bluuebunny/crossref_metadata_2025_split huggingface dataset:
My Search for Belonging: An Anxious Journey through Gender and Geology
Authors: Bosch Rachel 
Published: June 2024

ABSTRACT
In this story, I share with you my identities that have contributed to my feelings of otherness, alienation, and marginalization. These identities are my gender—broadly nonbinary, ranging from agender to genderflux—and mental illness diagnosis of generalized anxiety disorder. At various times in my life, these identities have been more prominent and played a greater role in my career path as a geoscientist. This chapter is loosely structured chronologically, beginning with memories from childhood and how they shaped who I am and my interest in science. I discuss my experiences in the educational system, beginning in public schools, taking more than 15 years to complete my M.S., and then earning my Ph.D. as a nontraditional student. I now use that position to advocate for others. In sharing the lessons that I have learned along the way, I hope that my story will help someone feel less alone and ease their path. Additionally, these lessons are intended to support advocates for equity, diversity, and inclusion to become stronger allies for LGBTQ+ folks and people with nonapparent disabilities, such as some mental illnesses.
Antiplatelet therapy after coronary artery bypass surgery: five year follow-up of randomised DACAB trial
Authors: Zhu Yunpeng , Zhang Wei , Dimagli Arnaldo , Han Lin , Cheng Zhaoyun , Mei Ju , Chen Xin , Wang Xiaowei , Zhou Yanzai , Xue Qing , Hu Junlong , Tang Min , Wang Rui , Song Yuanyuan , Kang Lei , Redfors Bjorn , Gaudino Mario , Zhao Qiang 
Published: June 2024

Abstract

Objective
To assess the effect of different antiplatelet strategies on clinical outcomes after coronary artery bypass grafting.

Design
Five year follow-up of randomised Different Antiplatelet Therapy Strategy After Coronary Artery Bypass Grafting (DACAB) trial.

Setting
Six tertiary hospitals in China; enrolment between July 2014 and November 2015; completion of five year follow-up from August 2019 to June 2021.

Participants
500 patients aged 18-80 years (including 91 (18.2%) women) who had elective coronary artery bypass grafting surgery and completed the DACAB trial.

Interventions
Patients were randomised 1:1:1 to ticagrelor 90 mg twice daily plus aspirin 100 mg once daily (dual antiplatelet therapy; n=168), ticagrelor monotherapy 90 mg twice daily (n=166), or aspirin monotherapy 100 mg once daily (n=166) for one year after surgery. After the first year, antiplatelet therapy was prescribed according to standard of care by treating physicians.

Main outcome measures
The primary outcome was major adverse cardiovascular events (a composite of all cause death, myocardial infarction, stroke, and coronary revascularisation), analysed using the intention-to-treat principle. Time-to-event analysis was used to compare the risk between treatment groups. Multiple post hoc sensitivity analyses examined the robustness of the findings.

Results

Follow-up at five years for major adverse cardiovascular events was completed for 477 (95.4%) of 500 patients; 148 patients had major adverse cardiovascular events, including 39 in the dual antiplatelet therapy group, 54 in the ticagrelor monotherapy group, and 55 in the aspirin monotherapy group. Risk of major adverse cardiovascular events at five years was significantly lower with dual antiplatelet therapy versus aspirin monotherapy (22.6%
v
29.9%; hazard ratio 0.65, 95% confidence interval 0.43 to 0.99; P=0.04) and versus ticagrelor monotherapy (22.6%
v
32.9%; 0.66, 0.44 to 1.00; P=0.05). Results were consistent in all sensitivity analyses.

Conclusions
Treatment with ticagrelor dual antiplatelet therapy for one year after surgery reduced the risk of major adverse cardiovascular events at five years after coronary artery bypass grafting compared with aspirin monotherapy or ticagrelor monotherapy.

Trial registration

NCT03987373ClinicalTrials.gov
NCT03987373
.
Maternal and child health intervention to promote behaviour change: a population-level cluster-randomised controlled trial in Honduras
Authors: Oles William , Alexander Marcus , Negron Rennie , Nelson Jennifer , Iriarte Emma , Airoldi Edoardo M. , Christakis Nicholas A. , Forastiere Laura 
Published: June 2024

ObjectivesTo assess the efficacy of a sustained educational intervention to affect diverse outcomes across the pregnancy and infancy timeline.SettingA multi-arm cluster-randomised controlled trial in 99 villages in Honduras’ Copán region, involving 16 301 people in 5633 households from October 2015 to December 2019.ParticipantsResidents aged 12 and older were eligible. A photographic census involved 93% of the population, with 13 881 and 10 263 individuals completing baseline and endline surveys, respectively.Intervention22-month household-based counselling intervention aiming to improve practices, knowledge and attitudes related to maternal, neonatal and child health.Primary and secondary outcome measuresPrimary outcomes were prenatal/postnatal care behaviours, facility births, exclusive breast feeding, parental involvement, treatment of diarrhoea and respiratory illness, reproductive health, and gender/reproductive norms. Secondary outcomes were knowledge and attitudes related to the primary outcomes.ResultsParents targeted for the intervention were 16.4% (95% CI 3.1%–29.8%, p=0.016) more likely to have their newborn’s health checked in a health facility within 3 days of birth; 19.6% (95% CI 4.2%–35.1%, p=0.013) more likely to not wrap a fajero around the umbilical cord in the first week after birth; and 8.9% (95% CI 0.3%–17.5%, p=0.043) more likely to report that the mother breast fed immediately after birth. Changes in knowledge and attitudes related to these primary outcomes were also observed. We found no significant effect on various other practices.ConclusionA sustained counselling intervention delivered in the home setting by community health workers can meaningfully change practices, knowledge and attitudes related to proper newborn care following birth, including professional care-seeking, umbilical cord care and breast feeding.Trial registration numberNCT02694679.
Faecal microbiota transplantation (FMT) in Norwegian outpatients with mild to severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): protocol for a 12-month randomised double-blind placebo-controlled trial
Authors: Skjevling Linn , Goll Rasmus , Hanssen Hege Marie , Johnsen Peter Holger 
Published: June 2024

IntroductionThe observed alteration of the intestinal microbiota in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the effect of transferring a healthy gut flora from a faecal donor using a faecal microbiota transplantation (FMT) will be explored in this trial.Methods and analysisThis is a protocol for a randomised, double-blind, placebo-controlled, parallel-group, single-centre trial, with 12 months follow-up. 80 participants will be included and randomised (1:1:2) to either donor FMT (from two different donors) or placebo (autologous FMT). Participants will be included by the International Clinical Criteria for ME/CFS. The clinical measures of ME/CFS and disease activity include Modified DePaul Questionnaire, Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), 36-Item Short Form Health Survey (SF-36), ROMA IV criteria, Food Frequency Questionnaire, Repeatable Battery for the Assessment of Neuropsychological Status, heart rate variability testing and reports on the use of antibiotics and food supplements, as well as biobanking of blood, urine and faeces.The primary endpoint is proportion with treatment success in FSS score in donor versus autologous FMT group 3 months after treatment. Treatment success is defined as an FSS improvement of more than 1.2 points from baseline at 3 months after treatment. Adverse events will be registered throughout the study.Ethics and disseminationThe Regional Committee for Medical Research Ethics Northern Norway has approved the study. The study has commenced in May 2019. Findings will be disseminated in international peer-reviewed journal(s), submitted to relevant conferences, and trial participants will be informed via phone calls.Trial registration numberNCT03691987.
Efficacy and safety of SBRT combined with sintilimab and IBI305 in patients with advanced HCC and previously failed immunotherapy: study protocol of a phase 2 clinical trial
Authors: Zhang Jinfeng , Yang Yongqiang , Wu Zilong , Zhang Sisi , Lin Zhenyu , Liu Hongli , Hu Jianli , Zhang Tao , Tang Jing , Xue Jun 
Published: June 2024

IntroductionHepatocellular carcinoma (HCC) is a leading cause of cancer-related death in China. The combination of immune checkpoint inhibitors (ICIs) and antiangiogenic drugs, such as bevacizumab and tyrosine kinase inhibitors, has been recommended as first-line treatment for advanced HCC. However, two-thirds of patients did not benefit from this form of immunotherapy. Currently, data on the subsequent regimen for patients previously treated with ICIs are lacking. Studies have shown that the combination of radiotherapy (RT) and ICIs is a potentially effective second-line therapy for HCC. This study aims to assess the efficacy and safety of combined therapy with stereotactic body RT (SBRT), sintilimab and IBI305 (a biosimilar of bevacizumab) in patients with HCC following the progression of first-line ICI therapy.Methods and analysisThis study is an open-label, single-arm, single-centre, phase 2 trial of 21 patients with advanced HCC in whom previous ICI therapy has failed. Participants will receive approximately 30–40 Gy/5–8F SBRT, followed by 200 mg sintilimab and 15 mg/kg IBI305 intravenously every 3 weeks. Treatment will continue until the development of unacceptable toxicity or disease progression. We will use Simon’s two-stage design, with the objective response rate (ORR) as the primary endpoint. Secondary endpoints include ORR of lesions without RT, disease control rate, progression-free survival, overall survival and safety.Ethics and disseminationThe study was authorised by the Medical Ethics Committee. Dissemination of results will occur via a peer-reviewed publication and other relevant media.Trial registration numberChiCTR2200056068.
Cancer patients’ perceptions of the meaning in life: a protocol for a meta-synthesis of qualitative research
Authors: Wang Shuman , Zheng Mimi , Xu Wenjie , Zhang Lijuan , Zhu Yu , Wan Hongwei 
Published: June 2024

IntroductionThe onset of cancer compels patients to grapple with existential questions. Enabling individuals with cancer, irrespective of the disease stage, to experience meaningful lives is of utmost importance in enhancing their overall quality of life. This study will synthesise qualitative research evidence to understand cancer patients’ perceptions and perspectives regarding their meaning in life. Such insights ultimately contribute to enhancing the profound experience of meaning throughout the life course of cancer patients.Methods and analysisThe English and Chinese databases we will search include the Cochrane Library, PubMed, MEDLINE, Web of Science, EMbase, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wan Fang Data, Chinese Biomedical Literature Database and VIP Database for Chinese Technical Periodicals. Two independent reviewers will assess the quality of the included studies using the standard JBI Critical Appraisal Checklist for Qualitative Research and extract data using the standard JBI Data Extraction Tool for Qualitative Research. The JBI meta-aggregation approach will be employed to compare, analyse and summarise the original results. To enhance confidence in the synthesised results of the qualitative study, the final synthesised study results will be graded using the JBI ConQual approach.Ethics and disseminationExternal ethical approval is not necessary for this review since it involves a retrospective analysis of publicly available primary data through secondary analysis. The findings of the review will be disseminated by publishing them in a peer-reviewed journal.PROSPERO registration numberCRD42023447664.
Heparin-binding protein as a biomarker for the diagnosis of sepsis in the intensive care unit: a retrospective cross-sectional study in China
Authors: Zuo Lingyun , Li Xiaoyun , Wang Luhao , Yuan Hao , Liao Zihuai , Zhou Si , Wu Jianfeng , Guan Xiangdong , Liu Yongjun 
Published: June 2024

ObjectivesThis study aims to investigate the diagnostic value of heparin-binding protein (HBP) in sepsis and develop a sepsis diagnostic model incorporating HBP with key biomarkers and disease-related scores for rapid, and accurate diagnosis of sepsis in the intensive care unit (ICU).DesignClinical retrospective cross-sectional study.SettingA comprehensive teaching tertiary hospital in China.ParticipantsAdult patients (aged ≥18 years) who underwent HBP testing or whose blood samples were collected when admitted to the ICU.Main outcome measuresHBP, C reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), interleukin-6 (IL-6), lactate (LAC), Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) score were recorded.ResultsBetween March 2019 and December 2021, 326 patients were enrolled in this study. The patients were categorised into a non-infection group (control group), infection group, sepsis group and septic shock group based on the final diagnosis. The HBP levels in the sepsis group and septic shock group were 45.7 and 69.0 ng/mL, respectively, which were significantly higher than those in the control group (18.0 ng/mL) and infection group (24.0 ng/mL) (p<0.001). The area under the curve (AUC) value of HBP for diagnosing sepsis was 0.733, which was lower than those corresponding to PCT, CRP and SOFA but higher than those of IL-6, LAC and APACHE II. Multivariate logistic regression analysis identified HBP, PCT, CRP, IL-6 and SOFA as valuable indicators for diagnosing sepsis. A sepsis diagnostic model was constructed based on these indicators, with an AUC of 0.901, a sensitivity of 79.7% and a specificity of 86.9%.ConclusionsHBP could serve as a biomarker for the diagnosis of sepsis in the ICU. Compared with single indicators, the sepsis diagnostic model constructed using HBP, PCT, CRP, IL-6 and SOFA further enhanced the diagnostic performance of sepsis.
ExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated (ECMO-RESCUE): study protocol for a prospective, multicentre, non-randomised cohort study
Authors: Chen Wei-yan , Guo Ze-bin , Kong Tian-yu , Chen Wei-xiao , Chen Xiao-hua , Yang Qilin , Wen Yi-chao , Wen Qi-rui , Zhou Feng , Xiong Xu-ming , Wen De-liang , Zhang Zhen-hui 
Published: June 2024

IntroductionSevere septic cardiomyopathy (SCM) is one of the main causes of refractory septic shock (RSS), with a high mortality. The application of venoarterial extracorporeal membrane oxygenation (ECMO) to support the impaired cardiac function in patients with septic shock remains controversial. Moreover, no prospective studies have been taken to address whether venoarterial ECMO treatment could improve the outcome of patients with sepsis-induced cardiogenic shock. The objective of this study is to assess whether venoarterial ECMO treatment can improve the 30-day survival rate of patients with sepsis-induced refractory cardiogenic shock.Methods and analysisExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated is a prospective, multicentre, non-randomised, cohort study on the application of ECMO in SCM. At least 64 patients with SCM and RSS will be enrolled in an estimated ratio of 1:1.5. Participants taking venoarterial ECMO during the period of study are referred to as cohort 1, and patients receiving only conventional therapy without ECMO belong to cohort 2. The primary outcome is survival in a 30-day follow-up period. Other end points include survival to intensive care unit (ICU) discharge, hospital survival, 6-month survival, quality of life for long-term survival (EQ-5D score), successful rate of ECMO weaning, long-term survivors’ cardiac function, the number of days alive without continuous renal replacement therapy, mechanical ventilation and vasopressor, ICU and hospital length of stay, the rate of complications potentially related to ECMO treatment.Ethics and disseminationThe trial has been approved by the Clinical Research and Application Institutional Review Board of the Second Affiliated Hospital of Guangzhou Medical University (2020-hs-51). Participants will be screened and enrolled from ICU patients with septic shock by clinicians, with no public advertisement for recruitment. Results will be disseminated in research journals and through conference presentations.Trial registration numberNCT05184296.
“When you’re hurt and you need serious help you call 999.” Educating children about emergency services and appropriate use of 999: An evaluation study of the Blue Light Hub app
Authors: Paine Amy L , Maclean Fiona 
Published: June 2024

ObjectivesIn the face of unprecedented demand, the Welsh Ambulance Services University NHS Trust developed ‘Blue Light Hub’: a new app to educate primary school-aged children about emergency services. Our overarching aim was to examine the effectiveness of the app.DesignPrimary school-aged children from three schools in South Wales, UK, played with the app for 2 hours over 2 weeks in class time. Children completed quizzes to assess their knowledge and awareness of, and confidence in engaging with, emergency services before and after using the app.ParticipantsOur evaluation focused on N=393 children who completed both the pre-test and post-test quizzes. On average, children were 8–9 years old (median school year, Year 4); 47.8% were male and 50.9% were female.ResultsAfter using the app, there was a significant increase in the proportion of children who knew of appropriate actions to take in non-emergency scenarios, χ2(1) = 26.01, and could provide a question a call handler would ask them if they called 999, χ2(1) = 13.79. There was also an increase in the proportion of children who could identify an National Health Service (NHS) service that could help them if they were unwell, χ2(1) = 33.31, name different roles in the NHS, χ2(1) = 12.80 and knew how dialling 111 could help them χ2(1) = 90.05 (all p values<0.001).ConclusionTo our knowledge, Blue Light Hub is the first app of its kind designed to educate primary school-aged children about emergency services. Our findings provide preliminary evidence that the app supports children’s knowledge and awareness of emergency services.
Association of parental obesity with the profile of metabolic-bariatric surgery patients: a cohort study of the German StuDoQ|MBE registry
Authors: Herrmann Stephan , Fink Mira , Fagnocchi Luca , Matsuo Koji , Fink Jodok , Lässle Claudia , Marjanovic Goran , Fichtner-Feigl Stefan , Pospisilik J Andrew , Seifert Gabriel 
Published: June 2024

ObjectivesTo investigate the association of parental obesity (PO) with onset of obesity, pre-surgical disease duration and body mass index (BMI) at the time of surgery in patients undergoing metabolic-bariatric surgery (MBS).DesignThis is a cohort study of the German StuDoQ registry for metabolic-bariatric diseases. All surgical cases from initiation of the registry in September 2015 until August 2020 were screened for pertinent information.SettingThe registry is based on participating German hospitals of various sizes.ParticipantsA total of 11 891 patients were included in this analysis, 74.2% of which were females and 25.8% males. Roux-en-Y gastric bypass was performed in 5652 (47.5%) cases, sleeve gastrectomy in 4618 (38.8%) cases and one-anastomosis gastric bypass in 1621 (13.6%) cases.ResultsOne-sided and two-sided PO are independently associated with early-onset obesity (OR 1.61, [95% CI, 1.47 to 1.76], p<0.001 and OR 2.45, [95% CI, 2.22 to 2.71], p<0.001) and prolonged pre-surgical disease duration (regression coefficient 2.39, [95% CI, 1.93 to 2.83], p<0.001 and regression coefficient 4.27, [95% CI, 3.80 to 4.75], p<0.001). Unlike one-sided PO, two-sided PO had a significant association with BMI at the time of surgery (regression coefficient 0.49, [95% CI, 0.14 to 0.85], p=0.006). Age at the onset of obesity and disease duration had a negative association with BMI at the time of surgery (regression coefficient −0.13, [95% CI, −0.14 to −0.11], p<0.001 and regression coefficient −0.05, [95% CI, −0.07 to −0.04], p<0.001).ConclusionsThis study established a clear association between PO status of patients undergoing MBS and their pre-surgical patient profile as well as known risk factors for poor postoperative response.
Zipime-Weka-Schista study protocol: a longitudinal cohort study and economic evaluation of an integrated home-based approach for genital multipathogen screening in women, including female genital schistosomiasis, human papillomavirus, Trichomonas and HIV in Zambia
Authors: Shanaube Kwame , Ndubani Rhoda , Kelly Helen , Webb Emily , Mayaud Philippe , Lamberti Olimpia , Fitzpatrick Jennifer , Kasese Nkatya , Sturt Amy , Van Lieshout Lisette , Van Dam Govert , Corstjens Paul L A M , Kosloff Barry , Bond Virginia , Hayes Richard , Terris-Prestholt Fern , Webster Bonnie , Vwalika Bellington , Hansingo Isaiah , Ayles Helen , Bustinduy Amaya L 
Published: June 2024

IntroductionMultiplathogen home-based self-sampling offers an opportunity to increase access to screening and treatment in endemic settings with high coinfection prevalence of sexually transmitted (HIV,Trichomonas vaginalis (Tv),human papillomavirus (HPV)) and non-sexually transmitted pathogens (Schistosoma haematobium (Sh)). Chronic coinfections may lead to disability (female genital schistosomiasis) and death (cervical cancer). The Zipime-Weka-Schista (Do self-testing sister!) study aims to evaluate the validity, acceptability, uptake, impact and cost-effectiveness of multipathogen self-sampling for genital infections among women in Zambia.Methods and analysisThis is a longitudinal cohort study aiming to enrol 2500 non-pregnant, sexually active and non-menstruating women aged 15–50 years from two districts in Zambia with 2-year follow-up. During home visits, community health workers offer HIV andTvself-testing and cervicovaginal self-swabs for (1) HPV by GeneXpert and, (2)ShDNA detection by conventional (PCR)and isothermal (recombinase polymerase assay) molecular methods.Schistosomaova and circulating anodic antigen are detected in urine. At a clinic follow-up, midwives perform the same procedures and obtain hand-held colposcopic images. High-risk HPV positive women are referred for a two-quadrant cervical biopsy according to age and HIV status. A cost-effectiveness analysis is conducted in parallel.Ethics and disseminationThe University of Zambia Biomedical Research Ethics Committee (UNZABREC) (reference: 1858-2021), the London School of Hygiene and Tropical Medicine (reference: 25258), Ministry of Health and local superintendents approved the study in September 2021.Written informed consent was obtained from all participants prior to enrolment. Identifiable data collected are stored securely and their confidentiality is protected in accordance with the Data Protection Act 1998.