for weekend sleep duration (1.40, 95% CI 1.02 to 1.93) and eating dinner regularly (1.55, 95% CI 1.01 to 2.37) had significant associations with high academic grades. No significant associations were found between physical activity and academic grades in both IUHSSs and PUHSSs (p>0.05). Moreover, IUHSSs with 9–13 healthy lifestyle behaviours were 3.25 times more likely to achieve high academic grades than IUHSSs with 1–6 healthy lifestyle behaviours (3.25, 95% CI 1.96 to 5.40). No significant associations were found in the combined associations between multiple lifestyle behaviours and academic grades among PUHSSs (p>0.05).
Conclusions
Correlations were observed between lifestyle behaviours and academic grades among high school students, and cumulative associations between multiple healthy lifestyle behaviours and academic outcomes appear to be stronger than the independent associations. These findings are particularly applicable to IUHSSs.
Læs mere Tjek på PubMedKlein, A., Wolters, N. E., Bol, E. J. M., Koelen, J., de Koning, L., Roetink, S. S. M., van Blom, J. J., Pronk, T., van der Heijde, C., Salemink, E., Bolinski, F., Riper, H., Karyotaki, E., Cuijpers, P., Schneider, S., Rapee, R. M., Vonk, P., Wiers, R. W.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Introduction
Emerging adulthood is a phase in life that is associated with an increased risk to develop a variety of mental health disorders including anxiety and depression. However, less than 25% of university students receive professional help for their mental health reports. Internet-based cognitive behavioural therapy (iCBT) may entail useful interventions in a format that is attractive for university students. The aim of this study protocol is to test the effectiveness of a therapist-guided versus a computer-guided transdiagnostic iCBT programme with a main focus on anxiety and depression.
Methods and analysis
University students with anxiety and/or depressive symptoms will be randomised to a (1) 7-week iCBT programme (excluding booster session) with therapist feedback, (2) the identical iCBT programme with computer feedback only or (3) care as usual. Participants in the care as usual condition are informed and referred to conventional care services and encouraged to seek the help they need. Primary outcome variables are self-reported levels of anxiety as measured with the General Anxiety Disorder-7 and self-reported levels of depression as measured with the Patient Health Questionnaire-9. Secondary outcomes include treatment adherence, client satisfaction, medical service use, substance use, quality of life and academic achievement. Assessments will take place at baseline (t1), midtreatment (t2), post-treatment (t3), at 6 months (t4) and 12 months (t5) postbaseline. Social anxiety and perfectionism are included as potentially important predictors of treatment outcome. Power calculations are based on a 3 (group) x 3 (measurement: pretreatment, midtreatment and post-treatment) interaction, resulting in an aimed sample of 276 participants. Data will be analysed based on intention-to-treat and per protocol samples using mixed linear models.
Ethics and dissemination
The current study was approved by the Medical Ethics Review Committee (METC) of the Academic Medical Centre, Amsterdam, The Netherlands (number: NL64929.018.18). Results of this trial will be published in peer-reviewed journals.
Trial registration number
NL7328.
Læs mere Tjek på PubMedBhusal, U. P., Sapkota, V. P.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Objectives
We analysed predictors of health insurance enrolment in Nepal, measured wealth-related inequality and decomposed inequality into its contributing factors.
Design
Cross-sectional study.
Setting
We used nationally representative data based on Nepal Multiple Indicator Cluster Survey 2019. Out of 10 958 households included in this study, 6.95% households were enroled in at least one health insurance scheme.
Primary outcome
measures health insurance (of any type) enrolment.
Results
Households were more likely to have health insurance membership when household head have higher secondary education or above compared with households without formal education (adjusted OR 1.87; 95% CI: 1.32 to 2.64)). Households with mass media exposure were nearly three times more likely to get enroled into the schemes compared with their counterparts (adjusted OR 2.96; 95% CI 2.03 to 4.31). Hindus had greater odds of being enroled (adjusted OR 1.82; 95% CI 1.20 to 2.77) compared with non-Hindus. Dalits were less likely to get enroled compared with Brahmin, Chhetri and Madhesi (adjusted OR 0.66; 95% CI 0.47 to 0.94). Households from province 2, Bagmati and Sudurpaschim were less likely to have membership compared with households from province 1. Households from Richer and Richest wealth quintiles were more than two times more likely to have health insurance membership compared with households from the poorest wealth quintile. A positive concentration index 0.25 (95% CI 0.21 to 0.30; p<0.001) indicated disproportionately higher health insurance enrolment among wealthy households.
Conclusions
Education of household head, exposure to mass media, religious and ethnic background, geographical location (province) and wealth status were key predictors of health insurance enrolment in Nepal. There was a significant wealth-related inequality in health insurance affiliation. The study recommends regular monitoring of inequality in health insurance enrolment across demographic and socioeconomic groups to ensure progress towards Universal Health Coverage.
Læs mere Tjek på PubMedLi, W., Song, Y., Chen, K., Ying, J., Zheng, Z., Qiao, S., Yang, M., Zhang, M., Zhang, Y.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Objective
Aiming to investigate diabetic retinopathy (DR) risk factors and predictive models by machine learning using a large sample dataset.
Design
Retrospective study based on a large sample and a high dimensional database.
Setting
A Chinese central tertiary hospital in Beijing.
Participants
Information on 32 452 inpatients with type-2 diabetes mellitus (T2DM) were retrieved from the electronic medical record system from 1 January 2013 to 31 December 2017.
Methods
Sixty variables (including demography information, physical and laboratory measurements, system diseases and insulin treatments) were retained for baseline analysis. The optimal 17 variables were selected by recursive feature elimination. The prediction model was built based on XGBoost algorithm, and it was compared with three other popular machine learning techniques: logistic regression, random forest and support vector machine. In order to explain the results of XGBoost model more visually, the Shapley Additive exPlanation (SHAP) method was used.
Results
DR occurred in 2038 (6.28%) T2DM patients. The XGBoost model was identified as the best prediction model with the highest AUC (area under the curve value, 0.90) and showed that an HbA1c value greater than 8%, nephropathy, a serum creatinine value greater than 100 µmol/L, insulin treatment and diabetic lower extremity arterial disease were associated with an increased risk of DR. A patient’s age over 65 was associated with a decreased risk of DR.
Conclusions
With better comprehensive performance, XGBoost model had high reliability to assess risk indicators of DR. The most critical risk factors of DR and the cut-off of risk factors can be found by SHAP method to render the output of the XGBoost model clinically interpretable.
Læs mere Tjek på PubMedJensen, H. A. R., Ekholm, O.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Objective
Information on the use of complementary and alternative medicine (CAM) in the general population is often collected by means of surveys, causing the reliability of data to rely on the memory accuracy of the respondent. The objective of this study was to examine the consistency in self-reported CAM use using data from two survey waves 4 years apart.
Design
Longitudinal study.
Setting/participants
Data were obtained from the Danish Health and Morbidity Surveys. A nationally representative subsample of the individuals invited in 2013 was reinvited in 2017. In all, 2297 individuals (≥16 years) completed the self-administered questionnaire in both waves, including questions on for example, CAM use.
Main outcome measures
The use of six different CAM therapies (acupuncture; craniosacral therapy; faith healing and/or clairvoyance; nutritional counselling; massage; osteopathy or other manipulative therapies; reflexology) was assessed by the response categories ‘Yes, within the past 12 months’, ‘Yes, but previously than within the past 12 months’ and ‘No’. For each CAM therapy, an inconsistent response was defined as either the response combination (1) ‘Yes, within the past 12 months’ in 2013 and ‘No’ in 2017, or (2) ‘Yes, within the past 12 months’ or ‘Yes, but previously than within the past 12 months’ in 2013 and ‘No’ in 2017.
Results
The inconsistency percentages varied across CAM therapies. The highest levels of inconsistency for CAM use within the past 12 months were observed for nutritional counselling (64.9 %) and faith healing and/or clairvoyance (36.4 %). The lowest proportion of inconsistent responses was observed for acupuncture (18.3%). Overall, the same pattern was observed for lifetime CAM use.
Conclusions
The results highlight the difficulty in obtaining reliable prevalence estimates on the use of CAM in the general population. Future studies should take these findings into account when interpreting similar analyses.
Læs mere Tjek på PubMedHagelskjaer, V., Nielsen, K. T., von Bulow, C., Oestergaard, L. G., Graff, M., Waehrens, E. E.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Introduction
The need to develop and evaluate interventions, addressing problems performing activities of daily living (ADL) among persons with chronic conditions, is evident. Guided by the British Medical Research Council’s guidance on how to develop and evaluate complex interventions, the occupational therapy programme (A Better everyday LifE (ABLE)) was developed and feasibility tested. The aim of this protocol is to report the planned design and methods for evaluating effectiveness, process and cost-effectiveness of the programme.
Methods and analysis
The evaluation is designed as a randomised controlled trial with blinded assessors and investigators. Eighty participants with chronic conditions and ADL problems are randomly allocated to ABLE or usual occupational therapy. Data for effectiveness and cost-effectiveness evaluations are collected at baseline (week 0), post intervention (week 10) and follow-up (week 26). Coprimary outcomes are self-reported ADL ability (ADL-Interview (ADL-I) performance) and observed ADL motor ability (Assessment of Motor and Process Skills (AMPS)). Secondary outcomes are perceived satisfaction with ADL ability (ADL-I satisfaction); and observed ADL process ability (AMPS). Explorative outcomes are occupational balance (Occupational Balance Questionnaire); perceived change (Client-Weighted Problems Questionnaire) and general health (first question of the MOS 36-item Short Form Survey Instrument). The process evaluation is based on quantitative data from registration forms and qualitative interview data, collected during and after the intervention period. A realist evaluation approach is applied. A programme theory expresses how context (C) and mechanisms (M) in the programme may lead to certain outcomes (O), in so-called CMO configurations. Outcomes in the cost-effectiveness evaluation are quality-adjusted life years (EuroQool 5-dimension) and changes in ADL ability (AMPS, ADL-I). Costs are estimated from microcosting and national registers.
Ethics and dissemination
Danish Data Protection Service Agency approval: Journal-nr.: P-2020-203. The Ethical Committee confirmed no approval needed: Journal-nr.: 19 045 758. Dissemination for study participants, in peer-reviewed journals and conferences.
Trial registration number
NCT04295837
Læs mere Tjek på PubMedHesketh, K., Low, J., Andrews, R., Jones, C. A., Jones, H., Jung, M. E., Little, J., Mateus, C., Pulsford, R., Singer, J., Sprung, V. S., McManus, A. M., Cocks, M.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Introduction
Exercise and physical activity (PA) are fundamental to the treatment of type 2 diabetes. Current exercise and PA strategies for newly diagnosed individuals with type 2 diabetes are either clinically effective but unsuitable in routine practice (supervised exercise) or suitable in routine practice but clinically ineffective (PA advice). Mobile health (mHealth) technologies, offering biometric data to patients and healthcare professionals, may bridge the gap between supervised exercise and PA advice, enabling patients to engage in regular long-term physically active lifestyles. This feasibility randomised controlled trial (RCT) will evaluate the use of mHealth technology when incorporated into a structured home-based exercise and PA intervention, in those recently diagnosed with type 2 diabetes.
Methods and analysis
This feasibility multicentre, parallel group RCT will recruit 120 individuals with type 2 diabetes (diagnosis within 5–24 months, aged 40–75 years) in the UK (n=60) and Canada (n=60). Participants will undertake a 6-month structured exercise and PA intervention and be supported by an exercise specialist (active control). The intervention group will receive additional support from a smartwatch and phone app, providing real-time feedback and enabling improved communication between the exercise specialist and participant. Primary outcomes are recruitment rate, adherence to exercise and loss to follow-up. Secondary outcomes include a qualitative process evaluation and piloting of potential clinical outcome measures for a future RCT.
Ethics and dissemination
The trial was approved in the UK by the South East Scotland Research Ethics Committee 01 (20/SS/0101) and in Canada by the Clinical Research Ethics Board of the University of British Columbia (H20-01936), and is being conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. Results will be published in peer-reviewed journals and presented at national and international scientific meetings.
Trial registration numbers
ISRCTN14335124; ClinicalTrials.gov: NCT04653532.
Læs mere Tjek på PubMedBrown, T. T., Hurley, V. B., Rodriguez, H. P.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Objective
Musculoskeletal problems like hip and knee osteoarthritis and low-back pain are preference sensitive conditions. Patient engagement strategies (PES), such as shared decision-making and motivational interviewing, can help align patients’ preferences with treatment options and potentially reduce spending. We assess the association of physician practice-level adoption of PES with utilisation and spending.
Design
Cross-sectional study in which patients were matched across low, moderate and high levels of PES via coarsened exact matching.
Setting
Primary and secondary care in 2190 physician practices.
Participants
39 336 hip, 48 362 knee and 67 940 low-back patients who were Medicare beneficiaries were matched to the 2017–2018 National Survey of Healthcare Organizations and Systems.
Primary and secondary outcome measures
Total hip replacement (THR), total knee replacement (TKR), 1–2 level posterior lumbar fusion (LF), total annual spending, components of total annual spending.
Results
Total annual spending for patients with musculoskeletal problems did not differ for practices with low versus moderate PES, low versus high PES or moderate versus high PES, but spending was significantly lower in some categories for practices with relatively higher PES adoption. For hospital-owned and health system-owned practices, the ORs of receiving LF were 0.632 (95% CI 0.396 to 1.009) for patients attributed to practices with high PES compared with patients attributed to practices with moderate PES. For independent practices, the odds of receiving THR were 1.403 (95% CI 1.035 to 1.902) for patients attributed to practices with moderate PES compared with patients attributed to practices with low PES.
Conclusions
Practice-level adoption of PES for patients with musculoskeletal problems was generally not associated with total spending. PES, however, may steer patients toward evidence-based treatments. Opportunities for overall spending reduction exist as indicated by the variation in the subcomponents of total spending by PES adoption.
Læs mere Tjek på PubMedLiu, H., Chen, G., Li, J., Hao, C., Zhang, B., Bai, Y., Song, L., Chen, C., Xie, H., Liu, T., Caine, E. D., Hou, F.
BMJ Open, 26.11.2021
Tilføjet 30.11.2021
Introduction
The postdischarge suicide risk among psychiatric patients is significantly higher than it is among patients with other diseases and general population. The brief contact interventions (BCIs) are recommended to decrease suicide risk in areas with limited mental health service resources like China. This study aims to develop a postdischarge suicide intervention strategy based on BCIs and evaluate its implementability under the implementation outcome framework.
Methods and analysis
This study will invite psychiatric patients and family members, clinical and community mental health service providers as the community team to develop a postdischarge suicide intervention strategy. The study will recruit 312 patients with psychotic symptoms and 312 patients with major depressive disorder discharged from Shenzhen Kangning Hospital (SKH) in a Sequential Multiple Assignment Randomised Trial. Participants will be initially randomised into two intervention groups to receive BCIs monthly and weekly, and they will be rerandomised into three intervention groups to receive BCIs monthly, biweekly and weekly at 3 months after discharge according to the change of their suicide risk. Follow-ups are scheduled at 1, 3, 6 and 12 months after discharge. With the intention-to-treat approach, generalised estimating equation and survival analysis will be applied. This study will also collect qualitative and quantitative information on implementation and service outcomes from the community team.
Ethics/dissemination
This study has received ethical approval from the Ethics Committee Review Board of SKH. All participants will provide written informed consent prior to enrolment. The findings of the study will be disseminated through peer-reviewed scientific journals, conference presentations. A project report will be submitted to the National Natural Science Foundation of China as the concluding report of this funded project, and to the mental health authorities in the Shenzhen to refine and apply evidence-based and pragmatic interventions into health systems for postdischarge suicide prevention.
Trial registration number
NCT04907669.
Læs mere Tjek på PubMedMinh-Duy Phan Kate M. Peters Laura Alvarez Fraga Steven C. Wallis Steven Hancock Nguyen Thi Khanh Nhu Brian Forde Michelle J. Bauer David L. Paterson Scott A Beatson Jeffrey Lipman Mark A. Schembri 1 School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia 2 Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia 3 University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia 4 Jamison Trauma Institute and Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia 5 University Hospital Complex of A Coruña (CHUAC), Biomedical Research Institute of A Coruña (INIBIC), A Coruña, Spain
Antimicrobial Agents And Chemotherapy, 15.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedJacqueline R. Phan Dung M. Do Minh Chau Truong Connie Ngo Julian H. Phan Shiv K. Sharma Angel Schilke Chrisabelle C. Mefferd Jacob V. Villarama Dengxun Lai Amber Consul Brian P. Hedlund Steven M. Firestine Ernesto Abel-Santos 1Department of Chemistry Biochemistry, University of Nevada, Las Vegas, NV, 89154 2Department of Pharmaceutical Sciences, Wayne State University, Detroit, Michigan, 48201 3School of Life Sciences, University of Nevada, Las Vegas, Las Vegas, NV, 89154 4School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, 89154 5School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV, 89154 6Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, Las Vegas, NV, 89154
Antimicrobial Agents And Chemotherapy, 15.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedRyosuke Yamamuro Muneyoshi Kimura Yuki Asano-Mori Masahiro Abe Shigeki Nakamura Takashi Umeyama Satoshi Yamagoe Yoshitsugu Miyazaki Sho Ogura Takashi Sakoh Takashi Mitsuki Kyosuke Yamaguchi Mitsuhiro Yuasa Daisuke Kaji Kosei Kageyama Aya Nishida Yuki Taya Kazuya Ishiwata Shinsuke Takagi Hisashi Yamamoto Go Yamamoto Naoyuki Uchida Atsushi Wake Shuichi Taniguchi Hideki Araoka 1Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan 2Department of Hematology, Toranomon Hospital, Tokyo, Japan 3Department of Fungal Infection, National Institute of Infectious Diseases, Tokyo, Japan 4Okinaka Memorial Institute for Medical Research, Tokyo, Japan
Antimicrobial Agents And Chemotherapy, 15.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedDavid Huang Despina Dobbins Parviz Ghahramani Ian Friedland Jonathan Steckbeck 1Peptilogics, Pittsburgh, Pennsylvania, USA 2Inncelerex, Jersey City, NJ, USA 3Clinical and Regualtory Consulting
Antimicrobial Agents And Chemotherapy, 22.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedJames A. Karlowsky Meredith A. Hackel Miki Takemura Yoshinori Yamano Echols Roger Daniel F. Sahm IHMA, Schaumburg, Illinois, USAa Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canadab Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japanc Research Planning Department, Shionogi & Co., Ltd., Osaka, Japand Infectious Disease Drug Development Consulting, LLC. Easton, Connecticut, USAe
Antimicrobial Agents And Chemotherapy, 22.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedBenjamin Williamson Adam Wilk Kevin D. Guerrero Timothy D. Mikulski Tony N. Elias Indira Sawh Geselle Cancino-Prado Dianne Gardam Christopher H. Heath Nelesh P. Govender David S. Perlin Milena Kordalewska Kelley R. Healey 1William Paterson University, Department of Biology, 300 Pompton Road, Wayne, NJ, USA 07470 2Center for Discovery and Innovation, Hackensack Meridian Health, 111 Ideation Way, Nutley, NJ, USA 07110 3 Department of Microbiology, PathWest Laboratory Medicine FSH Network, Fiona Stanley Hospital, Murdoch, Western Australia (WA), Australia 4 Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Australia 5 Infectious Diseases, Royal Perth Hospital, Perth, WA, Australia 6 Faculty of Health & Medical Sciences, University of Western Australia, Crawley, WA, Australia 7 Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Sandringham 2131, South Africa 8 School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, South Africa 9 MRC Centre for Medical Mycology, University of Exeter, Exeter, EX4 4PY, United Kingdom
Antimicrobial Agents And Chemotherapy, 11.10.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedJohanna J Kenyon Ruth M. Hall 1 Centre for Immunology and Infection Control, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia 2 School of Life and Environmental Sciences, The University of Sydney, NSW 2006, Australia
Antimicrobial Agents And Chemotherapy, 18.10.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedFernando J. Diggs Jonathan D. Edwards Kimberly B. Garza Ali A.M. Hassoun Spencer H. Durham aDepartment of Pharmacy, Huntsville, Hospital, Huntsville, Alabama, USA bDepartment of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama, USA cDepartment of Infectious Diseases, Huntsville Hospital, Huntsville, Alabama, USA dDepartment of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, Alabama, USA
Antimicrobial Agents And Chemotherapy, 18.10.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedRunhao Yu Zheng Chen Stefan Schwarz Hong Yao Xiang-Dang Du 1 College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, P. R. China. 2 Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Antimicrobial Agents And Chemotherapy, 1.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedMing Liu Wenhui Zhang Yifan Hu Pengyu Chen Zhiqiang Wang Ruichao Li 1Department of Marine Biology, College of Oceanography, Hohai University, Nanjing, P. R. China; 2Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou, P. R. China; 3Institute of Comparative Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P. R. China.
Antimicrobial Agents And Chemotherapy, 15.11.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedPier Giorgio Cojutti Matteo Rinaldi Eleonora Zamparini Nicolò Rossi Sara Tedeschi Matteo Conti Federico Pea Pierluigi Viale aDepartment of Medicine, University of Udine, Udine, Italy bInstitute of Clinical Pharmacology, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy cDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy dInfectious Diseases Unit, IRCCS Sant' Orsola Teaching Hospital, Bologna, Italy eSSD Clinical Pharmacology Unit, IRCCS Sant' Orsola Teaching Hospital, Bologna, Italy
Antimicrobial Agents And Chemotherapy, 18.10.2021
Tilføjet 30.11.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMed