bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous immunoglobulin treatment in childhood encephalitis (IgNiTE): a randomised controlled trial
Authors: Hill Matilda , Iro Mildred , Sadarangani Manish , Absoud Michael , Cantrell Liberty , Chong Kling , Clark Christopher , Easton Ava , Gray Victoria , Kneen Rachel , Lim Ming , Liu Xinxue , Pike Michael , Solomon Tom , Vincent Angela , Willis Louise , Yu Ly-Mee , Pollard Andrew J 
Published: February 2024

ObjectiveTo investigate whether intravenous immunoglobulin (IVIG) improves neurological outcomes in children with encephalitis when administered early in the illness.DesignPhase 3b multicentre, double-blind, randomised placebo-controlled trial.SettingTwenty-one hospitals in the UK.ParticipantsChildren aged 6 months to 16 years with a diagnosis of acute or subacute encephalitis, with a planned sample size of 308.InterventionTwo doses (1 g/kg/dose) of either IVIG or matching placebo given 24–36 hours apart, in addition to standard treatment.Main outcome measureThe primary outcome was a ‘good recovery’ at 12 months after randomisation, defined as a score of≤2 on the Paediatric Glasgow Outcome Score Extended.Secondary outcome measuresThe secondary outcomes were clinical, neurological, neuroimaging and neuropsychological results, identification of the proportion of children with immune-mediated encephalitis, and IVIG safety data.Results18 participants were recruited from 12 hospitals and randomised to receive either IVIG (n=10) or placebo (n=8) between 23 December 2015 and 26 September 2017. The study was terminated early following withdrawal of funding due to slower than anticipated recruitment, and therefore did not reach the predetermined sample size required to achieve the primary study objective; thus, the results are descriptive. At 12 months after randomisation, 9 of the 18 participants (IVIG n=5/10 (50%), placebo n=4/8 (50%)) made a good recovery and 5 participants (IVIG n=3/10 (30%), placebo n=2/8 (25%)) made a poor recovery. Three participants (IVIG n=1/10 (10%), placebo n=2/8 (25%)) had a new diagnosis of epilepsy during the study period. Two participants were found to have specific autoantibodies associated with autoimmune encephalitis. No serious adverse events were reported in participants receiving IVIG.ConclusionsThe IgNiTE (ImmunoglobuliN in the Treatment of Encephalitis) study findings support existing evidence of poor neurological outcomes in children with encephalitis. However, the study was halted prematurely and was therefore underpowered to evaluate the effect of early IVIG treatment compared with placebo in childhood encephalitis.Trial registration numberClinical Trials.govNCT02308982; ICRCTN registryISRCTN15791925.
Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
Authors: Lok Charmaine E , Hemmelgarn Brenda R , Moist Louise M , Polkinghorne Kevan , Tomlinson George , Tonelli Marcello 
Published: February 2024

IntroductionPatients with kidney failure with replacement therapy (KFRT) suffer premature cardiovascular (CV) mortality and events with few proven pharmacological interventions. Omega-3 polyunsaturated essential fatty acids (n-3 PUFAs) are associated with a reduced risk of CV events and death in non-dialysis patients and in patients with established CV disease but n-3 PUFAs have not been evaluated in the high risk KFRT patient population.Methods and analysisThis multicentre randomised, placebo controlled, parallel pragmatic clinical trial tests the hypothesis that oral supplementation with n-3 PUFA, when added to usual care, leads to a reduction in the rate of serious CV events in haemodialysis patients when compared with usual care plus matching placebo. A target sample size of 1100 KFRT patients will be recruited from 26 dialysis units in Canada and Australia and randomised to n-3 PUFA or matched placebo in a 1:1 ratio with an expected intervention period of at least 3.5 years. The primary outcome to be analysed and compared between intervention groups is the rate of all, not just the first, serious CV events which include sudden and non-sudden cardiac death, fatal and non-fatal myocardial infarction, stroke, and peripheral vascular disease events.Ethics and disseminationThis study has been approved by all institutional ethics review boards involved in the study. Participants could only be enrolled following informed written consent. Results will be published in peer-reviewed journals and presented at scientific and clinical conferences.Trial registration numberISRCTN00691795
Predictors of mortality in hospitalised patients with COVID-19: a 1-year case–control study
Authors: Camacho-Domínguez Laura , Rojas Manuel , Herrán María , Rodríguez Yhojan , Beltrán Santiago , Galindo Paola Saboya , Aguirre-Correal Nicolas , Espitia María , García Santiago , Bejarano Valeria , Morales-González Victoria , Covaleda-Vargas Jaime Enrique , Rodríguez-Jiménez Mónica , Zapata Elizabeth , Monsalve Diana M , Acosta-Ampudia Yeny , Anaya Juan-Manuel , Ramírez-Santana Carolina 
Published: February 2024

BackgroundA paucity of predictive models assessing risk factors for COVID-19 mortality that extend beyond age and gender in Latino population is evident in the current academic literature.ObjectivesTo determine the associated factors with mortality, in addition to age and sex during the first year of the pandemic.DesignA case–control study with retrospective revision of clinical and paraclinical variables by systematic revision of clinical records was conducted. Multiple imputations by chained equation were implemented to account for missing variables. Classification and regression trees (CART) were estimated to evaluate the interaction of associated factors on admission and their role in predicting mortality during hospitalisation. No intervention was performed.SettingHigh-complexity centre above 2640 m above sea level (masl) in Colombia.ParticipantsA population sample of 564 patients admitted to the hospital with confirmed COVID-19 by PCR. Deceased patients (n=282) and a control group (n=282), matched by age, sex and month of admission, were included.Main outcome measureMortality during hospitalisation.Main resultsAfter the imputation of datasets, CART analysis estimated 11 clinical profiles based on respiratory distress, haemoglobin, lactate dehydrogenase, partial pressure of oxygen to inspired partial pressure of oxygen ratio, chronic kidney disease, ferritin, creatinine and leucocytes on admission. The accuracy model for prediction was 80.4% (95% CI 71.8% to 87.3%), with an area under the curve of 78.8% (95% CI 69.63% to 87.93%).ConclusionsThis study discloses new interactions between clinical and paraclinical features beyond age and sex influencing mortality in COVID-19 patients. Furthermore, the predictive model could offer new clues for the personalised management of this condition in clinical settings.
Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial
Authors: Nadar Mohammed Sh , Alotaibi Naser , Manee Fahad 
Published: February 2024

ObjectivesTo compare the efficacy of a traditional cock-up splint, which supports the wrist only, with a modified splint that supports the wrist and the metacarpophalangeal (MCP) joints of the medial four digits in the treatment of carpal tunnel syndrome (CTS).DesignAn assessor-blind randomised controlled trial.SettingHospital-based hand therapy clinics.ParticipantsFifty-nine adults with mild-to-moderate CTS were randomly assigned to wear a wrist splint (control group) or an MCP splint (intervention group) for 6 weeks.Outcome measuresThe standardised outcome measures used included grip and pinch strength, the static two-point discrimination test, Phalen’s manoeuvre test, Tinel’s sign and the Boston CTS Questionnaire.ResultsBoth groups improved significantly from splint use in some clinical features. The wrist splint and the MCP splint groups had significant improvements in lateral pinch strength (p=0.032 and p=0.002, respectively), two-point discrimination of the thumb (p=0.003 and p=0.041, respectively), two-point discrimination of the index (p=0.035 and p=0.023, respectively) and the Phalen’s manoeuvre symptoms (p=0.025 and p=0.002, respectively). The MCP splint group had additional improvements over the wrist splint group in tip pinch (p=0.012) and Palmar pinch (p=0.011) strength.ConclusionSplinting is a practical and effective intervention option for improving the symptoms of CTS. A wrist splint that incorporates the MCP joints is more effective than the traditional wrist-only splint, with long-lasting improvements that remained consistent after 6 months of the splint intervention. Using the more effective MCP splint may consequently reduce disability, facilitate return to work and lower the associated costs.Trial registration numberISRCTN13189602.
Effects of length of residency on the development of physical and mental illnesses in immigrant women in Taiwan: a retrospective cohort study using nationwide data
Authors: Lee Pei-Chen , Chen Yi-Lung , Yang Hao-Jan 
Published: February 2024

ObjectivesThe majority of female immigrants who are married in Taiwan often face a variety of stresses, which may lead to physical or mental illness. Yet few studies have validated the impact of length of residency on physical and mental health using large-scale data. This study combined five nationwide databases and explored the impact of length of residency in Taiwan on the physical and mental health of female marriage immigrants.DesignThis is a retrospective cohort study.SettingTaiwan.ParticipantsA total of 168 202 female immigrants, who were registered in the national health insurance database from 2001 to 2017, were enrolled for analysis.MeasureThe length of residency was taken as the period from their first appearance in the national health insurance database to the end of 2017. Hypertension and diabetes were chosen as indices of physical health and depression as an index of mental health. Diagnosis standards were based on the International Classification of Disease, ninth or 10th Revision.ResultsThe physical and mental health of the immigrants deteriorated with increasing time of residence in Taiwan. Immigrants who had resided in Taiwan for 5–10 years or ≥10 years, respectively, had a 5.8-fold (95% CI: 3.46 to 9.74) or 6.29-fold (95% CI: 4.61 to 8.59) higher adjusted risk of developing hypertension; a 3.97-fold (95% CI: 2.54 to 6.21) or 9.18-fold (95% CI: 5.48 to 15.38) higher adjusted risk of developing diabetes; and a 5.01-fold (95% CI: 3.14 to 8.01) or 12.19-fold (95% CI: 8.65 to 17.18) higher adjusted risk of developing depression than their counterparts who had lived in Taiwan for ≤5 years.ConclusionThese findings suggest the time elapsed since migration can be a factor in the deterioration of both physical and mental health among female marriage immigrants in Taiwan.
Evaluation of a novel, multicomponent anxiety management programme for people with intellectual disability: protocol for a mixed-methods, quasi-experimental feasibility study
Authors: Acton Daniel , Williams Jonathan , Woodrow Ceri , Talbot Grace , Jones Steven , Lane Steven , Jaydeokar Sujeet 
Published: February 2024

IntroductionStudies have shown some benefits to single approaches to psychological therapies for the treatment of anxiety in people with intellectual disability such as modified cognitive–behavioural therapy and mindfulness. To our knowledge, no studies have used a multicomponent approach for the individual treatment of anxiety-related disorders in this population group. A co-production group of clinical experts and people with intellectual disability has created a novel multicomponent anxiety management programme (MCAMP-ID). The aims of this study are to investigate (1) the feasibility of this approach in reducing anxiety for people with a mild/moderate intellectual disability, (2) the feasibility of outcome measures and (3) the feasibility of completing a future randomised controlled trial of this programme. The data from this feasibility study will be used to inform trial design and to complete power calculation.Methods and analysisSixty people with intellectual disability will be invited to participate in the study across four intellectual disability services within one mental health trust in Northwest England. The specialist services will deliver either treatment as usual (TAU) or the novel intervention (MCAMP-ID). MCAMP-ID comprises of 10 individual sessions delivered by a member of the clinical team once a week for between 10 and 12 weeks. TAU will be based on standard treatment currently delivered to meet the person’s specific needs. The outcomes of the study will be feasibility of recruitment, attrition, adherence to the programme and suitability of outcome measures. A mixed-methods approach will be used to assess outcomes.Ethics and disseminationThe study received approval from the Research Ethics Committee and Health Research Authority (23/EM/0044) through the Integrated Research Application System (IRAS ID: 315557) in March 2023. Participants will provide informed consent before taking part. Study findings will be presented at conferences and published within a peer-reviewed journal.Trial registration numberISRCTN16062949.
Women’s perceptions and attitudes towards the use of AI in mammography in Sweden: a qualitative interview study
Authors: Viberg Johansson Jennifer , Dembrower Karin , Strand Fredrik , Grauman Åsa 
Published: February 2024

BackgroundUnderstanding women’s perspectives can help to create an effective and acceptable artificial intelligence (AI) implementation for triaging mammograms, ensuring a high proportion of screening-detected cancer. This study aimed to explore Swedish women’s perceptions and attitudes towards the use of AI in mammography.MethodSemistructured interviews were conducted with 16 women recruited in the spring of 2023 at Capio S:t Görans Hospital, Sweden, during an ongoing clinical trial of AI in screening (ScreenTrustCAD, NCT 04778670) with Philips equipment. The interview transcripts were analysed using inductive thematic content analysis.ResultsIn general, women viewed AI as an excellent complementary tool to help radiologists in their decision-making, rather than a complete replacement of their expertise. To trust the AI, the women requested a thorough evaluation, transparency about AI usage in healthcare, and the involvement of a radiologist in the assessment. They would rather be more worried because of being called in more often for scans than risk having overlooked a sign of cancer. They expressed substantial trust in the healthcare system if the implementation of AI was to become a standard practice.ConclusionThe findings suggest that the interviewed women, in general, hold a positive attitude towards the implementation of AI in mammography; nonetheless, they expect and demand more from an AI than a radiologist. Effective communication regarding the role and limitations of AI is crucial to ensure that patients understand the purpose and potential outcomes of AI-assisted healthcare.
Machine learning analysis of pathological images to predict 1-year progression-free survival of immunotherapy in patients with small-cell lung cancer
Authors: Shibaki Ryota , Fujimoto Daichi , Nozawa Tsukasa , Sano Akira , Kitamura Yuka , Fukuoka Junya , Sato Yuki , Kijima Takashi , Matsumoto Hirotaka , Yokoyama Toshihide , Miura Satoru , Hata Akito , Tamiya Motohiro , Taniguchi Yoshihiko , Sugisaka Jun , Furuya Naoki , Tanaka Hisashi , Yamamoto Nobuyuki , Koh Yasuhiro , Akamatsu Hiroaki 
Published: February 2024

BackgroundIn small-cell lung cancer (SCLC), the tumor immune microenvironment (TIME) could be a promising biomarker for immunotherapy, but objectively evaluating TIME remains challenging. Hence, we aimed to develop a predictive biomarker of immunotherapy efficacy through a machine learning analysis of the TIME.MethodsWe conducted a biomarker analysis in a prospective study of patients with extensive-stage SCLC who received chemoimmunotherapy as the first-line treatment. We trained a model to predict 1-year progression-free survival (PFS) using pathological images (H&E, programmed cell death-ligand 1 (PD-L1), and double immunohistochemical assay (cluster of differentiation 8 (CD8) and forkhead box P3 (FoxP3)) and patient information. The primary outcome was the mean area under the curve (AUC) of machine learning models in predicting the 1-year PFS.ResultsWe analyzed 100,544 patches of pathological images from 78 patients. The mean AUC values of patient information, pathological image, and combined models were 0.789 (range 0.571–0.982), 0.782 (range 0.750–0.911), and 0.868 (range 0.786–0.929), respectively. The PFS was longer in the high efficacy group than in the low efficacy group in all three models (patient information model, HR 0.468, 95% CI 0.287 to 0.762; pathological image model, HR 0.334, 95% CI 0.117 to 0.628; combined model, HR 0.353, 95% CI 0.195 to 0.637). The machine learning analysis of the TIME had better accuracy than the human count evaluations (AUC of human count, CD8-positive lymphocyte: 0.681, FoxP3-positive lymphocytes: 0.626, PD-L1 score: 0.567).ConclusionsThe spatial analysis of the TIME using machine learning predicted the immunotherapy efficacy in patients with SCLC, thus supporting its role as an immunotherapy biomarker.
Prospective evaluation and follow-up of nutritional status of children hospitalized in secondary-care level hospitals: a multicentre study
Authors: Hulst Jessie M. , van de Vorst Kelly , Olieman Joanne F. , Hendriks Daniëlle M. , Oudshoorn Johanna H. , Plötz Frans B. , Roskam Mariëlle , van der Schoor Sophie R.D. , Tramper-Stranders Gerdien A. , Verhoeven Jennifer J. , van Wering Herbert M. , Winder Eefje , Joosten Koen F.M. 
Published: February 2024

Although disease-associated undernutrition is still an important problem in hospitalized children that is often underrecognized, follow-up studies evaluating post-discharge nutritional status of children with undernutrition are lacking. The aim of this multicentre prospective observational cohort study was to assess the rate of acute undernutrition (AU) and/or having a high nutritional risk (HR) in children on admission to seven secondary-care level Dutch hospitals and to evaluate the nutritional course of AU/HR group during admission and post-discharge. STRONGkids was used to indicate HR, and AU was based on anthropometric data ( z-score < −2 for weight-for-age (WFA; <1 year) or weight-for-height (WFH; ≥1 year)). In total, 1985 patients were screened for AU/HR over a 12-month period. On admission, AU was present in 9.9% of screened children and 6.2% were classified as HR; 266 (13.4%) children comprised the AU/HR group (median age 2.4 years, median length of stay 3 days). In this group, further nutritional assessment by a dietitian during hospitalization occurred in 44% of children, whereas 38% received nutritional support. At follow-up 4–8 weeks post-discharge, 101 out of orginal 266 children in the AU/HR group (38%) had available paired anthropometric measurements to re-assess nutrition status. Significant improvement of WFA/WFH compared to admission (−2.48 vs. −1.51 SD; p < 0.001) and significant decline in AU rate from admission to outpatient follow-up (69.3% vs. 35.6%; p < 0.001) were shown. In conclusion, post-discharge nutritional status of children with undernutrition and/or high nutritional risk on admission to secondary-care level pediatric wards showed significant improvement, but about one-third remained undernourished. Findings warrant the need for a tailored post-discharge nutritional follow-up.
Laurentide Ice Sheet configuration in southern Ontario, Canada during the last glaciation (MIS 4 to 2) from stratigraphic drilling and LIDAR-based surficial mapping
Authors: Bukhari Syed , Eyles Nick , Mulligan Riley , Burt Abigail , Eyles Carolyn , Paulen Roger , Ross Martin , Putkinen Niko 
Published: February 2024

Regional subsurface mapping of glacial depositional systems preserved in buried bedrock paleovalleys, and quantitative analysis of new LiDAR imagery of surface glacial landforms using machine learning techniques, when combined, are powerful tools for assessing the dynamics of the Laurentide Ice Sheet (LIS) during the last (Wisconsinan) glaciation in southern Ontario. While age dating of deposits preserved below Last Glacial Maximum tills (LGM: marine isotope stage (MIS) 2 < c.24 000 years B.P. (ybp)) is still sparse, newly available sedimentological data derived by cored drilling, combined with legacy outcrop data, identify thick (100 m+) successions of glaciolacustrine sediments and a lack of till(s), indicating that the ice sheet margin did not extend beyond the Niagara Escarpment at the western end of Lake Ontario, during the earliest phases of the glaciation (MIS 4) or the ensuing mid-Wisconsinan (MIS 3). Ice was able to extend into New York State blocking the Rome outlet to the Hudson Valley ponding deep proglacial lakes in the glacio-isostatically depressed Huron–Ontario–Erie basins recorded by thick glaciolacustrine sediments in paleovalleys. These were cannibalized by an expanding Late Wisconsinan ice sheet after ∼24 000 ybp recorded by extensive till sheets resting on a marked erosional unconformity, with drumlinized surfaces. Analysis and visualization of LiDAR data identifies discrete statistically validated flow sets of highly elongated streamlined bedforms (mega-scale glacial lineations (MSGLs)). These provide key evidence of a major reorganization of the ice sheet margin during deglaciation into lobate paleo ice streams shortly after 17 400 ybp. MSGLs are cut across earlier LGM drumlinized tills creating widespread “palimpsest” surfaces. At least two principal phases of fast ice flow can be identified, marked by large fluxes of sediment and the rapid building of large gravel and sand-dominated moraine complexes within interlobate depocentres, the largest glacial landforms in southern Ontario. Analysis of LiDAR data further reveals the common presence of DeGeer moraines where ice margins retreated in water, and iceberg scours. Future work using LiDAR mapping has the objective of fully documenting the number, extent, and timing of ice streams to enhance glaciological modelling when the ice sheet rapidly lost mass.