bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive testing for mycophenolate exposure in children with renal transplant using urinary metabolomics
Authors: Taha Khalid , Sharma Atul , Kroeker Kristine , Ross Colin , Carleton Bruce , Wishart David , Medeiros Mara , Blydt‐Hansen Tom D. 
Published: December 2022

AbstractBackgroundDespite the common use of mycophenolate in pediatric renal transplantation, lack of effective therapeuic drug monitoring increases uncertainty over optimal drug exposure and risk for adverse reactions. This study aims to develop a novel urine test to estimate MPA exposure based using metabolomics.MethodsUrine samples obtained on the same day of MPA pharmacokinetic testing from two prospective cohorts of pediatric kidney transplant recipients were assayed for 133 unique metabolites by mass spectrometry. Partial least squares (PLS) discriminate analysis was used to develop a top 10 urinary metabolite classifier that estimates MPA exposure. An independent cohort was used to test pharmacodynamic validity for allograft inflammation (urinary CXCL10 levels) and eGFR ratio (12mo/1mo eGFR) at 1 year.ResultsFifty‐two urine samples from separate children (36.5% female, 12.0 ± 5.3 years at transplant) were evaluated at 1.6 ± 2.5 years post‐transplant. Using all detected metabolites (n = 90), the classifier exhibited strong association with MPA AUC by principal component regression (r = 0.56, p < .001) and PLS (r = 0.75, p < .001). A practical classifier (top 10 metabolites; r = 0.64, p < .001) retained similar accuracy after cross‐validation (LOOCV; r = 0.52, p < .001). When applied to an independent cohort (n = 97 patients, 1053 samples), estimated mean MPA exposure over Year 1 was inversely associated with mean urinary CXCL10:Cr (r = −0.28, 95% CI −0.45, −0.08) and exhibited a trend for association with eGFR ratio (r = 0.35, p = .07), over the same time period.ConclusionsThis urinary metabolite classifier can estimate MPA exposure and correlates with allograft inflammation. Future studies with larger samples are required to validate and evaluate its clinical application.
Combined transrectal and vaginal manual detorsion of pre‐cervical uterine torsion in cows
Authors: Đuričić Dražen , Samardžija Marko 
Published: December 2022

AbstractThe pre‐cervical uterine torsion is a rotation of a pregnant uterine horn on its longitudinal axis with the point of rotation located cranial to the cervix. After diagnosis based on vaginal and rectal examination, uterine detorsion was first transrectal approached because the cervix was not open and blocked. Five cases are described. The direction of rotation in all 5 cows was clockwise. The head of the calf was manually caught with the left hand per rectum and the entire uterus swayed several times in a left–right direction. During left–right swinging of the pregnant uterus and fetus, manually through the rectum, when the right swing tip reached, then abruptly tried to turn anti‐clockwise. The procedure was repeated several times. After partial transrectal detorsion, we could access the calf, vaginally, and detorsion with the right hand and the same procedure of swinging the calf were started, but vaginally. Even if the uterus was restored to the normal position, sometimes the calf remained in an unfavourable position; therefore, it was corrected in the dorsal position and prepared for a forced extraction. This is the first report of a successful combination of transrectal and vaginal manual detorsion of a rare pre‐cervical uterine torsion in cows.
Budget support to the health sector—The right choice for strong institutions? Evidence from panel data
Authors: Röthel Tim 
Published: December 2022

AbstractThis article examines the relationship of sector budget support to the health sector and the infant mortality rate for developing countries. Project‐type interventions have been widely used in developing countries in the past decades. These smaller‐scale interventions often did not bring the results that the donors would have wanted, at least on a macro level. At the beginning of the millennium, forums on aid effectiveness proposed new principles to increase the effectiveness of aid. Many scholars agreed that one of the answers would be budget support. This article tries to answer whether budget support is the efficient aid modality in countries with strong institutions. In the baseline scenario, a panel data analysis is applied, which includes 113 countries between 2010 and 2018. This dynamic linear panel model is estimated by using ordinary least squares (OLS) and system generalized method of moments (GMM). Health sector aid, in general, has a significant and negative effect on the infant mortality rate in the average country. Sector budget support is insignificant in the baseline estimation and when interacted with a governance variable. In contrast, project‐type interventions exhibit significant and negative effects on the outcome variable. The results indicate that sector budget support might not be the superior choice among the aid modalities in the health sector, even in countries with good governance.
Governing a pandemic: biopower and the COVID-19 response in Zimbabwe
Authors: Mhazo Alison T , Maponga Charles Chiedza 
Published: December 2022

IntroductionThe extraordinary explosion of state power towards the COVID-19 response has attracted scholarly and policy attention in relation to pandemic politics. This paper relies on Foucault’s theoretical differentiation of the political management of epidemics to understand how governmental framing of COVID-19 reflects biopolitical powers and how power was mobilised to control the pandemic in Zimbabwe.MethodsWe conducted a scoping review of published literature, cabinet resolutions and statutory instruments related to COVID-19 in Zimbabwe.ResultsThe COVID-19 response in Zimbabwe was shaped by four discursive frames: ignorance, denialism, securitisation and state sovereignty. A slew of COVID-19-related regulations and decrees were promulgated, including use of special presidential powers, typical of the leprosy model (sovereign power), a protracted and heavily policed lockdown was effected, typical of the plague model (disciplinary power) and throughout the pandemic, there was reference to statistical data to justify the response measures whilst vaccination emerged as a flagship strategy to control the pandemic, typical of the smallpox model (biopower). The securitisation frame had a large influence on the overall pandemic response, leading to an overly punitive application of disciplinary power and cases of infidelity to scientific evidence. On the other hand, a securitised, geopolitically oriented sovereignty model positively shaped a strong, generally well execucted, domestically financed vaccination (biopower) programme.ConclusionsThe COVID-19 response in Zimbabwe was not just an exercise in biomedical science, rather it invoked wider governmentality aspects shaped by the country’s own history, (geo) politics and various mechanisms of power. The study concludes that whilst epidemic securitisation by norm-setting institutions such as WHO is critical to stimulate international political action, the transnational diffusion of such charged frames needs to be viewed in relation to how policy makers filter the policy and political consequences of securitisation through the lenses of their ideological stances and its potential to hamper rather than bolster political action.
Indirect effects of COVID-19 on child and adolescent mental health: an overview of systematic reviews
Authors: Harrison Leila , Carducci Bianca , Klein Jonathan D , Bhutta Zulfiqar Ahmed 
Published: December 2022

IntroductionTo control the spread of COVID-19, mitigation strategies have been implemented globally, which may have unintended harmful effects on child and adolescent mental health. This study aims to synthesise the indirect mental health impacts on children and adolescents globally due to COVID-19 mitigation strategies.MethodsWe included relevant reviews from MEDLINE, Embase, PsycINFO, LILACS, CINAHL, The Cochrane Library and Web of Science until January 2022 that examined the impact of COVID-19-related lockdown and stay-at-home measures on the mental health of children and adolescents. Data extraction and quality assessments were completed independently and in duplicate by BC and LH. A Measurement Tool to Assess Systematic Reviews-2 was used to assess the methodological quality.ResultsEighteen systematic reviews, comprising 366 primary studies, found a pooled prevalence of 32% for depression (95% CI: 27 to 38, n=161 673) and 32% for anxiety (95% CI: 27 to 37, n=143 928) in children and adolescents globally following COVID-19 mitigation measures. Subgroup analyses also uncovered important differences for both depression and anxiety by World Health Organization regions with few studies from Africa and relative high burden of anxiety and depression in the Eastern Mediterranean region.ConclusionsOur findings reveal a high prevalence of depression and anxiety in children and adolescents during the COVID-19 pandemic, globally, compared with prepandemic estimates. These findings highlight the urgency for governments and policymakers to strengthen mental health systems in the COVID-19 recovery, especially in low-and middle-income countries where compounding psychological stress, access and affordability of care and discrepant reporting of mental health in this population remains a challenge. We also provide insight into how to alter mitigation strategies to reduce the unintended negative consequences for the health and well-being of children and adolescents in future pandemics.PROSPERO registration numberCRD42022309348.
Concept analysis of patient safety in home care: a hybrid model
Authors: Keyvanloo Shahrestanaki Sahar , Rafii Forough , Najafi Ghezeljeh Tahereh , Ashghali Farahani Mansoureh , Amrollah Majdabadi Kohne Zahra 
Published: December 2022

BackgroundPatient safety in home care is a fundamental and complex concept in nursing. This concept includes a number of challenges in patient care. Studies have shown that there is no clear and uniform definition for this concept.ObjectiveThe objective of the present study was to analyse patient safety in home care in Iran.MethodsThe study was done using a hybrid model at three phases, including theoretical, field work and the final analysis. We searched valid databases including MEDLIN and CINHAL; electronic references including Web of Science, Scopus, Ovid, ProQuest, PubMed and Persian databases including Magiran, IranDoc and SID during 2008–2022, using these Persian and English keywords: Patient Safety, Safety, Home Care Service, Domiciliary Care, Home Care and Home Health Care. A total of 16 articles were searched in the theoretical phase and then analysed by content analysis. In field work phase, nine participants were interviewed (nurse, family and patient) and then the interviews were analysed by the content analysis method. In the final analysis phase, a general analysis of the previous two phases was performed and after determining the attributes, antecedents and consequences, a final definition of patient safety in home care in Iran was presented.FindingsBased on different studies, patient safety in home care is a multifaceted concept, which encompasses physical, mental, social and practical dimensions. Evaluation, prevention, participation and commitment to the safety culture are the core features of this concept. The patient care concept depends on the commitment of the involved participants, adequate resources, environmental conditions, support of the involved centres (home care agency, hospital and the insurance), self-efficacy and the ability of the caregivers (nurses).ConclusionDefining the concept of patient safety in home care provides a basis for the development of a safe patient care system at home. This concept analysis for patient safety in home care could be a guide for future studies.
Structural and functional correlates of the response to deep brain stimulation at ventral capsule/ventral striatum region for treatment-resistant depression
Authors: Lai Yijie , Dai Lulin , Wang Tao , Zhang Yingying , Zhao Yijie , Wang Fengting , Liu Qimin , Zhan Shikun , Li Dianyou , Jin Haiyan , Fang Yiru , Voon Valerie , Sun Bomin 
Published: December 2022

BackgroundThough deep brain stimulation (DBS) shows increasing potential in treatment-resistant depression (TRD), the underlying neural mechanisms remain unclear. Here, we investigated functional and structural connectivities related to and predictive of clinical effectiveness of DBS at ventral capsule/ventral striatum region for TRD.MethodsStimulation effects of 71 stimulation settings in 10 TRD patients were assessed. The electric fields were estimated and combined with normative functional and structural connectomes to identify connections as well as fibre tracts beneficial for outcome. We calculated stimulation-dependent optimal connectivity and constructed models to predict outcome. Leave-one-out cross-validation was used to validate the prediction value.ResultsSuccessful prediction of antidepressant effectiveness in out-of-sample patients was achieved by the optimal connectivity profiles constructed with both the functional connectivity (R=0.49 at p<10-4; deviated by 14.4±10.9% from actual, p<0.001) and structural connectivity (R=0.51 at p<10-5; deviated by 15.2±11.5% from actual, p<10-5). Frontothalamic pathways and cortical projections were delineated for optimal clinical outcome. Similarity estimates between optimal connectivity profile from one modality (functional/structural) and individual brain connectivity in the other modality (structural/functional) significantly cross-predicted the outcome of DBS. The optimal structural and functional connectivity mainly converged at the ventral and dorsal lateral prefrontal cortex and orbitofrontal cortex.ConclusionsConnectivity profiles and fibre tracts following frontothalamic streamlines appear to predict outcome of DBS for TRD. The findings shed light on the neural pathways in depression and may be used to guide both presurgical planning and postsurgical programming after further validation.
Holistic strategy for promoting effective handoffs
Authors: Keebler Joseph Roland , Lazzara Elizabeth , Griggs Andrew , Tannenbaum Scott , Fernandez Rosemarie , Greilich Philip , Salas Eduardo 
Published: December 2022

BackgroundHandoffs are ubiquitous in modern healthcare practice, and they can be a point of resilience and care continuity. However, they are prone to a variety of issues. Handoffs are linked to 80% of serious medical errors and are implicated in one of three malpractice suits. Furthermore, poorly performed handoffs can lead to information loss, duplication of efforts, diagnosis changes and increased mortality.MethodsThis article proposes a holistic approach for healthcare organisations to achieve effective handoffs within their units and departments.ResultsWe examine the organisational considerations (ie, the facets controlled by higher-level leadership) and local drivers (ie, the aspects controlled by the individuals working in the units and providing patient care).ConclusionWe propose advice for leaders to best enact the processes and cultural change necessary to see positive outcomes associated with handoffs and care transitions within their units and hospitals.
Differential lifespan impacts on veterans by war exposure in the First World War
Authors: Wilson Nick , Clement C , Summers J A , Thomson G , Harper G 
Published: December 2022

IntroductionThere remains uncertainty around the impact of war on the lifespan of First World War (WW1) veterans. In particular, study comparison groups do not typically consider the ‘healthy soldier effect’.MethodsWe obtained lifespan data on a random sample of 857 war-exposed New Zealand WW1 veterans and compared this with lifespans of a non-war military cohort (n=1039). This comparison was possible as the non-war-cohort arrived in Europe too late to participate in the war, allowing a ‘natural experiment’ that avoided the ‘healthy solider effect’.ResultsThe lifespan comparisons indicated lower mean lifespan in the war-exposed veteran cohort compared with the non-war veteran cohort (69.7 vs 71.1 years; p=0.0405). This gap persisted (range: 0.8–1.1 years) but was no longer statistically significant when only considering the non-Māori ethnic grouping (nearly all European/Pākehā personnel), when excluding additional deaths in the immediate postwar period up to 31 December 1923, and when excluding participation in any other wars. This was the case in both analysis of variance and Cox proportional hazards regression adjusting for year of birth and occupational status. Within the war-exposed cohort, there were suggestive patterns of increasing lifespan with increasing occupational status and military rank (eg, 69.5, 70.0 and 70.7 mean years as group-level occupational status progressively increased). There were also stark differences in lifespan of 8.3 years between Māori (Indigenous) and non-Māori veterans (p=0.0083).ConclusionsThe pattern of reduced lifespan in war-exposed versus non-war-exposed veterans was compatible with a smaller previous New Zealand study with comparable methodology. Veterans who were Māori had significantly lower lifespans than non-Māori veterans. There are a number of feasible avenues to further improve this type of work with existing data sources.
Median effective dose of ropivacaine for prophylactic cervical cerclage in Chinese women: a dose-finding study
Authors: Liu Kun , Zhao Ping , Ding Mengmeng , Ji Haiyin , Tao Bingdong 
Published: December 2022

BackgroundAlthough intrathecal ropivacaine has been widely used for caesarean delivery, there are limited data for the use of ropivacaine for prophylactic cervical cerclage. We sought to determine the median effective dose of intrathecal ropivacaine for prophylactic cervical cerclage in 50% of patients (ED50) and the calculated dose required for successful block in 95% of patients (ED95).MethodsWe included Chinese women scheduled for prophylactic cervical cerclage under combined spinal-epidural (CSE) anaesthesia in the first or second trimester. A predetermined dose of intrathecal isobaric ropivacaine was administered. If this determined dose achieved an effective block at a level not lower than T12, the next dose was decreased by 0.5 mg. Otherwise, the next dose was increased by 0.5 mg. The primary outcome was the ED50 of intrathecal ropivacaine. Secondary outcomes included the calculated ED95, time from CSE to the start of surgery and so on.ResultsForty patients were included in the study, 23 (57.5%) of 40 received an effective block only with intrathecal ropivacaine, while 17 (42.5%) patients needed extra epidural lidocaine to achieve a successful block. The ED50 of intrathecal ropivacaine confirmed by isotonic regression was 6.9 mg (95% CI, 6.68 to 7.12 mg), and the calculated ED95 was 7.8 mg (95% CI, 7.69 to 10.05 mg). When an effective block was achieved with intrathecal ropivacaine alone, the time to resolution of the sensory and motor blocks was 90 (75–100) min and 90 (60–100) min, respectively.ConclusionsThe ED50 of intrathecal ropivacaine for prophylactic cervical cerclage was 6.9 mg. Intrathecal ropivacaine (7.8 mg) is likely to produce successful anaesthesia in 95% of patients undergoing prophylactic cervical cerclage.Trial registration numberChiCTR2100051418.
Baseline serum levels of cross-linked carboxy-terminal telopeptide of type I collagen predict abatacept treatment response in methotrexate-naive, anticitrullinated protein antibody-positive patients with early rheumatoid arthritis
Authors: Wu Chun , Hu Yanhua , Schafer Peter , Connolly Sean E , Wong Robert , Nielsen Signe Holm , Bay-Jensen Anne-Christine , Emery Paul , Tanaka Yoshiya , Bykerk Vivian P , Bingham Clifton O , Huizinga Thomas WJ , Fleischmann Roy , Liu Jinqi 
Published: December 2022

ObjectiveTo investigate correlations between biomarkers of bone remodelling and extracellular matrix turnover with baseline disease activity and treatment response in patients with early rheumatoid arthritis (RA).MethodsAssessingVeryEarlyRheumatoid arthritisTreatment-2 (AVERT-2;NCT02504268) included disease-modifying antirheumatic drug-naive, anti-citrullinated protein antibody (ACPA)-positive patients randomised to weekly subcutaneous abatacept+methotrexate (MTX) or abatacept placebo+MTX for 56 weeks. This post hoc exploratory subanalysis assessed the association between baseline disease activity and eight biomarkers (Spearman’s correlation coefficient), and whether baseline biomarkers (continuous or categorical variables) could predict treatment response at weeks 24 and 52 (logistic regression).ResultsPatient characteristics were similar between overall (n=752) and biomarker subgroup (n=535) populations and across treatments. At baseline, neoepitopes of matrix metalloproteinase-mediated degradation products of types III and IV collagen and of C reactive protein (CRP) showed the greatest correlations with disease activity; cross-linked carboxy-terminal telopeptide of type I collagen (CTX-I) showed weak correlation. Only CTX-I predicted treatment response; baseline CTX-I levels were significantly associated with achieving Simplified Disease Activity Index remission and Disease Activity Score in 28 joints (DAS28 (CRP)) <2.6 (weeks 24 and 52), and American College of Rheumatology 70 response (week 52), in patients treated with abatacept+MTX but not abatacept placebo+MTX. CTX-I predicted significant differential response between arms for DAS28 (CRP) <2.6 (week 24). Treatment differences were greater for abatacept+MTX in patients with medium/high versus low baseline CTX-I.ConclusionIn MTX-naive, ACPA-positive patients with early RA, baseline CTX-I predicted treatment response to abatacept+MTX but not abatacept placebo+MTX.
Comparison of official reporting on assisted suicide and euthanasia across jurisdictions
Authors: Worthington Ana , Regnard Claud , Sleeman Katherine E , Finlay Ilora 
Published: December 2022

ObjectivesOfficial data reports from countries where assisted suicide and euthanasia is legal are an important resource for discerning participation rates, patient safety and transparency in the way that assisted dying is legal. We aimed to identify what information is published in official data reports on assisted suicide and euthanasia across jurisdictions.MethodsWe searched for official data reports from every jurisdiction where assisted suicide or euthanasia is legal. Searches were conducted on these countries’ official health authority websites as well as on mainstream search engines. The data measures included within each report were described in four categories: participation data, patient characteristics, clinician characteristics, and drugs and dying process.ResultsWe found that 16 jurisdictions where assisted suicide or euthanasia is currently legal regularly publish data reports regarding its practice. The information included within these official reports varies greatly, with few measures published across all or most jurisdictions.ConclusionsDifferences in the kinds of information published within official reports on assisted suicide and euthanasia makes comparing the practice of assisted suicide and euthanasia across jurisdictions challenging. Many jurisdictions fail to report data measures, which could be valuable to the understanding of assisted suicide and euthanasia practices within that country. Improving data reporting across jurisdictions where assisted suicide and euthanasia is legal, for example, through establishing minimum requirements for data collection and reporting, is an important step towards ensuring patient safety and the transparent practice of assisted suicide and euthanasia.