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Is a novel digital system for arm and hand rehabilitation suitable for stroke survivors? A qualitative process evaluation of OnTrack
Conclusions This process evaluation supported initial theoretical assumptions that OnTrack would enable activity practice through the use of remote monitoring. There was a strong emphasis on the coaching role as a mechanism of impact supporting the technological intervention. These findings will inform the next stages of delivery in a definitive trial. Trial registration number NCT03944486.
Source: BMJ Open - August 18, 2023 Category: General Medicine Authors: Taylor, E., Fusari, G., Darzi, A., Jones, F. Tags: Open access, Rehabilitation medicine Source Type: research

RECREATE: a study protocol for a multicentre pilot cluster randomised controlled trial (cRCT) in UK stroke services evaluating an intervention to reduce sedentary behaviour in stroke survivors (Get Set Go) with embedded process and economic evaluations
This study is a pragmatic, multicentre, two-arm, external pilot cluster randomised controlled trial with embedded process and economic evaluations. UK-based stroke services will be randomised 1:1 to the intervention (usual care plus Get Set Go) or control (usual care) arm. Fifteen stroke services will recruit 300–400 stroke inpatient and carer participants, with follow-up at 6, 12 and 24 months. The proposed primary endpoint is stroke survivor self-reported Nottingham Extended Activities of Daily Living scale at 12 months. Endpoint analyses will be exploratory and provide preliminary estimates of intervention effect....
Source: BMJ Open - July 30, 2023 Category: General Medicine Authors: Airlie, J., Burton, L.-J., Copsey, B., English, C., Farrin, A., Fitzsimons, C. F., Holloway, I., Horrocks, J., Johansson, J. F., Mead, G., Moreau, L. A., Ozer, S., Patel, A., Yaziji, N., Forster, A., on behalf of the RECREATE Programme Management Group, A Tags: Open access, Rehabilitation medicine Source Type: research

Diabetes status and other factors as correlates of risk for thrombotic and thromboembolic events during SARS-CoV-2 infection: A nationwide retrospective case-control study using Cerner Real-World Data™
Conclusions Risk of TTE during COVID-19 illness is substantially higher in patients with diabetes. Further, risk for TTEs is higher in those with T1DM versus T2DM. Confirmation of increased diabetes-associated clotting risk in future studies may warrant incorporation of diabetes status into SARS-CoV-2 infection treatment algorithms.
Source: BMJ Open - July 9, 2023 Category: General Medicine Authors: Tallon, E. M., Gallagher, M. P., Staggs, V. S., Ferro, D., Murthy, D. B., Ebekozien, O., Kosiborod, M. N., Lind, M., Manrique-Acevedo, C., Shyu, C.-R., Clements, M. A. Tags: Open access, Diabetes and Endocrinology, COVID-19 Source Type: research

FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
Introduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusio...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Brännmark, C., Klasson, S., Stanne, T. M., Samuelsson, H., Alt Murphy, M., Sunnerhagen, K. S., Aberg, N. D., Jalnefjord, O., Björkman-Burtscher, I., Jood, K., Tatlisumak, T., Jern, C. Tags: Open access, Neurology Source Type: research

Association of the COVID-19 pandemic on stroke admissions and treatment globally: a systematic review
Conclusions During the COVID-19 pandemic, many populations hesitated to seek medical attention, decreasing hospital admissions for less severe strokes and increasing hospitalisation of more severe cases and mortality. The effect of the pandemic on society and healthcare systems needs to be addressed to improve stroke treatment pathways and prepare for potential future epidemics. PROSPERO registration number CRD42021248564.
Source: BMJ Open - March 17, 2023 Category: General Medicine Authors: Van Dusen, R. A., Abernethy, K., Chaudhary, N., Paudyal, V., Kurmi, O. Tags: Open access, Cardiovascular medicine, COVID-19 Source Type: research

Colchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial
Conclusions In this small, open-label, randomised trial of non-critically ill hospitalised patients with COVID-19, the combination of colchicine and rosuvastatin in addition to standard of care did not appear to reduce the risk of progression of COVID-19 disease or thromboembolic events, although the trial was underpowered due to a lower-than-expected event rate. The trial leveraged the power of electronic medical records for efficiency and improved follow-up and demonstrates the utility of incorporating electronic medical records into future trials. Trial registration NCT04472611.
Source: BMJ Open - February 24, 2023 Category: General Medicine Authors: Shah, T., McCarthy, M., Nasir, I., Archer, H., Ragheb, E., Kluger, J., Kashyap, N., Paredes, C., Patel, P., Lu, J., Kandel, P., Song, C., Khan, M., Huang, H., Ul Haq, F., Ahmad, R., Howes, C., Cambi, B., Lancaster, G., Cleman, M., Dela Cruz, C., Parise, H Tags: Open access, Infectious diseases, COVID-19 Source Type: research

Cardiovascular-related conditions and risk factors in primary care for deprived communities before and during the COVID-19 pandemic: an observational study in Northern England
Conclusion Recorded CVD-related risk factors and conditions remained comparable before and during COVID-19. These are higher in the Deep End than in England and similar or lower than the non-Deep End, with a higher optimal statin prescribing rate. However, it was not possible to control for age and sex. More work is needed to estimate the consequences of the pandemic on disadvantaged communities and to compare whether the findings are replicated in other areas of deprivation.
Source: BMJ Open - November 22, 2022 Category: General Medicine Authors: Fu, Y., Price, C., Haining, S., Gaffney, B., Julien, D., Whitty, P., Newton, J. L. Tags: Open access, Public health, COVID-19 Source Type: research

What is the feasibility and patient acceptability of a digital system for arm and hand rehabilitation after stroke? A mixed-methods, single-arm feasibility study of the 'OnTrack intervention for hospital and home use
Conclusions The intervention was found to be usable and acceptable by participants; study feasibility objectives were met and demonstrated that a definitive RCT would be viable and acceptable. Trial registration number NCT03944486.
Source: BMJ Open - September 28, 2022 Category: General Medicine Authors: Fusari, G., Gibbs, E., Hoskin, L., Lawrence-Jones, A., Dickens, D., Fernandez Crespo, R., Leis, M., Crow, J., Taylor, E., Jones, F., Darzi, A. Tags: Open access, Rehabilitation medicine Source Type: research

Effects of healthcare system transformations spurred by the COVID-19 pandemic on management of stroke and STEMI: a registry-based cohort study in France
Conclusions The pandemic did not markedly alter the functioning of the emergency network. Although stroke patient management deteriorated, the resilience of the STEMI pathway was linked to its stronger structuring. Transversal reorganisations, aiming at concentrating resources on emergency care, contributed to maintenance of the quality of care. Trial registration number NCT04979208.
Source: BMJ Open - September 21, 2022 Category: General Medicine Authors: Lesaine, E., Francis-Oliviero, F., Domecq, S., Bijon, M., Cetran, L., Coste, P., Lhuaire, Q., Miganeh-Hadi, S., Pradeau, C., Rouanet, F., Sevin, F., Sibon, I., Saillour-Glenisson, F., AVICOVID group, Faucheux, Leca Radu, Seignolles, Chazalon, Dan, Lucas, Tags: Open access, Public health, COVID-19 Source Type: research

COVID-19 postacute care major organ damage: a systematic review
Conclusions and implications of key findings Postacute COVID-19 major organ damage is common and likely higher than controls. However, there is substantial uncertainty. More consistent reporting of clinical outcomes and pre-COVID health status along with careful selection of control groups are needed to address evidence gaps. PROSPERO registration number CRD42020204788.
Source: BMJ Open - August 24, 2022 Category: General Medicine Authors: Greer, N., Bart, B., Billington, C. J., Diem, S. J., Ensrud, K. E., Kaka, A., Klein, M., Melzer, A. C., Reule, S., Shaukat, A., Sheets, K., Starks, J., Vardeny, O., McKenzie, L., Stroebel, B., Macdonald, R., Sowerby, K., Duan-Porter, W., Wilt, T. J. Tags: Open access, Infectious diseases, COVID-19 Source Type: research

Very early invasive angiography versus standard of care in higher-risk non-ST elevation myocardial infarction: study protocol for the prospective multicentre randomised controlled RAPID N-STEMI trial
Background There are a paucity of randomised data on the optimal timing of invasive coronary angiography (ICA) in higher-risk patients with non-ST elevation myocardial infarction (N-STEMI). International guideline recommendations for early ICA are primarily based on retrospective subgroup analyses of neutral trials. Aims The RAPID N-STEMI trial aims to determine whether very early percutaneous revascularisation improves clinical outcomes as compared with a standard of care strategy in higher-risk N-STEMI patients. Methods and analysis RAPID N-STEMI is a prospective, multicentre, open-label, randomised-controlled, pragmat...
Source: BMJ Open - May 3, 2022 Category: General Medicine Authors: Kite, T. A., Banning, A. S., Ladwiniec, A., Gale, C. P., Greenwood, J. P., Dalby, M., Hobson, R., Barber, S., Parker, E., Berry, C., Flather, M. D., Curzen, N., Banning, A. P., McCann, G. P., Gershlick, A. H. Tags: Open access, Cardiovascular medicine, COVID-19 Source Type: research

Impact of COVID-19 pandemic on acute stroke admissions and case-fatality rate in lower-income and middle-income countries: a protocol for systematic review and meta-analysis
Introduction The current review primarily aims to ascertain the impact of COVID-19 on stroke admission as well as stroke case fatality in Low-income and Middle-Income Countries (LMICs). Methods and analysis Four international databases (PubMed/Medline, Google Scholar, African Journals Online, Latin American and Caribbean Health Sciences Literature) and one preprint database (medRxiv). Studies will be included if they are conducted in LMICs, all stroke types without age and language restriction, from December 2019 to 31 December 2021. Two authors will screen the titles and abstracts against the prespecified eligibility cri...
Source: BMJ Open - April 25, 2022 Category: General Medicine Authors: Ackah, M., Salifu, M. G., Ameyaw, L., Boakye, H., Yeboah, C. O. Tags: Open access, Global health, COVID-19 Source Type: research

Experiences and actions related to living with type 1 diabetes during the COVID-19 pandemic in Norway: a qualitative study conducted during July to December 2020
Conclusions Patients experienced an increased psychosocial burden of T1DM and difficulties from a disrupted daily life affecting T1DM self-management routines. Uncertainty-reducing behaviours and actions to adapt to the situation provided a general sense of coping despite these difficulties. Tailored information and follow-up by telephone or video call was emphasised to reduce uncertainly distress and support adequate diabetes T1DM self-management.
Source: BMJ Open - April 7, 2022 Category: General Medicine Authors: Pleym, K., Iversen, M. M., Broström, A. Tags: Open access, Diabetes and Endocrinology, COVID-19 Source Type: research

Background incidence rates of hospitalisations and emergency department visits for thromboembolic and coagulation disorders in Ontario, Canada for COVID-19 vaccine safety assessment: a population-based retrospective observational study
Conclusions Our estimated background rates help contextualise observed events of these potential adverse events of special interest and to detect potential safety signals related to COVID-19 vaccines.
Source: BMJ Open - December 17, 2021 Category: General Medicine Authors: Nasreen, S., Calzavara, A. J., Sundaram, M. E., MacDonald, S. E., Righolt, C. H., Pai, M., Field, T. S., Zhou, L. W., Wilson, S. E., Kwong, J. C. Tags: Open access, Public health, COVID-19 Source Type: research

Impact of COVID-19 pandemic on haemorrhagic stroke admissions: a systematic review and meta-analysis
Conclusions The number of stroke admissions is lower in the pandemic period compared with the control period. There is a higher rate of haemorrhagic stroke in the pandemic period. Subgroup analysis identifies a significant increase in the occurrence of intracerebral haemorrhage in the pandemic period. Due to limited data and the impact of a single article, the impact of COVID-19 pandemic on subarachnoid haemorrhage is unclear.
Source: BMJ Open - December 14, 2021 Category: General Medicine Authors: You, Y., Niu, Y., Sun, F., Zhang, J., Huang, S., Ding, P., Wang, X. Tags: Open access, Public health, COVID-19 Source Type: research