bluuebunny/crossref_metadata_2025_split huggingface dataset:
Photoreceptor degeneration has heterogeneous effects on functional retinal ganglion cell types
Authors: Dyszkant Nadine , Oesterle Jonathan , Qiu Yongrong , Harrer Merle , Schubert Timm , Gonschorek Dominic , Euler Thomas 
Published: February 2025

AbstractRetinitis pigmentosa is a hereditary disease‐causing progressive degeneration of rod and cone photoreceptors, with no effective therapies. Using rd10 mice, which mirror the human condition, we examined its disease progression. Rods deteriorate by postnatal day (P) 45, followed by cone degeneration, with most photoreceptors lost by P180. Until then, retinal ganglion cells (RGCs) remain light‐responsive under photopic conditions, despite extensive outer retinal remodelling. However, it is still unknown if distinct functional RGC types alter their activity or are even lost during disease progression. Here, we asked if and how the response diversity of functional RGC types changes with rd10 disease progression. At P30, we identified all functional wild‐type RGC types also in rd10 retinae, suggesting that at this early degenerative stage, the full breadth of retinal output is still present. Remarkably, we found that the fractions of functional types changed throughout progressing degeneration between rd10 and wild‐type: responses of RGCs with ‘Off’‐components (‘Off’ and ‘On–Off’ RGCs) were more vulnerable than ‘On’‐cells, with ‘Fast On’ types being the most resilient. Notably, direction‐selective RGCs appeared to be more vulnerable than orientation‐selective RGCs. In summary, we found differences in resilience of response types (from resilient to vulnerable): ‘Uncertain’ > ‘Fast On’ > ‘Slow On’ > ‘On–Off’ > ‘Off’. Taken together, our results suggest that rd10 photoreceptor degeneration has heterogeneous effects on functional RGC types, with distinct sets of types losing their characteristic light responses earlier than others. This differential susceptibility of RGC circuits may be of relevance for future neuroprotective therapeutic strategies.
imageKey points
Retinitis pigmentosa is a hereditary disease causing progressive degeneration of rod and cone photoreceptors, with no effective therapies; it can be investigated using mutant mouse models, like rd10, that mirror the human condition.
Recent studies found that retinal ganglion cells (RGCs) in rd10 remain light‐responsive, despite extensive loss of photoreceptors and outer retinal remodelling; however, specific RGC types still may change or even lose their functional response profile during early degeneration.
Using two‐photon calcium imaging, we assessed if and how the light‐evoked activity of RGCs, and, hence, the retinal output to the brain, differs during the disease progression in rd10 compared to wild‐type mice.
We found differences in the resilience of functional RGC types: generally, ‘On’‐types were more resilient than ‘On–Off’ or especially ‘Off’ types.
Our data suggest that interventions may be more effective in the ‘On’ pathways, which turned out to be more resilient in rd10.
Stage III uterine prolapse in pregnancy as risk factor for puerperal uterine inversion
Authors: Cumbo Nicole , Platukus Alana , Schultz Pamela 
Published: February 2025

SummaryUterine inversion is a potentially life-threatening complication of childbirth that can result in haemorrhage, hysterectomy and even death. There are many maternal risk factors associated with uterine inversion, but one rarely seen in the literature is uterine prolapse. We present the case of a multigravida in her 20s who presented at 32 weeks gestation in preterm labour. Her pregnancy was complicated by stage III uterine prolapse. She delivered a liveborn preterm male. During the third stage of labour, there was a second-degree uterine inversion. The patient was given terbutaline, and the uterus was manually replaced via the Johnson maneuverer under general anaesthesia without significant morbidity. Uterine prolapse during pregnancy may be a risk factor for uterine inversion at the time of delivery. The case presented demonstrates the management of uterine inversion following a pregnancy complicated by stage III uterine prolapse.
De novo Graves’ thyroid eye disease after radioiodine treatment for toxic nodular thyroid disease
Authors: Sankar Adhithya , Singh Rashmita , Pearce Sushmita 
Published: February 2025

It is well known that radioactive iodine treatment (RAI) for thyrotoxicosis in Graves’ disease can precipitate worsening of thyroid eye disease (TED), particularly in susceptible patients. Less commonly, it has been associated withde novodevelopment of TED in those with Graves’ disease without a history. Prophylactic steroid treatment has been shown to reduce the incidence of this phenomenon in those with risk factors.Here, we describe a patient with thyrotoxicosis due to nodular thyroid disease rather than Graves’ disease and normal baseline thyroid-stimulating hormone receptor antibody (TRAb) levels and no other risk factors for TED, who subsequently developed new onset TED associated with thyrotoxicosis and elevated TRAb levels following RAI.
Bilateral recurrent painful ophthalmoplegic neuropathy in an adolescent female
Authors: Parotra Aabhasha , Mishra Rashmi , Rustagi Mridula Singh , Maheshwari Siddharth 
Published: February 2025

Recurrent painful ophthalmoplegic neuropathy (RPON) is a rare condition characterised by recurrent episodes of headache followed by ophthalmoplegia.An adolescent female presented with a throbbing unilateral headache associated with photophobia and phonophobia, progressing to binocular diplopia after 10–12 hours. She had two prior episodes that resolved spontaneously over 2-3 weeks. On examination, she exhibited binocular diplopia with restricted abduction in both eyes but no ptosis or abnormal reflexes. Neurological examination was otherwise normal. Investigations, including blood tests, cerebrospinal fluid analysis, MRI brain and nerve conduction studies, were all unremarkable. The case was diagnosed as RPON, given the absence of other pathologies and the clinical presentation.
Inequality in maternal delays related to maternal death at home and en route to a health facility in Ethiopia: insights from national mortality surveillance data
Authors: Tesfay Neamin , Hailu Girmay , Tariku Rozina , Firde Haymanot , Woldeyohannes Fistum Hadgu 
Published: February 2025

ObjectiveThis study aims to quantify and identify the contributors to inequity in the maternal mortality risk index for deaths occurring at home and en route to health facilities.Design and settingAnalysis of the Maternal Death Surveillance and Response data, encompassing maternal deaths reviewed in Ethiopia from 2013 to 2020.AnalysisThe Maternal Mortality Risk Index was computed using 14 variables grouped according to the three contributors to delay model: contributors to delay in seeking care, contributors to delay in reaching care and contributors to delay in receiving optimal care. Principal component analysis was employed to calculate the index descriptive statistics, and the Erreygers Normalised Concentration Index (ECI) measured inequalities in the maternal mortality risk index across different places of death. Blinder-Oaxaca decomposition analysis identified factors contributing to these disparities in maternal deaths at home and intransit.ParticipantsA total of 4530 reviewed maternal deaths were included in this study.ResultsECI was 0.18 (SE 0.02) for maternal deaths occurring at home and 0.12 (SE 0.01) for those en route to a health facility, indicating a higher concentration of deaths among women with a high maternal mortality risk index in both settings. Decomposition analysis identified marital status, educational status, maternal parity and residence as the key contributors to this disparity.ConclusionA notable disparity in the maternal mortality risk index was observed, with home and intransit deaths predominantly affecting women with a high maternal mortality risk index. To reduce these inequalities, efforts should be made to improve community health-seeking behaviour and establish effective referral linkages.
Prevalence and sociodemographic characteristics of functional impairment in community-dwelling older adults in China: a cross-sectional study
Authors: Li Xiaxia , Yu Wenhua , Liu Pan , Zhang Li , Zhang Yaxin , Li Yun , Tang Zhe , Ma Lina 
Published: February 2025

ObjectivesFunctional impairment is an early stage of disability, and timely identification and intervention are critical for the health of older adults. However, little is known about the functional impairment of Chinese older adults due to the absence of specialised assessment tools. This study aimed to explore the prevalence and socio-demographic characteristics of functional impairment in Chinese community-dwelling older adults using the Function Impairment Screening Tool (FIST), which was previously developed based on the Delphi method.DesignCross-sectional study.SettingCommunity-based.ParticipantsThe study included 6444 community-dwelling older adults from the China Comprehensive Geriatric Assessment Study.ResultsThe FIST identified functional impairment in 31.3% of Chinese community-dwelling older adults. The prevalence was higher among women and individuals in rural areas and increased with age. Illiteracy, no spouse, living alone, poor self-reported health, low income, limited meat intake, less exercise, chronic diseases and geriatric syndromes were associated with functional impairment. Furthermore, after adjusting for related variables, functional impairment was independently associated with disability (OR=138.5, 95% CI 70.0 to 273.9), frailty (OR=13.7, 95% CI 10.3 to 18.3), immobility (OR=6.9, 95% CI 5.4 to 8.9), fractures (OR=2.2, 95% CI 1.5 to 3.3) and falls (OR=2.6, 95% CI 1.8 to 3.7).ConclusionApproximately one-third of Chinese community-dwelling older adults experienced functional impairment, and its prevalence was associated with socio-psychological characteristics, lifestyle, chronic diseases and geriatric syndromes.
Cluster analysis of post-COVID-19 physical and mental health outcomes 3–6 months after SARS-CoV-2 infection: results of the French Prospective ALCOVID Cohort Study
Authors: Escoda Thomas , Chiche Laurent , Faralli Hervé , Cohen Frédéric , Halfon Philippe , Pegliasco Hervé , Rebaudet Stanislas 
Published: February 2025

ObjectivesThis study aims to characterise the diversity of post-COVID-19 physical and mental health outcomes, known as the post-COVID-19 condition (PCC), and the determining factors 3–6 months after acute SARS-CoV-2 infection.DesignThis is a prospective cohort study.SettingThis study took place at the European Hospital of Marseille, France.ParticipantsParticipants include patients with acute COVID-19 treated as inpatients or outpatients.InterventionsInterventions include face-to-face assessment of physical and mental health symptoms.Main outcome measuresMain outcome measures include symptom scores and scales, as well as paraclinical elements (thoracic CT scan, pulmonary functional tests). Multiple component analysis was used to identify clinical phenotypic clusters of PCC patients, as well as their initial comorbidity groups. A multinomial regression model was used to evaluate the association between the initial comorbidities and disease severity with PCC phenotype.ResultsA total of 210 patients agreed to participate, of which 157 (75%) reported at least one symptom at the 3–6 months visit; mostly asthenia, dyspnoea, psychiatric disorders such as anxiety, depression, post-traumatic stress disorder and cognitive disorders. Four PCC clusters were recognised: (1) paucisymptomatic PCC (n=82, 39%); (2) physical sequelae PCC (n=39, 18.6%), (3) pre-existing pulmonary comorbidities PCC (n=29, 13.8%); and (4) functional somatic and/or mental symptoms PCC (n=60, 28.6%). In addition to their PCC symptoms, the patients in these clusters differed in terms of their demographic characteristics (sex), comorbidities and severity of COVID-19.ConclusionsThe four identified PCC clusters corresponded to distinct and coherent clinical and paraclinical entities, making it possible to consider adapted and personalised prognosis and therapeutic interventions.
Protocol for a meta-review of interventions to prevent and manage ICU delirium
Authors: Jones Katherine Louise , Kundakci Burak , Booth Andrew , Pufulete Maria , Gibbison Ben 
Published: February 2025

IntroductionIntensive care unit (ICU) delirium is an acute brain dysfunction that affects up to 7 out of 10 patients admitted to ICUs. Patients who develop ICU delirium cannot think clearly, have trouble paying attention, do not understand what is happening around them and may see or hear things that are not there. ICU delirium increases the time patients spend in ICUs and hospitals and therefore healthcare costs. ICU delirium is also associated with increased mortality and dementia in the longer term. ICU delirium prevention and management strategies are likely to include both pharmacological and non-pharmacological components as part of a complex intervention, but it is unclear which components should be included. The objective of this meta-review is to systematically map the quantity and certainty of the available evidence from reviews and meta-analyses of randomised controlled trials (RCTs) of pharmacological and non-pharmacological interventions, which will be used to design a multicomponent intervention to prevent and manage ICU delirium.Methods and analysisA systematic search strategy was performed in MEDLINE (Ovid), Embase (Elsevier), Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and Web of Science (from inception to 26 September 2023), as well as Epistemonikos (from inception to 19 July 2023). We will include all critically ill adults (aged≥18 years) and any ICU delirium prevention or management intervention (pharmacological or non-pharmacological). For pharmacological interventions, we will include reviews of RCTs. For non-pharmacological interventions, we will consider reviews of RCTs, quasi-experimental and cohort studies. We will use the International Consensus Study (Del-COrS) core outcome set for research evaluating interventions to prevent or manage ICU delirium and synthesise our findings using quantitative data description methods. We will involve our Patient and Public Involvement group of people who experienced ICU delirium to develop and comment on such aspects as the research question, methodology and which outcomes are most important.Ethics and disseminationNo ethical approval is required for this study. The results of this meta-review will be disseminated through peer-reviewed publications and conferences. They will also form part of an evidence map and logic model for the prevention and management of ICU delirium.PROSPERO registration numberCRD42023473260
Supervised Injecting Room Cohort Study (SIRX): study protocol
Authors: Stewart Ashleigh C , Hickman Matthew , Agius Paul A , Scott Nick , Stone Jack , Roxburgh Amanda , O’Keefe Daniel , Higgs Peter , Kerr Thomas , Stoové Mark A , Thompson Alexander , Crawford Sione , Norman Josephine , Vella-Horne Dylan , Lloyd Zachary , Clark Nico , Maher Lisa , Dietze Paul 
Published: February 2025

BackgroundSupervised injecting facilities (SIFs) are designed to reduce the harms associated with injecting drug use and improve access to health and support services for people who need them. The Supervised Injecting Room Cohort Study (SIRX) aims to provide evidence of the effects, including cost-effectiveness, of a SIF embedded within a community health service, the Melbourne Medically Supervised Injecting Room (MSIR), which has a range of integrated harm reduction, health and social support services on-site.Methods and analysisThe SIRX study design involves two prospective cohort studies that collect behavioural data and retrospectively and prospectively linked administrative data for primary and tertiary health services, criminal justice records, and mortality. The two cohorts are: (1) participants drawn from the existing Melbourne Injecting Drug User Cohort Study (SuperMIX; established in 2008–ongoing) through which participants consent to annual behavioural surveys (including serological testing for HIV and hepatitis B and C viruses) and linkage to administrative data; and (2) the SIRX-Registration Cohort (SIRX-R; established in 2024) comprising registered MSIR clients who consent to a baseline behavioural survey and administrative data linkage including the frequency of SIF use, and the uptake of on-site services. Primary outcomes are aligned to the legislated aims of the Melbourne MSIR, including ambulance-attended non-fatal overdoses and all-cause and drug-related mortality. Using causal inference methods, analyses will estimate the effect of MSIR exposure (frequent use/infrequent use/no use) on these primary outcomes. The SIRX study also has a secondary focus on the effect of MSIR exposure on health service use and related outcomes.Ethics and disseminationSuperMIX Study (599/21) and SIRX-R Study (71/23) ethics approvals were obtained from Alfred Hospital Research Ethics Committee. Participants will be assessed for capacity to provide informed consent following a detailed explanation of the study. Participants are informed of their right to withdraw from the study at any time and that withdrawing does not impact their access to services. Aggregated research results will be disseminated via presentations at national and international scientific conferences and publications in peer-reviewed journals. Local-level reports and outputs will be distributed to key study stakeholders and policymakers. Summary findings via accessible outputs (eg, short infographic summaries) for participants will be displayed in relevant services including the Melbourne MSIR and the study van, and distributed via Harm Reduction Victoria.
Comprehensive coronary CT angiography in people living with HIV: a systematic review and meta-analysis
Authors: Phillips Tarin , Blake Gregory M , Aun Jonathan A , Conte Lisa M , Gadodia Ritika , Tuli Aakash , Nguyen Binh T , Robinson Sara L , Harrell Travis E , Murthy Venkatesh L , Hulten Edward 
Published: February 2025

ObjectivesPeople living with HIV (PLWH) were previously shown to have a higher prevalence of non-calcified coronary plaque with discrepant results for coronary stenosis and any plaque prevalence. This systematic review and meta-analysis summarise and estimate pooled effect sizes for observational studies among PLWH using comprehensive coronary CT angiography (CTA).DesignPreferred Reporting Items for Systematic Review and Meta-analysis reporting guidelines were used.Data sourcesPubMed, Embase, Web of Science, CINAHL, Cochrane Clinical Trials and EBM were searched from inception to 23 February 2024.Eligibility criteriaWe included studies evaluating coronary atherosclerosis in adult PLWH with controls and CTA results for plaque prevalence, extent, severity and high-degree stenosis.Data extraction and synthesisTwo independent reviewers used standardised methods to screen for relevance by title, abstract and full-text review. Two unblinded independent reviewers manually extracted data and rated study quality using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. A sensitivity analysis was performed with a fixed effects model. Publication bias was assessed by visual inspection of funnel plots and formal testing by Egger’s and Begg’s tests. Segment scores were evaluated using the difference of medians.ResultsPLWH showed a significantly higher prevalence of non-calcified plaque (34% (95% CI: 15% to 53%)) compared with controls (22% (95% CI: 6% to 38%)) with an OR of 1.61 (1.13–2.30, p=0.009). There was no significant difference in partially calcified plaque prevalence (OR=1.20, 0.96–1.49), stenosis prevalence (OR=1.34, 0.92–1.96) and median difference in Segment Involvement Score (SIS; 0.39, –0.01 to 0.79) in PLWH compared with controls who have a non-significant difference in calcified plaque (OR=0.80, 0.61–1.04). The prevalence of any plaque (OR=1.22, 0.93–1.61) and difference in median Segment Stenosis Score (−0.12, –0.60 to 0.35) did not differ between groups.ConclusionThis study demonstrates a greater prevalence of non-calcified plaque in PLWH than controls. Additional research is needed to assess quantitative CTA measurements. Increased power may reveal a difference in the prevalence of high-degree stenosis and median SIS score in PWLH, while controls may have a greater prevalence of calcified plaque.
Evaluation of quality policies and strategies in health systems: a scoping review
Authors: Pellense Márcia Cunha da Silva , Saturno Hernández Pedro Jesús , Caldas Anna Cláudia Sales Gomes , Gama Zenewton André da Silva 
Published: February 2025

ObjectivesImproving the quality of care requires specific, comprehensive and continuous attention from the administration of a health system. However, information on evaluations of national and subnational policies and strategies for quality is lacking. This study aims to map studies evaluating policies and strategies for quality in health systems around the world.DesignThis is a scoping review based on the guidelines of the Joanna Briggs Institute (JBI), guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).Data sourcesThe search for articles was carried out in the Embase, Medline/Pubmed, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature databases and in the grey literature in July 2024.Eligibility criteriaPublications describing a tool for evaluating interventions for quality in the health system and studies containing at least one conceptual framework related to the evaluation of policies and strategies for quality in the health system, in any language, were included.Data extraction and synthesisData selection was carried out independently by two reviewers, whose conflicts were resolved by consensus and the decision of a third reviewer. The findings were synthesised using a data extraction protocol adapted from two theoretical frameworks on National Quality Policies and Strategies proposed by the WHO.ResultsThe data search resulted in 133 potentially eligible studies, of which 14 studies were included in the review. We found 27 countries that had evaluated their policies or strategies, most of them in Asia (11) and Africa (9). Six studies used instruments to evaluate interventions for quality at the health system level. An instrument used in Afghanistan, Armenia, Guatemala and Mexico proved to be potentially useful for dissemination in other countries. Among the elements recommended by the WHO for the implementation of strategic policies for quality, the most present were governance and organisational structure.ConclusionsAlthough the evidence provides an indication of how countries have implemented their quality policies and strategies, we identified the need for tools to assess their impact on health systems.