bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of insurance coverage for non-vitamin K antagonist oral anticoagulants on quality of care and care disparities in patients hospitalised with atrial fibrillation in tertiary hospitals in China: interrupted time series analysis
Authors: Yang Na , Sun Zhaoqing , Liu Jun , Hao Yongchen , Long Deyong , Zhao Dong , Liu Jing 
Published: February 2025

ObjectiveTo examine recent patterns regarding oral anticoagulant (OAC) use among patients hospitalised with atrial fibrillation (AF) and quantify the impact of insurance coverage for non-vitamin K oral anticoagulants (NOACs) on quality of care and care inequality regarding OAC use among hospitalised patients with AF.DesignInterrupted time series analysis.SettingHospitals in China.ParticipantsA total of 36 393 patients hospitalised with non-valvular AF were involved between 2015 and 2019 across China.Primary and secondary outcome measuresOutcome was the impact of insurance coverage for NOACs on quality of care regarding OAC prescription using interrupted time series analysis with segmented regression models.ResultsOAC prescription rate during hospitalisation was 52.1% (31.3% for warfarin and 20.8% for NOACs) in patients with high-risk AF and 66.3% (29.8% for warfarin and 36.5% for NOACs) in low-risk patients. Insurance coverage for NOACs was associated with an immediate 10.9% (95% CI 7.6% to 14.3%) increase in NOAC prescription and a 0.33% (95% CI 0.08% to 0.58%) increase in the slope of the secular trend of NOAC prescription among all the patients. Disparities in NOAC prescription among hospitals decreased from 18.9 before the insurance coverage for NOACs to 3.4 after that. Similar results were found in patients with high risk of stroke.ConclusionA large gap exists between clinical practice and guideline recommendations regarding OAC prescription among patients hospitalised with AF in China. Insurance coverage may be an effective healthcare strategy to improve quality of care and reduce care disparities regarding OAC prescription among patients with AF.Trial registration numberNCT02309398.
Estimating the indirect costs associated with adenocarcinoma or squamous cell carcinoma of the oesophagus in Switzerland: evidence from a cross-sectional survey
Authors: Stoffel Sandro T , Bhadhuri Arjun , Salari Paola , Koeberle Dieter , Koessler Thibaud , Siebenhüner Alexander , Deantonio Letizia , Pless Miklos , Kahl Tim , Wicki Andreas , Oniangue-Ndza César , Schwenkglenks Matthias 
Published: February 2025

ObjectivesOur study investigated the impact of oesophageal cancer and its treatments on work productivity, leisure time, household chores and informal care in Switzerland. We assessed indirect costs for patients treated at different stages of adenocarcinoma or squamous cell carcinoma of the oesophagus.Design and settingA retrospective, non-interventional survey was conducted among patients diagnosed with early or advanced oesophageal cancer in Switzerland. Between January 2023 and October 2023, 126 patients participated from seven clinical centres across German, French and Italian language regions.Outcome measureSelf-reported lost time over a 4-week period, which was monetised to estimate indirect costs using respondents’ approximate earnings derived from national statistics.ResultsOf the 126 patients, 24 (19.0%) were disease-free at the time of the study, while 15.1% of patients were in stage I, 13.5% in stage II, 27.0% in stage III and 25.4% in stage IV. Most patients, across age groups and disease stages, reported no impact on their leisure time (62.2%), household chores (70.3%) or informal care needs (78.4%) in the last 4 weeks. For those affected, the mean loss of time was 9.5 hours per week for leisure (n=28) and 13.3 hours for household chores (n=21). Additionally, patients received an average of 11.8 hours of informal care per week (n=16). Among the patients who were employed at the beginning of the 4-week recall period (n=25), 57.1% reduced the degree of employment and/or missed work due to the disease and its treatments during that time, while 46.7% experienced presentism (decreased productivity at work). The estimated mean indirect costs over a 4-week period was (Swiss Francs) CHF2005 (€1874) per patient, with loss of work productivity being the largest contributor.ConclusionOesophageal cancer in Switzerland affects patients’ professional and personal lives, resulting in lost time and informal caregiving, leading to societal costs.
Digital and nurse-led support intervention in primary care during the first year after curative intent treatment for breast or prostate cancer: study protocol of two cluster randomised controlled pilot trials
Authors: Langius-Eklöf Ann , Craftman Åsa G , Gellerstedt Linda , Kelmendi Nazmije , Rooth Kristina , Gustavell Tina , Sundberg Kay 
Published: February 2025

IntroductionThe period directly after primary treatment for breast or prostate cancer is a time when patients feel unprepared about how to manage life and address unexpected health challenges. Supportive care should focus on identifying symptoms and concerns and involving survivors in their self‐care. Interventions using a blended model encompassing remote and in-person components may inform how supportive care can be organised. This protocol describes two pilot randomised controlled trials with the aim to investigate the acceptability, feasibility and potential effects of a 6 month digital and nurse-led support intervention in primary care for patients with breast or prostate cancer during the first year after primary treatment.Methods and analysisTwo cluster randomised pilot trials including patients with breast or prostate cancer during the first year after ending primary treatment will run from 2023 in primary care centres in Region Stockholm. The trials will have an estimated sample size of 20 patients in each arm. The intervention groups receive a digital and nurse-led support intervention in combination with standard care, and the control groups receive standard care alone. To assess acceptability and feasibility, the participants in the intervention groups and the study nurses will be interviewed. Furthermore, digitally logged data and field notes by study-specific nurses will be analysed. Data collection for the potential effects of the intervention is conducted through self-reported standardised and validated questionnaires at baseline, and at 3, 6, 12, 18 and 24 months. Data entry and analyses will be blinded to the researchers. Qualitative data will be analysed with content analysis, quantitative data will be evaluated by comparing changes within and between groups.Ethics and disseminationThis project was reviewed and approved by the Swedish Ethical Review Authority. Study results will be published in peer-reviewed journals and presented at scientific and professional meetings.Trial registration numbersClinicalTrials.gov,NCT06471452andNCT05100121.
Vaginal Microbiome Research Consortium for Africa: study protocol of a multicentre prospective clinical study to evaluate temporal vaginal microbial composition associated with maintenance of reproductive health in women in South Africa and Kenya
Authors: Kullin Brian Ronald , Gitome Serah , Happel Anna-Ursula , Pidwell Tanya , Lefevre Mellissa , Madikida Anda , Wekesa Pauline , Mahlangu Karabo , Ochieng James , Awili Lydia , Agolla Winnie , Otieno Rhoda , Mutharimi Amos , Ganief Yacoeb , Daniels Rezeen , Chicken Anika , Welp Kirsten , Livingstone Hannah , Swanepoel Caleb , Claassen-Weitz Shantelle , Kanyoka Pride , Ravel Jacques , Humphrys Michael , Bilski Lisa , Mulder Nicola , Bekker Linda-Gail , Gill Katherine , Jaspan Heather , Bukusi Elizabeth Anne , Passmore Jo-Ann Shelley 
Published: February 2025

IntroductionThe Vaginal Microbiome Research Consortium for Africa (VMRC4Africa) study is a multicentre observational cohort study. We aim to enrol parallel cohorts of 100 women from two sites in two African countries (N=200) (Desmond Tutu HIV Centre [DTHC], South Africa; Kenya Medical Research Institute [KEMRI], Kenya) to evaluate detailed temporal fluctuations in vaginal microbiota in young, generally healthy women from Southern and Eastern Africa.Methods and analysisCohorts in Kenya and South Africa will be followed up twice a week for 10 weeks to create detailed profiles of vaginal microbial community state types (CSTs; by 16S rRNA gene sequencing) and fungal communities (by internal transcribed spacer (ITS) sequencing) and to identify women with stableLactobacillus crispatus-dominated microbiota, with no evidence of genital inflammation, as assessed by the measurement of inflammatory cytokines.DiscussionThrough the establishment of this African vaginal sample biorepository, the intention will be to cultivateLactobacillusisolates to create a biobank from which to ultimately select geographically diverseLactobacillusstrains with health-promoting characteristics that can be co-formulated into live biotherapeutic products (LBPs) to treat bacterial vaginosis (BV) for women in sub-Saharan Africa.Ethics and disseminationThe VMRC4Africa study has been granted ethical approval by the Human Research Ethics Committees in South Africa (UCT HREC: 611/2022) and Kenya (KEMRI Scientific and Ethics Review Unit: SERU No. 4569). Deidentified microbial community compositional data will be made available on public databases. Results of the study will be published in peer-reviewed journals.
Using codesign workshops to develop a conceptual framework for a mobile health app targeting chronic low back pain self-management
Authors: Zhou Tianyu , Kirby-Ginns Sarah , Salman David , McGregor Alison H 
Published: February 2025

ObjectivesThe aim of this study was to gather insights from a diverse group of stakeholders, identify existing challenges and explore associated solutions to develop a conceptual framework that assists in the development of a chronic low back pain (CLBP) self-management app.DesignCodesign workshop methodology.SettingThe study was conducted online, allowing for the participation of a diverse group of stakeholders.ParticipantsParticipants were recruited through social media platforms and professional networks, including individuals with LBP for at least 3 months, healthcare professionals experienced in CLBP management and app developers with a background in digital health applications.InterventionsThe study used codesign workshops focused on brainstorming, communication and reflection exercises designed to foster collaboration and gather insights from stakeholders.Outcome measuresIdentification of key challenges and potential solutions for mobile health (mHealth) apps targeting CLBP.ResultsNine stakeholders identified four primary challenges in current back pain apps: belief and trust, motivation, safety and usability. The group also collaboratively developed and proposed practical solutions to these challenges.ConclusionsThis study illustrated the utility of the codesign workshop approach in generating critical insights for the development of a mHealth solution for CLBP. The insights gathered from these workshops can be used to inform future app development, potentially improving user engagement.
Injury and illness prevention practices in Qatar’s professional football clubs—implementation of the IP2NetWork
Authors: Hassanmirzaei Bahar , Schumacher Yorck Olaf , Tabben Montassar , Chaabane Mokthar , Chebbi Souhail , Daoud Ramadan , Heitor Miguel , Miladi Riadh , Rekik Raouf Nader , Skhiri Oussama , Bahr Roald 
Published: February 2025

BackgroundThe Aspetar Sports Injury and Illness Prevention Programme introduced the Aspetar IP2NetWork, a customizable injury prevention programme for professional football clubs in Qatar during the 2020/2021 season. It includes 23 focus areas selected by stakeholders to prevent sports-related health issues.ObjectiveTo assess the real world implementation of the IP2NetWork preventive focus areas during the first season after introduction, focusing on team adoption and player compliance.MethodsA survey was conducted among team physicians, physiotherapists and fitness coaches from the 18 professional football clubs in Qatar. The survey examined the implementation of the IP2NetWork focus areas and the roles of the different professionals in managing these areas.Results17 out of 18 clubs reported using IP2focus areas, applying an average of 11.4 areas (range 4–21). The most commonly used strategies were the Nordic hamstring exercise, cold water immersion, taping and concussion prevention. Team physicians led 38% of the focus areas, followed by physiotherapists (25%) and fitness coaches (24%), with 11% managed collaboratively. Fitness coaches primarily handled exercise-based areas like warm-ups and load monitoring. Preventive measures were applied to the full squad in 81% of cases, with 19% targeting at-risk players. Player compliance was high, with 86% of focus areas adopted by all or most players, rising to 97% for players identified to be at greater risk of injury or illness.ConclusionImplementing the IP2focus areas was widespread among teams in Qatar, with strong collaboration between medical staff. Player compliance, especially among at-risk players, was excellent, demonstrating the programme’s feasibility and effectiveness in real-world settings.
Early medical abortion before missed menses: a prospective observational study of outcomes of abortion at less than 30 days from last menstrual period
Authors: Wheate Elizabeth April , Reynolds-Wright John Joseph , Cameron Sharon T 
Published: February 2025

IntroductionHigh-sensitivity urine pregnancy tests can detect pregnancy before missed menses. The widespread availability of these tests, alongside improvements in abortion access in many settings, may mean more women present for abortion at a very early stage of pregnancy. We aimed to examine the outcome of early medical abortion (EMA) in pregnancies less than 30 days from last menstrual period (LMP).MethodsThis study analysed prospectively collected data on patients at less than 30 days from LMP seeking abortion at a single service in Edinburgh, UK between March 2020 and December 2023. We determined the effectiveness, outcomes of the pregnancy (complete abortion, ongoing pregnancy, incomplete abortion) and serious complications among those seeking EMA at this gestation.ResultsOf 13 565 patients seeking abortion, 78 (0.6%) presented with a self-reported positive home pregnancy test and less than 30 days from LMP. Some 63/78 patients (81%) proceeded to EMA with mifepristone followed by misoprostol. Of this group, 31/63 (49%) had a pre-abortion ultrasound. Complete abortion occurred in 58/63 (92%, 95% CI 82% to 97%), 4/63 (6%) had an ongoing pregnancy and 1 (1%) had a surgical evacuation for incomplete abortion. There were no serious complications.ConclusionsOnly a very small percentage of patients present for abortion before a missed period. Nevertheless, EMA at this stage is safe and effective. There may be a higher rate of ongoing pregnancy, and so those patients wishing to proceed to EMA should be advised of the importance of confirming success in line with local protocols.
Characterisation of MRGPRX2+mast cells in irritable bowel syndrome
Authors: Decraecker Lisse , Cuende Estévez María , Van Remoortel Samuel , Quan Runze , Stakenborg Nathalie , Wang Zheng , De Marco Elisabetta , Denadai-Souza Alexandre , Viola Maria Francesca , Garcia Caraballo Sonia , Brierley Stuart , Tsukimi Yasuhiro , Hicks Gareth , Winchester Wendy , Wykosky Jill , Fanjul Andrea , Gibson Tony , Wouters Mira , Vanden Berghe Pieter , Hussein Hind , Boeckxstaens Guy 
Published: February 2025

BackgroundMast cell activation is an important driver of abdominal pain in irritable bowel syndrome (IBS). While evidence supports the role of IgE-mediated mast cell activation in visceral pain development in IBS, the role of pseudoallergic MRGPRX2-mediated mast cell activation in this process remains unknown.ObjectiveWe investigated whether MRGPRX2-mediated mast cell activation plays a role in abdominal pain development in patients with IBS.DesignMRGPRX2 expression in mast cells and other immune cells was characterised across colon layers using flow cytometry. We evaluated whether MRGPRX2 agonists trigger mast cell degranulation and transient receptor potential vanilloid 1 (TRPV1) sensitisation in healthy human colonic submucosal plexus samples using live imaging. Rectal biopsies were then collected from patients with IBS and healthy volunteers (HV) and MRGPRX2+mast cell frequency, MRGPRX2 expression per cell, mast cell degranulation kinetics in response to MRGPRX2 agonists, MRGPRX2 agonistic activity and presence of MRGPRX2 agonists in biopsy supernatants were assessed.ResultsMRGPRX2+mast cells are enriched in the submucosa and muscularis of the healthy human colon. MRGPRX2 agonists induce mast cell degranulation and TRPV1 sensitisation in the healthy colon submucosa. While the frequency of rectal MRGPRX2+mast cells was unaltered in IBS, submucosal mast cells showed increased degranulation in response to MRGPRX2 agonists in IBS compared with HV. MRGPRX2 agonistic activity was increased in IBS rectal biopsy supernatant compared with HV, which was associated with increased levels of substance P.ConclusionThe MRGPRX2 pathway is functionally upregulated in the colon of patients with IBS, supporting its role in abdominal pain in IBS.
Understanding non-fatal drowning in Victoria, Australia: a 20-year analysis of hospital admission data
Authors: Calverley Hannah , Berecki-Gisolf Janneke , Peden Amy E , Matthews Bernadette Lucy 
Published: February 2025

BackgroundUnintentional drowning is a global public health concern, and in Australia, non-fatal drowning outcomes are estimated to be three times that of fatal incidents. Understanding non-fatal drowning trends would enable tailored prevention efforts to address the full burden of drowning, yet little research has investigated this.MethodsRetrospective analysis considered unintentional drowning-related hospital admissions in the state of Victoria, Australia between 1 July 2002 and 30 June 2022.ResultsOverall, 1849 hospital admissions resulted from non-fatal drowning in Victoria. Rates increased significantly by 1.86% annually (95% CI (0.91, 2.82)). Males and females recorded significant increases in hospital admission (2.4% (95% CI 0.7%, 4.2%) for females vs 1.6% (95% CI 0.5%, 2.7%) for males). Admission rates increased among several age groups, with significant increases recorded among young people aged 15–24 years (3.99%, p=0.0041), children aged 5–9 years (3.33%, p<0.04) and 25–64 years (3.07%, p=0.0001). Regarding regionality, drowning rates were higher with increasing remoteness, and people born in Oceania and Antarctica recorded the majority (86.1%) of hospital admissions over the 20 years.Discussion and conclusionsIncreases in hospital admissions over the 20 years are concerning and highlight the rising burden of drowning on Victorian health systems. These trends identify where preventative efforts may be directed to reduce drowning, especially regarding the prominence of children. Raising awareness of non-fatal drowning is necessary to demonstrate the full impact and burden of drowning and could be achieved through multisectoral collaboration, consistent communication and messaging, and innovative programmes and policy.
Phosphatidylserine as a tumor target for CAR-T cell therapy
Authors: Martín-Otal Celia , Sánchez-Moreno Inés , Gómez-Morón Alvaro , Castro Carla , Casares Noelia , Navarro Flor , Gorraiz Marta , Justicia-Lirio Pedro , Pareja Felix , Collantes María , Peñuelas Iván , Iñarrairaegui Mercedes , Sangro Bruno , Vivas Isabel , Larrayoz Marta , Rodriguez Juan Roberto , Prosper Felipe , Hervas-Stubbs Sandra , Martin-Cofreces Noa , Lasarte Juan Jose , Lozano Teresa 
Published: February 2025

BackgroundPhosphatidylserine (PS) exposed on apoptotic cells promotes immune clearance of dead cells without inducing inflammation. Conversely, PS exposure on live tumor cells promotes an immunosuppressive tumor microenvironment that hinders antitumor immune responses. After confirming elevated PS levels in various tumor cell lines and cancer tissues, we aimed to investigate its potential as a target antigen for chimeric antigen receptor T cell (CAR-T) therapy.MethodsWe used two different approaches to target PS. First, we employed the adaptor proteins, EDAnnexin or BCMAnnexin comprising annexin V and EDA (extra domain A of fibronectin) or B-cell maturation antigen (BCMA) antigens, to redirect the lytic activity of EDA CAR-T or BCMA CAR-T cells toward PS-expressing tumor cells. In a second approach, we developed an annexin V-based CAR (Anxa CAR-T) to directly recognize PS-positive tumor cells.ResultsThe adaptors proteins EDAnnexin and BCMAnnexin successfully redirected EDA CAR-T or BCMA CAR-T cell activity, leading to an efficient recognition of PS+tumor cells in vitro. However, the established immunological synapse differs significantly from that observed when CAR-T cells recognize the tumor cells directly. In vivo administration of the adaptor proteins, combined with the corresponding CAR-T cells, displayed antitumor activity in mice bearing PS+tumors. Regarding the second approach, Anxa CAR-T cells effectively recognized and killed PS+tumor cells in vitro. Nonetheless, PS exposure on T-cell membranes during T-cell activation impeded efficient Anxa CAR-T cell manufacturing due to fratricide. By optimizing retroviral dose to reduce Anxa CAR expression on the cell membrane, or by using the multikinase inhibitor dasatinib, the fratricide effect was mitigated, enabling successful Anxa CARLow-T cell production. Remarkably, Anxa CARLow-T cells demonstrated antitumor activity in in vivo murine models of PS+hepatocarcinoma and teratocarcinoma. No signs of toxicity were observed after Anxa CAR-T cell administration.ConclusionsPS holds promise as a target antigen for CAR-T cell therapy, underscoring the need to address fratricide as a key challenge in the development of PS-targeting CAR-T cells.