bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children living with disabilities are neglected in severe malnutrition protocols: a guideline review
Authors: Engl Magdalena , Binns Paul , Trehan Indi , Lelijveld Natasha , Angood Chloe , McGrath Marie , Groce Nora , Kerac Marko 
Published: February 2022

PurposeChildren living with disabilities are at high risk of malnutrition but have long been marginalised in malnutrition treatment programmes and research. The 2013 WHO guidelines for severe acute malnutrition (SAM) mention disability but do not contain specific details for treatment or support. This study assesses inclusion of children living with disabilities in national and international SAM guidelines.MethodsNational and international SAM guidelines available in English, French, Spanish or Portuguese were sourced online and via direct enquiries. Regional guidelines or protocols subspecialising in a certain patient group (eg, people living with HIV) were excluded. Eight scoping key informant interviews were conducted with experts involved in guideline development to help understand possible barriers to formalising malnutrition guidance for children living with disabilities.Results71 malnutrition guidelines were reviewed (63 national, 8 international). National guidelines obtained covered the greater part of countries with a high burden of malnutrition. 85% of guidelines (60/71) mention disability, although mostly briefly. Only 4% (3/71) had a specific section for children living with disabilities, while the remaining lacked guidance on consistently including them in programmes or practice. Only one guideline mentioned strategies to include children living with disabilities during a nutritional emergency. Most (99%,70/71) did not link to other disability-specific guidelines. Of the guidelines that included children living with disabilities, most only discussed disability in general terms despite the fact that different interventions are often needed for children with different conditions. Interviews pointed towards barriers related to medical complexity, resource constraints, epidemiology (eg, unrecognised burden), lack of evidence and difficulty of integration into existing guidelines.ConclusionChildren living with disabilities are under-recognised in most SAM guidelines. Where they are recognised, recommendations are very limited. Better evidence is urgently needed to identify and manage children living with disabilities in malnutrition programmes. More inclusion in the 2022 update of the WHO malnutrition guidelines could support this vulnerable group.
Protocol for development of a core outcome set for clinical trials in melasma
Authors: Ibrahim Sarah A , Kang Bianca Y , Schlessinger Daniel I , Chiren Sarah G , Tang Jennifer C , Kirkham Jamie J , Schmitt Jochen , Poon Emily , Maher Ian A , Sobanko Joseph F , Cartee Todd V , Alam Murad 
Published: February 2022

IntroductionMelasma is a pigmentation disorder of the skin. Characterised by brown to gray-brown patches on the face and neck, the condition predominantly affects women and has been associated with pregnancy, hormonal variation and sun exposure. Melasma can be disfiguring and anxiety-provoking, and quality of life is often adversely impacted. Management includes sun protection, laser and energy device therapy, topical and oral skin-bleaching agents and chemical peels. While clinical trials of melasma exist, there is a lack of consistency in reported outcomes, which has been a barrier to the aggregation of data in systematic reviews and meta-analyses. This protocol describes a planned process for development of a minimum set of outcomes (ie, ‘core outcome set’) that should be measured in all clinical trials of melasma.Methods and analysisAn exhaustive list of potential outcomes will be extracted from four sources: (1) systematic literature review of outcomes in clinical trials; (2) semistructured patient interviews; (3) brochures, pamphlets, clinical trial registries, and other published and unpublished sources and documentation; and (4) interviews with non-patient, non-physician stakeholders, including federal regulators, industry scientists and non-physician providers. An international two-round Delphi process will then be performed to identify the outcomes deemed most important to patients and physicians. Subsequently, a consensus meeting will be convened to review and process the results, and to vote on a final set of core outcomes.Ethics and disseminationEthics approval was provided by the Northwestern University Institutional Review Board (protocol ID: STU00201637). This study is registered with both the Core Outcome Measures in Effectiveness Trials and Cochrane Skin-Core Outcome Set Initiative initiatives, and this protocol is in accordance with the guidelines for protocol development of both groups. All findings from the study described in this protocol will be disseminated to all stakeholders involved in the development process and will be submitted for publication in peer-reviewed journals.PROSPERO registration numberCRD42020214189.
Reporting of exercise dose and dosage and outcome measures for gaze stabilisation in the literature: a scoping review
Authors: Cole Keith R , Goodman Karen , Volland Lena 
Published: February 2022

ObjectivesThe concept of this review is to examine and quantify the reporting of parameters of dose (duration, speed, head excursion) and dosage (daily and weekly frequency, duration) for gaze stabilisation exercises and to report on outcome measures used to assess change in gaze stabilisation following intervention. This review includes any population completing gaze stabilisation exercises.DesignScoping review.MethodsWe searched key terms in the following databases: PubMed, CINAHL, Scopus and Cochrane. Two researchers reviewed titles, abstracts and full-text articles for inclusion. Data retrieved included: patient diagnosis, specific interventions provided, dose and dosage of gaze stabilisation interventions and outcome measures.ResultsFrom the initial 1609 results, 138 studies were included. Data extraction revealed that only 13 studies (9.4%) reported all parameters of dose and dosage. Most studies used other interventions in addition to gaze stabilisation exercises. Half of the studies did not use a clinical or instrumented outcome measure of gaze stability, using only patient-reported outcome measures. Clinical tests of gaze stability were used in 21.1% of studies, and instrumented measures of gaze stability were used in 14.7% of studies.ConclusionsFull reporting of the dose and dosage of gaze stabilisation interventions is infrequent, impairing the ability to translate current evidence into clinical care. Most studies did not use a clinical or instrumented measure of gaze stabilisation as outcome measures, questioning the validity of intervention effects. Improved reporting and use of outcome measures are necessary to establish optimal intervention parameters for those with gaze stability impairments.
Experiences and well-being of healthcare professionals working in the field of ultrasound in obstetrics and gynaecology as the SARS-CoV-2 pandemic were evolving: a cross-sectional survey study
Authors: Bourne Tom , Kyriacou Christopher , Shah Harsha , Ceusters Jolien , Preisler Jessica , Metzger Ulrike , Landolfo Chiara , Lees Christoph , Timmerman Dirk 
Published: February 2022

ObjectiveAssess experience of healthcare professionals (HCPs) working with ultrasound in obstetrics and gynaecology during the evolving SARS-CoV-2 pandemic, given the new and unprecedented challenges involving viral exposure, personal protective equipment (PPE) and well-being.DesignProspective cross-sectional survey study.SettingOnline international survey. Single-best, open box and Hospital Anxiety and Depression Scale (HADS) questions.ParticipantsThe survey was sent to 35 509 HCPs in 124 countries and was open from 7 to 21 May 2020. 2237/3237 (69.1%) HCPs from 115 countries who consented to participate completed the survey. 1058 (47.3%) completed the HADS.Primary outcome measuresOverall prevalence of SARS-CoV-2, depression and anxiety among HCPs in relation to country and PPE availability.AnalysesUnivariate analyses were used to investigate associations without generating erroneous causal conclusions.ResultsConfirmed/suspected SARS-CoV-2 prevalence was 13.0%. PPE provision concerns were raised by 74.1% of participants; highest among trainees/resident physicians (83.9%) and among HCPs in Spain (89.7%). Most participants worked in self-perceived high-risk areas with SARS-CoV-2 (67.5%–87.0%), with proportionately more trainees interacting with suspected/confirmed infected patients (57.1% vs 24.2%–40.6%) and sonographers seeing more patients who did not wear a mask (33.3% vs 13.9%–7.9%). The most frequent PPE combination used was gloves and a surgical mask (22.3%). UK and US respondents reported spending less time self-isolating (8.8 days) and lower satisfaction with their national pandemic response (37.0%–43.0%). 19.8% and 8.8% of respondents met the criteria for moderate to severe anxiety and depression, respectively.ConclusionsReported prevalence of SARS-CoV-2 in HCPs is consistent with literature findings. Most respondents used gloves and a surgical mask, with a greater SARS-CoV-2 prevalence compared with those using ‘full’ PPE. HCPs with the least agency (trainees and sonographers) were not only more likely to see high-risk patients but also less likely to be protected. A fifth of respondents reported moderate to severe anxiety.
Supporting community health workers in fragile settings from a gender perspective: a qualitative study
Authors: Raven Joanna , Wurie Haja , Baba Amuda , Bah Abdulai Jawo , Dean Laura , Hawkins Kate , Idriss Ayesha , Kollie Karsor , Nallo Gartee E , Steege Rosie , Theobald Sally 
Published: February 2022

ObjectiveTo explore how gender influences the way community health workers (CHWs) are managed and supported and the effects on their work experiences.SettingTwo districts in three fragile countries. Sierra Leone—Kenema and Bonthe districts; Liberia—two districts in Grand Bassa county one with international support for CHW activities and one without: Democratic Republic of Congo (DRC)—Aru and Bunia districts in Ituri Province.Participants and methodsQualitative interviews with decision-makers and managers working in community health programmes and managing CHWs (n=36); life history interviews and photovoice with CHWs (n=15, in Sierra Leone only).ResultsWhile policies were put in place in Sierra Leone and Liberia to attract women to the newly paid position of CHW after the Ebola outbreak, these good intentions evaporated in practice. Gender norms at the community level, literacy levels and patriarchal expectations surrounding paid work meant that fewer women than imagined took up the role. Only in DRC, there were more women than men working as CHWs. Gender roles, norms and expectations in all contexts also affected retention and progression as well as safety, security and travel (over long distance and at night). Women CHWs also juggle between household and childcare responsibilities. Despite this, they were more likely to retain their position while men were more likely to leave and seek better paid employment. CHWs demonstrated agency in negotiating and challenging gender norms within their work and interactions supporting families.ConclusionsGender roles and relations shape CHW experiences across multiple levels of the health system. Health systems need to develop gender transformative human resource management strategies to address gender inequities and restrictive gender norms for this critical interface cadre.
Improving the quality of the performance and delivery of continuous renal replacement therapy (CRRT) to critically ill patients across a healthcare system: QUALITY CRRT: a study protocol
Authors: Opgenorth Dawn , Reil Ellen , Lau Vincent , Fraser Nancy , Zuege Danny , Wang Xiaoming , Bagshaw Sean M , Rewa Oleksa 
Published: February 2022

IntroductionContinuous renal replacement therapy (CRRT) is a continuous form of dialysis used to support critically ill patients with acute kidney injury. The ideal delivery of CRRT requires ongoing monitoring and reporting to adjust practice and deliver optimal therapy. However, this practice occurs variably.MethodsQUALITY CRRT is a multicentre, prospective, stepped-wedged, interrupted time series (ITS) evaluation of the effectiveness, safety and cost of implementing a multifaceted CRRT quality assurance and improvement programme across an entire healthcare system. This study will focus on the standardisation of CRRT programmes with similar structure, process and outcome metrics by the reporting of CRRT key performance indicators (KPIs). The primary outcome will be the quarterly performance of CRRT KPIs. Secondary outcomes will include patient-centred outcomes and economic outcomes. Analysis will compare pre-implementation and post-implementation groups as well as for the performance of KPIs using an ITS methodology. The health economic evaluation will include a within-study analysis and a longer-term model-based analysis.DiscussionThe effective delivery of CRRT to critically ill patients ideally requires a standardised approach of best practice assessment and ongoing audit and feedback of standardised performance measures. QUALITY CRRT will test the application of this strategy stakeholder engagement and stepped-wedged implementation across an entire healthcare system.Ethics and disseminationThis study has received ethics approval. We will plan to publish the results in a peer-reviewed journal.Trial registration numberNCT04221932.Protocol version1.0 (15 June 2020).
GPs’ views on the implementation of combined lifestyle interventions in primary care in the Netherlands: a qualitative study
Authors: van der Heiden W , Lacroix JPW , Moll van Charante EP , Beune EJAJ 
Published: February 2022

ObjectivesPrevention and lifestyle support are emerging topics in general practice. Healthcare insurance companies reimburse combined lifestyle interventions (CLIs) in the Netherlands since January 2019. CLIs support people with overweight (body mass index, BMI 25–30) or obesity (BMI >30) to reduce weight in peer groups. General practitioners (GPs) are key in the successful implementation of lifestyle interventions in primary care. This study explored GPs’ experiences and views on the implementation of CLIs to identify barriers and facilitators to the successful implementation in primary care.DesignQualitative study using semistructured interviews. Content analysis consisted of thematic coding and mapping a first stage of predefined and second stage of iterative evolving set of themes.SettingGPs were interviewed in a variety of primary care practices between February and April 2019.ParticipantsFifteen GPs were purposively recruited for semi-structured interviews through snowballing.ResultsExperiences with lifestyle support among GPs ranged from referring patients to other healthcare professionals to taking a proactive role in lifestyle support themselves. Whether or not GPs took an active role in lifestyle support was related to their belief in the effect of lifestyle interventions. Overall, GPs had little experience with CLI in every day practice. Perceived barriers were a lack of availability of CLIs in the region and the potential lack of added value of CLIs on top of existing lifestyle support. Perceived facilitators were coordination of care provision by GP cooperatives and monitoring of the CLI implementation and their results. Reimbursement of CLIs without any costs for participants enabled application.ConclusionThe importance of lifestyle interventions in primary care was acknowledged by all GPs, but they differed in their level of experience with providing lifestyle support and awareness of CLIs. Successful integration of CLIs with primary care requires a solid promotion, a well-coordinated implementation strategy and structural evaluation of long-term effectiveness.
Vitreoretinal specialists compared with residents on outcomes of primary laser retinopexy in preventing retinal detachment in 958 eyes
Authors: Moussa George , Samia-Aly Emma , Ch'ng Soon , Lett Kim Son , Mitra Arijit , Tyagi Ajai K , Sharma Ash , Andreatta Walter 
Published: February 2022

ObjectiveRetinal tears are the most common vitreoretinal (VR) emergency and retinopexy aims to reduce the risk of rhegmatogenous retinal detachment (RRD). Currently retinal laser is a required competence by the Royal College of Ophthalmologists for residents. We report 6-month detachment rate and repeat retinopexy rate of VR specialists compared with residents.Methods and analysisA retrospective, consecutive study of 958 eyes undergoing primary laser retinopexy (slit lamp or indirect laser) from January 2017–2020 was divided into training level by operator: specialty training (ST) 2–3, ST4–5, ST6–7 and VR specialists.ResultsWe report an overall 6-month RRD rate in 32/958 (3.3%) (ST2–3: 9/221 (4.1%), ST4–5: 15/373 (4.0%), ST6–7: 2/72 (2.8%) and VR specialists: 6/292 (2.1%)). We additionally report a repeat retinopexy rate of 189/958 (19.7%), (ST2–3: 44/221 (19.9%), ST4–5: 80/373 (21.4%), ST6–7: 16/72 (22.8%) and VR specialists: 49/292 (16.8%)]). Multivariable Cox survival regression analysis showed significant risk factors for developing RRD include male gender (p=0.018), high myopia (≤−6.00 Dioptres, p=0.004), ST2–3 (p=0.022) and ST4–5 (p=0.040) (relative to VR specialists) and by ST6–7, no significance was found (p=0.151). Significantly higher repeat retinopexy rates were associated with horseshoe tears (relative to round holes, p<0.001) and high myopia (p=0.026) with no difference between different training levels.ConclusionThere was a decreasing trend in RRD rate following primary retinopexy with increase in training. Although junior residents had a higher RRD rate than VR specialists, it was still favourable relative to other large case series. While there was no difference in subsequent laser retinopexy rate between training levels, the retreatment rate was associated with the type of tear and high myopia.
Deep learning-based classification of retinal vascular diseases using ultra-widefield colour fundus photographs
Authors: Abitbol Elie , Miere Alexandra , Excoffier Jean-Baptiste , Mehanna Carl-Joe , Amoroso Francesca , Kerr Samuel , Ortala Matthieu , Souied Eric H 
Published: February 2022

ObjectiveTo assess the ability of a deep learning model to distinguish between diabetic retinopathy (DR), sickle cell retinopathy (SCR), retinal vein occlusions (RVOs) and healthy eyes using ultra-widefield colour fundus photography (UWF-CFP).Methods and AnalysisIn this retrospective study, UWF-CFP images of patients with retinal vascular disease (DR, RVO, and SCR) and healthy controls were included. The images were used to train a multilayer deep convolutional neural network to differentiate on UWF-CFP between different vascular diseases and healthy controls. A total of 224 UWF-CFP images were included, of which 169 images were of retinal vascular diseases and 55 were healthy controls. A cross-validation technique was used to ensure that every image from the dataset was tested once. Established augmentation techniques were applied to enhance performances, along with an Adam optimiser for training. The visualisation method was integrated gradient visualisation.ResultsThe best performance of the model was obtained using 10 epochs, with an overall accuracy of 88.4%. For DR, the area under the receiver operating characteristics (ROC) curve (AUC) was 90.5% and the accuracy was 85.2%. For RVO, the AUC was 91.2% and the accuracy 88.4%. For SCR, the AUC was 96.7% and the accuracy 93.8%. For healthy controls, the ROC was 88.5% with an accuracy that reached 86.2%.ConclusionDeep learning algorithms can classify several retinal vascular diseases on UWF-CPF with good accuracy. This technology may be a useful tool for telemedicine and areas with a shortage of ophthalmic care.
Bleeding management in palliative medicine: subcutaneous tranexamic acid - retrospective chart review
Authors: Howard Paul , Curtin John 
Published: February 2022

ObjectivesTo investigate the efficacy and safety of subcutaneously (SC) administered tranexamic acid.MethodsA retrospective chart review of the use of SC tranexamic acid in a single palliative care centre. We reviewed the use of this approach since it was introduced in our locality 2 years ago. All clinical notes, medication administration records and infusion monitoring documentation were examined to ascertain therapeutic aim, efficacy and tolerability.ResultsSC tranexamic acid was administered to 22 patients. The most common causes of bleeding were coagulopathy (5), bleeding tumours (9) and thrombocytopaenia (5). The therapeutic aim was either to prevent (6) or treat (16) bleeding and was achieved in 17/22 patients. During this 2-year period, our experience evolved resulting in a greater use of short bolus infusions to achieve more rapid control of bleeding events. Both short and continuous SC infusions were well tolerated with no instances of SC site reactions. One patient developed a suspected arterial thrombus in the last hours of life around the time of converting from oral (PO) to SC tranexamic acid.ConclusionsSC administration of tranexamic acid appears to be an effective and well tolerated alternative option for the palliative management of bleeding when the PO and intravenous routes are not available. Further research is needed to clarify tranexamic acid’s safety in palliative populations.
Resonance contributions in $$B^-\rightarrow K^+K^-\pi ^-$$ within the light-cone sum rule approach
Authors: Shi Yu-Ji , Meißner Ulf-G. , Zhao Zhen-Xing 
Published: February 2022

AbstractIn this work, we study the resonance contributions to the decay $$B^-\rightarrow K^+K^-\pi ^-$$

B
-

→

K
+

K
-

π
-

, which is dominated by the scalar $$f_0(980), K_0^*(1430)$$

f
0

(
980
)

,

K
0
∗

(
1430
)

, vector $$\rho (1450), \phi (1020), K^*(892)$$

ρ

(
1450
)

,
ϕ

(
1020
)

,

K
∗

(
892
)

and tensor $$f_2(1270)$$

f
2

(
1270
)

resonances. The three-body decay is reduced to various quasi two-body decays, where the B meson firstly decays into a resonance and a pion or a kaon, subsequently the resonance decays into the other two final-state mesons. The quasi two-body decays are calculated within the light-cone sum rule approach utilizing the leading twist B meson light-cone distribution amplitudes. Finally, the decay branching fraction contributions from each resonance is calculated. Some of them are compatible with experiment or previous theoretical works. Including the effects of non-resonant and final-state interactions, we also evaluate the total branching fraction.