bluuebunny/crossref_metadata_2025 huggingface dataset:
Diverse NKT cells regulate early inflammation and neurological outcomes after cardiac arrest and resuscitation
Authors: Tamura Tomoyoshi , Cheng Changde , Villaseñor-Altamirano Ana B. , Yamada Kohei , Ikeda Kohei , Hayashida Kei , Menon Jaivardhan A. , Chen Xi Dawn , Chung Hattie , Varon Jack , Chen Jiani , Choi Jiyoung , Cullen Aidan M. , Guo Jingyu , Lin Xi , Olenchock Benjamin A. , Pinilla-Vera Mayra A. , Manandhar Reshmi , Sheikh Muhammad Dawood Amir , Hou Peter C. , Lawler Patrick R. , Oldham William M. , Seethala Raghu R. ,   Immunology of Cardiac Arrest Network (I-CAN), Baron Rebecca M. , Bohula Erin A. , Morrow David A. , Blumberg Richard S. , Chen Fei , Merriam Louis T. , Weissman Alexandra J. , Brenner Michael B. , Chen Xiang , Ichinose Fumito , Kim Edy Y. , Sohn H. S. , Rolland T. , Weil B. R.
Published: December 2024

Neurological injury drives most deaths and morbidity among patients hospitalized for out-of-hospital cardiac arrest (OHCA). Despite its clinical importance, there are no effective pharmacological therapies targeting post–cardiac arrest (CA) neurological injury. Here, we analyzed circulating immune cells from a large cohort of patients with OHCA, finding that lymphopenia independently associated with poor neurological outcomes. Single-cell RNA sequencing of immune cells showed that T cells with features of both innate T cells and natural killer (NK) cells were increased in patients with favorable neurological outcomes. We more specifically identified an early increase in circulating diverse NKT (dNKT) cells in a separate cohort of patients with OHCA who had good neurological outcomes. These cells harbored a diverse T cell receptor repertoire but were consistently specific for sulfatide antigen. In mice, we found that sulfatide-specific dNKT cells trafficked to the brain after CA and resuscitation. In the brains of mice lacking NKT cells (
Cd1d
−/−
), we observed increased inflammatory chemokine and cytokine expression and accumulation of macrophages when compared with wild-type mice.
Cd1d
−/−
mice also had increased neuronal injury, neurological dysfunction, and worse mortality after CA. To therapeutically enhance dNKT cell activity, we treated mice with sulfatide lipid after CA, showing that it improved neurological function. Together, these data show that sulfatide-specific dNKT cells are associated with good neurological outcomes after clinical OHCA and are neuroprotective in mice after CA. Strategies to enhance the number or function of dNKT cells may thus represent a treatment approach for CA.
Ferruginous hemeprotein HhuH facilitates the cadmium adsorption and chromium reduction in
Stenotrophomonas
sp. SY1
Authors: Zhou Zijie , Yu Hongbo , Liu Jiahui , Zhu Lin , Wang Gejiao , Shi Kaixiang
Published: December 2024

Cadmium (Cd) and chromium (Cr) are frequently encountered toxicants, while iron (Fe) plays a crucial role in bacterial survival under conditions of heavy metal stress. However, intracellular Fe ion depletion by heavy metals leads to a state of Fe starvation. Therefore, it is imperative to investigate the mechanism through which bacteria maintain a balance between heavy metal detoxification and Fe homeostasis. This study demonstrates Cd(II) immobilization and Cr(VI) reduction abilities of
Stenotrophomonas
sp. SY1, while proteomics reveals the upregulation of heme metabolism in response to Cd(II) and Cr(VI) exposure. The expression of the heme-uptake system in
Escherichia coli
can enhance Cd(II) immobilization and facilitate Cr(VI) reduction. The ferruginous hemeprotein HhuH exhibits the ability to chelate Cd(II) and reduce Cr(VI). The presence of Cd(II) and Cr(VI) in strain SY1 initially led to Fe starvation. Subsequently, the hemeprotein HhuH facilitated Cd(II) adsorption and Cr(VI) reduction, thereby restoring normal cellular Fe homeostasis. Our findings explain the hemeprotein-mediated mechanism for Cd(II) adsorption and Cr(VI) reduction, providing further insights into the correlation between heavy metal and Fe metabolism.

IMPORTANCE

Iron (Fe) is an indispensable trace element for many organisms, and virtually, all bacteria require Fe as a cofactor in enzymes to facilitate redox reactions involved in fundamental cellular processes during periods of heavy metal stress. Understanding bacterial response to Fe in heavy metal contamination is essential. Therefore, our study elucidates Cd(II) adsorption and Cr(VI) reduction processes mediated by the Fe-bearing hemeprotein HhuH. It is a unique trifunctional protein capable of chelating Cd(II) and reducing Cr(VI), demonstrating significant potential in the environmental remediation of heavy metals.
Supplemental Material: The onset of continental weathering recorded in Archean banded iron formations
Authors: Wang Changle , Robbins Leslie J. , al. et
Published: December 2024

Supporting discussion, methods, and geochemical data.  
Fundic gland adenocarcinoma
Authors: Goel Akash , Agrawal Komal , Mukherjee Urmi , Singla Vikas
Published: December 2024

Gastric malignancy is one of the most common malignancies diagnosed worldwide. Over the past many decades, extensive research has been made into the risk factors, pathogenesis and prognosis of gastric adenocarcinoma. However, gastric adenocarcinoma of the fundic gland (GA-FG) has been recently defined, and not much is known about its risk factors and pathogenesis. Since the first case, which was reported in 2007, only 195 cases have been described in the literature to date. The rarity of the lesion is the cause of unawareness of this entity among reporting pathologists, often leading to its misdiagnosis. Existing literature shows that the risk factors, pathogenesis and even the prognosis of GA-FG are remarkably different from gastric adenocarcinoma. Hence, early and correct diagnosis can have a significant impact on patient management and outcomes.
Limitations of athlete-exposures as a construct for comparisons of injury rates by gender/sex: a narrative review
Authors: Danielsen Ann Caroline , Gompers Annika , Bekker Sheree , Richardson Sarah S.
Published: December 2024

High rates of anterior cruciate ligament (ACL) injuries in girls’ and women’s sports have garnered significant attention from researchers, sport organisations and the media. Gender/sex disparities in ACL injury rates are often estimated using the construct of athlete-exposures (AEs), a widely used measure of exposure time in sports science and epidemiology that is defined as one athlete participating in one practice or competition. In this narrative review, we explain the limitations of AEs as a measure of exposure time and develop a series of conceptual critiques regarding the use of AEs for the purposes of comparing injury rates by gender/sex. We show that the differing training-to-match ratio and average team size between women and men—rooted in persistent gendered inequities in sports participation and professionalisation—may jeopardise the validity of using AEs for cross-gender comparisons and skew gender/sex disparities in ACL injury rates. To avoid bias, we invite researchers interested in gender/sex disparities in injury rates to collect finer-grained data including individual-level AEs disaggregated by training and competition, as well as to appropriately control for team size and training-to-match ratio at the data analysis stage. Any quantitative comparisons of injury rates should also thoroughly contextualise the limitations of AEs, including their inability to capture the potential qualitative differences between women’s and men’s training and sporting environments that may influence injury rates.
Pembrolizumab (MK-3475) plus platinum and gemcitabine as first-line treatment of recurrent/metastatic head and neck squamous cell carcinoma (PIPER): a phase 2, multicentre, single-arm protocol study in Malaysia
Authors: Cheong Sok Ching , Selvam Bawani , Ho Gwo Fuang , Muhamad Nor Ibtisam , Tan Chih Kiang , Wong Yoke Fui , Teo Soo Hwang , Lim Kue Peng , Chai Annie Wai Yeeng , Yahya Abqariyah , Wan Ishak Wan Zamaniah
Published: December 2024

Introduction

Treatment combination of pembrolizumab plus platinum and 5-fluorouracil (PF) has increased the survival of recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). The combination of platinum and gemcitabine (PG) has been shown to be superior to PF in the treatment of R/M nasopharyngeal carcinoma patients. Therefore, we hypothesise that the combination of pembrolizumab with PG would be comparable to pembrolizumab with PF as a first-line treatment in R/M HNSCC.

Methods and analysis

This is an open-label, multicentre, single-arm, phase 2 study of pembrolizumab plus PG for first-line treatment in subjects with R/M HNSCC in Malaysia. The study is conducted using the Optional Simon optimal 2-stage design. At the initial stage, 26 subjects will be enrolled and if seven or more patients achieve an objective response rate (ORR), then 63 patients will be enrolled. Subjects will be given pembrolizumab 200 mg3every 3 weeks up to 35 cycles in combination with chemotherapy for up to six cycles of platinum (either cisplatin at 35 mg/m2intravenous on day 1 and day 8 or carboplatin at area under the curve 5 intravenous on day 1 of each 3-week cycle) and gemcitabine at 1250 mg/m2intravenous on days 1 and 8 of a 3-week cycle. The primary end point is the ORR as per Response Evaluation Criteria in Solid Tumors 1.1. Secondary end points include the overall survival, progression free survival, response duration and safety. The exploratory objectives include relationships of microbiome profiles, prognostic and predictive biomarkers with the clinical responses.

Ethics and dissemination

The study was approved by the ethics committee of the University Malaya Medical Centre (202213–10884). Findings will be disseminated through conference presentations and peer review publications.

Trial registration number

ClinicalTrials.gov (www.clinicaltrial.gov);NCT05286619.
Is flat rate pricing for unlimited alcohol consumption associated with problematic alcohol consumption patterns? A cross-sectional study with the Japan COVID-19 and Society Internet Survey
Authors: Wakabayashi Mami , Kinjo Aya , Sugiyama Yoshifumi , Takada Midori , Iso Hiroyasu , Tabuchi Takahiro
Published: December 2024

Objectives

This study investigates the relationship between flat rate pricing for unlimited alcohol consumption in restaurants and bar and problematic alcohol consumption patterns identified by the Alcohol Use Disorders Identification Test (AUDIT) during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted using data from the Japan Society and New Tobacco Internet Survey in February 2022. A total of 19 585 current drinkers (55% of drinkers were men, and the mean age was 48.3 years) were categorised based on AUDIT scores; non-problem drinking (an AUDIT Score of 0–7), problem drinking (an AUDIT Score of 8 or over), hazardous alcohol use (an AUDIT Score of 8–14) and probable alcohol use disorders (an AUDIT Score of 15 or over). A score of 2 or higher in the third question of the AUDIT is identified as binge drinking. The explanatory variable was the presence of using flat rate pricing for unlimited alcohol consumption in the previous 12 months during the COVID-19 pandemic (February 2021 to February 2022). The associations of using the flat rate pricing with the problem or binge drinking, and with hazardous alcohol use or probable alcohol use disorders were analysed.

Results

People who used flat rate pricing during the COVID-19 pandemic were likely to be problem drinking and binge drinking compared with non-users of flat rate pricing; the respective adjusted ORs were 4.64 (95% CI: 4.24 to 5.07) and 3.65 (95% CI: 3.33 to 4.00) through multivariable binary logistic regression. The users of the flat rate pricing were associated with hazardous alcohol use and probable alcohol use disorder; the adjusted relative risk ratios were 3.40 (95% CI: 3.06 to 3.77) and 8.58 (95% CI: 7.51 to 9.80) through multinomial logistic regression.

Conclusions

Overall, using flat rate pricing for unlimited alcohol consumption was associated with both binge drinking and problem drinking, including hazardous alcohol use and probable alcohol use disorders.
Assessment of cognitive function after surgery for colorectal cancer—a scoping review
Authors: Ehrencrona Carolina , Levenskog Rebecka , Angenete Eva
Published: December 2024

Objective

Colorectal cancer is primarily treated with surgery. Major surgery and older age are risk factors associated with postoperative decline in cognitive function. In clinical research, a wide range of instruments have been used to assess cognitive function. There are no clear criteria for the measurement of postoperative cognitive dysfunction. This scoping review aimed to map how and when cognitive function has been assessed after surgery for colorectal cancer and the reported incidence of postoperative cognitive decline.

Design

Systematic scoping review following the JBI approach.

Data sources

Scopus and PubMed. Last search January 2023.

Eligibility criteria

Reports with outcomes of postoperatively assessed cognitive function in colorectal cancer patients with first assessment within 1 year of surgery were included.

Data extraction and synthesis

Data were extracted by one researcher and controlled for accuracy by a second researcher. Data were summarised in tables and charts.

Results

In total, 49 reports were included (16 clinical trials, 33 cohort studies). Cognitive function was assessed with patient-reported outcome measures, clinical screening tools, neurophysiological testing and complication classification. The definition was most often related to the specific instrument, as predefined cut-off or change from baseline. Assessments were performed between 1 hour and 36 months after surgery—few reports included follow-up both within and after 30 days postoperatively. Incidence of cognitive decline varied considerably (0%–64%), depending on the instrument, definition criteria and time of assessment. Most studies reported a decline in cognitive function after surgery with recovery during follow-up.

Conclusions

This study showed a heterogeneity in the choice of assessment method and measurement criteria for cognitive dysfunction after colorectal cancer surgery. A more unified measurement approach in further research would be beneficial to evaluate postoperative cognitive function and understand its impact on the daily lives of patients with colorectal cancer.

Trial registration number

10.17605/OSF.IO/2M3DT.
Interventions for HIV prevention and treatment among people of Haitian descent: a scoping review
Authors: Sternberg Candice Aurelus , Larson Michaela E , Chavez Jennifer V , Beauvoir Maika , Modi Shayla Parekh , Dale Sannisha K , Behar-Zusman Victoria
Published: December 2024

Background

People of Haitian descent were initially blamed as a cause of the HIV epidemic. Although progress has been made, people of Haitian descent have been disproportionately affected by both HIV and HIV stigma.

Objective

This scoping review aimed to assess publications focused on interventional HIV research with Haitian and Haitian-descent populations, particularly studies involving HIV prevention and treatment.

Eligibility criteria

The eligibility criteria for this scoping review were broad and included HIV prevention and/or treatment interventions that focused on people of Haitian descent. There were no date or language restrictions. We excluded review articles, opinions, editorials, supplement letters, withdrawn articles and viewpoints.

Sources of evidence

For the purposes of this scoping review, eight bibliographic databases were searched: PubMed, Embase, Medline, Cochrane Library, Scopus, Web of Science, PsychINFO and CINAHL.

Charting methods

The entire data charting process, from review of titles and abstracts, full-text review and data extraction for relevant articles was conducted in Covidence.

Results

Our review found that there were limited studies regarding Haitian populations. Of the 575 articles found, 39 were included in this review. Most of the included studies focused on women of Haitian descent and were conducted in Haiti. Furthermore, few studies focused on adolescents, and most studies did not leverage community-based participatory research strategies.

Conclusion

To address HIV-related health disparities among people of Haitian descent, new, research-based and community-based strategies are critically needed.
Impact of provincial economic development levels on public–private hospital co-development in China: an empirical analysis
Authors: Xu Zhihao , Tan Jialong , Nicholas Stephen , Maitland Elizabeth , Meng Zehua , Han Xinru , Wang Jian
Published: December 2024

Introduction

The co-development of public–private hospitals in China’s healthcare system significantly influences the system’s service utilisation, but the public–private hospital interaction is poorly understood. Bridging this knowledge gap is crucial for informed policy-making and promoting a more balanced healthcare system. This study measures China’s public–private hospital co-development and the impact of provincial and regional economic development levels on public–private hospital co-development.

Methods

We use service utilisation, a comprehensive measure of resource allocation, service capacity and service efficiency, to assess the co-development of China’s public and private hospitals. Using the coupling coordination degree model, a novel approach borrowed from physics, we measured the degree of interaction between the public and private pillars of China’s hospital system. Second, we measured the relationship between the degree of private–public hospital interaction and the level of provincial–regional economic development, including provincial direct and spillover effects. Data were collected on 2011–2021 service utilisation across 31 Chinese provinces. Fixed-effect models and the spatial Durbin model estimated the direct and spillover effects between the coupling coordination degree and the level of provincial economic development.

Results

We found that national, regional and provincial service utilisation in private hospitals expanded, while service utilisation remained constant in public hospitals. China’s private–public hospital co-development improved from the ‘barely co-developed’ (0.696 in 2011) to the ‘partially co-developed’ level (0.752 in 2021) in the public–private transitional co-development stage. We identified significant regional heterogeneity, with the eastern region co-development slightly better than the central region and both substantially better than the western region. There was also significant provincial heterogeneity. Increases in regional and provincial economic development promoted the service utilisation of private hospitals, improving the balanced co-development of public–private hospitals in the home and adjacent provinces (p<0.05).

Conclusions

To improve the co-development of public–private hospitals and avoid regional imbalances, regional and provincial hospital policies and regulations should be coordinated and equitable; private hospitals should cooperate with public hospitals through their professional management teams and medical equipment sharing to equalise medical resource allocations; and regional economic disparities should be addressed.
Non-absorbable surgical sutures versus autologous tendons in the reconstruction of medial patellofemoral ligaments: a randomised controlled trial protocol
Authors: Pan Linyuan , Liu Gaoming , Lu Wenhao , Liu Xu , Jin Hongfu , Xiao Wenfeng , Li Yusheng
Published: December 2024

Introduction

Arthroscopic-assisted medial patellofemoral ligament reconstruction (MPFLR) is a common surgical procedure for patellar dislocation. We present the protocol of a randomised controlled clinical trial to compare postoperative pain, knee function and quality of life outcomes of MPFL reconstruction using the non-absorbable surgical sutures (FiberWire) and semitendinosus tendon.

Methods and analysis

This single-blind, randomised controlled trial enrolled patients with patellar dislocation who were undergoing inpatient surgery at the Department of Orthopedics, Xiangya Hospital, Central South University. Participants were randomly allocated to either the experimental or the control group using a random number table method, with an equal number of 15 subjects in each group. The experimental group was treated with a FiberWire for the MPFLR, whereas the control group received reconstruction using the semitendinosus tendon. A standardised postoperative rehabilitation protocol was implemented for both groups. All subjects will be evaluated for imaging, pain, knee function and quality of life at five time points: preoperatively and at 1 month, 3 months, 6 months and 12 months postoperatively. MRI scans will be performed preoperatively and at 12 months postoperatively to assess changes in patellar tilt angles and congruence angles. Pain assessment is performed using the Visual Analogue Scale (VAS). Knee function will be assessed using the Kujala score, Lysholm score and International Knee Documentation Committee (IKDC) knee function score. Quality of life was assessed using the 12-Item Short Form Survey scale.

Ethics and dissemination

The trial was approved by the Medical Ethics Committee of Xiangya Hospital of Central South University on 26 October 2021 (ethics number: 202110478) and registered in the China Clinical Trials Registry on 15 March 2022. Data will be published in peer-reviewed journals and presented at national and international conferences.

Trial registration number

ChiCTR2200057574.
Considerations of equity in the development of tools that identify and respond to end-of-life carer support needs: a scoping review protocol
Authors: Brooks Joanna , Hall Alex , Higgerson James , Long Hannah , Urwin Sean , Rowland Christine
Published: December 2024

Introduction

Informal caregivers are essential in supporting end-of-life patients at home but are often ill-prepared for the carer role. There is growing interest in the development of tools to assess caregiver support needs and a recognised need for a greater focus on addressing inequities in end-of-life care. We plan to undertake a scoping review of available literature to (1) identify and describe tools developed to assess the support needs of informal caregivers in end-of-life care; (2) report on any inequities and under-represented groups in tool development and use.

Methods and analysis

The review will conform to best practice methodological guidance (Joanna Briggs Institute) for scoping reviews. The search strategy will target published and unpublished studies using any methodology, which reports on developing or using tools or measures to assess informal carer support needs in end-of-life/palliative care settings. The following databases will be searched: MEDLINE, CINAHL, PsycINFO, Web of Science, ASSIA and Proquest. Both title/abstract screening and full-text assessment will be undertaken to ensure eligibility. Searches will be conducted between May and December 2024. We will extract data relating to (1) tools/measures identified, and outcome measures used to assess these; (2) participant characteristics. Extracted data will be tabulated with accompanying narrative description to address the review objectives. Data will be extracted and write-up will be completed between January and May 2025.

Ethics and dissemination

This scoping review will provide an overview of the tools developed to identify and assess informal caregiver support needs in palliative and end-of-life care. The identification of any inequities will increase awareness of potentially underserved groups and contexts within the current literature, highlighting how future research and resource can be more equitably focused and implemented in a way that does not further embed disparity. Findings will be made publicly available through the Open Science Framework and disseminated through a peer-reviewed publication. As a scoping review of available literature, this work does not require ethical approval.
Exploring the effects of time-restricted eating on body weight and associated cardiometabolic outcomes in South African women living with HIV (TESSA): protocol for a randomised controlled trial
Authors: Mendham Amy E , Goedecke Julia H , Heckens Lorena , Hoosen Fatima , Pico Majken Lillholm , Kengne Andre P , Christensen Dirk L , Olesen Ole F , Quist Jonas Salling , Dave Joel , Færch Kristine , Groth Grunnet Louise
Published: December 2024

Introduction

We codesigned an intervention with a low-resourced community with the aim to investigate the effects of time-restricted eating (TRE) on changes in body weight and associated cardiometabolic outcomes in South African women living with overweight/obesity and HIV who have initiated dolutegravir (DTG)-based antiretroviral therapy (ART).

Methods and analysis

Women with overweight or obesity (body mass index ≥25 kg/m², no upper limit), aged 20–45 years, living with HIV and in a low-resourced community, and receiving DTG-based ART for less than 2 years will be recruited from a community healthcare centre in Khayelitsha, Cape Town (n=152). Participants will be randomised 1:1 to the TRE group (n=76) or standard of care control group (n=76) for 12 months. The TRE group will be required to restrict their eating window to ~8–10 hours/day and will receive nutritional information sessions at baseline and at 3, 6, 9 and 12 months. The primary outcome of body weight will be assessed at baseline and monthly. Cardiometabolic measures will be reported as secondary outcomes. At baseline, 6- and 12 months, an oral glucose tolerance test (to estimate insulin sensitivity and beta-cell function), questionnaires (sociodemographic, food insecurity, quality of life, social support and sleep quality) and a quantified food frequency questionnaire (total energy and macronutrient composition) will be completed. Every 3 months, appetite ratings, bioelectrical impedance (fat mass and fat-free mass), fasting venous bloods (glucose, insulin, gut hormones and systemic inflammation) and process evaluation (qualitative interviews) will be completed. Monthly monitoring will also include anthropometry and blood pressure.

Ethics and dissemination

The study is conducted in accordance with the Declaration of Helsinki and has been approved by the Human Research Ethics Committee of the University of Cape Town (628/2021). Verbal and written consent is required from study participants. Results of this study will be published in peer-reviewed journals and presented at conferences.

Trial registration number

PACTR202302484999720.
Multisectoral One Health collaborations across human, animal and environmental health: a protocol paper for an umbrella systematic review of conceptual and analytical approaches to sustainability
Authors: Dar Osman Ahmed , Akhbari Melika , Nacer Hadjer
Published: December 2024

Introduction

Recent decades have seen a growth in multisectoral and transdisciplinary approaches to improving global health, particularly across human, animal and environmental health-related sciences that advocate for participatory, systems-based perspectives to understanding and promoting health and well-being in the context of social and ecological interactions. For several issues, including human health, animal health and food security, researchers have highlighted the need for transdisciplinary One Health approaches to assess the sustainability of interventions. To understand the current thinking and conceptualisation of sustainability across One Health disciplines, we present a protocol paper for an umbrella systematic review study planned in 2024.

Methods and analysis

A search strategy based on Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines was developed. The Medline, Embase, Global Health and Web of Science Core Collection were the four databases interrogated through the search strategy and included all articles found in the English language up to 14 April 2024. Meta-analyses, systematic, structured literature reviews and narrative reviews on sustainability will be included and a full-text review of all articles will be undertaken. The articles will be quality appraised using the AMSTAR 2 tool. Data that cover proposed factors influencing and characterising sustainability will be extracted across One Health disciplines including similarities and differences, and a summative content analysis will be completed to identify any emerging themes and develop an analytical framework. The conceptualisation of sustainability in the context of One Health multisectoral approaches will be summarised, a definition of sustainability proposed and include an identification of tools for measuring and assessing sustainability.

Ethics and dissemination

No primary data will be collected; therefore, ethical approval will not be required. The results will be disseminated in peer-reviewed literature and conference presentations. The findings will also be directly disseminated to the Quadripartite agencies.

Prospero registration number

CRD42018094031
Outcomes for women with diabetes admitted for labour care to midwifery units in the UK: a national prospective cohort study and survey of practice using the UK Midwifery Study System (UKMidSS)
Authors: Morelli Alessandra , Smith Lisa , Karia Amar , Marshall Amber , Plachcinski Rachel , Tyler Wendy , Rowe Rachel
Published: December 2024

Objectives

To describe outcomes in women admitted for labour care to midwifery units with gestational or pre-existing diabetes, compare outcomes with other women admitted to the same units and describe admission and care guidance in midwifery units typically admitting women with diabetes.

Design

A national cohort study and a survey of practice.

Setting

We used the UK Midwifery Study System to collect data from midwifery units in the UK between October 2021 and February 2023.

Participants

Women with a diagnosis of diabetes admitted for labour care to a midwifery unit were compared with a cohort of women without diabetes admitted for labour care to the same units.

Primary and secondary outcome measures

The primary outcome was a composite measure of maternal outcome reflecting the need for obstetric care (one or more of augmentation, instrumental birth, caesarean birth, maternal blood transfusion, third or fourth-degree perineal tear, maternal admission to higher level care). We also investigated a number of secondary maternal and neonatal outcomes.

Results

Overall, 420 (0.7% (95% CI 0.67% to 0.82%) of the 56 648 women admitted to midwifery units in the study period were recorded as having diabetes, most (84%) with diet-controlled gestational diabetes. Women with diabetes were no more likely than comparison women to experience the composite primary outcome (18.7% vs 20.7%, adjusted relative risk=1.31, 95% CI 0.96 to 1.80). We found no statistically significant differences between the two groups for the secondary maternal and neonatal outcomes investigated: augmentation, postpartum haemorrhage >1.5 L, shoulder dystocia, maternal blood transfusion and maternal admission for higher level care, Apgar <7 at 5 min, initiation of breast feeding and neonatal unit admission.

Conclusions

The findings of this study provide evidence that selected women with well-controlled gestational diabetes may safely plan birth in midwifery units on the same site as obstetric and neonatal services. With clear admission criteria and careful care planning, access to a midwifery unit provides an opportunity to increase choice, reduce intervention and improve outcomes for these women.
Temporal trends and spatial heterogeneity of sanitation facilities in Ethiopia: evidence from the 2005–2019 Demographic and Health Surveys
Authors: Azanaw Jember , Tsegaye Mesenbet , Mesele Wodage
Published: December 2024

Background

The main aim of sanitation is to prevent human contact with faecal pathogens to decrease occurrences of diseases. However, no region in the world is on the right track to accomplish Sustainable Development Goal (SDG) 6.2 for universal access to sanitation. Sub-Saharan Africa, including Ethiopia, is significantly behind in meeting the 2030 SDG 6.2 targets. Hence, this study focused on the spatial and temporal analysis of sanitation in Ethiopia based on four demographic health surveys.

Design

This research was undertaken among households in Ethiopia based on a weighted sample size. Variables with a p<0.2 in bivariable analysis were incorporated into the multivariable analysis. Subsequently, a 95% CI and a p<0.05 were used to assess the statistical significance of the final model. Global and local indicators of spatial correlation were done. Statistical analyses were performed by using STATA V.17 and ArcGIS V.10.7 software.

Results

This study includes data from 13 721 households in the 2005 Ethiopian Demographic and Health Survey (EDHS), 16 702 households in the 2011 EDHS, 16 650 households in the 2016 EDHS and 8663 households in the 2019 EDHS. The prevalence of improved sanitation facilities in Ethiopia was 20.46%, 25.61%, 25.86% and 27.45% based on EDHS 2005, 2011, 2016 and 2019, respectively. Global Moran’s I spatial autocorrelations, hotspots and spatial interpolation analysis indicated the inequality of improved sanitation facilities. Educational status of primary (adjusted OR, AOR 2.43, 95% CI 2.00, 2.95), secondary (AOR 2.02, 95% CI 1.61, 2.54) and higher (AOR 4.12, 95% CI 3.35, 7.54), watching television (AOR 5.49, 95% CI 4.37, 6.89), urban areas (AOR 9.08, 95% CI 6.69, 12.33) and region were factors statistically associated with sanitation facilities.

Conclusion

The overall finding of this study concludes a very slow increment in sanitation facilities over time and the presence of geographical heterogeneity in Ethiopia. Educational status, watching television, wealth index, community-level education, type of residence and region were factors statistically associated with sanitation facilities.
Analysing the effects of National Centralised Drug Procurement and Price Negotiation Policies on novel hypoglycaemic drug usage and costs in Shanghai, China: an interrupted time series analysis
Authors: Song Jie , Guo Wei , Jin Chunlin , Xu Yuan , Hu Xiaojing , Zhang Zheng , Lin Hai
Published: December 2024

Objectives

To analyse the impacts of multiple rounds of National Centralised Drug Procurement Policy (NCDP) and National Drug Price Negotiation Policy (NDPN) on the utilisation, expenditure and daily cost of novel hypoglycaemic drugs.

Design

The drug procurement data were obtained from the Shanghai Medical Procurement Agency between January 2016 and December 2022. We examined changes in volume, expenditure of overall hypoglycaemic drugs by descriptive analysis. For novel hypoglycaemic drugs, we employed interrupted time series analysis with segmented regression to investigate the change in usage, expenditure and daily cost of specific drug affected by related policies.

Setting

All the public and private hospitals in Shanghai, China.

Primary outcome measures

Volume, expenditure and daily cost of novel hypoglycaemic drugs.

Results

From 2016 to 2022, the overall usage and expenditure of hypoglycaemic drugs in Shanghai have been gradually increasing. Consumption of novel hypoglycaemic drugs had shown a rapid increase, which was significantly increased by 212.28 defined daily doses (95% CI 188.25, 236.31, p<0.001) after policy implementation. For each specific drug, daily cost was significantly decreased immediately after policy implementation (p<0.001). Dulaglutide, loxenatide, liraglutide, semaglutide and dapagliflozin had all seen significant increases in consumption and expenditure after NDPN implementation (p<0.001). Vildagliptin and saxagliptin, which were affected by the NCDP, experienced a significant decrease in usage. Empagliflozin and canagliflozin, which were regulated by both NCDP and NDPN, experienced an initial increase, followed by a significant decline. Consumption of beinaglutide and exenatide was not upregulated by NDPN.

Conclusion

Implementation of NDPN and NCDP had successfully cut-off the price of novel hypoglycaemic drugs and significantly increased their utilisation. In the future, the government needs to control pharmaceutical expenses more strictly while ensuring the rational use of the drugs.
Assessing the relationship between teaching quality and satisfaction with clinical teachers among medical students: a correlational cross-sectional study
Authors: Amini Keyvan , Salehzadeh Meisam , Noktehsanj Reza
Published: December 2024

Objectives

This study aimed to determine the relationship between teaching quality and satisfaction with clinical teachers among medical students at Ardabil University of Medical Sciences.

Design

A correlational cross-sectional study was conducted in 2023 on 255 medical students in Ardabil (northwest Iran).

Setting

The study was conducted in Ardabil, a city in northwest Iran, within a medical school that trains future healthcare professionals. This environment allows for assessing the educational quality and clinical training provided to a diverse group of medical students.

Participants

Participants were selected through simple random sampling. Data were collected using a demographic information form, the Persian version of the System for Evaluation of Teaching Qualities questionnaire, and the Medical Students’ Satisfaction with Clinical Education questionnaire.

Results

The overall mean scores for teaching quality and satisfaction with clinical teachers among medical students were 3.37±0.56 and 3.22±0.72, respectively. The highest mean score for teaching quality was related to professional attitude towards students (3.46±0.83), while the lowest was for the teaching and learning environment (3.28±0.68). Multiple linear regression analysis revealed that subscales of teaching quality (student assessment and feedback) and residence status were predictors of satisfaction with clinical teachers, accounting for 31.4% of the total variance (F=9.908, p<0.001).

Conclusion

The study highlights that regular and constructive feedback is pivotal for promoting student development in clinical education. We propose that clinical educators implement structured feedback mechanisms to improve educational conditions that encourage ongoing student communication. Additionally, assessing learners’ performance systematically can help educators identify specific areas where students require further assistance. We can enhance learning outcomes by fostering an environment that prioritises feedback and evaluation and better equips students with the necessary skills to address real-world challenges. Ultimately, these improvements will benefit students and educators, leading to a more effective clinical education experience.
Comparative efficacy of non-pharmacological management for chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis protocol
Authors: Qin Zongshi , Zhang Chao , Wei Xinyao , Cui Jiaming , Yu Yanlan , Pang Ran , Li Xiao , Kwong Joey S W , Doiron R. Christopher , Nickel J. Curtis , Wu Jiani
Published: December 2024

Background

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has posed a significant burden on affected individuals and healthcare systems. While pharmacological treatments are commonly used, non-pharmacological management strategies have gained attention for their potential benefits in improving CP/CPPS symptoms. However, the comparative efficacy of these non-pharmacological interventions remains unclear. The aim of this study is to assess the comparative effectiveness of non-pharmacological interventions for CP/CPPS regarding prostatic symptoms.

Method

This systematic review and network meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search will be conducted in electronic databases, including PubMed, Embase, Cochrane Library and Web of Science, to identify relevant studies. Eligible studies will include randomised controlled trials investigating non-pharmacological management strategies for CP/CPPS. Two independent reviewers will screen the retrieved citations, extract data and assess the risk of bias. Data synthesis will involve performing a network meta-analysis to compare the efficacy of different non-pharmacological interventions while considering both direct and indirect evidence.

Ethics and dissemination

The review does not require ethical approval. The findings of the review will be disseminated through publication in an academic journal, presentations at conferences and various media outlets.

PROSPERO registration number

CRD42024506143.
Qualitative analysis of concordance in advance care planning discussions between patients with advanced cancer and their surrogate decision makers
Authors: Chen Qian , Liang Siqi , Liang Jingzhang , Xu Jiefang , Liang Mengna , Lu Qiaocong
Published: December 2024

Objectives

This study aimed to explore the concordance in advance care planning (ACP) discussions between patients with advanced cancer and surrogate decision makers within an oncology ward.

Design

Purposive and snowball sampling methods were used in this qualitative study, which involved conducting semistructured interviews to gather patients with advanced cancer and their surrogate decision makers. Interpretative phenomenological analysis was performed on the interview data to identify commonalities and differences in ACP discussions and to explore the factors influencing these differences.

Setting

The research was conducted in the oncology ward of a tertiary hospital located in Foshan, China.

Participants

Participants included a total of 15 pairs of patients with advanced cancer and their surrogate decision makers in oncology wards.

Results

Interpretative phenomenological analysis yielded three main themes and fourteen subthemes. The identified themes were: (1) personal factor; (2) family intrinsic factors and (3) external factor.

Conclusion

This study revealed the consistency of ACP between patients with advanced cancer and their surrogate decision makers in China and its influencing factors. Future research should further explore family-centred ACP practices, delve into how family factors influence the implementation of ACP for patients and develop conceptual frameworks and implementation strategies for ACP that align with Chinese cultural values and healthcare systems. These efforts will contribute to enhancing understanding in clinical practice, advancing scientific research and guiding policy formulation. ACP holds promise as a crucial intervention to improve the quality of end-of-life care for patients with advanced cancer in China, playing a central role in the field of palliative care in the country.
Being kind to ourselves: group compassion-focused therapy (CFT) versus treatment as usual (TAU) to improve depression and anxiety in dementia – a protocol for a mixed-methods feasibility randomised controlled trial within the NHS
Authors: Spector Aimee , Melville Melissa , Craig Catriona , Henderson Catherine , Hiskey Syd , Knapp Martin , Kusel Yvette , Oliver Keith , Robinson Louise , Royan Lindsay , Stott Joshua , Williams Lisa , Evans Rachel
Published: December 2024

Introduction

Depression and anxiety are common in dementia, with a devastating impact. However, there remains a lack of evidence-based psychological therapies for this clinical group. Compassion-focused therapy (CFT), a talking therapy which addresses feelings of shame and stigma, has shown benefits in other clinical populations. This study is a mixed-methods feasibility randomised controlled trial (RCT) of group CFT for people with dementia and symptoms of anxiety and/or depression, to determine if a future definitive RCT is feasible.

Methods and analysis

50 people with mild-to-moderate dementia and symptoms of anxiety and/or depression will be randomised to either the intervention arm (12 sessions of group CFT plus treatment as usual (TAU)) or the control arm (TAU). Primary outcome measures include the feasibility of conducting an RCT in terms of recruitment, acceptability, suitability of secondary outcome measures and fidelity. Blind assessments will be conducted at baseline, approximately 16 weeks and 6 months follow-up, to collect data on depression, anxiety, quality of life, quality of the carer–patient relationship, cognition, self-compassion and carer burden. Qualitative interviews will be used to gather participant, carer/supporter and clinician perspectives on the value, acceptability and feasibility of the intervention.

Ethics and dissemination

This study has been approved by the London Riverside REC (Ref: 23/LO/0535) and the Health Research Authority (HRA) ethical approval process through the Integrated Research Application System (IRAS ID: 327086). We plan to publish the results in open-access peer-reviewed journals, present data at conferences and provide feedback to the study participants, sponsors and funders.

Trial registration number

ISRCTN20868432.
INFLUENCE OF CONCRETE MASONRY UNIT WEB GEOMETRY ON THE RESISTANCE OF CONCENTRICALLY AND ECCENTRICALLY LOADED HOLLOW MASONRY PRISMS
Authors: Savkina Olga , Feldman Lisa R.
Published: December 2024

An experimental investigation of 198 hollow concrete block masonry prisms was conducted to assess the influence of web geometry on their response to either concentric loading using a test setup conforming to CSA S304 requirements or axially eccentric loading. Prisms were five courses tall and one block wide, constructed in running bond, and were either constructed using concrete masonry units with full height webs conforming to the requirements of CSA A165 or ASTM C90, or knock-out units meeting the normalized web area requirements in ASTM C90. The stress versus strain response for prisms constructed with any of the three concrete masonry unit geometries were consistent for each type of loading applied. Prisms constructed with concrete blocks with thicker webs experienced lower strain immediately prior to failure. Results also showed that web geometry influenced resistance to concentric loading but does not affect resistance to eccentric loading.
The implications of climate change for New Zealand’s freshwater fish
Authors: Canning A.D. , Zammit C. , Death R.G.
Published: December 2024

Climate change is poised to reshape ecological communities globally by driving species into new environments and altering interactions between species. Conservation efforts should not only address current pressures but also plan for future pressures, such as sensitive species moving into degraded environments or arising problematic trophic interactions. This study sought to assess how climate change may affect the end-of-century distributions of New Zealand’s native and nonnative freshwater fish, including consequences for the overlap between trout (a nonnative sports fish) and native species vulnerable to trout predation. Random forest modelling was used to predict end-of-century distributions for New Zealand’s freshwater fish based on six hydrologically downscaled global climate models across four representative concentration pathways. Severe climate change impacts could drive nine native fish species to extinction or near-extinction and cause substantial declines in another eight native species. Seven nonnatives are also predicted to decline substantially, including a 30%–40% reduction in the extent of trout. To avert these potential extinctions, it is crucial to mitigate climate change severity and improve land use impacting freshwater ecosystems.