bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do we conduct a national transfusion related lookback program?
Authors: Priddee Nicole , Pietrek Tiffany , McLintock Lorna , Masterson Elizabeth , Rowley Megan , Roy Kirsty , Yeung Alan , Anya Ike , Carter Daniel , Barclay Stephen , Jackson Celia , Hawkins Gill , Steedman Nicola 
Published: July 2024

AbstractBackgroundLookback investigations are conducted by blood services when a risk of transmission of infection from a donor to a recipient has been identified. They involve tracing transfusion recipients and offering them testing for the relevant infectious agent. Results are relayed to the recipient to provide reassurance that there has been no transmission or to ensure appropriate treatment and care if required, and blood services are able to learn lessons from the planning, delivery, and outcomes of the investigation.A national lookback exercise was conducted in Scotland following the introduction of a test to identify occult hepatitis B infection, as recommended by the UK Advisory Committee for the Safety of Blood, Tissues and Organs (SaBTO) in 2021.Methods and MaterialsThis paper outlines the development and delivery of a national lookback program. It discusses the logistical, economic, ethical, regulatory, and scientific issues that were considered during the planning and delivery of the lookback exercise.ResultsDevelopment and delivery of a national lookback required robust governance, engagement of all relevant stakeholders and a shared understanding of aims, effective communication, systems, resources, limitations, and project management. Outcomes included a high testing uptake, low levels of reported anxiety, and a comprehensive data set.ConclusionKey aspects for delivery of a successful large‐scale lookback program include a patient‐centered approach, clear and accessible communication, and whole‐systems multiagency collaboration. Major challenges include stakeholder engagement and capacity.
EPIC-CP pilot trial study protocol: a multicentre, randomised controlled trial investigating the feasibility and acceptability of social prescribing for Australian children with cerebral palsy
Authors: Ostojic Katarina , Karem Isra , Paget Simon , Berg Alison , Burnett Heather , Scott Timothy , Martin Tanya , Dee-Price Betty-Jean , McIntyre Sarah , Smithers-Sheedy Hayley , Mimmo Laurel , Masi Anne , Scarcella Michele , Azmatullah Sheikh , Calderan Jack , Mohamed Masyitah , Olaso Anne , van Hoek Matthew , van Hoek Debbie , Woodbury Mackenzie , Wilkinson Alunya , Chambers Georgina , Zwi Karen , Dale Russell , Eapen Valsamma , Lingam Raghu , Strnadová Iva , Woolfenden Susan 
Published: July 2024

IntroductionThe social determinants of health contribute to poorer health outcomes for children with cerebral palsy (CP) and are barriers to families accessing health services. At an individual level, social determinants of health are experienced as unmet social needs, for example, unsafe housing conditions. There is emerging evidence that clinical pathways for the systematic identification and referral to services for unmet social needs can support families to address these needs. These clinical pathways have not been implemented for children with CP. The objectives are to investigate the feasibility and acceptability of two co-designed social needs clinical pathways for parents/caregivers of children with CP—social prescribing (ie, Community Linker plus resource pack) compared with resource pack only.Methods and analysisThis pilot randomised controlled trial will run at the three tertiary paediatric rehabilitation services in New South Wales, Australia. A total of 120 participants will be recruited, with randomisation stratified by study site. A survey tool will be used to identify families experiencing unmet social needs. Parents/caregivers who report one or more unmet social need/s and consent will be eligible. The active control group will receive a resource pack containing information on community services to support unmet social needs. The social prescribing intervention group will receive one-on-one Community Linker support, in addition to the resource pack. The survey tool, intervention, logic model, and resource pack were co-designed with patient families and their healthcare workers. Feasibility of the research design and the clinical pathways will be evaluated using the number/proportion of parents/caregivers who complete the survey tool, consent, engage with the intervention, and complete research measures. Acceptability will be evaluated using questionnaires and qualitative interviews.Ethics and disseminationHuman research ethics approval was granted by the Sydney Children’s Hospitals Network Human Research Ethics Committee (2022/ETH01688). Participants and stakeholders will receive updates and findings via regular communication channels including meetings, presentations, and publications.Trial registration numberAustralia New Zealand Clinical Trials Registry: 12622001459718.
Asian Neonatal Network Collaboration (AsianNeo): a study protocol for international collaborative comparisons of health services and outcomes to improve quality of care for sick newborn infants in Asia – survey, cohort and quality improvement studies
Authors: Isayama Tetsuya , Miyake Fuyu , Rohsiswatmo Rinawati , Dewi Rizalya , Ozawa Yuri , Tomotaki Seiichi , Morisaki Naho , Chee Seok Chiong , Neoh Siew Hong , Imperial Ma Lourdes S , Velasco Belen Amparo E , Chang Yun Sil , Cho Su Jin , Youn YoungAh , Quek Bin Huey , Poon Woei Bing , Amin Zubair , Jayaratne Kapila , Kumara Saman , Lin Yuh-Jyh , Chang Jui-Hsing , Lin Hsiang Yu , Lin Ming-Chih , Nuntnarumit Pracha , Ngerncham Sopapan , Prempunpong Chatchay , Prempraphan Pathaporn , Supapannachart Sarayut , Kusuda Satoshi 
Published: July 2024

IntroductionReducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed to improving the quality of neonatal care; however, the involvement of low-to-middle-income countries was limited. This project aims to form an international collaboration among neonatal networks in Asia (AsianNeo), including low-, middle- and high-income countries (or regions). Specifically, it aims to determine outcomes in sick newborn infants, especially very low birth weight (VLBW) infants or very preterm infants, with a view to improving the quality of care for such infants.Methods and analysisCurrently, AsianNeo comprises nine neonatal networks from Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan and Thailand. AsianNeo will undertake the following four studies: (1) institutional questionnaire surveys investigating neonatal intensive care unit resources and the clinical management of sick newborn infants, with a focus on VLBW infants (nine countries/regions); (2) a retrospective cohort study to describe and compare the outcomes of VLBW infants among Asian countries and regions (four countries/regions); (3) a prospective cohort study to develop the AsianNeo registry of VLBW infants (six countries/regions); and (4) implementation and evaluation of educational and quality improvement projects in AsianNeo countries and regions (nine countries/regions).Ethics and disseminationThe study protocol was approved by the Research Ethics Board of the National Center for Child Health and Development, Tokyo, Japan (reference number 2020–244, 2022–156). The study findings will be disseminated through educational programmes, quality improvement activities, conference presentations and medical journal publications.
Chasing cancer: does the social-to-medical spending ratio relate to cancer incidence and mortality in Canadian provinces? A retrospective cohort study
Authors: MacLellan Cameron , Kershaw Paul , Kneebone Ronald D , McLaren Lindsay , Reiman Tony , Urquhart Robin , Dutton Daniel J 
Published: July 2024

IntroductionCancer is the leading cause of death in Canada, and cases are expected to rise by 83% between 2012 and 2042. Jurisdictions with higher ratios of social-to-medical spending exhibit better population health outcomes; however, the connection between the ratio and both cancer incidence and mortality is not well established. We aim to determine the association between the ratio and both age-standardised cancer incidence and mortality.MethodsUsing linear regressions with provincial and yearly fixed effects, we measured associations between the ratio and incidence of the four most common cancers in Canada (ie, lung and bronchus, colorectal, breast and prostate cancer), and mortality from any cancer, from 1992 to 2017 (incidence) and 2000 to 2019 (mortality).ResultsA one-cent increase in social spending for each dollar spent on medical services was significantly associated with a decrease in colorectal (−0.2%), breast (−0.1%), and prostate cancer (−0.6%). The relationship is statistically insignificant and negligible for lung cancer incidence and cancer mortality.ConclusionThe ratio was significantly associated with a decrease in three out of four cancer incidence categories, but not mortality. This implies that, consistent with the social determinants of health, preventing cancer incidence might be a function of social spending, whereas medical spending is more relevant for individuals already diagnosed with cancer. This analysis points to the importance of a health-in-all-policies perspective, as social spending might be more important for population health than spending on the medical care system. We provide evidence that morbidity measures are responsive to the ratio, building on a literature focused on mortality.
Self-performed Rh typing: a cross-sectional study
Authors: Dethier Divya , Tschann Mary , Roman Meliza , Chen John J , Soon Reni , Kaneshiro Bliss 
Published: July 2024

ObjectiveTo evaluate whether patients are capable and willing to self-administer and interpret an EldonCard test to determine their Rh status.MethodsThis was a cross-sectional study in Honolulu, HI, USA of pregnancy-capable people aged 14–50 years who did not know their blood type and had never used an EldonCard. Participants independently completed EldonCard testing, determined their Rh type and answered a survey on feasibility and acceptability. Separately, a blinded clinician recorded their interpretation of the participant’s EldonCard. When available, we obtained blood type from the electronic health record (EHR). We measured Rh type agreement between participant, clinician and EHR, as well as participant comfort and acceptability of testing.ResultsOf the 330 total participants, 288 (87.3%) completed testing. Patients and clinicians had 94.0% agreement in their interpretation of the EldonCard for Rh status. Patient interpretation had 83.5% agreement with EHR while clinician and EHR had 92.3% agreement. Sensitivity of EldonCard interpretation by patient and clinician was 100%. Specificity was 83.2% for patients and 92.2% for clinicians. Two patients (of 117) had Rh-negative blood type in the EHR. The vast majority of participants found the EldonCard testing easy (94.4%) and felt comfortable doing the testing (93.7%). Participants with lower education levels felt less confident (p=0.003) and less comfortable with testing (p=0.038); however, their ability to interpret results was similar to others (p=0.051).ConclusionsPatient-performed Rh typing via the EldonCard is an effective and acceptable option for patients, and could be used as a primary screening test for Rh status.
Vitamin D affects the risk of disease activity in multiple sclerosis
Authors: Giordano Antonino , Clarelli Ferdinando , Pignolet Béatrice , Mascia Elisabetta , Sorosina Melissa , Misra Kaalindi , Ferrè Laura , Bucciarelli Florence , Manouchehrinia Ali , Moiola Lucia , Martinelli Vittorio , Rocca Maria A , Liblau Roland , Filippi Massimo , Esposito Federica 
Published: July 2024

BackgroundVitamin D (VitD) affects the risk of multiple sclerosis (MS), but the impact on disease activity is controversial. We assessed whether VitD is associated with the No-Evidence of Disease Activity-3 (NEDA-3) status at 2 years from disease-modifying treatment (DMT) start, and whether this association is causal or the result of confounding factors. Furthermore, we explored if a genetic predisposition to higher VitD levels affects the risk of disease activity.Methods230 untreated relapsing-remitting MS patients underwent serum 25-OH-vitamin-D measurement, and the association between seasonally adjusted VitD and disease activity was tested. Modelling a Polygenic Risk Score from a Genome-Wide Association Study on ~400 000 individuals, we studied the impact of genetic predisposition to higher VitD on the NEDA-3 status in 1408 independent MS patients. Two-sample Mendelian randomisation (MR) was used to assess causality.ResultsLower baseline VitD was associated with decreased probability of NEDA-3 at 2 years (p=0.019). Particularly, VitD levels <20 ng/mL conferred an over twofold risk of disease activity (OR 2.36, 95% CI 1.30 to 3.88, p=0.0037). Genetic predisposition to higher VitD levels was associated with delayed age at MS onset (p=0.018) and with a higher probability of NEDA-3 status (p=0.034). MR confirmed causality between VitD and the risk of disease activity (p=0.041).ConclusionsVitD levels before DMT start affect the risk of disease activity in MS. Genetic predisposition to higher VitD levels confers a lower risk of disease activity and is associated with delayed MS onset. Our work prompts future prospective studies regarding VitD supplementation and lifestyle interventions to hamper disease activity in MS.
Conversion to general anesthesia and intravenous supplementation during intrapartum cesarean delivery with an indwelling epidural catheter: a retrospective study
Authors: Stav Michael Yohay , Fein Shai , Matatov Yuri , Hoffman Dana , Heesen Philip , Binyamin Yair , Iluz-Freundlich Daniel , Eidelman Leonid , Orbach-Zinger Sharon 
Published: July 2024

BackgroundIntraoperative pain during cesarean delivery with or without conversion to general anesthesia has been shown to negatively impact maternal and perinatal morbidity. Efforts to reduce these adverse events are a recent focus of obstetric anesthesia care. We aimed to assess rates of and risk factors for conversion to general anesthesia and intraoperative pain during intrapartum cesarean delivery with an indwelling epidural catheter in our academic center.MethodsIn this retrospective cohort study, all women undergoing cesarean delivery with an indwelling epidural catheter between January 2017 and June 2022 were included. Labor epidural analgesia was provided according to a standardized protocol, and conversion to epidural anesthesia was achieved in the operating room before surgery. We determined the conversion rate to general anesthesia and associated risk factors. Second, we examined the rate of administration of analgesics/sedatives and related risk factors in cesarean cases that were not converted to general anesthesia.ResultsAmong the 1192 women undergoing intrapartum cesarean delivery with epidural anesthesia, there were 97 cases with conversion to general anesthesia (8.1%), of which 87 (89.7%) were due to a failed epidural. Higher age, higher weight, and higher gestational age were associated with decreased odds of conversion to general anesthesia. Higher gravidity and longer surgical time were associated with increased odds. An emergent indication was not associated with conversion to general anesthesia. Intravenous analgesic/sedative supplementation occurred in 141 cases (12.9%). Higher age was associated with decreased odds of supplementation, and longer surgical time was associated with increased odds.ConclusionIn our tertiary academic center, the rate of intraoperative conversion to general anesthesia and administration of analgesic/sedative medication among women undergoing intrapartum cesarean delivery with epidural anesthesia was relatively high. Emergency cesarean delivery was not associated with either of the above endpoints.
What role do socioeconomic and clinical factors play in disease activity states in rheumatoid arthritis? Data from a large UK early inflammatory arthritis audit
Authors: Adas Maryam , Dey Mrinalini , Norton Sam , Lempp Heidi , Buch Maya H , Cope Andrew , Galloway James , Nikiphorou Elena 
Published: July 2024

BackgroundPersistently active rheumatoid arthritis (pactiveRA) may be due to the interplay between biological and non-biological factors. The role of socioeconomic factors remains unclear.ObjectivesTo explore which biological and non-biological factors associate with pactiveRA.MethodsAdults with early RA in the National Early Inflammatory Arthritis Audit, recruited from May 2018 to October 2022, were included if having pactiveRA or persistently low RA (plowRA). The pactiveRA was defined as three consecutive Disease Activity Score-28 joints (DAS28) of >3.2 at baseline, 3 and 12 months. The plowRA was defined as DAS28 ≤3.2 at 3 and 12 months. Stepwise forward logistic regression was used to explore associations with pactiveRA (outcome). Age and gender were included a priori, with socioeconomic factors and comorbidities as exposure variables.Results682 patients with pactiveRA and 1026 plowRA were included. Compared with plowRA, patients with pactiveRA were younger (58, IQR: 49–67) versus (62, IQR: 52–72), and included more women (69% vs 59%). The pactiveRA was associated with worse scores in patient-reported outcomes at baseline, and anxiety and depression screens. Overall, there was clear social patterning in pactiveRA, with age-by-gender interaction. Logistic regression indicated age, gender, social deprivation and previous or current smoking, were independently associated with pactiveRA, after controlling for disease severity markers (seropositivity). Depression, lung disease, gastric ulcers and baseline corticosteroid use, were also associated with pactiveRA (p<0.05 for all).ConclusionSocioeconomic factors and deprivation were associated with pactiveRA, independent of clinical and disease characteristics. Identifying ‘adverse’ socioeconomic drivers of pactiveRA can help tailor interventions according to individual need.
Variability in self-reported and biomarker-derived tobacco smoke exposure patterns among individuals who do not smoke by poverty income ratio in the USA
Authors: Titus Andrea R , Shelley Donna , Thorpe Lorna E 
Published: July 2024

IntroductionTobacco smoke exposure (TSE) among individuals who do not smoke has declined in the USA, however, gaps remain in understanding how TSE patterns across indoor venues—including in homes, cars, workplaces, hospitality venues, and other areas—contribute to TSE disparities by income level.MethodsWe obtained data on adults (ages 18+, N=9909) and adolescents (ages 12–17, N=2065) who do not smoke from the National Health and Nutrition Examination Survey, 2013–2018. We examined the prevalence of self-reported, venue-specific TSE in each sample, stratified by poverty income ratio (PIR) quartile. We used linear regression models with a log-transformed outcome variable to explore associations between self-reported TSE and serum cotinine. We further explored the probability of detectable cotinine among individuals who reported no recent TSE, stratified by PIR.ResultsSelf-reported TSE was highest in cars (prevalence=6.2% among adults, 14.2% among adolescents). TSE in own homes was the most strongly associated with differences in log cotinine levels (β for adults=1.92, 95% CI=1.52 to 2.31; β for adolescents=2.37 95% CI=2.07 to 2.66), and the association between home exposure and cotinine among adults was most pronounced in the lowest PIR quartile. There was an income gradient with regard to the probability of detectable cotinine among both adults and adolescents who did not report recent TSE.ConclusionsHomes and vehicles remain priority venues for addressing persistent TSE among individuals who do not smoke in the USA. TSE survey measures may have differential validity across population subgroups.
Rectal organoid morphology analysis (ROMA) as a novel physiological assay for diagnostic classification in cystic fibrosis
Authors: Cuyx Senne , Ramalho Anabela Santo , Fieuws Steffen , Corthout Nikky , Proesmans Marijke , Boon Mieke , Arnauts Kaline , Carlon Marianne S , Munck Sebastian , Dupont Lieven , De Boeck Kris , Vermeulen François 
Published: July 2024

BackgroundDiagnosing cystic fibrosis (CF) is not always straightforward, in particular when sweat chloride concentration (SCC) is intermediate and <2 CF-causingCFTRvariants are identified. The physiological CFTR assays proposed in the guidelines, nasal potential difference and intestinal current measurement, are not readily available nor feasible at all ages. Rectal organoid morphology analysis (ROMA) was previously shown to discriminate between organoids from subjects with and without CF based on a distinct phenotypical difference: compared with non-CF organoids, CF organoids have an irregular shape and lack a visible lumen. The current study serves to further explore the role of ROMA when a CF diagnosis is inconclusive.MethodsOrganoid morphology was analysed using the previously established ROMA protocol. Two indices were calculated: the circularity index to quantify the roundness of organoids and the intensity ratio as a measure of the presence of a central lumen.ResultsRectal organoids from 116 subjects were cultured and analysed together with the 189 subjects from the previous study. ROMA almost completely discriminated between CF and non-CF. ROMA indices correlated with SCC, pancreatic status and genetics, demonstrating convergent validity. For cases with an inconclusive diagnosis according to current guidelines, ROMA provided additional diagnostic information, with a diagnostic ROMA classification for 18 of 24 (75%).DiscussionROMA provides additional information to support a CF diagnosis when SCC and genetics are insufficient for diagnostic classification. ROMA is standardised and can be centralised, allowing future inclusion in the diagnostic work-up as first-choice physiological assay in case of an unclear diagnosis.