bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are there opportunities to improve care as patients transition through the cancer care continuum? A scoping review
Authors: Kersen Jaling , Kurbatfinski Stefan , Thomas Abigail , Ibadin Seremi , Hezam Areej , Lorenzetti Diane , Chandarana Shamir , Dort Joseph C , Sauro Khara M 
Published: December 2024

PurposePatients with cancer experience many Transitions in Care (TiC), occurring when a patient’s care transfers between healthcare providers or institutions/settings. Among other patient populations, TiC are associated with medical errors, patient dissatisfaction and elevated healthcare use and expenditure. However, our understanding of TiC among patients with cancer is lacking.ObjectiveTo map and characterise evidence about TiC among patients with cancer.ParticipantsAdult patients with cancer at any stage in the cancer continuum.InterventionEvidence sources exploring TiC among patients with cancer were eligible.OutcomeEvidence sources exploring TiC among patients with cancer using any outcome were eligible.SettingAny setting where a patient with cancer received care.DesignThis scoping review included any study describing TiC among patients with cancer with no restrictions on study design, publication type, publication date or language. Evidence sources, identified by searching six databases using search terms for the population and TiC, were included if they described TiC. Two independent reviewers screened titles/abstracts and full texts for eligibility and completed data abstraction. Quantitative data were summarised using descriptive statistics and qualitative data were synthesised using thematic analysis.ResultsThis scoping review identified 801 evidence sources examining TiC among patients with cancer. Most evidence sources focused on the TiC between diagnosis and treatment and breast or colorectal cancer. Six themes emerged from the qualitative evidence sources: the transfer of information, emotional impacts of TiC, continuity of care, patient-related factors, healthcare provider-related factors and healthcare system-related factors. Interventions intended to improve TiC among patients with cancer were developed, implemented or reviewed in 163 evidence sources.ConclusionWhile there is a large body of research related to TiC among patients with cancer, there remains a gap in our understanding of several TiC and certain types of cancer, suggesting the need for additional evidence exploring these areas.
Gender differences in antibiotic use behaviour and access to antibiotics in low- and middle-income countries: a scoping review protocol
Authors: Adewusi Oluwafemi J , Cassidy Rebecca , Aboderin Aaron , Bailey Simon , Hotham Sarah 
Published: December 2024

IntroductionIn low- and middle-income countries (LMICs), the persistent lack of access and high inappropriate use of antibiotics, which are fuelled by gender-related factors, continue to facilitate antimicrobial resistance. This in turn reduces the capacity to treat infectious diseases. However, there is a lack of clarity on the nature and extent of the available evidence on gender influence on access to antibiotics and antibiotic use behaviour. This proposed study will systematically review the available literature to map out the scope of evidence on gender differences and, importantly, the related factors influencing antibiotic use and access to antibiotics in LMICs.Methods and analysisThis scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Major databases (MEDLINE, PsycINFO and CINAHL) will be searched via the EBCOhost and Web of Science platforms for peer-reviewed articles. Title and abstract screening, as well as full paper review, will be conducted by a single reviewer, with 20% of identified citations reviewed independently by two other reviewers. A predefined excel spreadsheet will be used for data extraction and analysis. Findings will be presented thematically in a narrative summary and tables.Ethics and disseminationObtaining ethics approval is not required for this study. The findings will contribute to understanding gender health inequalities and areas for further research on strategies to incorporate gender considerations in antimicrobial stewardship efforts in LMICs. The study findings will be disseminated through presentations in seminars, scientific conferences and publications in peer-reviewed journals.
Social Health Insurance for Universal Health Coverage in Low and Middle-Income Countries (LMICs): a retrospective policy analysis of attainments, setbacks and equity implications of Kenya’s social health insurance model
Authors: Nungo Susan , Filippon Jonathan , Russo Giuliano 
Published: December 2024

ObjectivesTo analyse the potential of the Social Health Insurance (SHI) model to support the achievement of Universal Health Coverage (UHC) in Low and Middle-Income Countries (LMICs) through a policy analysis case study of Kenya’s National Health Insurance Fund (NHIF).DesignWe used an adaptation of the policy triangle framework to perform a retrospective policy analysis of Kenya’s NHIF, drawing from semistructured interviews and analysis of published documents and grey literature.SettingWe focused on Kenya’s NHIF as a case study.ParticipantsWe conducted 21 interviews with key stakeholders including policy experts, healthcare providers and formal and informal sector workers. We then triangulated the interview findings with document analysis.ResultsOnly 17% of Kenya’s population are currently covered by the SHI as of 2023. Only 27% of the informal economy is covered by the NHIF, implying very low uptake and/or retention rates. We found little stakeholder engagement in the policy implementation process and minimum adoption of expert advice. Our analysis suggest that political affiliations and positions of power heavily influence health financing policies in Kenya. Purchasing and payment of healthcare was found to be riddled with inefficiencies, including slow bureaucratic reimbursement procedures, little expertise by rural hospital clerks, misappropriations and favouritism of specific private healthcare providers. We also found that group-based parallel schemes and penalty payments for defaulted premiums widened the existing inequity gap in healthcare access.ConclusionAlthough the SHI system is perceived to increase coverage and the quality of health services in Kenya, substantial structural and contextual challenges appear to deter its suitability to finance the attainment of Universal Health Coverage. From Kenya’s experience, we identify little informal sector participation, inefficiencies in purchasing and payment of healthcare services, as well lack of political goodwill, as key bottlenecks for the implementation of SHI schemes in LMICs. LMICs adopting SHI need to also implement co-financing arrangements that do not impose on the population to co-finance, strategic purchasing systems, political goodwill and good governance for the SHI systems to be beneficial.
Does primary posterior tracheopexy prevent collapse of the trachea in newborns with oesophageal atresia and tracheomalacia? A study protocol for an international, multicentre randomised controlled trial (PORTRAIT trial)
Authors: van Stigt Marit J B , van Hal Anne-Fleur R L , Bittermann Arnold J N , Butler Colin R , Ceelie Ilse , Cianci Daniela , de Coppi Paolo , Gahm Caroline , Hut Julia E , Joosten Koen F M , Lemmers Petra M A , Mullassery Dhanya , Nandi Reema , Pullens Bas , Staals Lonneke M , Svensson Jan F , Tytgat Stefaan H A J , van de Ven Peter M , Wijnen René M H , Vlot John , Lindeboom Maud Y A 
Published: December 2024

IntroductionTracheomalacia (TM) often occurs in children with oesophageal atresia (OA), leading to recurrent respiratory symptoms and in severe cases to blue spells or ultimately respiratory arrest. In some patients, a secondary posterior tracheopexy may then be indicated. This secondary surgery, as well as respiratory morbidity, may be prevented by performing a primary posterior tracheopexy (PPT) concurrent with primary OA correction. The aim of this trial is to determine if a PPT can decrease—or prevent—tracheal collapse in newborns with OA and TM. Additionally, the trial aims to determine whether the potential observed effect of PPT on tracheal stability is sustained over time.Methods and analysisThis is an international multicentre double-blind randomised controlled trial. Seventy-eight children with OA type C will be randomised 1:1 into the no-PPT group or PPT group. Randomisation will be stratified by centre. The degree and location of TM are assessed during preoperative, intraoperative and two postoperative tracheobronchoscopies. The occurrence of TM will be evaluated during three routine follow-up consultations until the age of 6 months. The primary outcome is the degree of collapse of the tracheal wall during the intraoperative tracheobronchoscopy (after performing the PPT/no-PPT), measured in percentages. The difference in the mean degree of collapse will be compared between the no-PPT and the PPT groups using linear regression, adjusting for centre and the preoperative degree of tracheal collapse at baseline. The adjusted mean difference will be reported as effect size together with its 95% CI.Ethics and disseminationPatients will be included after written parental informed consent. The risks and burden associated with the trial are minimal. The institutional review board of the University Medical Center Utrecht has approved this protocol (METC-number 23-256/A). Results will be shared in a peer-reviewed scientific journal and presented at international conferences.Trial registration numberNCT06335862.
Prevalence and characteristics of liver steatosis and fibrosis in type 2 diabetes mellitus (T2DM) patients: a cross-sectional study in populations of eastern China
Authors: Yu Hekai , Su Xianghui , Tao Wenxuan , Sun Weixia , Zhang Xiaoyan , Han Qing , Zhao Zhuoxiao , Zhang Yan , Chen Xiaoqian , Liu Xinliang , Jia Dianrong , Fang Li , Li Ling 
Published: December 2024

ObjectivesTo describe the prevalence, clinical characteristics and risk factors of liver steatosis and fibrosis in type 2 diabetes mellitus (T2DM) patients in eastern China.DesignA cross-sectional, multicentre study based on an ongoing cohort study.Setting16 clinics in eastern China, including primary clinics to tertiary hospitals.Participants1816 patients with T2DM diagnosis who met the inclusion criteria were recruited into the study.InterventionParticipants underwent elastography examination.Main outcome measuresDescriptive analysis was performed to calculate the prevalence and characteristics of liver steatosis and fibrosis. The correlated factors were analysed using single- and multivariate logistic regression analysis.ResultsThe prevalence of liver steatosis in T2DM patients is 69.7%, with 46% moderate to severe steatosis. 34.6% and 6.7% of the patients were detected with liver fibrosis and cirrhosis. Steatosis patients were younger, had higher body mass index (BMI), higher levels of insulin resistance and more severe lipid metabolism disorders. Similar trends of differences were observed in patients with fibrosis. Female gender (OR=0.574, 95% CI 0.381 to 0.865), BMI (OR=1.491, 95% CI 1.375 to 1.616), disease duration, inflammation and serum lipid profile markers were risk factors of steatosis, while BMI (OR=1.204, 95% CI 1.137 to 1.275) and female gender (OR=0.672, 95% CI 0.470 to 0.961) were still the most significant predictors of liver fibrosis.ConclusionsThe prevalence of liver steatosis and fibrosis were high in patients with T2DM. Liver steatosis and fibrosis in these patients appeared to be more associated with lipid metabolism disorders and insulin resistance rather than glucose levels.Trial registration numberClinical trial:NCT05597709.
Effect of different modes of administration of esketamine combined with supraclavicular brachial plexus block on the incidence of rebound pain after upper limb fracture surgery: study protocol for a single-centre, double-blinded, randomised controlled trial
Authors: Jiang Wencai , Peng Yanhua , Chen Xuemeng , Fu Lijuan , Zhai Wenhu , Zhang Xianjie , Zhou Yukai 
Published: December 2024

BackgroundSupraclavicular brachial plexus block (SCB) is a common regional analgesic technique for upper limb fracture surgery, but it often leads to rebound pain. Our primary aim is to determine whether different administration methods of esketamine can reduce rebound pain in patients undergoing SCB for upper limb fracture surgery.Methods/designThis study is designed as a single-centre, double-blinded, prospective, randomised controlled trial. Patients undergoing upper limb fracture surgery, who plan to use a tourniquet, aged 18–60 years, with a body mass index of 18–30 kg/m2and an American Society of Anaesthesiologists classification of I–III will be randomised into three groups after providing written informed consent: group N (perineural esketamine/ropivacaine); group V (intravenous esketamine/perineural ropivacaine); and group C (perineural ropivacaine). The primary outcome will be the percentage of patients experiencing rebound pain within 24 hours postoperatively. Secondary outcomes include the Numeric Rating Scale (NRS) score of rebound pain, the onset of rebound pain, (since performing SCB), the cumulative area under the curve of NRS pain severity scores through 48 hours postsurgery, postoperative opioid consumption at 48 hours postoperatively, onset and duration of the sensory blockade, onset and duration of the motor blockade and adverse reactions and adverse events. Patients will be followed-up to 48 hours postoperatively.DiscussionsThis protocol describes the design of a randomised controlled trial to evaluate the effect of different modes of administration of esketamine combined with SCB on the incidence of rebound pain after upper limb fracture surgery. The results may help to identify the most effective methods for managing pain in patients undergoing upper limb fracture surgery.Ethics and disseminationThis study has been approved by the Ethics Committee of the Deyang People’s Hospital (2023-03-010-K01). It was registered on the Chinese Clinical Trials Registry on 24 August 2023. We intend to publish the results in a peer-reviewed journal.Trial registration numberChiCTR2300075083.
‘You grow with the allergy’: a grounded theory study of families’ experiences with food allergy risk or diagnosis in early childhood
Authors: Hörold Madlen , Gerhardinger Katharina , König Mara , Rohr Magdalena , Weigt Julia , Apfelbacher Christian , Brandstetter Susanne 
Published: December 2024

ObjectiveChildhood food allergy is increasing in western societies. Preventing and managing food allergies is therefore essential for both parents and children. Given the limited previous research on parents’ experiences of food allergy prevention in early childhood, this study aimed to develop a grounded theory to understand the experiences and interactions of families whose children are at risk of, or have been diagnosed with, food allergy.DesignUsing a constructivist grounded theory approach, we used initial, focused and theoretical coding, as well as constant comparative analysis and memoing to interpret our data.SettingThematic interviews were conducted in Germany between March and September 2022.ParticipantWe included 28 carers (25 mothers and 3 fathers) of children aged 0–3 years diagnosed with food allergy or at risk of food allergy. We recruited participants using snowball and theoretical sampling.ResultsWe developed a theory that we named ‘negotiating uncertainty in childhood food allergy’. This theory describes the experiences and interactions of families with a child at risk or diagnosed with food allergy with the central phenomena of negotiation uncertainty. Negotiation is used to transform perceived challenges of uncertainty into feelings of competence in relation to (the prevention of) food allergy. Core themes included ‘parental roles’, ‘healthcare’, ‘childcare’, ‘informal support’ and ‘family routines’. To cope with the challenges, parents relied on two main resources: self-efficacy and health literacy.ConclusionThe study highlights the dynamic process of negotiation within families at risk of or coping with paediatric food allergy. Furthermore, our findings highlight the need to promote parental health literacy.
Schizophrenia in children, adults and older people with intellectual disability compared with the general population: a Swedish register study (IDcare)
Authors: Bakken Trine Lise , Sandberg Magnus , Axmon Anna 
Published: December 2024

BackgroundThe knowledge about the prevalence of schizophrenia among people with intellectual disabilities (ID) is sparse, particularly concerning the distribution in different age groups.AimsTo investigate the prevalence of diagnoses in the schizophrenia spectrum among people with ID compared with the general population (gPop).MethodsThis was an 8-year longitudinal register study. The participants were all residents of Skåne on 1 January 2014. People with a diagnosis of ID (F7 in International Statistical Classification of Diseases and Related Health Problems 10th Revision) or Down syndrome (DS; Q90), or service and support for people with ID/autism spectrum disorder (ASD) comprised the ID cohort (n=14 716). After excluding family members of people in the ID cohort, the remaining population of Skåne comprised the gPop cohort (n=1 226 955).The primary outcome measure was having at least one diagnosis in the schizophrenia spectrum (F20-F29). Secondary outcomes were single diagnoses within the schizophrenia spectrum.ResultsThe prevalence of schizophrenia spectrum diagnoses was 7.2% in the ID cohort. This was more than an eightfold increase compared with the gPop (relative risk (RR) 8.45; 95% CI 7.94 to 9.00). The risk was also high among children (aged 0–18 years at the start of the study period; RR 9.42; 95% CI 7.36 to 12.05). In the subcohort comprising those with a diagnosis of DS, the risk of schizophrenia diagnosis was more than twice as high as in gPop. Concomitant ASD or genetic syndrome did not carry an excess risk among people with ID when compared with the gPop.ConclusionsThe findings of the present study support earlier assumptions that people with vulnerable brains develop psychotic disorders more frequently and that the onset age is lower than among people in the gPop. Habilitation services for children and adolescents, as well as general mental health services, should keep in mind that schizophrenia may be present when children and adolescents show severely decreased functioning, anxiety or aggressive behaviour.
Antiviral therapy for chronic hepatitis delta: new insights from clinical trials and real-life studies
Authors: Lampertico Pietro , Anolli Maria Paola , Roulot Dominique , Wedemeyer Heiner 
Published: December 2024

Chronic hepatitis D (CHD) is the most severe form of viral hepatitis, carrying a greater risk of developing cirrhosis and its complications. For decades, pegylated interferon alpha (PegIFN-α) has represented the only therapeutic option, with limited virological response rates and poor tolerability. In 2020, the European Medicines Agency approved bulevirtide (BLV) at 2 mg/day, an entry inhibitor of hepatitis B virus (HBV)/hepatitis delta virus (HDV), which proved to be safe and effective as a monotherapy for up to 144 weeks in clinical trials and real-life studies, including patients with cirrhosis. Long-term BLV monotherapy may reduce decompensating events in patients with cirrhosis. The combination of BLV 2 mg with PegIFN-α increased the HDV RNA undetectability rates on-therapy but not off-therapy, compared with PegIFN monotherapy. However, combination therapy, but not BLV monotherapy, may induce hepatitis B surface antigen (HBsAg) loss in some patients. The PegIFN lambda study has been discontinued due to liver toxicity issues, while lonafarnib boosted with ritonavir showed limited off-therapy efficacy in a phase 3 study. Nucleic acid polymer-based therapy is promising but large studies are still lacking. New controlled trial data come from molecules, such as monoclonal antibodies and/or small interfering RNA, that target HBsAg or HBV RNAs, which demonstrated not only profound HDV suppression, but also HBsAg decline.While waiting for new compounds to be approved as monotherapy or in combination, BLV monotherapy 2 mg/day remains the only approved therapy for CHD, at least in the European Union region.
Hepatic TM6SF2 activates antitumour immunity to suppress metabolic dysfunction-associated steatotic liver disease-related hepatocellular carcinoma and boosts immunotherapy
Authors: Zhang Yating , Xie Mingxu , Wen Jun , Liang Cong , Song Qian , Liu Weixin , Liu Yali , Song Yang , Lau Harry Cheuk Hay , Cheung Alvin Ho-Kwan , Man Kwan , Yu Jun , Zhang Xiang 
Published: December 2024

BackgroundTransmembrane 6 superfamily member 2 (TM6SF2) has a protective role against metabolic dysfunction-associated steatotic liver disease (MASLD).ObjectiveWe aim to investigate the mechanistic role and therapeutic potential of hepatic TM6SF2 in MASLD-related hepatocellular carcinoma (HCC).DesignHepatocyte-specificTm6sf2knockout (Tm6sf2∆hep) mice were fed with high-fat/high-cholesterol (HFHC) diet or diethylnitrosamine plus HFHC diet to induce MASLD-HCC. TM6SF2 function was also evaluated in orthotopic MASLD-HCC mice. Human MASLD-HCC specimens were included to evaluate clinical significance.ResultsTM6SF2 was downregulated in tumours compared with adjacent normal tissues from MASLD-HCC patients. Hepatocyte-specificTm6sf2knockout exacerbated tumour formation in mice with diet-induced or diet-induced and carcinogen-induced MASLD-HCC. The tumour-promoting effect ofTm6sf2knockout was verified in orthotopic MASLD-HCC mice, while mice bearingTm6sf2-overexpressing tumours had opposite phenotypes. We observed the reduction of interferon-gamma (IFN-γ)+CD8+T cells in the tumours ofTm6sf2∆hepmice and orthotopicTm6sf2knockout mice, while the tumour-suppressive effect ofTm6sf2was abolished after depleting CD8+T cells. The correlation between TM6SF2 and CD8+T cells was confirmed in human MASLD-HCC tissues, inferring that TM6SF2 could promote antitumour immunity. Mechanistically, TM6SF2 directly bound to IKKβ and inhibited NF-κB signalling pathway to reduce interleukin (IL)-6 secretion, thereby activating cytotoxic CD8+T cells. IL-6 neutralisation abolished the tumour-promoting and immunosuppressive effects ofTm6sf2knockout in mice. Moreover, introducingTm6sf2by adenovirus improved immunotherapy response against MASLD-HCC in mice.ConclusionHepatic TM6SF2 protects against MASLD-HCC and activates cytotoxic CD8+T cells via NF-κB-IL-6 axis. TM6SF2 is a promising strategy for sensitising MASLD-HCC to immunotherapy.