bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thoracic perfusion of antiangiogenic agents combined with chemotherapy for treating malignant pleural effusion in non-small cell lung cancer: a network meta-analysis
Authors: Xu Yan , Cui Yingying , Jiang Liming , Yu Yinan , Si Wei , Zhu Xiaohua 
Published: December 2024

ObjectivesDifferent intrathoracic perfusion therapeutic regimens are available for non-small cell lung cancer with malignant pleural effusion (MPE). Antiangiogenic agents are often used to control MPE, and the results are satisfactory. Here, we performed a network meta-analysis to reveal optimal combinations of antiangiogenic agents and chemical agents and assess their effectiveness and safety.DesignSystematic review and network meta-analysis.Data sourcesPubMed/Medline, Embase, Cochrane, Web of Science, Wanfang, VIP Database and Chinese National Knowledge Infrastructure were searched from inception to May 2023. Eligible studies were randomised controlled trials that reported on curative effect of MPE.Data extraction and synthesisThe Cochrane Collaboration tool was used to assess risk of bias. The consistency was evaluated by examining the agreement between direct and indirect effects. Network meta-analysis was performed and the ranking probabilities of being at each possible rank for each intervention were estimated. Comparison-adjusted funnel plots were obtained to assess publication bias.ResultsA total of 46 studies were included in the analysis. Among them, we included a total of seven interventions. A total of 3026 patients participated in this analysis. According to the results of the network meta-analysis, some antiangiogenic agents combined with chemotherapy regimens improved objective response rate (ORR) and disease control rate (DCR) and quality of life (QOL). The rank probabilities suggested that in terms of ORR, DCR and QOL, Endostar plus lobaplatin was the first-ranked intervention.ConclusionAdministration of antiangiogenic agents plus chemical agents significantly improved the clinical response and QOL. In addition, Endostar plus lobaplatin was the most effective combination.PROSPERO registration numberCRD42021284786.
Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China
Authors: Cai Boyong , Zheng Mengli , Li Yimin , Chen Zhicao , Zhong Canxin , Chen Xiaochun , Chen Guiquan 
Published: December 2024

ObjectivesThis study investigated the prognostic role of log odds of negative lymph node/T stage (LONT) and established a nomogram based on LONT to predict the prognosis in colorectal cancer (CRC) patients.DesignA retrospective cohort study.Setting and participantsWe enrolled 80 518 CRC patients from the Surveillance, Epidemiology and End Results database between 2010 and 2015. The dataset was split into a training cohort (56 364 patients) and a validation cohort (24 154 patients) at a ratio of 7:3. Furthermore, 500 CRC patients who underwent surgery in the Tenth Affiliated Hospital of Southern Medical University between 1 January 2017 and 20 December 2018, were recruited as the external validation set.Outcome measures1-, 3- and 5-year cancer-specific survival (CSS).MethodsThe univariate and multivariate Cox regression analyses were carried out to identify the significant independent prognostic factors of CSS. A nomogram was established based on LONT to predict the prognosis. The performance of the nomogram was comprehensively assessed via the time-dependent receiver operating characteristic curve, concordance index (C-index), calibration curve and decision curve analysis (DCA) comprehensively. Moreover, Kaplan-Meier curves were performed to assess the CSS of the three risk subgroups.ResultLONT was a significant independent prognostic factor for CSS (LONT1 vs LONT2, HR=0.670, 95% CI 0.642 to 0.698, p<0.001; LONT1 vs LONT3, HR=0.443, 95% CI 0.420 to 0.467, p<0.001). LONT, age, sex, race, subsite, differentiation, histology, tumour size, T stage, N stage, M stage and chemotherapy were included in the nomogram. The 1-, 3- and 5-year survival area under the curve were 0.856, 0.862 and 0.852, respectively. The C-index of the model was 0.809 (95% CI 0.825 to 0.839) in the model. The calibration curve and DCA verified the favourable predictive performance and clinical application of the nomogram.ConclusionCRC patients with a high LONT had a low incidence of CSS. The nomogram based on LONT could effectively predict the CSS of CRC.
Ocular biometric parameters in Chinese preschool children and physiological axial length growth prediction using machine learning algorithms: a retrospective cross-sectional study
Authors: Liu Duanke , Zhao Heng , Tang Tao , Li Xuewei , Shi Xiaoqing , Ma Jiahui , Zhou Jingwei , Zhao Chenxu , Li Yan , Wang Kai , Zhao Mingwei 
Published: December 2024

ObjectivesTo examine the ocular biometric parameters and predict the annual growth rate of the physiological axial length (AL) in Chinese preschool children aged 4–6 years old.MethodsThis retrospective cross-sectional study included 1090 kindergarten students (1090 right eyes) between the ages of 4 and 6 years from Pinggu and Chaoyang District, Beijing. Dioptre values were ascertained following cycloplegic autorefraction. Predicted AL was obtained through the application of the Gaussian process regression model as an optimisation technique. Subsequently, the annual growth rate of physiological AL for non-myopic preschool children (n=1061) was computed via the backward difference method.ResultsIn total, 85.4% of preschool children (931 individuals) had hyperopic refractive status in the 4–6 years age group, while only 2.7% (29 individuals) showed myopia. Boys had longer AL, larger AL-to-corneal radius ratio, deeper anterior chamber depth and lower lens power. The average physiological axial growth for boys and girls ranged from 0.050 mm/year to 0.165 mm/year and 0.063 mm/year to 0.168 mm/year, respectively. As age increased, the physiological AL growth in non-myopic cases decreased. Additionally, as hyperopic spherical equivalent refraction error lessened, the physiological AL growth component slowed down.ConclusionsIn preschool children, refractive development predominantly exhibits mild hyperopia. The concept of physiological AL provides valuable insights into the complexities of ocular development.
Parents’ knowledge, attitudes and practices towards the prevention and treatment of dust mite allergy: a cross-sectional study in Shenyang (China)
Authors: Liu Si , Zhou Qianlan , Dai Bing , Chen Li , Zhang Qinzhen , Han Lina , Li Xiaowen , Shen Wenxin , Shan Lishen 
Published: December 2024

ObjectiveThis cross-sectional study aimed to evaluate parents’ knowledge, attitudes and practices (KAP) concerning the prevention and treatment of dust mite allergy in children.DesignThis cross-sectional study survey was conducted from September to December 2022 at Shengjing Hospital, Affiliated with China Medical University.ParticipantsA total of 503 parents of children with dust mite allergies participated, with 253 parents having children undergoing desensitisation treatment and 250 parents whose children did not. Selection criteria were carefully defined to include parents directly responsible for caring children with dust mite allergies.Primary and secondary outcome measuresTwo distinct questionnaires were administered to parents, tailored for those with and without children undergoing desensitisation treatment. These questionnaires covered demographic information, allergy diagnosis, treatment details and KAP related to dust mite allergy. Primary outcomes included parents’ scores on KAP regarding dust mite allergy prevention and treatment. Secondary outcomes involved analysing the interaction between these factors using pathway analysis.ResultsParents of children undergoing desensitisation treatment exhibited higher scores for all items of knowledge, attitude and overall practice than those without desensitisation therapy (all p values<0.05). The pathway analyses revealed that in the non-desensitisation group, knowledge directly affected attitude (β=0.22, p<0.001) and attitude directly affected practice (β=0.16, p<0.001), but the knowledge did not affect practice (β=−0.01, 0.06, p<0.001). In the desensitisation group, knowledge directly affected attitude (β=0.13, p=0.028), but the practice was not affected by attitude (β=0.08, p<0.001) or knowledge (β=0.03, 0.12, p<0.001).ConclusionsThe study highlighted differing levels of KAP among parents of children with dust mite allergies. The KAP was influenced by desensitisation therapy status. While attitudes tended to be favourable, practices were suboptimal, particularly among parents whose children did not receive desensitisation treatment. These findings emphasise the importance of targeted educational interventions to enhance parental awareness and practices regarding dust mite allergy management, especially in cases where desensitisation treatment is not pursued. Further research is warranted to explore effective strategies for improving parental engagement and adherence to preventive measures.
Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain
Authors: Bradley Conor Patrick , Orchard Vanessa , Sykes Robert A , McKinley Gemma , McConnachie Alex , Donnelly Paul , Watt Jodi , Kellman Peter , Quinn Terry , Fullerton Natasha , Berry Colin 
Published: December 2024

Introduction
Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascular angina and is associated with increased morbidity and mortality. The vascular anatomy of the heart and brain is similar with conduit arteries distributed over the surface of these organs which in turn branch into a network of microscopic penetrating arteries which provide organ perfusion via an end-organ microcirculation. It has also been demonstrated that coronary microvascular dysfunction and CSVD share common vascular risk factors and pathophysiological mechanisms of disease. This has led to a link between the conditions being hypothesised, however, there is an evidence gap clearly demonstrating this relationship. The CorCMR (coronary microvascular angina cardiovascular magnetic resonance imaging) brain imaging study will provide novel insights into the associations between small vessel disease of the heart and brain and related clinical significance.

Methods and analysis
The CorCMR brain imaging study is a prospective, observational, multicentre cohort study including a blinded, central analysis and independent clinical trials unit; a prespecified study nested within the CorCMR trial. We will enrol patients with anginal symptoms who have undergone invasive coronary angiography which has demonstrated no obstructive coronary artery disease. The participants will then undergo brain MRI (to detect CSVD) immediately followed by a quantitative stress perfusion cardiac MRI (to detect coronary microvascular dysfunction). Participants will also undergo neurocognitive testing. The objectives of the study are to assess the prevalence of MRI features of CSVD in patients with angina and no obstructive coronary artery disease; to assess the association between coronary microvascular dysfunction and CSVD and to assess the association between CSVD and cognition.

Ethics and dissemination
The CorCMR study is approved by the UK National Research Ethics Service (Reference 20/WS/0159). Findings will be disseminated through peer-reviewed publications. All patients provided written informed consent.

Trial registration number

ClinicalTrials.gov ID
NCT04805814
.
Evaluation instruments for public health policies for elderly care: a scoping review protocol
Authors: Amorim Margareth Santos de , Medeiros Kleyton Santos de , Seixas Clarissa Terenzi , Nobre Thaiza Teixeira Xavier 
Published: December 2024

IntroductionThe global phenomenon of population ageing is expanding rapidly, with WHO projecting that the number of individuals aged 60 and over will reach 2.1 billion by 2050, a significant rise from 900 million in 2015. This pronounced growth poses substantial challenges to healthcare systems globally, necessitating the development of effective public policies to ensure adequate access to healthcare services for the elderly demographic. In this context, this scoping review aims to identify and analyse theoretical and logical models, as well as evaluation instruments, of public policies directed at elderly healthcare.Methods and analysisThis scoping review protocol is developed in accordance with the Joanna Briggs Institute manual and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Article searches will be conducted in the following databases: Embase, Medline/PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences and Science Direct. Additionally, searches will be performed on Google Scholar and in the grey literature (www.opengrey.eu). The search strategy will be conducted in January 2025, without language restriction for identifying texts. A descriptive analysis of the mapped studies will be conducted, categorising them by analysis categories. The results will be presented through a narrative summary of the findings to examine how they correlate with the review’s objective and research question.Ethics and disseminationThis study does not require ethical review due to its nature. The results will be submitted for publication in a peer-reviewed journal and presented at a scientific conference.Trial registration numberOpen Science Framework:https://doi.org/10.17605/OSF.IO/AV4WH.
PREVENTion and treatment of incontinence-associated dermatitis through a codesigned manual (PREVENT-IAD): a study protocol for a feasibility cluster randomised controlled trial with a nested process evaluation
Authors: Woodward Sue , Graham Tanya , Sooriah Sangeeta , Beeckman Dimitri , Chatterton Chris , Fader Mandy , Fiorentino Francesca , Fitzpatrick Joanne M , Harris Ruth , Kottner Jan , Norton Christine , Worsley Peter 
Published: December 2024

IntroductionIncontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence‐associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidence-based clinical algorithm and an e-learning training programme for the prevention and treatment of IAD. The aim of the study is to establish the feasibility of conducting a definitive trial to examine the clinical and cost-effectiveness of the IAD manual. The objectives are to assess recruitment and attrition rates, acceptability of the IAD manual and intervention fidelity.Methods and analysisA feasibility cluster randomised controlled trial will be conducted in residential nursing homes and in the homes of people receiving formal care support in London and Hampshire, England. A total of six clusters including n=248 participants who are incontinent of urine, or faeces will be included. At each intervention site, care staff will be trained to implement the IAD manual over a 6-month period. Quantitative outcomes include IAD incidence and severity, IAD-related pain, satisfaction with care and mental health. A qualitative evaluation of care staff and care receivers’ experiences of participation will be conducted. Rates and proportions of each feasibility outcome will be described informing the sample size estimation for a definitive cluster randomised controlled trial. A thematic analysis of the qualitative data will be guided by a logic model detailing potential factors impacting on both the study methodology and adoption of the IAD manual into routine care.Ethics and disseminationThe study received the approval of the Queens Square Ethics Committee Health Research Authority 23/LO/036, (Project ID 296167). Results will be disseminated through peer-reviewed open-access journals and international conferencesTrial registration numberISRCTN70866724.
Randomised, placebo-controlled, double-blinded, four-way crossover trial to demonstrate the comparative pharmacodynamic equivalence of a non-invasive diagnostic test for adrenal insufficiency in a healthy population: the STARLIT-2 study protocol
Authors: Date Kathryn L , Baster Kathleen , Caunt Sharon L , Cohen Judith , Debono Miguel , Fearnside Jane , Johnson Trevor N , Ross Richard J , Taylor Rosie N , Elder Charlotte J 
Published: December 2024

Introduction
Cortisol is an essential stress hormone and failure of its production, known as adrenal insufficiency (AI), is associated with significant mortality due to adrenal crisis. The Short Synacthen Test (SST) is the current diagnostic test of choice for AI, but it is both invasive and resource intensive. Globally, there is an unmet need for a non-invasive, cost-effective test. A novel formulation, Nasacthin, has been developed, which can be delivered intranasally, with the resultant glucocorticoid levels measured in saliva instead of blood. The Salivary Test of Adrenal Response to Liquid Intranasal Tetracosactide (STARLIT-2) study aims to clinically validate the Nasacthin test in healthy volunteers.

Methods and analysis
STARLIT-2 is a randomised, placebo-controlled, double-blinded, four-way crossover trial. 32 healthy adults and children will be randomised to receive each of four study drugs (Synacthen, Nasacthin and their respective placebos) over four study visits (one per visit). Paired blood and saliva samples will be collected from participants at baseline, and then at 30, 60, 90 and 120 min after drug administration. Additional salivary samples will be collected at 180, 240, 360 and 480 min after drug administration. The primary outcome measures are to compare the mean serum cortisol at 30 min after Synacthen or Nasacthin dose, with a view to determine non-inferiority; and to compare the mean change from baseline in serum cortisol at 30 min after active and placebo doses of both Synacthen and Nasacthin, aiming to demonstrate superiority of active over placebo. In addition, the proportion of participants for which Nasacthin produces a rise above a preset serum cortisol threshold at 30 min will be determined, with the negative per cent agreement with the SST calculated using the SST as the reference standard.

Ethics and dissemination
The study and its amendments have been reviewed and approved by South Central–Hampshire A Research Ethics Committee. Results will be disseminated in peer-reviewed journals and conference presentations, and feedback to trial participants will be facilitated following consultation with patient and public involvement and engagement groups.

Trial registration number

NCT62724177
Novel electroretinography devices to detect hydroxychloroquine retinopathy: study protocol for a diagnostic accuracy and feasibility study
Authors: Lee Chan Ning , Wafa Hatem A , Murphy George , Galloway James , Mahroo Omar A , Jackson Timothy L 
Published: December 2024

IntroductionAnnual screening for hydroxychloroquine (HCQ) retinopathy is recommended, and electroretinography (ERG) is considered a gold-standard test, but there are screening shortfalls and standard ERG is burdensome and has limited availability. Newer, portable ERG devices using skin-based electrodes may increase screening capacity but need validation. This study aims to determine initial device accuracies and feasibility of further research.Methods and analysisProspective diagnostic device accuracy and feasibility study comparing novel ERG devices to standard screening tests. Three groups of 35 participants on HCQ, categorised by HCQ retinopathy (definite, possible and no retinopathy), and 35 healthy control participants, recruited by consecutive sampling, will have full field and multifocal ERG index tests, delivered using skin-contact electrodes by two devices—RETEval full-field and UTAS multifocal ERG, both manufactured by LKC Technologies (Gaithersburg, Maryland, USA), compared with spectral-domain optical coherence tomography and autofluorescence reference tests graded by two masked, independent retinal specialists. Eligible HCQ participants will either have diagnosed HCQ retinopathy or be eligible for screening per UK guidelines. Healthy control participants will have no prior HCQ exposure and be of similar age and sex to HCQ participants. Primary outcome is device-specific sensitivity and specificity. Secondary outcomes include the effect of dilation on device outputs, analysis of discriminatory waveforms, device acceptability and recruitment rate. Safety outcomes include adverse and serious adverse events and device events.Ethics and disseminationCambridge East ethics committee gave a favourable opinion (24/EE/0011, 23/02/2024). Results will be published in a peer-reviewed ophthalmology journal.Trial registration numberClinicalTrials.govNCT06035887.
To what extent did households in developing countries forgo needed healthcare during the COVID-19 pandemic? Repeated survey estimates from 25 countries in 2020 and 2021
Authors: Kakietek Jakub , Dayton Eberwein Julia , Kerr Amanda , Stacey Nicholas 
Published: December 2024

IntroductionDuring the first year of the COVID-19 pandemic, health system disruptions, fear of becoming infected with COVID-19, mobility restrictions and lockdowns, and reduced household incomes likely contributed to households forgoing needed healthcare. The objective of this study was to measure the prevalence of forgone healthcare and how its drivers changed between the early period of the pandemic in 2020 and the first half of 2021.MethodsUsing repeated measures collected over two time periods in 63 000 households in 25 low-income and middle-income countries, this analysis documents how the prevalence of forgone healthcare and its drivers changed between 2020 and 2021.ResultsIn 2020, in the sample pooled across all countries, 17.9% of households reported not being able to obtain needed healthcare. The prevalence of forgone care was 15.6% in low-income countries (LICs), 17.0% in lower-middle-income countries (LMICs) and 20.5% in upper-middle-income countries (UMICs). In 2021, the prevalence of forgone care was lower—10.3% in the pooled sample, 7.9% in LICs, 15.1% in LMICs and 5.3% in UMICs. Financial barriers were the most common reason for not obtaining needed healthcare in both time periods: 42% in 2020 and 45% in 2021 and were higher in LICs and LMICs than in UMICs.ConclusionThis study is a comprehensive analysis of the changes in forgone care in low-income and middle-income countries. It documents the predominance of financial barriers among those who could not obtain needed healthcare. It suggests the importance of pandemic preparedness to protect access by vulnerable households to essential healthcare service. The study also demonstrates that phone surveys could, at scale, be a cost-effective way to improve the monitoring of progress towards universal health coverage.