bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimising early detection of degenerative cervical myelopathy: a systematic review of quantitative screening tools for primary care
Authors: Inzerillo Sean , Jagtiani Pemla , Jones Salazar 
Published: January 2025

BackgroundEarly diagnosis of degenerative cervical myelopathy (DCM) is often challenging due to subtle, non-specific symptoms, limited disease awareness and a lack of definitive diagnostic criteria. As primary care physicians are typically the first to encounter patients with early DCM, equipping them with effective screening tools is crucial for reducing diagnostic delays and improving patient outcomes. This systematic review evaluates the efficacy of quantitative screening methods for DCM that can be implemented in primary care settings.MethodsA systematic search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted across PubMed, Embase and Cochrane Library up to July 2024 using keywords relevant to DCM screening. Studies were included if they evaluated the sensitivity and specificity of DCM screening tools applicable to primary care settings. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsThe search identified 14 studies evaluating 18 screening methods for DCM. Questionnaires consistently showed high diagnostic accuracy, with Youden indices exceeding 0.60, while only three out of nine conventional physical performance tests met the same threshold. Sensor-assisted tests, particularly those using advanced technology like finger-wearable gyro sensors, exhibited the highest diagnostic accuracy but present challenges related to accessibility and learning curves.ConclusionThis review highlights the potential of quantitative screening methods for early DCM detection in primary care. While questionnaires and conventional tests are effective and accessible, sensor-assisted tests offer greater accuracy but face implementation challenges. A tailored, multifaceted approach is crucial for improving outcomes. Future research should focus on validating these tools in diverse populations and standardising diagnostic criteria.
Daily iron supplementation does not impact on prevalence of exclusive breastfeeding or growth in young breastfed Gambian infants
Authors: Stelle Isabella , Bah Mamadou , Verhoef Hans , Moore Sophie , Cerami Carla 
Published: January 2025

BackgroundIn a randomised placebo-controlled trial among exclusively breastfed rural Gambian infants aged 6–10 weeks at randomisation, daily iron supplementation for 14 weeks improved iron status. This secondary analysis explores the impact of iron supplementation on duration of exclusive breastfeeding and growth.MethodsBreastfed 6–10 week-old infants were supplemented for 14 weeks with either daily iron or placebo (n=101). Infant feeding practices were assessed weekly through questionnaires. Survival analysis was used to measure the effect of iron supplementation on age at and time to cessation of exclusive breastfeeding. Groups were also compared regarding the change in anthropometric z-scores between baseline and endline.ResultsAt endline, 31% (n=31/101) of infants were exclusively breastfed. There was no evidence that iron supplementation reduced the time to cessation of exclusive breastfeeding (median: 70 days (range: 7–105 days), iron: 67 days; placebo 71 days; Kaplan-Meier, log-rank test: p=0.15; Cox regression, crude HR: 1.42, 95% CI: 0.86 to 2.34, p=0.17; HR adjusting for infant age and sex: 1.40, 95% CI: 0.85 to 2.31, p=0.19) or age at cessation of exclusive breastfeeding (median time: 18 weeks (range:1–24 weeks), iron: 16 weeks; placebo 18 weeks; Kaplan-Meier, log-rank test: p=0.13; crude HR=1.47, 95% CI: 0.89, 2.43; p=0.13; HR adjusting for infant age and sex=1.44, 95% CI: 0.87, 2.39 p=0.16) There was no evidence that iron supplementation affected infant weight (p=0.79) or length (p=0.64) at endline or change in z-scores during the intervention period for weight-for-age (p=0.99), length-for-age (p=0.70) and weight-for-length (p=0.89). There was no evidence that duration of exclusive breastfeeding impacted endline anthropometric outcomes.ConclusionAlthough requiring replication in larger trials, these findings do not raise concerns about iron supplementations’ effect on feeding or growth in exclusively breastfed infants.
Community health system capacities and capabilities within an evolving community health policy framework: mixed methods study of stakeholders in central Uganda
Authors: Kabanda Richard , Ocaatre Ronald Miria , Atwine Diana , Kim Bounggui , Waiswa Simon Erisa , Kavuma Prichard Denzel , Lee Yeni , Mutoni Loretah , Kim Solyi , Park Yein , Okuga Monica , Tweheyo Raymond 
Published: January 2025

ObjectivesEmpowering communities through identifying and unlocking community capacities and capabilities is vital for improving community health systems. This study assessed the community health system’s status quo and readiness for implementing a government-led, partner-supported community health worker project.DesignA mixed methods cross-sectional study.SettingTwo districts and one city in central Uganda.Participants21 key informants (KIIs) with district leaders, 4 focus group discussions (FGDs) with community health workers (CHWs) termed as village health teams in the Ugandan setting and a survey of 487 CHWs and 419 pregnant women who had childbirth 12 months before.Study measuresKIIs and FGDs explored community health system resources using the WHO health systems building blocks and the UNICEF health system strengthening maturation model. However, the surveys explored the work-related attributes and services delivered by the CHWs and to the community, respectively.AnalysisA framework analysis was used for qualitative data in NVivo 14. While descriptive and stratified analyses were conducted for quantitative data in Stata I/C 15.0: proportions for the varied geographical entities were compared using the t-test with p values <0.05 considered significant, one-way ANOVA was used to compare means.ResultsOverall, all sites had relatively strong governance of community health only challenged by multiple implementing partners that were weakly coordinated. There was an exclusive paper-based information management system that linked to the national DHIS-2 software. Community reporting rates varied between 20% and 80%. Community health financing was weak, similarly to commodities availability. The mean age of the community health workforce was high at 50.9 (SD 11.9); the majority reported adequate skills in service delivery except for community first aid, Kangaroo mother care and noncommunicable diseases. Households’ most received CHW services included home visits, treatment for sick under-five children and child immunisation.ConclusionsThe existing CHW system has governance and reporting strengths but could be enhanced through revitalization, enhanced coordination of stakeholders, providing appropriate training, work tools, supervision and engaging the community for accountability of results.
Systematic review of health and social outcomes among Indigenous People exposed to the child welfare system: a protocol
Authors: Schwartz Flint D. , Pride Tara M. , Stewart Sherry H. , Mackinnon Sean P. , Robinson Margaret 
Published: January 2025

IntroductionThe link between parent-child separation through child welfare systems and negative health and social outcomes is well documented. In contrast, despite the over-representation of Indigenous children and youth in child welfare systems, the relationship between child welfare system involvement and health and social outcomes among Indigenous populations has not been systematically reviewed. Our objective is to assess whether Indigenous People who have been exposed to a child welfare system personally or intergenerationally (ie, parents and/or grandparents) within Canada, Australia, New Zealand and the USA (CANZUS countries) and the circumpolar region are at an increased risk for negative health and social outcomes compared with other exposed and non-exposed groups.Methods and analysisWe will undertake a comprehensive exploration of literature documenting health and social outcomes for Indigenous individuals with personal or intergenerational exposure to a child welfare system. The search will encompass nine databases, including Ovid MEDLINE, APA PsycINFO, Bibliography of Native North Americans, CINAHL, EMBASE, Public Affairs Index, Scopus, Social Work Abstracts and Sociological Abstracts. Additionally, reference lists of included studies will be examined. The literature search will include studies up to 4 October 2024 and will adhere to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Findings will be presented in summary tables through narrative synthesis, and if feasible, a meta-analysis will quantify the impact of child welfare exposure on health and social outcomes.Ethics and disseminationThe results of this systematic review will synthesise current evidence regarding health and social outcomes related to personal and intergenerational child welfare exposure among Indigenous populations in CANZUS countries and circumpolar regions. This information could help support future policy and practice decision-making. Findings will be widely disseminated through peer-review publications and community presentations aimed at various interested parties, including policymakers, professional practitioners and clinicians, and service users (ie, clients, family members, caregivers).PROSPERO registration numberCRD42023434543
Global regional and national burden of cataract attributable to high body mass index from 1990 to 2019
Authors: Zhang Baodong , Ding Yuxi , Lan Xiaowen 
Published: January 2025

ObjectivesIn order to estimate long-term trends of the years lived with disability (YLDs) for cataract due to high body mass index (BMI).Design and participantsData were retrieved from the Global Burden of Disease (GBD) 2019. The global cases, age-standardised rates (ASR) of YLDs for cataract attributable to high BMI were described by age, sex, geographical location and sociodemographic index (SDI). The estimated average annual percentage change (AAPC) was analysed to quantify the trends of ASR of YLD from 1990 to 2019.Primary outcome measuresYears lived with disability.ResultsGlobally, there were 370.4 (95% UI: 163.2 to 689.3) YLDs due to cataract attributed to high BMI in 2019, more than triple the number in 1990. Moreover, the ASR of YLD increased during 1990–2019, with AAPC of 1.54 (95% CI: 1.41 to 1.66). In 2019, the burden of cataract due to high BMI was higher in females and the elderly population. North Africa and the Middle East were the high-risk areas of cataract attributable to high BMI in 2019, with Saudi Arabia being the country with the heaviest burden. In terms of SDI, low-middle SDI regions had the greatest number of cataract-related YLDs due to high BMI in 2019.ConclusionThe global YLDs for cataract due to high BMI have shown a notable increase from 1990 to 2019. Addressing BMI control may contribute to cataract prevention, highlighting a potential public health impact, particularly in low-SDI locations and among the elderly.
Protocol for the development of a global core outcome set for the surgical treatment of differentiated thyroid cancer: a literature review and international Delphi survey
Authors: van de Berg Daniël J , Mooij Christiaan F , van Trotsenburg A S Paul , Jamaludin Faridi S , van Santen Hanneke M , Clement Sarah C , Vriens Menno R , Bruinstroop Eveline , Kruijff Schelto , Peeters Robin P , Verburg Frederik A , Netea-Maier Romana T , Seur Angelique , Nieveen van Dijkum Els J M , Engelsman Anton F , Derikx Joep P M 
Published: January 2025

IntroductionThere is a lack of consensus on the optimal surgical strategy for differentiated thyroid cancer (DTC), partly due to inconsistent reporting of outcomes. This limits the ability to compare study results, hindering the ability to draw conclusions regarding novel treatment strategies. The development of a core outcome set (COS) reduces heterogeneity in the selection and reporting of clinical trial outcomes. Currently, there is no COS for the surgical treatment of DTC. We aim to reach a global consensus among patients and physicians on the COS for the surgical treatment for patients with DTC of all ages.Methods and analysisThe DTC-COS development will consist of three phases: first, an extensive literature review will be performed to identify reported outcomes in studies regarding surgical treatment for DTC in patients of all ages. Second, a 2-step or 3-step Delphi procedure will be performed to identify a final set of core outcomes out of the selected outcomes from the literature review. For this Delphi survey, both healthcare professionals and patients will be invited. Third, an (online) expert meeting with participants from every stakeholder group is organised to ratify the final core outcome set. The final COS will be reported in accordance with the COS-Standards for Reporting statement.Ethics and disseminationThe medical research ethics committee of the Amsterdam UMC confirmed that the Dutch Medical Research Involving Human Subjects Act (WMO) does not apply to this study and that full approval by the committee is not required. The study is registered in the COMET initiative database (registration number 2597). Results will be presented in peer-reviewed academic journals and at (international) conferences.Trial registration numberCOMET initiative database 2597
Missed opportunity for nasal continuous positive airway pressure in preterm neonates admitted at a tertiary-level hospital newborn unit in Kenya: a mixed method study
Authors: Kakibibi Peace , Marangu-Boore Diana , Murila Florence 
Published: January 2025

BackgroundRespiratory Distress Syndrome (RDS) is the most common complication of preterm neonates. It remains one of the major public health concerns that contribute to neonatal mortality and morbidity, especially in Africa, where 80% of neonatal mortality is estimated to be caused by preterm complications. Nasal Continuous Positive Airway Pressure (NCPAP) ventilation is the preferred mode of RDS treatment. However, NCPAP is not easily accessible to every preterm neonate in low- and middle-income countries, and this is the case in Kenya.ObjectivesTo determine the proportion of preterm neonates admitted to the newborn unit (NBU) at Kenyatta National Hospital (KNH), a tertiary referral hospital in Kenya, with a missed opportunity for NCPAP and to determine the barriers and facilitators of NCPAP utilisation.Design and settingWe conducted a hospital-based cross-sectional study that employed interactive explanatory concurrent mixed methods. The quantitative approach determined the proportion of missed opportunities for NCPAP in preterm neonates admitted to the KNH newborn unit, while the qualitative approach explored the barriers and facilitators of NCPAP utilisation.ParticipantsPreterm neonates of gestation less than 37 weeks in the first 48 hours of life who met the criteria for NCPAP. The key informants were mainly different staff cadres from the newborn unit, a procurement officer and a biomedical engineer.Primary and secondary outcome measuresThe proportion of preterm infants admitted to the newborn unit with a missed opportunity for NCPAP, and the barriers and facilitators of NCPAP utilisation.Results167 preterm neonates were reviewed from July to November 2021 and analysed of whom 33.5% (95% CI 26.8% to 41.0%) missed the opportunity to receive NCPAP. 20 key informants were interviewed from September to October 2021. Facilitators of NCPAP use reported were (1) training of health workers, (2) availability of NCPAP machines, (3) KNH being a national and tertiary referral hospital able to receive neonates referred with RDS, (4) global evidence that NCPAP use is beneficial and (5) technology development. Barriers to NCPAP use were mainly (1) inadequate number of NCPAP machines, (2) inadequate training and mentorship, (3) inadequate and inappropriate size of NCPAP consumables, (4) staff shortage, (5) long servicing turnaround time, (6) long cleaning turnaround time, (7) infrastructure challenges and (8) insufficient utilities.ConclusionThe missed opportunity for NCPAP in preterm neonates in Kenya is high. Barriers to NCPAP are related to medical products and technologies, health workforce-related challenges and service delivery. We recommend the provision of more NCPAP machines including supporting infrastructure and appropriate consumables, human resource support, frequent training and mentorship on NCPAP use.
Association between endostatin and mortality in patients with acute dyspnoea, with or without congestive heart failure: a single-centre, prospective, observational study
Authors: Yaghoubi Alexander , Heijl Caroline , Khoshnood Ardavan M , Wändell Per Erik , Carlsson Axel C , Wessman Torgny 
Published: January 2025

ObjectiveThe aim of this study was to assess associations between endostatin levels and short-term mortality in unsorted acute hospitalised dyspnoea patients with or without congestive heart failure (CHF), adjusted for common cardiovascular risk factors.Design, setting and participantsIn this prospective observational study, 723 hospitalised patients who visited the emergency department at Skåne University Hospital, Sweden, between 2013 and 2018 were included. Of these, 276 had a history of CHF. The association between endostatin levels and 1 month and 3-month mortality was evaluated, stratified by whether patients had a history of CHF or not.ResultsPatients with prior CHF had higher endostatin levels, higher short-term mortality and were more likely to have CHF as discharge diagnosis. In a fully adjusted model, endostatin was independently associated with 3-month mortality (HR=1.01 per 1 ng/mL increment of endostatin; 95% CI 1.00 to 1.02; p=0.016). No evidence of association was identified with 1-month mortality.ConclusionsEndostatins are potential biomarkers for 3 months’ mortality in patients hospitalised with CHF seeking emergency care with acute dyspnoea. Further studies are needed in different settings to assess the predictive value of endostatins in patients with CHF.
Long-term outcome of oesophageal atresia in adolescence (TransEAsome): a national French cohort study protocol
Authors: Leroy Mélanie , Aumar Madeleine , Duhamel Marie , Dauchet Luc , Figeac Martin , Gaillard Segolene , Hankard Regis , Labreuche Julien , Marot Guillemette , Reversat Julie , Armand Viviane , Salzet Michel , Sfeir Rony , Vandel Jimmy , Gottrand Frédéric 
Published: January 2025

IntroductionTheTransEAsomeproject, funded by the Agence Nationale de la Recherche, aims to evaluate the long-term outcomes of patients with oesophageal atresia (OA) between 13 and 14 years old and establish multiomics profiles using data from the world’s biggest OA registry.Methods and analysisTransEAsomeis a national multicentre population-based cohort study recruiting participants from all qualified French centres for OA surgery at birth. The primary objective is to assess the prevalence of gastro-oesophageal reflux disease in adolescence among patients with OA, with several secondary objectives including the identification of risk factors and multiomic profiles from oesophageal biopsies and blood samples collected between 13 and 14 years old, compared with a control group. This comprehensive characterisation of phenotype and omic profiles aims to enhance the understanding of disease evolution in patients with OA and inform tailored care management strategies.Ethics and disseminationThe study, coconstructed with input from patients, parents and research-expert adolescents, has obtained approval from the ethics research committee: Comité de protection des personnes Est II. Findings will be disseminated to various target audiences, including the scientific community, research participants, the patient community, the general public, regulatory authorities and policymakers. Data will be made available in a Findable, Accessible, Interoperable, Reusable format on the France Cohortes platform on study completion.Trial registration numberNCT05995171:Clinical trial
Cross-sectional analysis of caesarean sections according to the Robson 10-group classification system in Somalia
Authors: Barut Adil , Erkok Umut , Hassan Hiba Bashir 
Published: January 2025

BackgroundCaesarean section (CS) is an important indicator of access to and quality of maternal health services. The WHO recommends the Robson 10-group classification system as a global standard for assessing, monitoring and comparing CS rates at all levels. Identification of the Robson groups that contribute the most to the overall CS is important to determine possible modifiable factors in our attempts to reduce the CS rate. This study was designed to analyse CS deliveries performed in a tertiary referral centre in Somalia according to the Robson 10-group classification system.DesignThis retrospective study included data on consecutive mothers who had deliveries from 1 January 2022 to 1 July 2023.MethodsData were categorised according to the Robson classification. Each patient’s data was coded according to Robson’s specifications.ResultsA total of 3030 deliveries were analysed. Of these, 1156 (38.2 %) were CS. Among the five largest Robson groups, the highest absolute contribution to CSs was found in group 5, with 11.4% followed by group 10 with a corresponding contribution of 9.4%. In the next three largest Robson groups (groups 1, 3, 4), the absolute contributions were 3.9%, 3.4% and 3.3%, respectively. The total percentages of CSs among all deliveries (n=3030) and among all CSs (n=1156) in the five largest Robson groups were 31.3% and 82.2%, respectively.ConclusionOur analysis showed that the overall caesarean section rate was 38.2%, and those major contributors were Robson groups 5 and 10.