bluuebunny/crossref_metadata_2025 huggingface dataset:
Confronting the Philippines' war on drugs: A literature review
Authors: Lamchek Jayson S. , Jopson Teresa
Published: April 2024

Upon election in 2016, President Rodrigo Duterte launched one of the world's most lethal and aggressive anti‐drug campaigns known as the War on Drugs in the Philippines. The War on Drugs unleashed an unprecedented level of violence while enjoying high public approval in the Philippines throughout Duterte's presidency. Scholars from a variety of disciplines grappled with understanding the significance and impact of the War on Drugs, generating a substantial literature. How have scholars contributed to critical understanding and practice that confront the Philippines' War on Drugs? We analyse and assess the state of the scholarship on the Philippines' War on Drugs by reviewing 140 scholarly materials. We find that scholars contextualized the popularity of violence, documented its various actual effects on Philippine society, and to a lesser extent, offered alternatives. Our literature review synthesises two major analytical approaches explaining the drug war: as penal populism and as moral politics. Scholars describe the War on Drugs as a way of governing society through violence and with impunity for extrajudicial killings and human rights abuses, using legitimising moral discourses. We present key findings on the drug war's actual consequences, underscoring its catastrophic impact across various communities except the drug trade itself. Throughout, we offer reflections on blind spots, highlighting the value of considering the historical context and deeper structural and political‐economic drivers. We arrive at a research agenda intended to aid scholars in engaging with the persistent issues in the War on Drugs as it continues to be implemented by the Philippine government.
Genome sequence and cell biological toolbox of the highly regenerative, coenocytic green feather alga Bryopsis
Authors: Ochiai Kanta K. , Hanawa Daiki , Ogawa Harumi A. , Tanaka Hiroyuki , Uesaka Kazuma , Edzuka Tomoya , Shirae‐Kurabayashi Maki , Toyoda Atsushi , Itoh Takehiko , Goshima Gohta
Published: April 2024

Green feather algae (Bryopsidales) undergo a unique life cycle in which a single cell repeatedly executes nuclear division without cytokinesis, resulting in the development of a thallus (>100 mm) with characteristic morphology called coenocyte. Bryopsis is a representative coenocytic alga that has exceptionally high regeneration ability: extruded cytoplasm aggregates rapidly in seawater, leading to the formation of protoplasts. However, the genetic basis of the unique cell biology of Bryopsis remains poorly understood. Here, we present a high‐quality assembly and annotation of the nuclear genome of Bryopsis sp. (90.7 Mbp, 27 contigs, N50 = 6.7 Mbp, 14 034 protein‐coding genes). Comparative genomic analyses indicate that the genes encoding BPL‐1/Bryohealin, the aggregation‐promoting lectin, are heavily duplicated in Bryopsis, whereas homologous genes are absent in other ulvophyceans, suggesting the basis of regeneration capability of Bryopsis. Bryopsis sp. possesses >30 kinesins but only a single myosin, which differs from other green algae that have multiple types of myosin genes. Consistent with this biased motor toolkit, we observed that the bidirectional motility of chloroplasts in the cytoplasm was dependent on microtubules but not actin in Bryopsis sp. Most genes required for cytokinesis in plants are present in Bryopsis, including those in the SNARE or kinesin superfamily. Nevertheless, a kinesin crucial for cytokinesis initiation in plants (NACK/Kinesin‐7II) is hardly expressed in the coenocytic part of the thallus, possibly underlying the lack of cytokinesis in this portion. The present genome sequence lays the foundation for experimental biology in coenocytic macroalgae.
Resolution of chronic regurgitation in an 8 month old Babydoll sheep by thoracoscopic treatment of a vascular ring anomaly
Authors: McOnie Rebecca C. , Buote Nicole J. , Hackett Eileen S. , Scrivani Peter V. , Mazan Melissa R. , Lehmann Fionna , Pomerantz Leah K. , Mitchell Katharyn J.
Published: April 2024

Objective

The objective was to describe the successful thoracoscopic treatment of esophageal entrapment resulting from a vascular ring anomaly (VRA) comprising a persistent right aortic arch (PRAA) and left ligamentum arteriosum (LA) in a Babydoll sheep wether.

Study design

Case report.

Animal

Eight month old Babydoll sheep wether, 13 kg.

Methods

The patient presented with a weight half that of its sibling, persistent regurgitation following eating, and delayed growth noted from the age of approximately 2 months, coinciding with the introduction of solid feed into the diet. Plain thoracic radiographs were within normal limits but computed tomography angiography (CTA) confirmed multiple congenital vascular anomalies. The primary finding was esophageal and tracheal entrapment by a PRAA and left LA. Thoracoscopic transection of the LA was performed with a bipolar vessel sealing device with the aid of transesophageal endoscopy.

Results

Immediate improvement in attitude and absence of regurgitation were observed. The patient was discharged and subsequently reintroduced to grazing and long‐stem hay, which were previously not tolerated. By 6 months post discharge, the patient's weight was 36 kg, comparable to an age‐matched sibling and considered appropriate for the stage of growth.

Conclusion

Thoracoscopic transection of the LA in sheep is a feasible treatment for esophageal compression resulting from a VRA. Surgical intervention resolved the clinical signs and allowed normal digestive rumination, restoring bidirectional esophageal function in a ruminant.
Fractional model for blood flow under MHD influence in porous and non-porous media
Authors: Ayaz Fatma , Heredağ Kübra
Published: April 2024

In this research, the Magnetohydrodynamic flow model within a porous vessel containing blood was examined. What makes this study intriguing is the inclusion of a fractional-order derivative term in the Magnetohydrodynamic flow system equations. Fractional derivatives were chosen for their ability to encompass both integer and fractional-order derivatives, leading to more realistic modeling results. The numerical solution for the partial differential equation system was obtained using the finite differences method. Solutions were derived using both central difference and backward difference approaches to enhance the reliability of the results. The Grünwald-Letnikov derivative approach was employed for the fractional derivative term, while the Crank-Nicolson method was applied for other terms. Solutions were obtained for velocity, temperature, and concentration profiles. Subsequently, a thorough analysis was conducted to investigate variations in these solutions for changing values of significant flow parameters such as Hartmann number, Grashof number, solute Grashof number, a small positive constant, radiation parameter, Prandtl number, and Schmidt number. Additionally, the study analyzed changes in the fractional derivative order. Finally, the impact of flow parameters on flow in a non-porous medium was investigated, and the results were presented graphically. The study highlighted the significant effects of various parameters on blood flow.
Congenital pterygium with anterior segment dysgenesis: rare ocular manifestation in Rubinstein-Taybi syndrome
Authors: Angmo Dewang , Thulkar Tanmay , Shaw Ekta , Beri Nitika
Published: April 2024

Pterygium is a benign, wing-shaped fibrovascular overgrowth of subconjunctival tissue that can encroach over the cornea. This condition usually occurs in individuals aged 20–40 years but is rarely seen in children. We report a case of an infant with Rubenstein-Taybi syndrome presenting with nebulo-macular corneal opacity and congenital pterygium. On examination under anaesthesia, bilateral infero-nasal nebulo-macular corneal opacity (6 × 5 mm) with a whitish pink tissue originating from nasal bulbar conjunctiva was noticed. The probe test was negative for this tissue. To the best of our knowledge, only two other cases of congenital pterygium have been reported in the literature. The presence of this anomaly supports the hypothesis of genetic factors having a role in the development of pterygium.
Beware of epistaxis: fatal pseudoaneurysm rupture 30 years after treatment of acromegaly
Authors: Carreira Ana , Muna Solomon , Grossman Ashley B , Korbonits Márta
Published: April 2024

We present a fatal complication of treatment in a patient with early-onset acromegaly, treated with two transsphenoidal operations, radiotherapy, radiosurgery and pegvisomant. He was diagnosed in his 30s, and controlled from his 40s, with stable residual tumour within the left cavernous sinus. In his 60s, 30 years after surgery/radiotherapy and 14 years after radiosurgery, he developed recurrent episodes of mild epistaxis. A week later, he presented at his local hospital’s emergency department with severe epistaxis and altered consciousness. He was diagnosed with a ruptured internal carotid artery (ICA) pseudoaneurysm, but unfortunately died before treatment could be attempted.

ICA pseudoaneurysms are rare complications of surgery or radiotherapy and can present with several years of delay, often with epistaxis. This case highlights the importance of life-long monitoring in patients with previous pituitary interventions and early recognition of epistaxis as a herald sign of a potentially catastrophic event, thus leading to timely treatment.
Herpes zoster of posterior division of mandibular branch of trigeminal nerve
Authors: Karanth Tulasi , Lal Neetu
Published: April 2024

Herpes zoster is a disease caused by the reactivation of dormant varicella zoster virus present in the sensory root ganglion. It presents with a vesicular rash on an erythematous base similar to that seen in classical varicella, however, with only a single dermatomal distribution. The rash is usually seen throughout the affected dermatome as the dorsal root ganglia for each dermatome are clustered together. We present a case of an otherwise healthy male who developed a vesicular rash confined to the distribution of the posterior division of the mandibular nerve. Though the entire mandibular nerve arises from a single ganglion, the skin area supplied by the anterior division of the mandibular nerve was spared. This case provides evidence to show that there is anatomic segregation of cell bodies of nerves traversing anterior and posterior divisions of mandibular division in the trigeminal ganglion and that partial involvement of a sensory root ganglion is possible in immunocompetent patients.
Benign multinodular goitre presenting as acute decompensated type two respiratory failure
Authors: Khalil Abdullah , Liyanage Sampath , Ishaq Hazeera , Babu Anoop
Published: April 2024

Acute airway obstruction is a life-threatening complication of benign goitre mostly occurring in cases of known progressing goitres. The index presentation of goitre with decompensated type two respiratory failure is an exceedingly rare and a diagnostically challenging presentation. We discuss the case of a woman in her 50 s, who had been diagnosed with asthma by her general practitioner, but during admission was found to have a large goitre with retrosternal extension causing critical tracheal compression. She presented with acute decompensated type two respiratory failure. We explore the diagnostic confounding posed by the patient’s background of asthma and describe the initial management of the patient with non-invasive ventilation by the emergency department. The diagnosis of upper airway obstruction was not apparent which is an interesting anomaly in this case. She underwent an emergency hemithyroidectomy and recovered with a resolution of her respiratory symptoms. Histology confirmed benign multinodular hyperplasia.
Building a house without foundations? A 24-country qualitative interview study on artificial intelligence in intensive care medicine
Authors: McLennan Stuart , Fiske Amelia , Celi Leo Anthony
Published: April 2024

Objectives

To explore the views of intensive care professionals in high-income countries (HICs) and lower-to-middle-income countries (LMICs) regarding the use and implementation of artificial intelligence (AI) technologies in intensive care units (ICUs).

Methods

Individual semi-structured qualitative interviews were conducted between December 2021 and August 2022 with 59 intensive care professionals from 24 countries. Transcripts were analysed using conventional content analysis.

Results

Participants had generally positive views about the potential use of AI in ICUs but also reported some well-known concerns about the use of AI in clinical practice and important technical and non-technical barriers to the implementation of AI. Important differences existed between ICUs regarding their current readiness to implement AI. However, these differences were not primarily between HICs and LMICs, but between a small number of ICUs in large tertiary hospitals in HICs, which were reported to have the necessary digital infrastructure for AI, and nearly all other ICUs in both HICs and LMICs, which were reported to neither have the technical capability to capture the necessary data or use AI, nor the staff with the right knowledge and skills to use the technology.

Conclusion

Pouring massive amounts of resources into developing AI without first building the necessary digital infrastructure foundation needed for AI is unethical. Real-world implementation and routine use of AI in the vast majority of ICUs in both HICs and LMICs included in our study is unlikely to occur any time soon. ICUs should not be using AI until certain preconditions are met.
Effectiveness of an online recovery training for employees exposed to blurred boundaries between work and non-work: Bayesian analysis of a randomised controlled trial
Authors: Brückner Hanna , Wallot Sebastian , Horvath Hanne , Ebert David Daniel , Lehr Dirk
Published: April 2024

Background

Blurred work–non-work boundaries can have negative effects on mental health, including sleep.

Objectives

In a randomised control trial, we aimed to assess the effectiveness of an online recovery training programme designed to improve symptoms of insomnia in a working population exposed to blurred boundaries.

Methods

128 participants with severe insomnia symptoms (Insomnia Severity Index ≥15) and working under blurred work and non-work conditions (segmentation supplies <2.25) were randomly assigned to either the recovery intervention or a waitlist control group (WLC). The primary outcome was insomnia severity, assessed at baseline, after 2 months (T2) and 6 months (T3).

Findings

A greater reduction in insomnia was observed in the intervention compared with the WLC group at both T2 (d=1.51; 95% CI=1.12 o 1.91) and T3 (d=1.63; 95% CI=1.23 to 2.03]. This was shown by Bayesian analysis of covariance (ANCOVA), whereby the ANCOVA model yielded the highest Bayes factor (BF10=3.23×e60] and a 99.99% probability. Likewise, frequentist analysis revealed significantly reduced insomnia at both T2 and T3. Beneficial effects were found for secondary outcomes including depression, work-related rumination, and mental detachment from work. Study attrition was 16% at T2 and 44% at T3.

Conclusions

The recovery training was effective in reducing insomnia symptoms, work related and general indicators of mental health in employees exposed to blurred boundaries, both at T2 and T3.

Clinical implications

In addition to demonstrating the intervention’s effectiveness, this study exemplifies the utilisation of the Bayesian approach in a clinical context and shows its potential to empower recipients of interventional research by offering insights into result probabilities, enabling them to draw informed conclusions.

Trial registration number

German Clinical Trial Registration (DRKS): DRKS00006223,https://drks.de/search/de/trial/DRKS00006223
68Ga-FAPI-04 positron emission tomography/CT and laparoscopy for the diagnosis of occult peritoneal metastasis in newly diagnosed locally advanced gastric cancer: study protocol of a single-centre prospective cohort study
Authors: Zhang Shunyu , Hu Qiancheng , Chen Xinchuan , Zhou Nan , Huang Qiyue , Tan Sirui , Su Minggang , Gou Hongfeng
Published: April 2024

Introduction

Accurate baseline clinical staging is critical to inform treatment decision-making for patients with gastric cancers. Peritoneal metastasis (PM) is the most common form of metastasis in gastric cancer and mainly diagnosed by diagnostic laparoscopy and peritoneal lavage evaluation. However, diagnostic laparoscopy is invasive and less cost-effective. It is urgent to develop a safe, fast and non-invasive functional imaging method to verify the peritoneal metastasis of gastric cancer. The aim of our study was to evaluate the proportion of patients in whom68Ga-FAPI-04 positron emission tomography/CT (PET/CT) led to a change in treatment strategy and to assess the diagnostic accuracy of68Ga-FAPI-04 PET/CT for the detection of occult peritoneal metastasis compared with laparoscopic exploration.

Methods and analysis

In this single-centre, prospective diagnostic test accuracy study, a total of 48 patients with locally advanced gastric or gastro-oesophageal junction adenocarcinoma (cT4a-b, N0-3, M0, based on CT images) who are considering radical tumour surgery will be recruited. All participants will undergo68Ga-FAPI-04 PET/CT before the initiation of laparoscopic exploration. The primary outcome is the proportion of patients with occult peritoneal metastatic lesions detected by68Ga-FAPI-04 PET/CT, leading to a change in therapy strategy. The secondary outcomes include the diagnostic performance of68Ga-FAPI-04 PET/CT for occult peritoneal metastasis, including sensitivity, specificity, accuracy, positive predictive value and negative predictive value.

Ethics and dissemination

The study protocol was approved by the Ethics Committee of West China Hospital, Sichuan University (2022-1484). Study results will be presented at public and scientific conferences and in peer-reviewed journals.

Trial registration number

ChiCTR2300067591.
Impact of an ICU bed capacity optimisation method on the average length of stay and average cost of hospitalisation following implementation of China’s open policy with respect to COVID-19: a difference-in-differences analysis based on information management system data from a tertiary hospital in southwest China
Authors: Zheng Qingyan , Zeng Zhongyi , Tang Xiumei , Ma Li
Published: April 2024

Objectives

Following the implementation of China’s open policy with respect to COVID-19 on 7 December 2022, the influx of patients with infectious diseases has surged rapidly, necessitating hospitals to adopt temporary requisition and modification of ward beds to optimise hospital bed capacity and alleviate the burden of overcrowded patients. This study aims to investigate the effect of an intensive care unit (ICU) bed capacity optimisation method on the average length of stay (ALS) and average cost of hospitalisation (ACH) after the open policy of COVID-19 in China.

Design and setting

A difference-in-differences (DID) approach is employed to analyse and compare the ALS and ACH of patients in four modified ICUs and eight non-modified ICUs within a tertiary hospital located in southwest China. The analysis spans 2 months before and after the open policy, specifically from 5 October 2022 to 6 December 2022, and 7 December 2022 to 6 February 2023.

Participants

We used the daily data extracted from the hospital’s information management system for a total of 5944 patients admitted by the outpatient and emergency access during the 2-month periods before and after the release of the open policy in China.

Results

The findings indicate that the ICU bed optimisation method implemented by the tertiary hospital led to a significant reduction in ALS (HR −0.6764, 95% CI −1.0328 to −0.3201, p=0.000) and ACH (HR −0.2336, 95% CI −0.4741 to −0.0068, p=0.057) among ICU patients after implementation of the open policy. These results were robust across various sensitivity analyses. However, the effect of the optimisation method exhibits heterogeneity among patients admitted through the outpatient and emergency channels.

Conclusions

This study corroborates a significant positive impact of ICU bed optimisation in mitigating the shortage of medical resources following an epidemic outbreak. The findings hold theoretical and practical implications for identifying effective emergency coordination strategies in managing hospital bed resources during sudden public health emergency events. These insights contribute to the advancement of resource management practices and the promotion of experiences in dealing with public health emergencies.
Art therapies and cognitive function in elderly with subjective cognitive decline: a protocol for a network meta-analysis
Authors: Liu Qian , Wang Fang , Tan Lixia , Liu Li , Hu Xiuying
Published: April 2024

Introduction

Subjective cognitive decline means a decline in the subjective perception of self-cognitive function, which is likely to evolve into mild cognitive impairment and dementia. The number of elderly with subjective cognitive decline has increased, bringing huge burdens and challenges to caregivers and society. With the increase in research on art therapies, some of them have gradually been proven to be effective for cognitive function. Therefore, this study aims to summarise the evidence and identify the best art therapy for elderly with subjective cognitive decline.

Methods and analysis

We will include published randomised controlled trials written in English and Chinese if the intervention is one of the art therapies and applied in people aged 60 and above with subjective cognitive decline. Eight electronic databases, including the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Elsevier, China BioMedical Literature Database, China National Knowledge Infrastructure, VIP Database and Wanfang Database, will be searched from January 2013 to December 2023. Art therapies will mainly include music therapy, reminiscence therapy, painting therapy, dance therapy, reading therapy, horticultural therapy, museum therapy, calligraphy therapy and so on. The outcome will be cognitive function. Study selection, data extraction and quality assessment will be performed by two reviewers. The risk of bias will be evaluated according to the Cochrane Collaboration’s risk-of-bias tool, and the evidence quality will be assessed with the Grading of Recommendations Assessment, Development and Evaluation. Standard pairwise meta-analysis and Bayesian network meta-analysis will be conducted. The probabilities of each art therapy will be ranked based on the surface under the cumulative ranking curve.

Ethics and dissemination

Ethical approval is not required for reviewing published studies. To provide important evidence for clinicians and guideline developers, the findings of this study will be submitted to a peer-reviewed journal.

PROSPERO registration number

CRD42023443773.
Knowledge, attitudes and practice towards postoperative nursing of patients with digit replantation and skin flap transplantation among new nurses in Beijing: a cross-sectional survey
Authors: Zhang Shuang , Li Yuchen , Tong Mingxiao , Wen Zheng , Xue Yunhao
Published: April 2024

Objective

To explore the knowledge, attitudes and practice (KAP) towards the postoperative nursing of patients with digit replantation and skin flap transplantation among new nurses.

Design

Cross-sectional survey.

Setting

Two tertiary medical centres in Beijing, China.

Participants

New nurses with working experience within 2 years.

Primary and secondary outcome measures

The demographic characteristics of the nurses and their KAP towards the postoperative nursing of patients with digit replantation and skin flap transplantation were collected using a self-administered questionnaire. The primary outcome was the KAP scores towards the postoperative nursing of patients with digit replantation and skin flap transplantation. The secondary outcomes were the factors associated with the KAP scores and how the KAP dimensions interacted among them.

Results

A total of 206 valid questionnaires were collected. The mean KAP scores were 7.72±3.28 (total score 13; 59.3%), 37.95±6.05 (total score 50; 75.9%) and 38.23±6.12 (total score 45; 84.9%), indicating poor knowledge, moderately favourable attitudes and active practice. The structural equation model analysis showed that knowledge directly influences attitudes (β=0.82, 95%CI 0.60 to 1.05, p<0.001) and that attitudes directly influence practices (β=0.72, 95%CI 0.62 to 0.83, p<0.001). Knowledge had no direct influence on practices (β=0.10, 95%CI −0.09 to 0.29, p=0.313), but the indirect influence was significant (β=0.60, 95%CI 0.41 to 0.78, p<0.001).

Conclusion

The lack of sufficient knowledge towards the postoperative nursing of patients with digit replantation and skin flap transplantation among nurses with <2 years of experience and the correlation among the KAP dimensions suggested the importance of proper training.
Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden: a multicentre repeated cross-sectional study
Authors: Larsson Margaretha , Ahlstrand Inger , Larsson Ingrid , Lood Qarin , Hammar Isabelle Andersson , Sundler Annelie J , Pennbrant Sandra , Ekman Aimée , Forsberg Elenita , Hedén Lena , Nunstedt Håkan , Sterner Anders , Hallgren Jenny
Published: April 2024

Objective

The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.

Design

The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors.

Setting

Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers.

Participants

Of 2283 students, 851 (37.3%) participated.

Results

The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11.

Conclusions

The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students’ health and well-being in the long run.
Influence of maternal and neonatal continuum of care on the risk of intergenerational cycle of stunting: a cross-sectional study
Authors: Kumala Putri Dwi Sisca , Sari Kencana , Utami Nur Handayani , Djaiman Sri Poedji Hastoety
Published: April 2024

Objectives

This study aimed to analyse the influence of the continuum of care during pregnancy and neonatal periods on the risk of intergenerational cycle of stunting.

Design

This study was a cross-sectional study, with data analysed from the 2018 Basic Health Research in Indonesia.

Settings

Basic Health Research 2018 was conducted throughout 513 cities/regencies in 34 provinces in Indonesia. The households were selected through two-stage sampling methods. First, census blocks (CB) were selected using probability proportional to size methods in each urban/rural stratum from each city/regency. Ten households were then selected from each CB using systematic sampling methods. All family members of the selected households were measured and interviewed.

Participants

This study analyses 31 603 children aged 0–24 months.

Outcomes measures

The dependent variable was the risk of the intergenerational cycle of stunting. Mothers who had a height less than 150.1 cm (short stature mothers) and had children (≤ 24 months of age) with length-for-age Z-score less than −2 Standard Deviation (SD) of the WHO Child Growth Standard (stunted children) were defined as at risk of the intergenerational cycle of stunting.

Results

Mothers with incomplete maternal and neonatal care visits were 30% more likely to be at risk on the intergenerational cycle of stunting (OR (95% CI): 1.3 (1.00 to 1.63)) after adjusting for economic status.

Conclusion

The continuum of maternal and neonatal healthcare visits could potentially break the intergenerational cycle of stunting, especially in populations where stunted mothers are prevalent.
Community antibiotic prescribing in patients with COVID-19 across three pandemic waves: a population-based study in Scotland, UK
Authors: Ciaccio Laura , Donnan Peter T , Parcell Benjamin J , Marwick Charis A
Published: April 2024

Objectives

This study aims to examine community antibiotic prescribing across a complete geographical area for people with a positive COVID-19 test across three pandemic waves, and to examine health and demographic factors associated with antibiotic prescribing.

Design

A population-based study using administrative data.

Setting

A complete geographical region within Scotland, UK.

Participants

Residents of two National Health Service Scotland health boards with SARS-CoV-2 virus test results from 1 February 2020 to 31 March 2022 (n=184 954). Individuals with a positive test result (n=16 025) had data linked to prescription and hospital admission data ±28 days of the test, general practice data for high-risk comorbidities and demographic data.

Outcome measures

The associations between patient factors and the odds of antibiotic prescription in COVID-19 episodes across three pandemic waves from multivariate binary logistic regression.

Results

Data included 768 206 tests for 184 954 individuals, identifying 16 240 COVID-19 episodes involving 16 025 individuals. There were 3263 antibiotic prescriptions ±28 days for 2395 episodes. 35.6% of episodes had a prescription only before the test date, 52.3% of episodes after and 12.1% before and after. Antibiotic prescribing reduced over time: 20.4% of episodes in wave 1, 17.7% in wave 2 and 12.0% in wave 3. In multivariate logistic regression, being female (OR 1.31, 95% CI 1.19 to 1.45), older (OR 3.02, 95% CI 2.50 to 3.68 75+ vs <25 years), having a high-risk comorbidity (OR 1.45, 95% CI 1.31 to 1.61), a hospital admission ±28 days of an episode (OR 1.58, 95% CI 1.42 to 1.77) and health board region (OR 1.14, 95% CI 1.03 to 1.25, board B vs A) increased the odds of receiving an antibiotic.

Conclusion

Community antibiotic prescriptions in COVID-19 episodes were uncommon in this population and likelihood was associated with patient factors. The reduction over pandemic waves may represent increased knowledge regarding COVID-19 treatment and/or evolving symptomatology.
Prevalence and perceptions of flavour capsule cigarettes among adults who smoke in Brazil, Japan, Republic of Korea, Malaysia and Mexico: findings from the ITC surveys
Authors: Kyriakos Christina N , Erinoso Olufemi , Driezen Pete , Thrasher James F , Katanoda Kota , Quah Anne C K , Tabuchi Takahiro , Perez Cristina de Abreu , Seo Hong Gwan , Kim Su Young , Nordin Amer Siddiq Amer , Hairi Farizah Mohd , Fong Geoffrey T , Filippidis Filippos T
Published: April 2024

Introduction

The global market of flavour capsule cigarettes (FCCs) has grown significantly over the past decade; however, prevalence data exist for only a few countries. This study examined prevalence and perceptions of FCCs among adults who smoke across five countries.

Methods

Cross-sectional data among adults who smoked cigarettes came from the International Tobacco Control Policy Evaluation Project Surveys—Brazil (2016/2017), Japan (2021), Republic of Korea (2021), Malaysia (2020) and Mexico (2021). FCCs use was measured based on reporting one’s usual/current brand or favourite variety has flavour capsule(s). Perceptions of the harmfulness of one’s usual brand versus other brands were compared between those who used capsules versus no capsules. Adjusted logistic regression models examined correlates of FCC use.

Results

There were substantial differences in the prevalence of FCC use among adults who smoke across the five countries: Mexico (50.3% in 2021), Republic of Korea (31.8% in 2021), Malaysia (26.5% in 2020), Japan (21.6% in 2021) and Brazil (6.7% in 2016/2017). Correlates of FCC use varied across countries. Capsule use was positively associated with being female in Japan and Mexico, younger age in Japan, Republic of Korea and Malaysia, high education in Brazil, Japan and Mexico, non-daily smoking in Republic of Korea, and having plans to quit in Japan and Republic of Korea. There was no consistent pattern of consumer perceptions of brand harmfulness.

Conclusion

Our study documented the high prevalence of FCCs in some countries, pointing to the need to develop and implement regulatory strategies to control these attractive products.
Protocol for the development of a core outcome set and reporting guidelines for locoregional treatment in neoadjuvant systemic breast cancer treatment trials: the PRECEDENT project
Authors: Potter Shelley , Avery Kerry , Ahmed Rosina , de Boniface Jana , Chatterjee Sanjoy , Dodwell David , Dubsky Peter , Iwata Hiroji , Jiang Michael , Lee Han-Byoel , MacKenzie Mairead , Poulakaki Fiorita , Richardson Andrea L , Sepulveda Karla , Spillane Andrew , Thompson Alastair M , Werutsky Gustavo , Wright Jean L , Zdenkowski Nicholas , Cowan Katherine , McIntosh Stuart
Published: April 2024

Introduction

Neoadjuvant systemic anticancer therapy (neoSACT) is increasingly used in the treatment of early breast cancer. Response to therapy is prognostic and allows locoregional and adjuvant systemic treatments to be tailored to minimise morbidity and optimise oncological outcomes and quality of life. Accurate information about locoregional treatments following neoSACT is vital to allow the translation of downstaging benefits into practice and facilitate meaningful interpretation of oncological outcomes, particularly locoregional recurrence. Reporting of locoregional treatments in neoSACT studies, however, is currently poor. The development of a core outcome set (COS) and reporting guidelines is one strategy by which this may be improved.

Methods and analysis

A COS for reporting locoregional treatment (surgery and radiotherapy) in neoSACT trials will be developed in accordance with Core Outcome Measures in Effectiveness Trials (COMET) and Core Outcome Set-Standards for Development guidelines. Reporting guidance will be developed concurrently.

The project will have three phases: (1) generation of a long list of relevant outcome domains and reporting items from a systematic review of published neoSACT studies and interviews with key stakeholders. Identified items and domains will be categorised and formatted into Delphi consensus questionnaire items. (2) At least two rounds of an international online Delphi survey in which at least 250 key stakeholders (surgeons/oncologists/radiologists/pathologists/trialists/methodologists) will score the importance of reporting each outcome. (3) A consensus meeting with key stakeholders to discuss and agree the final COS and reporting guidance.

Ethics and dissemination

Ethical approval for the consensus process will be obtained from the Queen’s University Belfast Faculty Ethics Committee. The COS/reporting guidelines will be presented at international meetings and published in peer-reviewed journals. Dissemination materials will be produced in collaboration with our steering group and patient advocates so the results can be shared widely.

Registration

The study has been prospectively registered on the COMET website (https://www.comet-initiative.org/Studies/Details/2854).
Cost-effectiveness of diagnostic tools and strategies for the screening and diagnosis of tuberculosis disease and infection: a scoping review
Authors: Ockhuisen Tom , de Nooy Alexandra , Jenkins Helen E , Han Alvin , Russell Colin A , Khan Shaukat , Girdwood Sarah , Ruhwald Morten , Kohli Mikashmi , Nichols Brooke E
Published: April 2024

The objective of this scoping review is to understand the cost-effectiveness of current and future tools/strategies for screening and diagnosis of tuberculosis (TB) infection and disease. To this end, PubMed, EMBASE and SCOPUS were used to identify any English language reports on the cost-effectiveness of TB infection/disease screening/diagnostic strategies published between 1 January 2017 and 7 October 2023. Studies included high-burden/risk TB populations, compared diagnostic/screening methods and conducted a cost-effectiveness/economic evaluation. We stratified the included articles in four groups (cost-effectiveness of diagnosing TB disease/infection and cost-effectiveness of screening for TB disease/infection). A full-text review was conducted, and relevant costing data extracted. Of the 2417 articles identified in the initial search, 112 duplicates were removed, and 2305 articles were screened for title and abstract. 23 full articles were reviewed, and 17 fulfilled all inclusion criteria. While sputum smear microscopy (SSM) has been the primary method of diagnosing TB disease in high-burden countries, the current body of literature suggests that SSM is likely to be the least cost-effective tool for the diagnosis of TB disease. Further scale-up with molecular diagnostics, such as GeneXpert and Truenat, was shown to be broadly cost-effective, with a multitest approach likely to be cost-effective for both screening and diagnosis. There is an urgent need to increase access and remove barriers to implementation of diagnostics that have been repeatedly shown to be cost-effective, as well as to develop new diagnostic and screening technologies/strategies to address current barriers to scale-up.
Disability weights for environmental noise-related health states: results of a disability weights measurement study in Europe
Authors: Charalampous Periklis , Maas Carolien C H M , Haagsma Juanita A
Published: April 2024

Introduction

Measurement of the burden of disease using disability-adjusted life years requires disability weights to quantify health losses for non-fatal consequences of disease and injury. We aimed to obtain a set of disability weights for environmental and non-environmental noise-related health states (NOISE) using a nationally representative sample survey among the general population of four European countries; and to compare the resulting NOISE disability weights with those estimated in the Global Burden of Disease 2010 (GBD 2010) and European (EURO) disability weights measurement studies.

Methods

We administered a web-based survey among a cohort of individuals from Hungary, Italy, Sweden and the Netherlands. It included paired comparison questions on 82 different health states. Each respondent performed 13 paired comparison tasks. We analysed paired comparison responses with probit regression analysis, and regression results were anchored on the disability weight scale between 0 (equivalent to full health) and 1 (equivalent to death).

Results

In total, 4056 respondents participated in the study. Comparison of the regression results from paired comparison responses for each country-specific dataset with those run on the pooled dataset showed high linear correlations (0.96–0.98, p<0.001). The resulting disability weights ranged from 0.005 for mild impairment of distance vision and mild anaemia to 0.761 for intensive care unit admission. The disability weight for moderate and severe annoyance was 0.006 and 0.011, respectively. Comparison of disability weights showed a higher correlation between EURO and NOISE disability weights (pseudo R-squared=0.955, Pearson correlation=0.954) compared with GBD 2010 and NOISE disability weights (pseudo R-squared=0.893, Pearson correlation=0.946).

Conclusions

The NOISE disability weights are consistent and highly correlated across the four European countries. The NOISE disability weights set can be used to estimate the burden of disease attributable to noise-related outcomes across Europe.
Rehabilitation needs screening to identify potential beneficiaries: a scoping review
Authors: De Groote Wouter , Corso Melissa , Murnaghan Kent , Duttine Antony , Sabariego Carla
Published: April 2024

Objectives

The aim is to identify and compare the content of screening tools and needs assessments used to select rehabilitation beneficiaries and to describe the context of their use.

Design

Scoping review.

Data sources

We systematically searched five indexed databases for studies published from 1 January 2010 to 3 February 2023.

Eligibility criteria

We searched for papers published in English only. Papers describe a screening tool or needs assessment aiming to prospectively select potential beneficiaries of rehabilitation services based on a cut-off score or classification system.

Data extraction and synthesis

We charted the evidence according to the characteristics of the paper, rehabilitation needs screening context, screening tool and content of the screening tool. A descriptive synthesis is provided for screening methodology, settings, target populations, rehabilitation need types and phases of care. The WHO International Classification of Functioning, Disability and Health is used to categorise screening items.

Results

We identified 24 tools that use a range of screening methodologies, but mostly questionnaires that are used by health workers. Most tools have been proposed for the identification of a rehabilitation beneficiary among people with selected health conditions assessing the need to access a specific rehabilitation intervention, programme or occupational group. The majority of tools screen for current functioning limitations, and this is often the only screening component. When mapping screening items with the WHO International Classification of Functioning, Disability and Health (ICF), almost all ICF chapters for body functions and activities and participation have been included across screening tools, with the following most frequently included ICF categories: emotional functions (b152), acquiring, keeping and terminating a job (d845), sensation of pain (b280) and carrying out daily routine (d230).

Conclusions

Rehabilitation need screening tools commonly include the screening for current functioning limitations among people with selected health conditions. A screening tool that is applicable across health conditions and settings is not available.
Phase 1a dose escalation study of ivonescimab (AK112/SMT112), an anti-PD-1/VEGF-A bispecific antibody, in patients with advanced solid tumors
Authors: Frentzas Sophia , Austria Mislang Anna Rachelle , Lemech Charlotte , Nagrial Adnan , Underhill Craig , Wang Wenjing , Wang Zhongmin Maxwell , Li Baiyong , Xia Yu , Coward Jermaine I G
Published: April 2024

Background

Studies showed that vascular endothelial growth factor (VEGF) inhibitors could improve therapeutic efficacy of PD-1/PD-L1 antibodies by transforming the immunosuppressive tumor microenvironment (TME) into an immunoresponsive TME. Ivonescimab is a first-in-class, humanized tetravalent bispecific antibody targeting PD-1 and VEGF-A simultaneously. Here, we report the first-in-human, phase 1a study of ivonescimab in patients with advanced solid tumors.

Methods

Patients with advanced solid tumors were treated with ivonescimab 0.3, 1, 3, 10, 20 or 30 mg/kg intravenously every 2 weeks using a 3+3+3 dose escalation design. Dose expansion occurred at 10 and 20 mg/kg in selected tumor types. The primary objective was to assess the safety and tolerability, and to determine the maximum tolerated dose (MTD). The secondary objectives included pharmacokinetics, pharmacodynamics and preliminary antitumor activity based on Response Evaluation Criteria in Solid Tumors V.1.1.

Results

Between October 2, 2019 and January 14, 2021, a total of 51 patients were enrolled and received ivonescimab. Two dose-limiting toxicities were reported at 30 mg/kg. The MTD of ivonescimab was 20 mg/kg every 2 weeks. Grade≥3 treatment-related adverse events (TRAEs) occurred in 14 patients (27.5%). The most common TRAEs of any grade were rash (29.4%), arthralgia (19.6%), hypertension (19.6%), fatigue (17.6%), diarrhea (15.7%) and pruritus (11.8%). The most common grade≥3 TRAEs were hypertension (7/51, 13.7%), alanine aminotransferase increased (3/51, 5.2%), aspartate aminotransferase increased (2/51, 3.9%) and colitis (2/51, 3.9%). Of 47 patients who had at least one postbaseline assessment, the confirmed objective response rate was 25.5% (12/47) and disease control rate was 63.8% (30/47). Among 19 patients with platinum-resistant ovarian cancer, 5 patients (26.3%) achieved partial response (PR). Efficacy signals were also observed in patients with mismatch repair proficient (pMMR) colorectal cancer, non-small cell lung cancer, and both MMR deficient and pMMR endometrial cancer.

Conclusions

Ivonescimab demonstrated manageable safety profiles and promising efficacy signals in multiple solid tumors. Exploration of alternative dosing regimens of ivonescimab monotherapy and combination therapies is warranted.

Trial registration number

NCT04047290.
Patient-perspective and feasibility of home finger-prick testing to complement and facilitate large-scale research in rheumatology
Authors: Besten Yaëlle R , Boekel Laura , Steenhuis Maurice , Hooijberg Femke , Atiqi Sadaf , Leeuw Maureen , Vogelzang Erik H , Keijser Jim , Keijzer Sofie , Loeff Floris C , Gerritsen Martijn , Tas Sander W , Nurmohamed Michael T , Rispens Theo , Wolbink Gertjan
Published: April 2024

Background

During the COVID-19 pandemic, we developed a digital research platform to longitudinally investigate COVID-19-related outcomes in patients with rheumatic diseases and healthy controls. We used home finger-prick testing in order to collect serum samples remotely and increase the overall efficiency of the platform. The aim of the present study was to evaluate the success rate of the finger prick and patients’ perspective towards the finger prick.

Methods

Serum samples were collected up to five times during follow-up, either via a venepuncture at the research institute or a finger prick from participants’ home. Participants were asked to complete a digital evaluation questionnaire of the finger prick after their attempts.

Results

A total of 2135 patients and 899 controls performed at least one finger prick and were included in this study. The first finger prick was successfully done by 92% (95% CI: 90% to 93%) of patients, 94% (95% CI: 92% to 95%) of controls, 93% (95% CI: 92% to 94%) of all participants aged ≤70 years and 89% (95% CI: 86% to 92%) of all participants aged >70 years. Sex did not impact these success rates. Repeated failure occurred in 11/439 (0.8%) patients and 4/712 (0.6%) controls. Both patients and controls were less willing to perform a finger prick for individual healthcare compared with scientific research.

Conclusion

The vast majority of participants, among which elderly and patients with rheumatic diseases, were able to successfully draw the required amount of blood for serological analyses. This shows that finger-prick testing is suitable for a high-throughput implementation to monitor patients remotely.