bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of national guidance on survival for babies born at 22 weeks’ gestation in England and Wales: population based cohort study
Authors: Smith Lucy K , van Blankenstein Emily , Fox Grenville , Seaton Sarah E , Martínez-Jiménez Mario , Petrou Stavros , Battersby Cheryl ,   MBRRACE-UK Perinatal Surveillance Group
Published: November 2023

ObjectivesTo explore the effect of changes in national clinical recommendations in 2019 that extended provision of survival focused care to babies born at 22 weeks’ gestation in England and Wales.DesignPopulation based cohort study.SettingEngland and Wales, comprising routine data for births and hospital records.ParticipantsBabies alive at the onset of care in labour at 22 weeks+0 days to 22 weeks+6 days and at 23 weeks+0 days to 24 weeks+6 days for comparison purposes between 1 January 2018 and 31 December 2021.Main outcome measuresPercentage of babies given survival focused care (active respiratory support after birth), admitted to neonatal care, and surviving to discharge in 2018-19 and 2020-21.ResultsFor the 1001 babies alive at the onset of labour at 22 weeks' gestation, a threefold increase was noted in: survival focused care provision from 11.3% to 38.4% (risk ratio 3.41 (95% confidence interval 2.61 to 4.45)); admissions to neonatal units from 7.4% to 28.1% (3.77 (2.70 to 5.27)), and survival to discharge from neonatal care from 2.5% to 8.2% (3.29 (1.78 to 6.09)). More babies of lower birth weight and early gestational age received survival focused care in 2020-21 than 2018-19 (46% to 64% at <500g weight; 19% to 31% at 22 weeks+0 days to 22 weeks+3 days).ConclusionsA change in national guidance to recommend a risk based approach was associated with a threefold increase in 22 weeks’ gestation babies receiving survival focused care. The number of babies being admitted to neonatal units and those surviving to discharge increased.
Systematic literature review and network meta-analysis of therapies for psoriatic arthritis on patient-reported outcomes
Authors: Nash Peter , Dutz Jan P , Peterson Steve , Patel Barkha P , Eaton Kiefer , Shawi May , Zazzetti Federico , Wei James Cheng-Chung 
Published: November 2023

ObjectivesHead-to-head clinical trials are common in psoriasis, but scarce in psoriatic arthritis (PsA), making treatment comparisons between therapeutic classes difficult. This study describes the relative effectiveness of targeted synthetic (ts) and biologic (b) disease-modifying antirheumatic drugs (DMARDs) on patient-reported outcomes (PROs) through network meta-analysis (NMA).DesignA systematic literature review (SLR) was conducted in January 2020. Bayesian NMAs were conducted to compare treatments on Health Assessment Questionnaire Disability Index (HAQ-DI) and 36-item Short Form (SF-36) Health Survey including Mental Component Summary (MCS) and Physical Component Summary (PCS) scores.Data sourcesOvid MEDLINE (including Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily),Embase and Cochrane Central Register of Controlled Trials.Eligibility criteriaPhase III randomised controlled trials (RCTs) evaluating patients with PsA receiving tsDMARDS, bDMARDs or placebo were included in the SLR; there was no restriction on outcomes.Data extraction and synthesisTwo independent researchers reviewed all citations. Data for studies meeting all inclusion criteria were extracted into a standardised Excel-based form by one reviewer and validated by a second reviewer. A third reviewer was consulted to resolve any discrepancies, as necessary. Risk of bias was assessed using the The National Institute for Health and Care Excellence clinical effectiveness quality assessment checklist.ResultsIn total, 26 RCTs were included. For HAQ-DI, SF-36 PCS and SF-36 MCS scores, intravenous tumour necrosis factor (TNF) alpha inhibitors generally ranked higher than most other classes of therapies available to treat patients with PsA. For almost all outcomes, several interleukin (IL)-23, IL-17A, subcutaneous TNF and IL-12/23 agents offered comparable improvement, while cytotoxic T-lymphocyte-associated antigen 4, phosphodiesterase-4 and Janus kinase inhibitors often had the lowest efficacy.ConclusionsWhile intravenous TNFs may provide some improvements in PROs relative to several other tsDMARDs and bDMARDs for the treatment of patients with PsA, differences between classes of therapies across outcomes were small.
Clinician and patient perspectives on the barriers and facilitators to physical rehabilitation in intensive care: a qualitative interview study
Authors: Woodbridge Huw R , Norton Christine , Jones Mandy , Brett Stephen J , Alexander Caroline M , Gordon Anthony C 
Published: November 2023

ObjectivesThe objective of this study is to explore patient, relative/carer and clinician perceptions of barriers to early physical rehabilitation in intensive care units (ICUs) within an associated group of hospitals in the UK and how they can be overcome.DesignQualitative study using semi-structured interviews and thematic framework analysis.SettingFour ICUs over three hospital sites in London, UK.ParticipantsFormer ICU patients or their relatives/carers with personal experience of ICU rehabilitation. ICU clinicians, including doctors, nurses, physiotherapists and occupational therapists, involved in the delivery of physical rehabilitation or decisions over its initiation.Primary and secondary outcomes measuresViews and experiences on the barriers and facilitators to ICU physical rehabilitation.ResultsInterviews were carried out with 11 former patients, 3 family members and 16 clinicians. The themes generated related to: safety and physiological concerns, patient participation and engagement, clinician experience and knowledge, teamwork, equipment and environment and risks and benefits of rehabilitation in intensive care. The overarching theme for overcoming barriers was a change in working model from ICU clinicians having separate responsibilities (a multidisciplinary approach) to one where all parties have a shared aim of providing patient-centred ICU physical rehabilitation (an interdisciplinary approach).ConclusionsThe results have revealed barriers that can be modified to improve rehabilitation delivery in an ICU. Interdisciplinary working could overcome many of these barriers to optimise recovery from critical illness.
Assessing tobacco retailer compliance with flavoured tobacco product sales restrictions: a cross-sectional study of four California cities
Authors: Yang Joshua S , Cuomo Raphael , Nguyen Quincy , Merrill Regina , McMann Tiana , Nali Matthew , Gooneratne Chrismarie , Le Nicolette , Cui Mandy , Mackey Tim K 
Published: November 2023

BackgroundGovernments are passing laws to restrict the sale of flavoured tobacco products (FTPs), but retailer compliance with such policies may vary. This study compared tobacco retailer compliance with local ordinances restricting the sale of FTPs across various localities in Southern California.MethodsAttempts to purchase FTPs from a random sample of tobacco retailers in a convenience sample of four cities in Southern California with FTP sales restrictions were made from June to August 2022. Trained shoppers of legal tobacco purchasing age entered tobacco retailers and purchased prohibited FTPs if they were on display or asked salespersons for menthol cigarettes or a flavoured e-cigarette, completing purchases if they were made available.ResultsAmong 141 stores, 39.9% of stores were non-compliant with local ordinances. Non-compliance varied by city, occurring in 49.3%, 43.8%, 15.4% and 0% of stores across four cities. The highest proportion of non-compliance was among vape or tobacco shops (91.2%) followed by convenience and liquor stores (36.4%), grocery stores and pharmacies (15.4%), and gas stations (13.5%).ConclusionPrior to California’s statewide sales restriction on flavoured tobacco, compliance with local sales restrictions was variable across cities and store types.
Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method
Authors: Shinjo Daisuke , Ozawa Nobuaki , Nakadate Naoya , Kanamori Yutaka , Matsumoto Kimikazu , Noguchi Takashi , Ohtera Shosuke , Kato Hitoshi 
Published: November 2023

BackgroundsFew paediatric and perinatal quality indicators (QIs) have been developed in the Japanese setting, and the quality of care is not assured or validated. The aim of this study was to develop QIs in paediatric and perinatal care in Japan using an administrative database and confirm the feasibility and applicability of the indicators using a single-site practice test.MethodsWe used a RAND-modified Delphi method that integrates evidence review with expert consensus development. QI candidates were generated from clinical practice guidelines (CPGs) available in English or Japanese and existing QIs in nine selected paediatric or perinatal conditions. Consensus building was based on independent panel ratings. The performance of QIs was retrospectively assessed using data from an administrative database at the National Children’s Hospital. Data between April 2018 and March 2019 were used, while data between April 2019 and March 2021 were also used for selected condition, considering the small number of patients. Each QI was calculated as follows: number of times the indicator was met/number of participants×100.ResultsFrom the literature review conducted between 2010 and 2020, 124 CPGs and 193 existing indicators were identified to generate QI candidates. Through the consensus-building process, 133 QI candidates were assessed and 79 QIs were accepted. The practice test revealed wide variations in the process-level performance of QIs in four categories: patient safety: median 43.9% (IQR 16.7%–85.6%), general paediatrics: median 98.8% (IQR 84.2%–100%), advanced paediatrics: median 94.4% (IQR 46.0%–100%) and advanced obstetrics: median 80.3% (IQR 59.6%–100%).ConclusionsWe established 79 QIs for paediatric and perinatal care in Japan using an administrative database that can be applied to hospitals nationwide. The practice test confirmed the measurability of the developed QIs. Benchmarking these QIs will be an attractive approach to improving the quality of care.
Performing Nordic hamstring strength testing with additional weight affects the maximal eccentric force measured: do not compare apples to oranges
Authors: Amundsen Roar , Møller Merete , Bahr Roald 
Published: November 2023

BackgroundNordic hamstring test devices are commonly used to measure maximal eccentric hamstring force. The ability to control the final phase of the exercise has been adopted as a criterion to add weight when testing, without substantial evidence. We investigated if adding weight affected the maximal force measured, and if there were differences between players who could and could not control the final phase.MethodsFemale (n=84) and male (n=56) football players performed a Nordic hamstring strength test with 0, 5 and 10 kg. We used visual inspection to assess the ability to control the final phase (approximately last 20°), as per previously published studies.ResultsMaximal force was higher when tested with 5 kg (females: +8 N (2%), p<0.001; males: +18 N (4%), p<0.001) and 10 kg (females: +17 N (5%), p<0.001; males: +27 N (6%), p<0.001) compared with 0 kg. This was the case for both groups, those who could control the final phase (5 kg: +16 N (4%), p<0.001; 10 kg: +28 N (7%), p<0.001) and those who could not (5 kg: +9 N (3%), p<0.001; 10 kg: +15 N (4%), p<0.001).ConclusionBoth players who could and could not control the final phase of the Nordic hamstring test demonstrated higher maximal force when adding weight to testing. Therefore, this should not be used to decide if players should perform testing with or without weight. Either all participants or none should be tested with weight, and the same approach should be used both for pre-testing and post-testing.
Accuracy of visual estimation of ejection fraction in patients with heart failure using augmented reality glasses
Authors: Choi Sungwoo , Nah Sangun , Cho Young Soon , Moon Inki , Lee Jae Wook , Ah Lee Choung , Moon Ji Eun , Han Sangsoo 
Published: November 2023

ObjectiveLeft ventricular ejection fraction (LVEF) is measured to assess haemodynamic status and cardiac function. It may be difficult to accurately measure in patients with heart failure (HF) as they are often poorly echogenic. The augmented reality (AR) technology is expected to provide real-time guidance that will enable more accurate measurements.MethodsA prospective, randomised, case-crossover simulation study was conducted to confirm the effect of AR glasses on echocardiographic interpretation in patients with HF. 22 emergency physicians participated. The participants were randomly assigned to two groups. Group A estimated the visual ejection fraction of echocardiographic video clips without the AR glasses, while group B estimated them with glasses. After a washout period, the two groups crossed over. The estimates were then compared with the ejection fraction measurements obtained by echocardiologists; intraclass correlation coefficient (ICC) was calculated.ResultsThe ICC with glasses (0.969, 95% CI 0.966 to 0.971) was higher than without glasses (0.705, 95% CI 0.681 to 0.727) among all participants. In the subgroup analysis, the first-year and second-year residents showed the most significant difference, with an ICC of 0.568 (95% CI 0.508 to 0.621) without glasses compared with 0.963 (95% CI 0.958 to 0.968) with glasses. For the third-year and fourth-year residents group, the ICC was 0.754 (95% CI 0.720 to 0.784) without glasses and 0.972 (95% CI 0.958 to 0.968) with glasses. Among the group of attending physicians, the ICC was 0.807 (95% CI 0.775 to 0.834) without glasses and 0.973 (95% CI 0.969 to 0.977) with glasses.ConclusionsAR glasses could be helpful in measuring LVEF and could be more helpful to those with little visual estimation experience.
c-Met immunohistochemistry as reflex test at diagnosis for non-small cell lung cancer: a real-world experience from a monocentric case series
Authors: Bontoux Christophe , Hofman Veronique , Abboute Milissa , Lespinet-Fabre Virginie , Lalvée Salomé , Goffinet Samantha , Bordone Olivier , Long-Mira Elodie , Lassalle Sandra , Murcy Florent , Rignol Guylène , Heeke Simon , Ilie Marius , Hofman Paul 
Published: November 2023

AimsRecent clinical trials have shown promising results with drugs targeting the hepatocyte growth factor receptor (c-Met) for advanced non-small cell lung cancers overexpressing c-Met. We assessed reflex testing of c-Met immunohistochemistry (IHC) at diagnosis for NSCLC in the real-world.MethodsWe retrospectively collected clinical, pathological and molecular data of cases diagnosed with NSCLC in our institution from January 2021 to June 2023. We performed c-Met IHC (SP44 clone) and scored the expression using a H-score and a three-tier classification.Results391 cases with interpretable c-Met IHC staining were included. The median age at diagnosis was 70 years (range 25–89 years) including 234 males (male/female ratio 1:5). 58% of the samples came from surgical resections, 35% from biopsies and 8% from cytological procedures. 52% of cases were classified as c-Met-positive (H-score≥150) and 19% were classified as c-Methigh(≥50%, 3+). 43% of the c-Metnegpresented with lymph node and/or visceral metastases at diagnosis vs 55% for c-Methigh(p=0.042). 23% of the adenocarcinomas showed c-Methighexpression vs 3% for squamous cell carcinomas (p=0.004). 27% of the c-Metnegcases had a high PD-L1 expression vs 58% of c-Methighcases (p<0.001).METex14 skipping was present in 8% of the c-Methighcases.ConclusionsSystematic c-Met testing in daily routine for NSCLC patients is feasible, highlighting a potential correlation with clinicopathological and molecular features.
Inflammatory bowel disease patients have an increased risk of acute coronary syndrome: a systematic review and meta-analysis
Authors: Zaka Ammar , Mridha Naim , Subhaharan Deloshaan , Jones Mark , Niranjan Selvanayagam , Mohsen Waled , Ramaswamy Pradeep K 
Published: November 2023

ObjectivesSystemic inflammation is increasingly being recognised as a possible mechanism for acute arterial thrombotic events, including acute coronary syndrome (ACS). Despite this, there is conflicting data on the risk of ACS in patients with inflammatory bowel disease (IBD). We performed a contemporary systematic review and meta-analysis to identify the risk of ACS in patients with IBD.MethodsPubMed, MEDLINE, EMBASE, CENTRAL and Web of Science were searched up to 27 October 2022. Multivariable-adjusted or propensity matched studies with a non-IBD control cohort were included. HRs were pooled using a random-effects model. Subgroup and sensitivity analyses were conducted in order to explore sources of heterogeneity.ResultsTwelve retrospective cohort studies were included (225 248 IBD patients). Patients with IBD were associated with an increased risk of ACS in both adjusted (HR 1.23; 95% CI 1.08 to 1.41) and unadjusted analyses (HR 1.50; 95% CI 1.16 to 1.92). Substantial heterogeneity was observed (i2=88, p=0.002 and i2=98%, p=0.002, respectively). Subgroup analysis of age revealed a greater association of ACS in IBD patients <40 years of age (relative HR 1.50; 95 CI 1.15 to 1.96).ConclusionPatients with IBD demonstrated an independently increased risk of ACS. Prospective studies are required to explore the relationship with disease activity and duration, concomitant medication use and angiographic characteristics and outcomes.PROSPERO registration numberCRD42022367846.
Validation of a novel point-of-care ultrasound method to assess diaphragmatic excursion
Authors: Da Conceicao Diogo , Perlas Anahi , Giron Arango Laura , Wild Kim , Li Qixuan , Huszti Ella , Chowdhury Jayanta , Chan Vincent 
Published: November 2023

IntroductionPoint-of-care ultrasound can assess diaphragmatic function and rule in or rule out paresis of the diaphragm. While this is a useful bedside tool, established methods have significant limitations. This study explores a new method to assess diaphragmatic motion by measuring the excursion of the uppermost point of the zone of apposition (ZOA) at the mid-axillary line using a high-frequency linear ultrasound probe and compares it with two previously established methods: the assessment of the excursion of the dome of the diaphragm (DOD) and the thickening ratio at the ZOA.MethodsThis is a single-centre, prospective comparative study on elective surgical patients with normal diaphragmatic function. Following research ethics board approval and patient written consent, 75 elective surgical patients with normal diaphragmatic function were evaluated preoperatively. Three ultrasound methods were compared: (1) assessment of the excursion of the DOD using a curvilinear probe through an abdominal window; (2) assessment of the thickening fraction of the ZOA; and (3) assessment of the excursion of the ZOA. The last two methods performed with a linear probe on the lateral aspect of the chest.ResultsSeventy-five patients were studied. We found that the evaluation of the excursion of the ZOA was more consistently successful (100% bilaterally) than the evaluation of the excursion of the DOD (98.7% and 34.7% on the right and left sides, respectively). The absolute values of the excursion of the ZOA were greater than and well correlated with the values of the DOD.ConclusionOur preliminary data from this exploratory study suggest that the evaluation of the excursion of the ZOA on the lateral aspect of the chest using a linear probe is consistently successful on both right and left sides. Future studies are needed to establish the distribution of normal values and suggest diagnostic criteria for diaphragmatic paresis or paralysis.Trial registration numberNCT03225508.
Heterogeneity of determining disease severity, clinical course and outcomes in systemic sclerosis-associated interstitial lung disease: a systematic literature review
Authors: Petelytska Liubov , Bonomi Francesco , Cannistrà Carlo , Fiorentini Elisa , Peretti Silvia , Torracchi Sara , Bernardini Pamela , Coccia Carmela , De Luca Riccardo , Economou Alessio , Levani Juela , Matucci-Cerinic Marco , Distler Oliver , Bruni Cosimo 
Published: November 2023

ObjectiveThe course of systemic sclerosis-associated interstitial lung disease (SSc-ILD) is highly variable and different from continuously progressive idiopathic pulmonary fibrosis (IPF). Most proposed definitions of progressive pulmonary fibrosis or SSc-ILD severity are based on the research data from patients with IPF and are not validated for patients with SSc-ILD. Our study aimed to gather the current evidence for severity, progression and outcomes of SSc-ILD.MethodsA systematic literature review to search for definitions of severity, progression and outcomes recorded for SSc-ILD was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Medline, Embase, Web of Science and Cochrane Library up to 1 August 2023.ResultsA total of 9054 papers were reviewed and 342 were finally included. The most frequent tools used for the definition of SSc-ILD progression and severity were combined changes of carbon monoxide diffusing capacity (DLCO) and forced vital capacity (FVC), isolated FVC or DLCO changes, high-resolution CT (HRCT) extension and composite algorithms including pulmonary function test, clinical signs and HRCT data. Mortality was the most frequently reported long-term event, both from all causes or ILD related.ConclusionsThe studies presenting definitions of SSc-ILD ‘progression’, ‘severity’ and ‘outcome’ show a large heterogeneity. These results emphasise the need for developing a standardised, consensus definition of severe SSc-ILD, to link a disease specific definition of progression as a surrogate outcome for clinical trials and clinical practice.PROSPERO registration number CRD42022379254.Cite Now
Trends in vaping and nicotine product use among youth in Canada, England and the USA between 2017 and 2022: evidence to inform policy
Authors: Hammond David , Reid Jessica L 
Published: November 2023

Background
Preventing uptake of nicotine products among youth remains a central objective of tobacco control policy. Comparing trends in the use of nicotine across countries provides an opportunity to identify emergent product trends and to evaluate ‘natural experiments’ in policies.

Methods
Repeat cross-sectional data were analysed from eight waves of the International Tobacco Control Youth Tobacco and Vaping Survey, conducted between 2017 and 2022. Non-probability samples of youth aged 16–19 years in Canada, England and the USA (N=104 473) completed online surveys including measures on vaping, smoking and use of other nicotine products. This paper summarises findings across the 5-year period of the study, as part of a comprehensive report on key indicators of youth vaping in the three countries.

Results
The youth nicotine market has rapidly evolved across the three countries, with different patterns of combustible and non-combustible product use in Canada, the USA and England. These changes are primarily attributable to trends in youth vaping: following declines during the initial COVID-19 pandemic period, by 2022, vaping prevalence neared pre-pandemic levels in the USA and Canada, and reached record highs in England. Notable shifts also occurred in the types of vaping products used by youth, including increased use of disposable, nicotine salt-based products. Additional findings are reported on a range of policy-relevant indicators, including for vaping products, promotions and purchasing.

Conclusions
Patterns of nicotine use among youth have rapidly evolved in recent years due to the proliferation of nicotine products, the COVID-19 pandemic and the emerging impact of policy measures.