bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cluster-randomised controlled equivalence trial of the Surprise Soap handwashing intervention among older children living in a refugee settlement in Sudan
Authors: Watson Julie , Osman Ibtihal Mohammed-Elhassan , Amon-Tanoh Maud , Deola Claudio , MacDougall Amy , Cumming Oliver 
Published: October 2023

IntroductionIncreasing handwashing with soap (HWWS) among older children in emergency settings can have a large public health impact, however, evidence on what works is limited. One promising approach is the ‘Surprise Soap’ intervention in which a novel soap with an embedded toy is delivered to children in a short, participatory household session that includes a glitter game and HWWS practice. Here, we evaluate this intervention against a standard intervention in a complex emergency setting.MethodsA cluster-randomised controlled equivalence trial was conducted in Naivasha refugee settlement, Sudan. Blinding was not possible. 203 randomly selected households, with at least one child aged 5–12, were randomised to receive the Surprise Soap intervention (n=101) or a standard intervention comprising a short household session with health messaging and plain soap distribution (n=102). The primary outcome was the proportion of prespecified potential HWWS events observed for children aged 5–12, accompanied by HWWS, at baseline, 4, 12 and 16 weeks post intervention delivery.Results200 households were included in the analyses: 101 intervention and 99 control. No difference in intervention effectiveness was observed at any follow-up (4 weeks: adjusted rate ratio (RR) 1.2, 95% CI 0.8 to 1.7; 12 weeks: RR 0.8, 95% CI 0.5 to 1.1; 16 weeks: RR 1.1, 95% CI 0.8 to 1.5). However, we observed increased HWWS in both arms at 4 weeks (27 and 23 percentage point increase in the intervention and control arm, respectively) that was sustained at 16 weeks.ConclusionsWe find that the Surprise Soap intervention is no more effective at increasing older children’s HWWS than a standard, household-level, health-based intervention in this complex humanitarian emergency. There appears to be no marginal benefit in terms of HWWS that would justify the additional cost of implementing the Surprise Soap intervention. Further trials that include a passive control arm are needed to determine the independent effects of each intervention and guide future intervention design.
Prognostic prediction models for oropharyngeal squamous cell carcinoma (OPSCC): a protocol for systematic review, critical appraisal and meta-analysis
Authors: Lu Zhen , Zhou Xinyi , Fu Leiwen , Li Yuwei , Tian Tian , Liu Qi , Zou Huachun 
Published: October 2023

IntroductionOropharyngeal squamous cell carcinoma (OPSCC) is increasingly prevalent and has significantly heterogeneous risks of survival for diagnosed individuals due to the inter-related risk factors. Precise prediction of the risk of survival for an individual patient with OPSCC presents a useful adjunct to therapeutic decision-making regarding the management of OPSCC. The aim of this systematic review, critical appraisal and meta-analysis is to assess prognostic prediction models for OPSCC and lay a foundation for future research programmes to develop and validate prognostic prediction models for OPSCC.Methods and analysisThis protocol will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocol statement. Based on predefined criteria, electronic databases including MEDLINE, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure (CNKI) will be searched for relevant studies without language restrictions from inception of databases to present. This study will systematically review published prognostic prediction models for survival outcomes in patients with OPSCC, describe their characteristics, compare performance and assess risk of bias and real-world clinical utility. Selection of eligible studies, data extraction and critical appraisal will be conducted independently by two reviewers. A third reviewer will resolve any disagreements. Included studies will be systematically summarised using appropriate tools designed for prognostic prediction modelling studies. Risk of bias and quality of studies will be assessed using the Prediction Model Risk of Bias Assessment Tool and the Transparent Reporting of a multivariable prediction model for individual prognosis or diagnosis. Performance measures of these models will be pooled and analysed with meta-analyses if feasible.Ethics and disseminationThis review will be conducted completely based on published data, so approval from an ethics committee or written consent is not required. The results will be disseminated through a peer-reviewed publication.PROSPERO registration numberCRD42023400272.
Burden and causes of pregnancy-related mortality in The Gambia: evidence from census and health and demographic surveillance data
Authors: Jasseh Momodou , Sanyang Nyakassi , Bittaye Mustapha , Mohammed Nuredin I , Gazeley Ursula Maria , Antonio Martin , Reniers Georges 
Published: October 2023

BackgroundThe Gambia lacks capacity to estimate its burden and causes of pregnancy-related mortality (PRM) to guide reproductive health programming. We used census and Health and Demographic Surveillance System (HDSS) data from Farafenni and Basse to establish levels and causes of PRM in The Gambia.MethodsUsing reported deaths and births in the 2013 Gambian census, national and regional pregnancy-related mortality ratios (PRMRatios) were derived as the ratio of pregnancy-related deaths (PRDs) per 100 000 live births (lbs). Verbal autopsies were interpreted using InterVA-5, and PRDs linked with extracted HDSS data to estimate annual PRMRatios.ResultsThe census yielded national PRMRatio of 861 per 100 000 lbs in 2012. Regional levels of 1877, 1232 and 1096 per 100 000 lbs were registered in rural regions of Kuntaur, Mansakonko and Basse, respectively; while urban areas of Banjul and Kanifing registered about half these levels. Women aged 15–19 and 40–49 had greater risks of dying from pregnancy-related causes. HDSS data produced lower PRMRatios (95% CI) ranging from 858 per 100 000 lbs (149–4969) for Farafenni in 2005, and 479 per 100 000 lbs (328–698) for Basse in 2008 to 184 (24–1450) and 173 (61–487) per 100 000 lbs, respectively. InterVA-5 returned pregnancy-induced hypertension and obstetric haemorrhage as the main causes, accounting for at least 70% of all PRDs.ConclusionThe census-based PRMRatios for 2012 were consistent with the sociodemographic and reproductive health indicators that prevailed at that time and represented the burden of PRM. While HDSS-derived PRMRatios were lower, the cause-of-death distribution produced was consistent with previous observations elsewhere.
Workplace violence in the COVID-19 era: a qualitative analysis of harassment and threats against public health professionals in Canada
Authors: Regehr Cheryl , Regehr Kaitlyn , Goel Vivek , Sato Christa , Lyons Kelly , Rudzicz Frank 
Published: October 2023

ObjectivesThis study reports the results of a qualitative study involving public health professionals and documents their experiences with cyberviolence, harassment and threats during the COVID-19 pandemic.Method and analysisThe research adopted a discovery-oriented qualitative design, using constructivist grounded theory method and long interview style data collection. Twelve public health professionals from across Canada who held responsibility for COVID-19 response and public health measures in their respective jurisdictions participated. Constant comparative analysis was used to generate concepts through inductive processes.ResultsData revealed a pattern that began with mainstream media engagement, moved to indirect cyberviolence on social media that fuelled outrage and polarisation of members of the public, followed by direct cyberviolence in the form of email abuse and threats, and finally resulted in physical threats and confrontation—which were then glorified and amplified on social media. The prolonged nature and intensity of harassment and threats led to negative somatic, emotional, professional and social outcomes. Concerns were raised that misinformation and comments undermining the credibility of public health professionals weakened public trust and ultimately the health of the population. Participants provided recommendations for preventing and mitigating the effects of cyber-instigated violence against public health professionals that clustered in three areas: better supports for public health personnel; improved systems for managing communications; and legislative controls on social media including reducing the anonymity of contributors.ConclusionThe prolonged and intense harassment, abuse and threats against public health professionals during COVID-19 had significant effects on these professionals, their families, staff and ultimately the safety and health of the public. Addressing this issue is a significant concern that requires the attention of organisations responsible for public health and policy makers.
Factors influencing viral shedding time in non-severe paediatric infection with the SARS-CoV-2: a single-centre retrospective study
Authors: Hong Ping , li Chengmei , Tian Xianmin , Che Datian 
Published: October 2023

BackgroundThe aim of this study was to determine the factors influencing viral shedding time (VST) in non-severe paediatric infection with SARS-CoV-2).MethodsWe conducted a retrospective analysis of data from 240 non-severe paediatric infection with the SARS-CoV-2. Multivariate Cox regression analysis was used to identify independent predictors associated with VST.ResultsTwo hundred and forty patients were included in the study. The median duration of VST was 10 days (IQR, 8–13 days). Compared with patients aged <1 year, children aged 6–12 years (adjusted HR (aHR): 1.849; 95% CI 1.031 to 3.315) and >12 years (aHR: 2.180; 95% CI 1.071 to 4.439) had shorter VST. Non-leucopenia patients (aHR: 1.431; 95% CI 1.005 to 2.038) also had a lower VST.DiscussionThe results of this study show that children aged <1 year and children with leucopenia had longer SARS-CoV-2 VST. These factors should be taken into account when developing policies for the isolation of patients with COVID-19.
Breast feeding in infants diagnosed with phenylketonuria (PKU): a scoping review
Authors: Kalvala Jahnavi , Chong Lydia , Chadborn Neil , Ojha Shalini 
Published: October 2023

BackgroundPhenylketonuria (PKU) is the most common inherited disease of amino acid metabolism, characterised by elevated levels of phenylalanine (Phe). There is a lack of infant feeding guidance for those with PKU. From birth to 6 months of age, breast feeding is the optimal nutrition for an infant and continuing breast feeding for infants with PKU is recommended by European guidelines. However, human breast milk contains Phe in varying quantities, and therefore, the effects breast feeding might have on infants with PKU needs careful consideration.AimTo assess the effects of breast feeding (exclusive or partial) compared with low-Phe formula feeding in infants diagnosed with PKU, on blood Phe levels, growth and neurodevelopmental scores.MethodsThe Cochrane Inborn Errors of Metabolism Trials Register, MEDLINE and Embase were searched (date of latest search: 9 August 2022). Studies were included if they looked at the effects of breast feeding in infants diagnosed with PKU compared with formula feeding. Predetermined outcomes included blood Phe levels, growth in the first 2 years of life and neurodevelopmental scores.ResultsSeven observational studies (282 participants) met the inclusion criteria. All studies compared continuation of breast feeding with low-Phe formula versus formula feeding only. While most studies concluded that there was no difference in mean serum Phe levels in their follow-up period, two reported that breastfed infants were more likely to have a normal mean Phe level. Two studies described no difference in mean weight gain after birth, while one found that breastfed infants were more likely to have higher mean weight gain. Two studies commented that breastfed infants achieved higher developmental scores in childhood as compared with formula fed infants.ConclusionAlthough there are no randomised trials, observational evidence suggests that continuation of breast feeding and supplementation with low-Phe formula is safe and may be beneficial for infants diagnosed with PKU.
Systematic review of physiological and psychological outcomes of surgery for pectus excavatum supporting commissioning of service in the UK
Authors: Walsh Jamie , Walsh Ross , Redmond Karen 
Published: October 2023

BackgroundPectus excavatum (PEx) is the most common congenital chest wall abnormality affecting 1 in 400 births in the UK. PEx is associated with significant physiological and psychological impairment. While readily surgically correctable, the benefits that surgery can bring have been debated and proven difficult to objectively measure. In the UK, this has led to the decommissioning of PEx surgery. The aim of this review is to conduct a systematic search of the literature on PEx surgery to assess physiological and psychological outcomes.MethodsA systematic review of the MEDLINE (PubMed), Embase and Cochrane databases was performed. Articles were sought which included patients undergoing surgery for PEx and reported on changes in cardiopulmonary measures, symptoms, quality of life and psychological assessments before and after surgical repair. Last search was performed in July 2022 and relevant findings were synthesised by narrative review.ResultsFifty-one articles were included in qualitative synthesis, with 34 studies relating to physiological outcomes and 17 studies relating to psychological and quality of life measures. Twenty-one studies investigated pulmonary function at rest. There was no change in forced vital capacity or forced expiratory volume in 1 second following open repair and transient reductions followed closed repair. In the 11 studies investigating echocardiography, transthoracic rarely demonstrated cardiac compression; however, transoesophageal demonstrated intraoperative relief in cardiac compression in severe cases. Sixteen studies investigated exercise testing (cardiopulmonary exercise testing, CPET), 12 of which demonstrated significant improvement following surgery, both in maximal oxygen consumption and oxygen pulse. Seventeen studies investigated quality of life, all but one of which showed improvement following repair of PEx. All papers that reported on patient satisfaction following surgery found high rates, between 80% and 97%.DiscussionWhile the majority of studies to date have been small and data heterogeneous, the literature shows that for many patients with PEx, there exists a cardiopulmonary limitation that while difficult to objectify, is likely to improve with surgical repair. Resting parameters offer little yield in aiding this except in the most severe cases. CPET therefore offers a better option for dynamic assessment of this limitation and improvements following repair. Surgery significantly improves psychological well-being and quality of life for patients with PEx.
Impact on all-cause mortality of a case prediction and prevention intervention designed to reduce secondary care utilisation: findings from a randomised controlled trial
Authors: Bull Lucy M , Arendarczyk Bartlomiej , Reis Sara , Nguyen An , Werr Joachim , Lovegrove-Bacon Thomas , Stone Mark , Sherlaw-Johnson Christopher 
Published: October 2023

BackgroundHealth coaching services could help to reduce emergency healthcare utilisation for patients targeted proactively by a clinical prediction model (CPM) predicting patient likelihood of future hospitalisations. Such interventions are designed to empower patients to confidently manage their own health and effectively utilise wider resources. Using CPMs to identify patients, rather than prespecified criteria, accommodates for the dynamic hospital user population and for sufficient time to provide preventative support. However, it is unclear how this care model would negatively impact survival.MethodsEmergency Department (ED) attenders and hospital inpatients between 2015 and 2019 were automatically screened for their risk of hospitalisation within 6 months of discharge using a locally trained CPM on routine data. Those considered at risk and screened as suitable for the intervention were contacted for consent and randomised to one-to-one telephone health coaching for 4–6 months, led by registered health professionals, or routine care with no contact after randomisation. The intervention involved motivational guidance, support for self-care, health education, and coordination of social and medical services. Co-primary outcomes were emergency hospitalisation and ED attendances, which will be reported separately. Mortality at 24 months was a safety endpoint.ResultsAnalysis among 1688 consented participants (35% invitation rate from the CPM, median age 75 years, 52% female, 1139 intervention, 549 control) suggested no significant difference in overall mortality between treatment groups (HR (95% CI): 0.82 (0.62, 1.08), pr(HR<1=0.92), but did suggest a significantly lower mortality in men aged >75 years (HR (95% CI): 0.57 (0.37, 0.84), number needed to treat=8). Excluding one site unable to adopt a CPM indicated stronger impact for this patient subgroup (HR (95% CI): 0.45 (0.26, 0.76)).ConclusionsEarly mortality in men aged >75 years may be reduced by supporting individuals at risk of unplanned hospitalisation with a clear outreach, out-of-hospital nurse-led, telephone-based coaching care model.
Rationale and design of the United Kingdom Heart Failure with Preserved Ejection Fraction Registry
Authors:   UK HFpEF Collaborative Group
Published: October 2023

ObjectiveHeart failure with preserved ejection fraction (HFpEF) is a common heterogeneous syndrome that remains imprecisely defined and consequently has limited treatment options and poor outcomes.MethodsThe UK Heart Failure with Preserved Ejection Fraction Registry (UK HFpEF) is a prospective data-enabled cohort and platform study. The study will develop a large, highly characterised cohort of patients with HFpEF. A biobank will be established. Deep clinical phenotyping, imaging, multiomics and centrally held national electronic health record data will be integrated at scale, in order to reclassify HFpEF into distinct subgroups, improve understanding of disease mechanisms and identify new biological pathways and molecular targets. Together, these will form the basis for developing diagnostics and targeted therapeutics specific to subgroups. It will be a platform for more effective and efficient trials, focusing on subgroups in whom targeted interventions are expected to be effective, with consent in place to facilitate rapid recruitment, and linkage for follow-up. Patients with a diagnosis of HFpEF made by a heart failure specialist, who have had natriuretic peptide levels measured and a left ventricular ejection fraction >40% are eligible. Patients with an ejection fraction between 40% and 49% will be limited to no more than 25% of the cohort.ConclusionsUK HFpEF will develop a rich, multimodal data resource to enable the identification of disease endotypes and develop more effective diagnostic strategies, precise risk stratification and targeted therapeutics.Trial registration numberNCT05441839.
Shortness of breath as a diagnostic factor for acute coronary syndrome in male and female callers to out-of-hours primary care
Authors: Spek Michelle , Venekamp Roderick P , Erkelens Daphne C A , van Smeden Maarten , Wouters Loes T C M , den Ruijter Hester M , Rutten Frans H , Zwart Dorien L 
Published: October 2023

ObjectiveChest discomfort and shortness of breath (SOB) are key symptoms in patients with acute coronary syndrome (ACS). It is, however, unknown whether SOB is valuable for recognising ACS during telephone triage in the out-of-hours primary care (OHS-PC) setting.MethodsA cross-sectional study performed in the Netherlands. Telephone triage conversations were analysed of callers with chest discomfort who contacted the OHS-PC between 2014 and 2017, comparing patients with SOB with those who did not report SOB. We determine the relation between SOB and (1) High urgency allocation, (2) ACS and (3) ACS or other life-threatening diseases.ResultsOf the 2195 callers with chest discomfort, 1096 (49.9%) reported SOB (43.7% men, 56.3% women). In total, 15.3% men (13.2% in those with SOB) and 8.4% women (9.2% in those with SOB) appeared to have ACS. SOB compared with no SOB was associated with high urgency allocation (75.9% vs 60.8%, OR: 2.03; 95% CI 1.69 to 2.44, multivariable OR (mOR): 2.03; 95% CI 1.69 to 2.44), but not with ACS (10.9% vs 12.0%; OR: 0.90; 95% CI 0.69 to 1.17, mOR: 0.91; 95% CI 0.70 to 1.19) or ‘ACS or other life-threatening diseases’ (15.0% vs 14.1%; OR: 1.07; 95% CI 0.85 to 1.36, mOR: 1.09; 95% CI 0.86 to 1.38). For women the relation with ACS was 9.2% vs 7.5%, OR: 1.25; 95% CI 0.83 to 1.88, and for men 13.2% vs 17.4%, OR: 0.72; 95% CI 0.51 to 1.02. For ‘ACS or other life-threatening diseases’, this was 13.0% vs 8.5%, OR: 1.60; 95% CI 1.10 to 2.32 for women, and 7.5% vs 20.8%, OR: 0.81; 95% CI 0.59 to 1.12 for men.ConclusionsMen and women with chest discomfort and SOB who contact the OHS-PC more often receive high urgency than those without SOB. This seems to be adequate in women, but not in men when considering the risk of ACS or other life-threatening diseases.
Theoretical corrections of $$R_D$$ and $$R_{D^*}$$
Authors: Long Xin-Xin , Zhao Shu-Min , Liu Ming-Yue , Wang Xi , Wang Yi-Tong , Yang Zhong-Jun , Dong Xing-Xing , Feng Tai-Fu 
Published: October 2023

Abstract$$R_{D^{(*)}}$$

R

D

(

∗
)

is the ratio of branching ratio $$\overline{B} \rightarrow D^{(*)}\tau \overline{\nu }_{\tau }$$

B
¯

→

D

(

∗
)

τ

ν
¯

τ

to $$\overline{B} \rightarrow D^{(*)}l\overline{\nu }_{l}~(l=e,~\mu )$$

B
¯

→

D

(

∗
)

l

ν
¯

l

(
l
=
e
,

μ
)

. There is a gap of 2$$\sigma _{exp}$$

σ

exp

or more between its experimental value and the prediction under the standard model (SM). People extend the MSSM with the local gauge group $$U(1)_X$$

U

(
1
)

X

to obtain the $$U(1)_X$$

U

(
1
)

X

SSM. Compared with MSSM, $$U(1)_X$$

U

(
1
)

X

SSM has more superfields and effects. In $$U(1)_X$$

U

(
1
)

X

SSM, we research the semileptonic decays $$\overline{B} \rightarrow D^{(*)}l\overline{\nu }_{l}$$

B
¯

→

D

(

∗
)

l

ν
¯

l

and calculate $$R_{D^{(*)}}$$

R

D

(

∗
)

. The numerical results of $$R_{D^{(*)}}$$

R

D

(

∗
)

are further corrected under $$U(1)_X$$

U

(
1
)

X

SSM, which are much better than the SM predictions. After correction, the theoretical value of $$R_{D^{(*)}}$$

R

D

(

∗
)

can reach one $$\sigma _{exp}$$

σ

exp

range of the averaged experiment central value.