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Pembrolizumab was recently demonstrated to have survival benefit in patients with recurrent or metastatic head and neck squamous cell carcinoma (r/mHNSCC). However, the cost-effectiveness of pembrolizumab versus chemotherapy in China remains uncertain.

This analysis aimed to describe the cost-effectiveness of pembrolizumab versus standard-of-care (SOC) therapy in r/mHNSCC in China.

A Markov model consisting of three health states (stable, progressive and dead) was developed to compare the cost and effectiveness of pembrolizumab with SOC in platinum-resistant r/mHNSCC. AMI-1 Model inputs for transition probabilities and toxicity were collected from the KEYNOTE-040 trial, while health utilities were estimated from a literature review. Cost data were acquired for the payer's perspective in China. Costs and outcomes were discounted at an annual rate of 3.0%. Sensitivity analyses were conducted to test the uncertainties surrounding model parameters.

The primary outcome was incremental cost-effectiveness ratios (m-resistant r/mHNSCC in China.

NCT02252042; Post-results.

NCT02252042; Post-results.

Physical inactivity due to changes in our society towards more sedentary behaviours is leading to health problems. Increasing physical activity might be a good strategy to improve physical strength and reduce the prevalence of illnesses associated with prolonged sitting. Office workers exhibit a sedentary lifestyle with short rest periods or even without pauses during the workday. It is important to perform workplace interventions to treat musculoskeletal disorders caused by prolonged sitting and lack of movement adopted on the office setting. This article describes a protocol for a systematic review to evaluate the effectiveness of exercise interventions on office workers in their work environment.

A literature search will be performed in the PubMed, CINAHL Plus, Cochrane Library, Scopus, ISI WoS and PeDRO databases for randomised controlled trials and studies published from 1 January 2010 to 31 July 2020 in English or Spanish. The participants will be office workers who spend most of their work time in a sitting position. The interventions performed will include any type of exercise intervention in the workplace. The outcome measures will vary in accordance with the aim of the intervention observed. The results of the review and the outcomes from the studies reviewed will be summarised with a narrative synthesis. The review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.

Ethical approval is not required. The review outcomes and the additional data obtained will be disseminated through publications and in scientific conferences.

CRD42020177462.

CRD42020177462.

Cardiovascular disease (CVD) is highly preventable and optimal treatments based on absolute risk can halve risk of future events. Compared with women, men have higher risks of developing CVD. However, women can experience suboptimal treatment. We aimed to quantify sex differences in CVD risk, assessment and treatment in Australian adults.

Cross-sectional analysis of nationally representative data from interview, physical measures, medication review and blood and urine samples, from 2011 to 2012 Australian Health Survey participants aged 45-74 (n=11 518).

CVD risk factors, absolute 5-year risk of a primary CVD event, blood pressure and cholesterol assessment in the previous 2 and 5 years and use of recommended CVD preventive medications were compared using Poisson regression to estimate age-adjusted male versus female prevalence ratios (PRs).

Women had a generally more favourable CVD risk factor profile than men, including lower current smoking prevalence (women=14.5%; men=18.4%, PR=0.78, 95% CI=0.70 ten=41.4%, PR=0.55, 95% CI=0.31 to 0.96).

Women have a more favourable CVD risk factor profile than men. Preventive treatment is uncommon and women with prior atherosclerotic CVD are around half as likely as men to be receiving recommended treatment.

Women have a more favourable CVD risk factor profile than men. Preventive treatment is uncommon and women with prior atherosclerotic CVD are around half as likely as men to be receiving recommended treatment.

Neck pain causes serious social and economic burden. Research on the use of acupuncture for managing cervical spondylosis has increased over time, with the quality of studies showing an improved trend. The present study seeks to use a systematic review approach to understand efficacy and safety of acupuncture for treatment of neck pain caused by cervical spondylosis.

We will search PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wanfang database and VIP databases, from their inception to July 2020, to identify and retrieve all randomised controlled trials, describing the use of acupuncture for treatment of cervical spondylosis. Thereafter, two reviewers will independently select the studies, extract data and assess the risk of bias. Any disagreements, between them, will be resolved through a discussion with a third reviewer. Data synthesis and statistical analyses will be performed using the Revman V.5.3 software. Specifically, data will be synthesised by either fixed-effects (heterogeneity less than 50%) or random-effects models, following a heterogeneity test, with outcome measures focusing on pain intensity, functional disability, psychological improvements and adverse events. In cases where no considerable heterogeneity is detected, a meta-analysis will be conducted.

No ethical approval will be required for this study, since it does not infringe on anyone's interests. The findings will be published in a peer-reviewed journal or disseminated through conferences.

CRD42020152379.

CRD42020152379.

To contribute to the current understanding of depressive disorders in sub-Saharan African (SSA) countries by examining the association of depressive symptoms with cardiovascular and cardiometabolic conditions in a population-based study of middle-aged and older adults in rural Burkina Faso.

This study was conducted in the Nouna Health and Demographic Surveillance System in north-western Burkina Faso, in a mixed rural and small-town environment. The data were obtained between May and July 2018.

Consenting adults over 40 years of age (n=3026).

Depressive symptoms were assessed using the Patient Health Questionnaire depression module (PHQ-9). Chronic cardiometabolic conditions were assessed via a lipid panel and glycated haemoglobin measures from serum, alongside anthropometry and blood pressure measurements and a self-reported questionnaire. Multivariable linear regression was used to test the relationship between depressive symptoms and cardiovascular/cardiometabolic conditions after controlling for so, in contrast to observations in high income countries. However, consequences of cardiovascular disease such as stroke and heart attack were associated with depressive symptoms in older adults in Burkina Faso.

The simplest and cheapest method for cervical cancer screening is visual inspection after application of acetic acid (VIA). However, this method has limitations for correctly identifying precancerous cervical lesions (sensitivity) and women free from these lesions (specificity). We will assess alternative screening methods that could improve sensitivity and specificity in women living with humanimmunodeficiency virus (WLHIV) in Southern Africa.

We will conduct a paired, prospective, screening test accuracy study among consecutive, eligible women aged 18-65 years receiving treatment for HIV/AIDS at Kanyama Hospital, Lusaka, Zambia. We will assess a portable magnification device (Gynocular, Gynius Plus AB, Sweden) based on the Swede score assessment of the cervix, test for high-risk subtypes of human papillomavirus (HR-HPV, GeneXpert, Cepheid, USA) and VIA. All study participants will receive all three tests and the reference standard at baseline and at six-month follow-up. The reference standard is histolol.

NCT03931083; Pre-results.

NCT03931083; Pre-results.

Hypertension is a chronic disease with 31% worldwide prevalence in adults. It has been associated with non-adherence to therapeutic regime with a negative impact on the prognosis of the disease and healthcare-associated costs. So, it is necessary to identify effective interventions to improve adherence among the afflicted population. The objective of this protocol is to describe the methods for a systematic review that will evaluate the effect of individual interventions so as to improve adherence to the prescribed pharmacological treatment, as well as to prescribed diet and physical activity in adults with primary hypertension.

A systematic search of studies will be conducted in PubMed/MEDLINE, BVS, CINAHL, Embase, Cochrane and Scopus databases. Randomised and non-randomised clinical studies conducted in human beings, published from 1 January 2009 to 13 December 2019, are to be included, in any language. Adherence to pharmacological treatment, diet and physical activity, measured by direct and indirect methods, will be the primary outcome. Two independent reviewers will select relevant studies and will extract the data following the Cochrane's Handbook for Systematic Reviews of Approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Methodological quality will be evaluated using the risk-of-bias (RoB) 2 and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tools. Risk of bias will also be evaluated, and if the criteria are met, a meta-analysis will be finally performed.

Information to be analysed is of a grouped nature, and given that its sources are published studies, no ethics committee approval is required. Results will be published in scientific journals, and in conferences, seminars and symposiums. Copyrights will be addressed by giving due credit through bibliographic references.

CRD42020147655.

CRD42020147655.

To analyse the relationship between first author's gender and ethnicity (estimated from first name and surname), and chance of publication of rapid responses in the

(BMJ). To analyse whether other features of the rapid response account for any gender or ethnic differences, including the presence of multiple authors, declaration of conflicts of interests, the presence of Twitter handle, word count, reading ease, spelling and grammatical mistakes, and the presence of references.

A retrospective observational study.

Website of the BMJ (BMJ.com).

Publicly available rapid responses submitted to BMJ.com between 1998 and 2018.

Publication of a rapid response as a letter to the editor in the BMJ.

We analysed 113 265 rapid responses, of which 8415 were published as letters to the editor (7.4%). Statistically significant univariate correlations were found between odds of publication and first author estimated gender and ethnicity, multiple authors, declaration of conflicts of interest, the presence of Twcation. This suggests that the reasons for the differences of these groups lies elsewhere.

To assess the association of fluoroquinolone use with tendon ruptures compared with no fluoroquinolone and that of the four most commonly prescribed non-fluoroquinolone antibiotics in the USA.

Retrospective observational study.

US seniors enrolled in the federal old-age, survivor's insurance programme.

1 009 925 Medicare fee-for-service beneficiaries and their inpatient, outpatient, prescription drug records were used.

Seven oral antibiotics, fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) and amoxicillin, amoxicillin-clavulanate, azithromycin and cephalexin.

All tendon ruptures combined, and three types of tendon ruptures by anatomic site, Achilles tendon rupture, rupture of rotator cuff and other tendon ruptures occurred in 2007-2016.

Of three fluoroquinolones, only levofloxacin exhibited a significant increased risk of tendon ruptures-16% (HR=1.16; 95% CI 1.06 to 1.28), and 120% (HR=2.20; 95% CI 1.50 to 3.24) for rotator cuff and Achilles tendon rupture, respectively, in the ≤30 days window.

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