bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inpatient and postdischarge mortality among children with anaemia and malaria parasitaemia in Kenya: a cohort study
Authors: Ngari Moses , Mwangome Martha , Ouma Nelson , Nyaguara Amek , Mturi Neema , Obiero Christina , Kamau Alice , Walson Judd L , Iversen Per O , Maitland Kathryn , Snow Robert W , Berkley James 
Published: October 2024

BackgroundAnaemia and malaria are leading causes of paediatric hospitalisation and inpatient mortality in sub-Saharan Africa. However, there is limited empirical data on survival following hospital discharge. We aimed to estimate independent effects of anaemia and malaria parasitaemia on inpatient and 1 year postdischarge mortality among Kenyan children.MethodsA retrospective cohort study among children admitted to Kilifi County Hospital (KCH) from 2010 to 2019 and followed-up for 1 year postdischarge in Kilifi Health and Demographic Surveillance System (KHDSS). The main exposures were anaemia and malaria parasitaemia at the time of hospital admission while inpatient and 1 year postdischarge mortality were the outcomes.ResultsWe included 9431 admissions among 7578 children (43% girls), median (IQR) age 19 (9.9‒23) months. 2069 (22%), 3893 (41%) and 1140 (12%) admissions had mild, moderate and severe anaemia, whereas 366 (3.9%), 779 (8.3%) and 224 (2.4%) had low, medium and high malaria parasitaemia, respectively. Overall, there were 381 (4.0%) inpatient deaths: 317/381 (83%) and 47/381 (12%) among children with any level of anaemia and malaria parasitaemia, respectively. Moderate and severe, but not mild anaemia, were positively associated with inpatient death. Low and high level parasitaemia were positively associated with inpatient mortality, while medium level parasitaemia was negatively associated. There were 228 (3.1%) postdischarge deaths: 32.8 (95% CI 28.8‒37.3) deaths/1000 child-years. 180/228 (79%) deaths occurred within 6 months after index discharge and 99/228 (43%) occurred in the community. Overall, 180/228 (79%) and 10/228 (4.4%) postdischarge deaths occurred among children with any level of anaemia and malaria parasitaemia, respectively. Severe anaemia was positively associated with postdischarge mortality (adjusted HR 1.94 (95% CI 1.11‒3.40)), while medium level parasitaemia was negatively associated.ConclusionInterventions to create awareness of postdischarge risks, improve uptake of existing interventions and improved discharge processes targeting high-risk groups such as children admitted with severe anaemia, need to be prioritised.
Piloting a patient navigation programme for individuals living with dementia, their care partners and members of the care team: protocol for a mixed-methods evaluation
Authors: Doucet Shelley , MacNeill Lillian , Jarrett Pam , Faig Karla , Luke Alison 
Published: October 2024

IntroductionInternationally, the number of individuals living with dementia continues to rise. Individuals living with dementia, their care partners and their care team face many barriers and challenges to accessing dementia care resources and supports. One solution to address the multifaceted care needs of this population is patient navigation (PN).Methods and analysisThis protocol describes the implementation and evaluation plan for a pilot PN programme in New Brunswick (NB) Canada for individuals living with dementia, their care partners and care providers. This project will include two components: (1) an in-person PN programme called Navigating Dementia NB/ Naviguer la démence NB and (2) two virtual peer-to-peer navigational support groups. The PN programme will be codesigned with stakeholders including researchers, patient partners, clinicians and health system managers. Patient navigators will be housed at six primary care sites across the province and the services will be offered in English and French. We will conduct a mixed-methods evaluation to explore the characteristics and experiences of participants who enrol in the PN programme and the navigational support groups, as well as the facilitators and barriers to implementation. Data collection will include navigation charts, Facebook analytics, as well as postintervention surveys, semistructured interviews and focus groups. All participants will provide written informed consent to take part in the intervention and have their data collected for research and evaluation purposes. Demographic data will be analysed using frequency and central tendency measures, while qualitative data from interviews and focus groups will undergo thematic analysis. Content analysis will be used to analyse posts published to the Facebook groups. The evaluation will assess the programme’s effectiveness in the short and medium terms, evaluating its ability to achieve the intended outcomes.Ethics and disseminationThis study has been approved by the research ethics boards at the University of New Brunswick, Université de Moncton, Horizon Health Network and Vitalité Health Network. Knowledge translation activities (eg, presentations at local, national and international conferences; publications for open-access journals; reports and lay summaries) will be undertaken to share the findings from this pilot project with diverse stakeholders, such as decision-makers, health system managers, clinicians and the general public.
Is disinformation more likely to spread? A fuzzy-set qualitative comparative analysis of emerging infectious diseases on China’s short video platform
Authors: Xu Yongbin , Wen Sanmei , Zhang Liwen , Su Jing 
Published: October 2024

ObjectivesThis study aimed to develop a model for the dissemination of information on emerging infectious diseases (EIDs) by identifying the specific features of mpox (monkeypox)-related short video content that encourages public sharing.DesignThis was an exploratory analysis of the dissemination of information on short video platform.Main outcome measuresFocusing on Douyin (TikTok in mainland China), this study collected data from the top 500 most popular short videos using ‘monkeypox’ as the keyword from 1 May 2022 to 31 October 2022. Under the guidance of the health belief model, the videos were coded using two sets of conditional variables: information type variables and information content variables. The information type variables distinguish between fact-checking information and disinformation. Regarding information content variables, this study integrated the features of audiovisual media with the needs of the Chinese public, introducing efficacy information. The study then used fuzzy-set qualitative comparative analysis to analyse the correlation and consistency between the video contents and the level of public sharing, which was the outcome variable. Subsequently, a Poisson regression model was estimated to verify their significance on video-sharing volume.ResultsThe results showed that there were three configurations of short video content related to mpox which could trigger a high level of sharing among the general public. It was found that the number of fact-checked cases in the most widely disseminated short videos of mpox was 21.8:1 compared with the number of disinformation cases. Therefore, it can be concluded that fact-checked information was more likely to spread than disinformation in the case of an outbreak of EIDs on China’s short video platforms. Based on the analysis of the three configurations, we also found that they separately formed three paths of the short video communication model, and each path had a more significant variable playing a central role. We named each pathway after the core variable: authoritative source path, personal efficacy path and disinformation path.ConclusionsThis study developed a model for information dissemination of EIDs and found that fact-checked content was more likely to spread on Chinese short video platforms instead of disinformation. It also explored public demand for guidance on EIDs precautions.
New cancer medicines in Europe 2010–2020: comparison of medicines with or without extensions of indications
Authors: Ruuskanen Anna-Maria , Kurko Terhi , Sarnola Kati , Klintrup Katariina , Koskinen Hanna 
Published: October 2024

IntroductionDuring the last decade, extensions of therapeutic indications have been one of the most common methods to extend the lifecycle of a medical product in the post-authorisation phase and to increase the use and sales of medicines. The aim of this study was to gain understanding of the lifecycle of cancer medicines and especially the role and level of evidence extensions in comparison to first indications.Materials and methodsWe identified all new outpatient cancer medicines approved by the European Medicines Agency between 2010 and 2020 and the extensions to their indications. We compared general study design characteristics from the European public assessment reports using critical appraisal tools and clinical added value assessments.ResultsWe identified altogether 55 new outpatient cancer medicines, 31 of which had one or more extension(s) of indication and 24 had no extension of indication. In total, there were 57 extensions. The most common extension of indication was a change in the treatment line (35%). Compared with first indications, the overall quality of studies supporting extensions was better in terms of study designs. The proportion of medicines providing CAV was higher in extensions compared with first indication of medicines with and without extensions.ConclusionsBased on different assessments and perspectives, we found that extensions of indications are a very common and important part of extending the lifecycle of outpatient cancer medicines in Europe. Our findings also suggest that the clinical value of cancer medicines increases with extensions.
The changing nature of worry about COVID-19 among the English public: a secondary analysis of 73 national, cross-sectional surveys, January 2020 to April 2022
Authors: Rubin G James , Smith Louise E , Amlôt Richard , Fear Nicola T , Potts Henry WW , Michie Susan 
Published: October 2024

ObjectivesTo investigate worry about COVID-19 during the pandemic, and whether worry was associated with phase of the pandemic, COVID-19 death and incidence rates, Government interventions (including lockdown and advertising), age, being clinically at-risk, ethnicity, thinking that the Government had put the right measures in place, perceived risk of COVID-19 to self and the UK, and perceived severity of COVID-19.DesignSecondary analysis of a series of cross-sectional surveys.Setting73 online surveys conducted for the English Department of Health and Social Care between 28 January 2020 and 13 April 2022.ParticipantsParticipants were people aged 16 years and over living in the UK (approximately 2000 per wave).Primary outcome measuresOur primary outcome was self-reported worry about COVID-19.ResultsRates of being ‘extremely’ or ‘very’ worried changed over time. Worry increased as infection rates increased and fell during lockdowns, but the association became less obvious over time. Respondents aged 60 years and over were less likely to be worried after the launch of the vaccination campaign, while those who were clinically at-risk or from a minoritised ethnic community were more likely to be worried. Higher worry was associated with higher perceived risk, and higher perceived severity of COVID-19. There was no evidence for an association with agreeing that the Government was putting the right measures in place to prevent the spread of COVID-19. The launch of graphic Government advertising campaigns about COVID-19 had no noticeable effect on levels of public worry.ConclusionsIn future infectious disease outbreaks, spikes in worry may attenuate over time, although some sections of society may experience higher anxiety than others.
In-utero transfer, survival-focused care and survival to 28-days at 22-24 weeks’ gestation pre- and post- implementation of an extreme prematurity management guideline in Victoria, Australia
Authors: Gordon Hannah G , Shub Alexis , Stewart Michael J , Kane Stefan C , Cheong Jeanie LY , Roberts Calum T , Holberton James , Boland Rosemarie A 
Published: October 2024

BackgroundCare for infants born at 22–24 weeks’ gestation varies globally, with an increasing willingness to provide survival-focused (‘active’) care for infants born at 22 weeks’ gestation in recent years. This study aims to report changes in care for infants born at 22–24 weeks before and after the introduction of a statewide guideline for extreme prematurity (EP).MethodsA retrospective cohort study was conducted, including all live births at 22–24 weeks in tertiary perinatal centres from 1 January 2015 to 31 December 2022 in Victoria, Australia. Medical records were reviewed to obtain antenatal history and perinatal outcomes. Data on in utero referral and transfer to tertiary perinatal centres were sourced from the statewide perinatal emergency retrieval service (Paediatric Infant Perinatal Emergency Retrieval, PIPER) database. Changes in PIPER referrals and transfers, survival-focused care and survival at 28 days preguideline and postguideline were assessed using logistic regression.ResultsFollowing the guideline, at 22 weeks’ gestation, there was an increase in referrals to PIPER and a 3.31 (95% CI 1.84 to 5.95) higher likelihood of in utero transfer to tertiary centres.Following the guideline, infants had a 6.67 (95% CI 1.40 to 31.72) higher likelihood of receiving survival-focused care at 22 weeks, and a 5.57 (95% CI 1.22 to 25.44) higher likelihood at 23 weeks. All 24-week live births received survival-focused care at birth. The 28-day survival for infants who received survival-focused care was unchanged preguideline and postguideline.ConclusionFollowing the publication of the EP guideline in Victoria, in utero referrals and transfers at 22 weeks’ gestation have increased, as has survival-focused management of inborn live births at 22–24 weeks.
Risk stratification by renal function and NYHA class in patients with hypotension initiated on sacubitril/valsartan: a retrospective cohort study from 17 centres in Japan
Authors: Kanaoka Koshiro , Nasu Takahito , Kikuchi Atsushi , Ijichi Takeshi , Shibata Tatsuhiro , Kida Keisuke , Kagiyama Nobuyuki , Fujimoto Wataru , Ishii Syunsuke , Iwanaga Yoshitaka , Miyamoto Yoshihiro , Matsumoto Shingo 
Published: October 2024

BackgroundPatients with heart failure exhibiting low systolic blood pressure (SBP) have a poor prognosis. Sacubitril/valsartan reduces cardiovascular events; however, its use in patients with low SBP has not been fully examined. Therefore, in this study, we aimed to investigate the association between baseline SBP and adverse events (AEs) in patients starting sacubitril/valsartan therapy using data from a real-world registry in Japan.MethodsWe analysed data from a multicentre retrospective study, including patients who initiated sacubitril/valsartan between August 2020 and August 2021. The patients were categorised into five groups based on their baseline SBP (<100, 100–109, 110–119, 120–129 and ≥130 mm Hg). The composite of AEs occurring within 3 months according to baseline SBP and the patient characteristics associated with AEs in a baseline SBP <110 mm Hg were analysed.ResultsAmong the 964 patients newly prescribed sacubitril/valsartan, the median (IQR) age was 73 (61–80) years, and 388 (40.2%) patients had a baseline SBP <110 mm Hg. AEs occurred in 24% (n=232) of patients. The adjusted ORs for all AEs were 1.91 (95% CI (CI) 1.13–3.23; p=0.02) for the SBP <100 mm Hg group and 3.33 (95% CI 1.98 to 5.59; p<0.001) for the SBP 100–109 mm Hg group, compared with the SBP 110–119 mm Hg group. In patients with a baseline SBP <110 mm Hg, factors associated with an increased risk of AEs included a higher New York Heart Association class (II, III or IV) and a lower estimated glomerular filtration rate <30 mL/min/1.73 m2.ConclusionsCaution is needed when initiating sacubitril/valsartan in patients with lower baseline SBP. The severity of heart failure and kidney function may be useful for risk stratification in these high-risk patients.
Gravitational lensing around a dual-charged stringy black hole in plasma background
Authors: Kala Shubham , Nandan Hemwati , Abebe Amare , Roy Saswati 
Published: October 2024

AbstractOne of the strongest tools to verify the predictions of general relativity (GR) has been the gravitational lensing around various compact objects. Using a dual charged stringy black hole produced from dilaton-Maxwell gravity, we investigate the impact of the plasma parameter on gravitational lensing and black hole shadow in this study. Detailed investigations are performed to mark the impact of the homogeneous and non-homogeneous plasma environment on the electric and magnetic charge parameters of stringy black hole. In order to compare the results, we have also considered the vacuum scenario of the dual charged stringy black hole. Our results show that the effect of homogeneous plasma environment is much stronger in comparison to vacuum for the case of electrically charged stringy black hole. However, in the case of magnetically charged stringy black hole, the deflection angle gets decreased in presence of the homogeneous plasma medium. It has been observed that the radius of the shadow increases in a non-homogeneous plasma environment for electrically charged stringy black hole, whereas it decreases for magnetically charged stringy black hole in presence of the same plasma environment. This study aims to investigate how different plasma environments influence these fascinating astrophysical phenomena.
Resonating Between Past and Present: Long-Term History for the Island of New Guinea
Authors: Denham Tim , Muke John 
Published: October 2024

The archaeology of the island of New Guinea is ancient and surprising, yet it is highly fragmentary in space and time. Consequently, archaeology provides only local and fleeting glimpses of social life in the distant past. In this review, we consider several key themes, such as initial colonization at least 55,000 years ago, the emergence of agriculture by at least 7,000–6,400 years ago, and social diversification in the last few thousand years. We build our discussions around robust archaeological records that convey a coherent impression of what people were doing in the past. We also highlight the ways in which archaeology can be repurposed to address contemporary issues, including social and environmental problems, and flag how a distinctive New Guinean archaeology could be rooted in a vegecultural conception of social life and time.
Dyschloremia and Renal Outcomes in Critically Ill Patients With Sepsis: A Prospective Cohort Study
Authors: Thanekar Saurabh M. , Shanbhag Vishal , Prabhu Attur Ravindra , Nagaraju Shankar Prasad , Rangaswamy Dharshan , Shenoy Srinivas Vinayak , Bhojaraja Mohan Varadarayanahalli , Rao Indu Ramachandra 
Published: October 2024

Introduction: Chloride is the most abundant extracellular anion; however, abnormalities of serum chloride (dyschloremia) are often overlooked. This study aimed to study the association of dyschloremia with AKI and major adverse kidney events at Day 30 (MAKE30) in critically ill patients with sepsis.Materials and Methods: This prospective single‐center cohort study included adult patients with sepsis admitted in a tertiary care hospital in India. Patients with advanced chronic kidney disease, requiring dialysis at admission, or with hospital stay of less than 72 h were excluded. Hyperchloremia and hypochloremia were defined as chloride levels of > 110 mEq/L and < 95 mEq/L, respectively. The primary outcome measure was MAKE30—a composite of death, need for dialysis, or sustained loss of kidney function at Day 30.Results: In a cohort of 400 patients with a mean age of 60 (±15) years, AKI was seen in 301 (75.2%) and MAKE30 in 171 (42.8%). Hyperchloremia and hypochloremia were seen in 19.3% (n = 77) and 32.3% (n = 129), respectively, in the first 72 h of ICU stay. Hypochloremia, but not hyperchloremia, was independently associated with both MAKE30 (OR: 2.56, 95% CI: 1.13–5.79; p = 0.024) and new‐onset or worsening AKI (OR: 2.52, 95% CI: 1.17–5.41; p = 0.019). There was no association between hyperchloremia and either MAKE30 (OR: 1.07, 95% CI: 0.43–2.69; p = 0.882) or new‐onset/worsening AKI (OR: 0.89, 95% CI: 0.38–2.09; p = 0.781).Conclusion: Hypochloremia, but not hyperchloremia, was associated with MAKE30 in this cohort of critically ill patients with sepsis.Trial Registration: Clinical Trial Registry identifier: CTRI//2022/02/040519
Soluble CD146 Cooperates with VEGFa to Generate an Immunosuppressive Microenvironment in CD146-Positive Tumors: Interest of a Combined Antibody-Based Therapy
Authors: Joshkon Ahmad , Traboulsi Wael , Terme Magali , Bachelier Richard , Fayyad-Kazan Hussein , Dignat-George Françoise , Foucault-Bertaud Alexandrine , Leroyer Aurelie S. , Bardin Nathalie , Blot-Chabaud Marcel 
Published: October 2024

Abstract
Tumor development necessitates immune escape through different mechanisms. To counteract these effects, the development of therapies targeting immune checkpoints (ICP) has generated interest as they have produced lasting objective responses in patients with advanced metastatic tumors. However, many tumors do not respond to inhibitors of ICPs, necessitating to further study the underlying mechanisms of exhaustion. VEGFa, a proangiogenic molecule secreted by tumors, was described to participate to tumor immune exhaustion by increasing ICPs, justifying in part the use of an anti-VEGFa mAb, bevacizumab, in patients. However, recent studies from our group have demonstrated that tumors can escape anti-VEGFa therapy through the secretion of soluble CD146 (sCD146). In this study, we show that both VEGFa and sCD146 cooperate to create an immunosuppressive microenvironment by increasing the expression of ICPs. In addition, sCD146 favors protumoral M2-type macrophages and induces the secretion of proinflammatory cytokines. An anti-sCD146 mAb reverses these effects and displays additive effects with the anti-VEGFa antibody to eliminate tumors in a syngeneic murine model grafted with melanoma cells. Combining bevacizumab with mucizumab could thus be of major therapeutic interest to prevent immune escape in malignant melanoma and other CD146-positive tumors.