bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mapping the range of policies relevant to care of small and nutritionally at-risk infants under 6 months and their mothers in Ethiopia: a scoping review protocol
Authors: McGrath Marie , Woldie Mirkuzie , Berhane Melkamu , Abera Mubarek , Hailu Endashaw , Rana Ritu , Lanyero Betty , Grijalva-Eternod Carlos , Abdissa Alemseged , Girma Tsinuel , Kerac Marko , Smythe Tracey 
Published: September 2023

IntroductionEvidence gaps limit management of small and/or nutritionally at-risk infants under 6 months and their mothers, who are at higher risk of death, illness, malnutrition and poor growth and development. These infants may be low birth weight, wasted, stunted and/or underweight. An integrated care model to guide their management (MAMI Care Pathway) is being tested in a randomised controlled trial in Ethiopia. Evaluating the extent to which an innovation is consistent with national policies and priorities will aid evidence uptake and plan for scale.Methods and analysisThis review will evaluate the extent to which the MAMI Care Pathway is consistent with national policies that relate to the care of at-risk infants under 6 months and their mothers in Ethiopia. The objectives are to describe the range and characteristics, concepts, strategic interventions, coherence and alignment of existing policies and identify opportunities and gaps. It will be conducted in accordance with the JBI methodology for scoping reviews (PRISMA-ScR). Eligible documents include infant and maternal health, nutrition, child development, food and social welfare-related policies publicly available in English and Amharic. The protocol was registered on the Open Science Framework Registry on 20 June 2022 (https://osf.io/m4jt6).Grey literature will be identified through government and agency websites, national and subnational contacts and Google Scholar, and published policies through electronic database searches (MEDLINE, EMBASE and Global and Health Information). The searches will take place between October 2023 and March 2024. A standardised data extraction tool will be used. Descriptive analysis of data will be undertaken. Data will be mapped visually and tabulated. Results will be described in narrative form. National stakeholder discussions will inform conclusions and recommendations.Ethics and disseminationEthical approval is not required as data consist solely of publicly available material. Findings will be used to evidence national and international policy and practice.
Prevalence and impact of chronic dysglycaemia among patients with COVID-19 in Swedish intensive care units: a multicentre, retrospective cohort study
Authors: Balintescu Anca , Rysz Susanne , Hertz Carl , Grip Jonathan , Cronhjort Maria , Oldner Anders , Svensen Christer , Mårtensson Johan 
Published: September 2023

ObjectiveUsing glycated haemoglobin A1c (HbA1c) screening, we aimed to determine the prevalence of chronic dysglycaemia among patients with COVID-19 admitted to the intensive care unit (ICU). Additionally, we aimed to explore the association between chronic dysglycaemia and clinical outcomes related to ICU stay.DesignMulticentre retrospective observational study.SettingICUs in three hospitals in Stockholm, Sweden.ParticipantsCOVID-19 patients admitted to the ICU between 5 March 2020 and 13 August 2020 with available HbA1c at admission. Chronic dysglycaemia was determined based on previous diabetes history and HbA1c.Primary and secondary outcomesPrimary outcome was the actual prevalence of chronic dysglycaemia (pre-diabetes, unknown diabetes or known diabetes) among COVID-19 patients. Secondary outcome was the association of chronic dysglycaemia with 90-day mortality, ICU length of stay, duration of invasive mechanical ventilation (IMV) and renal replacement therapy (RRT), accounting for treatment selection bias.ResultsA total of 308 patients with available admission HbA1c were included. Chronic dysglycaemia prevalence assessment was restricted to 206 patients admitted ICUs in which HbA1c was measured on all admitted patients. Chronic dysglycaemia was present in 82.0% (95% CI 76.1% to 87.0%) of patients, with pre-diabetes present in 40.2% (95% CI 33.5% to 47.3%), unknown diabetes in 20.9% (95% CI 15.5% to 27.1%), well-controlled diabetes in 7.8% (95% CI 4.5% to 12.3%) and uncontrolled diabetes in 13.1% (95% CI 8.8% to 18.5%). All patients with available HbA1c were included for the analysis of the relationship between chronic dysglycaemia and secondary outcomes. We found no independent association between chronic dysglycaemia and 90-day mortality, ICU length of stay or duration of IMV. After excluding patients with specific treatment limitations, no association between chronic dysglycaemia and RRT use was observed.ConclusionsIn our cohort of critically ill COVID-19 patients, the prevalence of chronic dysglycaemia was 82%. We found no robust associations between chronic dysglycaemia and clinical outcomes when accounting for treatment limitations.
Transdiagnostic MRI markers of psychopathology following traumatic brain injury: a systematic review and network meta-analysis protocol
Authors: Samiotis Alexia , Hicks Amelia J , Ponsford Jennie , Spitz Gershon 
Published: September 2023

IntroductionPsychopathology following traumatic brain injury (TBI) is a common and debilitating consequence that is often associated with reduced functional and psychosocial outcomes. There is a lack of evidence regarding the neural underpinnings of psychopathology following TBI, and whether there may be transdiagnostic neural markers that are shared across traditional psychiatric diagnoses. The aim of this systematic review and meta-analysis is to examine the association of MRI-derived markers of brain structure and function with both transdiagnostic and specific psychopathology following moderate–severe TBI.Methods and analysisA systematic literature search of Embase (1974–2022), Ovid MEDLINE (1946–2022) and PsycINFO (1806–2022) will be conducted. Publications in English that investigate MRI correlates of psychopathology characterised by formal diagnoses or symptoms of psychopathology in closed moderate–severe TBI populations over 16 years of age will be included. Publications will be excluded that: (a) evaluate non-MRI neuroimaging techniques (CT, positron emission tomography, magnetoencephalography, electroencephalogram); (b) comprise primarily a paediatric cohort; (c) comprise primarily penetrating TBI. Eligible studies will be assessed against a modified Joanna Briggs Institute Critical Appraisal Instrument and data will be extracted by two independent reviewers. A descriptive analysis of MRI findings will be provided based on qualitative synthesis of data extracted. Quantitative analyses will include a meta-analysis and a network meta-analysis where there are sufficient data available.Ethics and disseminationEthics approval is not required for the present study as there will be no original data collected. We intend to disseminate the results through publication to a high-quality peer-reviewed journal and conference presentations on completion.PROSPERO registration numberCRD42022358358.
Implications of nicotine vaping products for tobacco control in ASEAN low-income and middle-income countries: in-depth interviews with experts from the region
Authors: Stubbs Thomas , White Victoria , Yong Hua-Hie , Toumbourou John W 
Published: September 2023

ObjectivesThe use of nicotine vaping products (NVPs) has increased in low-income and middle-income countries (LMICs) in the Association of Southeast Asian Nations (ASEAN) region; however, it is uncertain what implications the presence and use of NVPs have for tobacco control.DesignIn-depth interviews were conducted to explore ASEAN tobacco control experts’ (n=11) views on the rise of NVP use in ASEAN LMICs, current NVP policies, the potential harm reduction and smoking cessation utilities of these devices, and what implications they may have for tobacco control. Data were analysed using inductive, reflexive thematic analysis.ResultsFive themes emerged: (1) NVPs threaten tobacco control in ASEAN LMICs; (2) commercial factors influence youth appeal and access: product attributes, marketing, supply chains; (3) opposition to the smoking cessation and harm reduction utilities of NVPs; (4) policies are inconsistent and fragmented in the region; and (5) tobacco industry power and tactics have been used to capture NVP markets.ConclusionsASEAN tobacco control experts believe that NVPs pose a threat to youth and non-smokers in LMICs in the region, largely because of tobacco industry NVP marketing activities. They do not support the use of NVPs for smoking cessation or harm reduction and call for more restrictions and consistent policy enforcement across the region to protect young people, while also cautiously recognising that use of NVPs may have some benefits for smokers.
Modelling the transmission of dengue, zika and chikungunya: a scoping review protocol
Authors: Romero-Leiton Jhoana P , Acharya Kamal Raj , Parmley Jane Elizabeth , Arino Julien , Nasri Bouchra 
Published: September 2023

IntroductionAedesmosquitoes are the primary vectors for the spread of viruses like dengue (DENV), zika (ZIKV) and chikungunya (CHIKV), all of which affect humans. Those diseases contribute to global public health issues because of their great dispersion in rural and urban areas. Mathematical and statistical models have become helpful in understanding these diseases’ epidemiological dynamics. However, modelling the complexity of a real phenomenon, such as a viral disease, should consider several factors. This scoping review aims to document, identify and classify the most important factors as well as the modelling strategies for the spread of DENV, ZIKV and CHIKV.Methods and analysisWe will conduct searches in electronic bibliographic databases such as PubMed, MathSciNet and the Web of Science for full-text peer-reviewed articles written in English, French and Spanish. These articles should use mathematical and statistical modelling frameworks to study dengue, zika and chikungunya, and their cocirculation/coinfection with other diseases, with a publication date between 1 January 2011 and 31 July 2023. Eligible studies should employ deterministic, stochastic or statistical modelling approaches, consider control measures and incorporate parameters’ estimation or considering calibration/validation approaches. We will exclude articles focusing on clinical/laboratory experiments or theoretical articles that do not include any case study. Two reviewers specialised in zoonotic diseases and mathematical/statistical modelling will independently screen and retain relevant studies. Data extraction will be performed using a structured form, and the findings of the study will be summarised through classification and descriptive analysis. Three scoping reviews will be published, each focusing on one disease and its cocirculation/co-infection with other diseases.Ethics and disseminationThis protocol is exempt from ethics approval because it is carried out on published manuscripts and without the participation of humans and/or animals. The results will be disseminated through peer-reviewed publications and presentations in conferences.
Antimicrobial photodynamic therapy with erythrosine and blue light on dental biofilm bacteria: study protocol for randomised clinical trial
Authors: Gonçalves Marcela Leticia Leal , Sobral Ana Paula Taboada , Gallo Juliana Maria Altavista Sagretti , Gimenez Thais , Ferri Elza Padilha , Ianello Sara , Motta Pamella de Barros , Motta Lara Jansiski , Horliana Anna Carolina Ratto Tempestini , Santos Elaine Marcílio , Bussadori Sandra Kalil 
Published: September 2023

IntroductionThe objective is to investigate the effect of antimicrobial photodynamic therapy (aPDT) mediated by erythrosine and a blue light-emitting diode (LED) in the reduction of bacteria in dental biofilm.Methods and analysisThis clinical trial will be conducted with 30 patients who have biofilm, but without the presence of periodontal pockets, and who are being treated at the Dental Clinic of Universidade Metropolitana de Santos. A split-mouth model will be used (n=30), with group 1 control (conventional treatment) and group 2 (conventional treatment and aPDT). The bicarbonate jet will be used to remove dental biofilm in both groups. The treatment will be carried out in one session. aPDT will be performed before cleaning/prophylaxis, only in group 2. Participants will rinse with the photosensitiser erythrosine (diluted to 1 mM) for 1 min of pre-irradiation time, so that the drug can stain all the bacterial biofilm. Then, the D-2000 LED (DMC) will be applied, emitting at a wavelength of ʎ=470 nm, radiant power of 1000 mW, irradiance of 0.532 W/cm2and radiant exposure of 63.8 J/cm2. Irradiation will be performed until the biofilm of the cervical region is illuminated for 2 min/point (4 cm2). The microbiological examination will be performed from samples of supragingival biofilm collected from the gingival sulcus. Collection will be performed in each experimental site before irradiation, immediately after the irradiation procedure and after the prophylaxis. Colony-forming units will be counted and the data will be submitted for statistical analysis for comparison of pretreatment and post-treatment results and between groups (conventional X aPDT).Ethics and disseminationThis study has been approved by the Ethics Committee of Universidade Metropolitana de Santosunder process number 66984123.0.0000.5509. Results will be published in peer-reviewed journals and will be presented at conferences.Trial registration numberNCT05805761.
Socioecological risk factors associated with Malaria in Pregnancy in an endemic state of India: a retrospective study
Authors: Saroha Poonam , Gupta Sanjeev Kumar , Yadav Chander Prakash , Gill Jasmita , Sahoo Prakash , Singh Himmat , H C Vani , Pati Sanghamitra , Rahi Manju , Sharma Amit 
Published: September 2023

IntroductionMalaria in Pregnancy (MiP) has significant adverse effects on both mother and fetus. Pregnant women in regions with unstable malaria transmission are three times more vulnerable to infection. This study analysed malaria prevalence among pregnant women in Odisha, India from 2016 to 2020 and compared it with overall malaria rates. Socioecological factors potentially influencing MiP prevalence were also examined.MethodsDistrict-wise cases of malaria-positive pregnant women were analysed using a prevalence index named Malaria in Pregnancy rate (MiPr). The association of MiP with multidimensional poverty, forest cover and tribal population was studied. These three socioecological variables were compared with high and low MiPr (MiPr ≥1 or <1) respectively.ResultsA strong positive association was observed between the Annual Parasite Index (API) and the MiPr in 2016 (0.95), 2017 (0.97), 2018 (0.88), 2019 (0.97) and 2020 (0.97). The districts comprising a multidimensionally poor population of 45% or more accounted for 67% of the MiP cases in 2020. The odds of getting MiP (MiPr ≥1) were 82.5 times higher in the districts where the tribal population was ≥50% and 3.39 times higher in the districts where the forest cover was ≥40%. In 2020, two districts with high MiPr, Malkangiri (MiPr=5.61) and Rayagada (MiPr=3.24), were above the threshold for all three variables.ConclusionsThis work highlights an urgent need to increase awareness by the national control programme and the community in vulnerable regions through control and protection measures for pregnant women at higher risk of severe disease.
What can Safety Cases offer for patient safety? A multisite case study
Authors: Liberati Elisa Giulia , Martin Graham P , Lamé Guillaume , Waring Justin , Tarrant Carolyn , Willars Janet , Dixon-Woods Mary 
Published: September 2023

BackgroundThe Safety Case is a regulatory technique that requires organisations to demonstrate to regulators that they have systematically identified hazards in their systems and reduced risks to being as low as reasonably practicable. It is used in several high-risk sectors, but only in a very limited way in healthcare. We examined the first documented attempt to apply the Safety Case methodology to clinical pathways.MethodsData are drawn from a mixed-methods evaluation of the Safer Clinical Systems programme. The development of a Safety Case for a defined clinical pathway was a centrepiece of the programme. We base our analysis on 143 interviews covering all aspects of the programme and on analysis of 13 Safety Cases produced by clinical teams.ResultsThe principles behind a proactive, systematic approach to identifying and controlling risk that could be curated in a single document were broadly welcomed by participants, but was not straightforward to deliver. Compiling Safety Cases helped teams to identify safety hazards in clinical pathways, some of which had been previously occluded. However, the work of compiling Safety Cases was demanding of scarce skill and resource. Not all problems identified through proactive methods were tractable to the efforts of front-line staff. Some persistent hazards, originating from institutional and organisational vulnerabilities, appeared also to be out of the scope of control of even the board level of organisations. A particular dilemma for organisational senior leadership was whether to prioritise fixing the risks proactively identified in Safety Cases over other pressing issues, including those that had already resulted in harm.ConclusionsThe Safety Case approach was recognised by those involved in the Safer Clinical Systems programme as having potential value. However, it is also fraught with challenge, highlighting the limitations of efforts to transfer safety management practices to healthcare from other sectors.
Impact of the Syrian conflict and forced displacement on respiratory health: an analysis of primary data from a humanitarian organisation
Authors: Basha Lena , Socarras Alex , Akhter Mohammed Waseem , Hamze Mohamed , Albaik Ahmad , Hussein Imad , Tarakji Ahmad , Hamadeh Mufaddal , Loutfi Randa , Kewara Mazen , Abbara Aula 
Published: September 2023

BackgroundDespite a decade of conflict, there has been little exploration of respiratory health in Syria, notwithstanding the known impacts of conflict on lung health. Our aim is to explore the burden and trends of respiratory consultations in Syrian American Medical Society (SAMS) facilities in northwest Syria through an ecological analysis.MethodsWe performed a retrospective review of routinely collected data relating to respiratory presentations in SAMS’ facilities between March 2017 and June 2020; we compared data by facility type, infectious versus non-infectious aetiologies and age.ResultsData were available for 5 058 864 consultations, of which 1 228 722 (24%) were respiratory presentations, across 22 hospitals, 22 primary healthcare centres, 3 mobile clinics and 1 polyclinic. The median number of respiratory consultations per month was 30 279 (IQR: 25 792–33 732). Key findings include: 73% of respiratory consultations were for children; respiratory presentations accounted for up to 38% of consultations each month, seasonal variation was evident; respiratory tract infections accounted for 91% of all respiratory presentations. A steep decrease in consultations occurred between the end of 2019 (160 000) and the first quarter of 2020 (90 000), correlating with an escalation of violence in Idlib governorate.ConclusionThis study presents the largest quantitative analysis of respiratory data collected during the Syrian conflict. It supports the need for improved measures to aid the prevention, diagnosis and management of respiratory conditions during conflict as well as further research to explore the impact of conflict on respiratory health.
Treatment and prognosis of colorectal cancer with synchronous peritoneal metastases: 11-year single institute experience
Authors: Qin Xiusen , Yang Zifeng , Li Yang , Luo Jian , Wang Hui , Wang Huaiming 
Published: September 2023

BackgroundTreatment of colorectal cancer (CRC) with synchronous peritoneal metastases (SPM) is controversial, and its prognosis remains poor. Here, we analysed the association between treatment strategies and the outcomes of patients with colorectal SPM and devised a nomogram to improve their prognosis prediction.MethodsWe retrospectively analysed patients with colorectal SPM treated at The Sixth Affiliated Hospital, Sun Yat-sen University from June 2007 to June 2018. The Kaplan-Meier method with log-rank tests was used to compare the overall survival (OS) among patients undergoing different therapeutic regimens. Cox proportional hazards regression analysis was used to identify the prognostic factors. After variable selection, a nomogram was developed to predict the OS of patients with colorectal SPM.ResultsA total of 371 patients with colorectal SPM were eligible for this study. The median OS of all patients was 15.0 months (95% CI, 13.1 to 16.9), with a 3-year and 5-year OS rate of 23.7% and 16.9%, respectively. Patients who underwent complete cytoreductive surgery (CC0–1) had a better median OS of 49 months (p<0.001). Cox multivariate analysis showed that age >65 years; cancer antigen 125 level >35 U/mL; peritoneal carcinomatosis index >16 scores; and undergoing cytoreductive surgery, chemotherapy and hyperthermic intraperitoneal chemotherapy were independent prognostic factors for OS. The c-index of the prognostic nomogram was 0.747 (95% CI, 0.474 to 1.020).ConclusionsOur study suggests that patients with colorectal SPM who receive comprehensive treatment might achieve better prognoses. The prognostic nomogram demonstrated good predictive performance for patients with colorectal SPM.
ATM inhibition augments type I interferon response and antitumor T-cell immunity when combined with radiation therapy in murine tumor models
Authors: Jin Won Jong , Zangl Luke M , Hyun Meredith , Massoud Elian , Schroeder Kaleb , Alexandridis Roxana A , Morris Zachary S 
Published: September 2023

BackgroundRadiation therapy (RT) elicits DNA double-strand breaks, resulting in tumor cytotoxicity and a type I interferon (IFN) response via stimulator of interferon genes (STING) activation. We investigated whether combining RT with an ataxia-telangiectasia mutated inhibitor promoted these effects and amplified tumor immunity.MethodsMice-bearing syngeneic flank tumors (MOC2 head and neck squamous cell carcinoma or B78 melanoma) were treated with tumor-directed RT and oral administration of AZD0156. Specific immune cell depletion, type 1 interferon receptor 1 knock-out mice (IFNAR1-KO), and STING-deficient tumor cells were used to investigate tumor-immune crosstalk following RT and AZD0156 treatment.ResultsCombining RT and AZD0156 reduced tumor growth compared with RT or AZD0156 alone in mice bearing MOC2 or B78 tumors. Low-dose AZD0156 (1–100 nM) alone did not affect tumor cell proliferation but suppressed tumor cell clonogenicity in combination with RT. Low-dose AZD0156 with RT synergistically increased IFN-β, major histocompatibility complex (MHC)-I, and programmed death-ligand 1 (PD-L1) expression in tumor cells. In contrast to wild-type mice, IFNAR1-KO mice showed reduced CD8+T cell tumor infiltration and poor survival following RT+AZD0156 treatment. CD8+T cell depletion reduced antitumor response during RT+AZD0156 treatment. STING-deficient MOC2 (MOC2-STING+/–) or B78 (B78-STING–/–) tumors eliminated the effects of RT+AZD0156 on the expression of IFN-β, MHC-I, and PD-L1, and reduced CD8+T cell infiltration and migration. Additional anti-PD-L1 therapy promoted antitumor response by elevation of tumor-MHC-I and lymphocyte activation.ConclusionsCombined radiation and AZD0156 increase STING-dependent antitumor response. Tumor-derived cell-autonomous IFN-β amplification drives both MHC-I and PD-L1 induction at the tumor cell surface, which is required by anti-PD-L1 therapy to promote antitumor immune response following RT and AZD0156 combination therapy.