bluuebunny/crossref_metadata_2025_split huggingface dataset:
Income precarity and child and parent weight change during the COVID-19 pandemic: a cross-sectional analysis of the Ontario Parent Survey
Authors: Anderson Laura N , Yoshida-Montezuma Yulika , Jambon Marc , Smith Brendan T. , Carsley Sarah , Gonzalez Andrea 
Published: December 2022

ObjectivesTo describe child and parent weight change during the pandemic, overall and by income precarity.DesignA cross-sectional online survey was conducted.SettingCaregivers of children 0–17 years of age living in Ontario, Canada, during the COVID-19 pandemic from May 2021 to July 2021.ParticipantsA convenience sample of parents (n=9099) with children (n=9667) living in Ontario were identified through crowdsourcing.Primary outcome measureParents recalled, for themselves and their child, whether they lost weight, gained weight or remained the same over the past year. OR and 95% CI were estimated using multinomial logistic regression for the association between income precarity variables and weight loss or gain, adjusted for age, gender and ethnicity.ResultsOverall, 5.5% of children lost weight and 20.2% gained weight. Among adolescents, 11.1% lost weight and 27.1% gained weight. For parents, 17.1% reported weight loss and 57.7% reported weight gain. Parent weight change was strongly associated with child weight change. Income precarity measures, including job loss by both parents (OR=7.81, 95% CI 5.16 to 11.83) and disruption to household food supply (OR=6.05, 95% CI 4.77 to 7.68), were strongly associated with child weight loss. Similarly, job loss by both parents (OR=2.03, 95% CI 1.37 to 3.03) and disruption to household food supply (OR=2.99, 95% CI 2.52 to 3.54) were associated with child weight gain.ConclusionsWeight changes during the COVID-19 pandemic were widespread and income precarity was strongly associated with weight loss and weight gain in children and parents. Further research is needed to investigate the health outcomes related to weight change during the pandemic, especially for youth, and the impacts of income precarity.
Study protocol for an observational cohort evaluating incidence and clinical relevance of perioperative elevation of high-sensitivity troponin I and N-terminal pro-brain natriuretic peptide in patients undergoing lung resection
Authors: Alonso María , Popova Ekaterine , Martin-Grande Ascencion , Pérez-Vélez Javier , Trujillo Juan Carlos , Gajate Luis , de Miguel Marcos , González-Tallada Anna , Martínez-Téllez Elisabeth , Cladellas-Gutierrez Esther , Planas Georgina , de Pablo Angélica , Parise Diego , Candela-Toha Angel , de Nadal Miriam 
Published: December 2022

IntroductionMyocardial injury after non-cardiac surgery has been defined as myocardial injury due to ischaemia, with or without additional symptoms or ECG changes occurring during or within 30 days after non-cardiac surgery and mainly diagnosed based on elevated postoperative cardiac troponin (cTn) values. In patients undergoing thoracic surgery for lung resection, only postoperative cTn elevations are seemingly not enough as an independent predictor of cardiovascular complications. After lung resection, troponin elevations may be regulated by mechanisms other than myocardial ischaemia. The combination of perioperative natriuretic peptide measurement together with high-sensitivity cTns may help to identify changes in ventricular function during thoracic surgery. Integrating both cardiac biomarkers may improve the predictive value for cardiovascular complications after lung resection. We designed our cohort study to evaluate perioperative elevation of both high-sensitivity troponin I (hs-TnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients undergoing lung resection and to establish a risk score for major cardiovascular postoperative complications.Methods and analysisWe will conduct a prospective, multicentre, observational cohort study, including 345 patients undergoing elective thoracic surgery for lung resection. Cardiac biomarkers such as hs-TnI and NT-proBNP will be measured preoperatively and at postoperatively on days 1 and 2. We will calculate a risk score for major cardiovascular postoperative complications based on both biomarkers’ perioperative changes. All patients will be followed up for 30 days after surgery.Ethics and disseminationAll participating centres were approved by the Ethics Research Committee. Written informed consent is required for all patients before inclusion. Results will be disseminated through publication in peer-reviewed journals and presentations at national or international conference meetings.Trial registration numberNCT04749212.
Burden and trends of multiple sclerosis in China from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019
Authors: Li Min , Zhou Na , Duan Shengnan , Zhong Hua , Jiang Rong , Yuan Ni 
Published: December 2022

ObjectiveTo compare the burden of multiple sclerosis disease indicators in the Asia-Pacific countries, China and globally through the Global Burden of Disease 2019 (GBD2019) Database, and to analyse the changes of multiple sclerosis disease burden in China from 1990 to 2019.Study designObservational study based on the Global Burden of Disease.SettingThe relevant incidence, prevalence, death and disability-adjusted life year (DALY) rates and corresponding age-standardised rates (ASRs) and sociodemographic index (SDI) in China, globally and in Asia-Pacific countries were extracted from the GBD2019 Database to further study the age-standardised incidence, prevalence and mortality, and the relationship between DALY rate and SDI.ResultsVarious disease burden indicators of multiple sclerosis in China are at low level in the world, and the prevalence, incidence and DALY rates have slowly increased from 1990 to 2019. During this period, the age-standardised prevalence rate (ASPR) of multiple sclerosis in China showed an upward trend, while the age-standardised death rate (ASDR), age-standardised DALY rate (ASR-DALY) and age-standardised incidence rate all decreased to varying degrees, which were roughly consistent with the global amplitude changes, and all indicators are similar to most countries in the Asia-Pacific region. As the value of the SDI increases, the ASPR of multiple sclerosis was trending upward, and the ASDR was trending downward.ConclusionCompared with other countries in the Asia-Pacific region, China is in a low state of disease burden indicators. However, as a developing country and the most populous country in the world, the total number of patients is not small, and as a rare disease, the treatment cost is relatively expensive, and the treatment cost of the complications caused by the disease is not low. The construction of the medical security system should be strengthened to reduce its burden on individuals, families and society.
Heat Storage in the Upper Indian Ocean: The Role of Wind-Driven Redistribution
Authors: Duan Jing , Li Yuanlong , Cheng Lijing , Lin Pengfei , Wang Fan 
Published: December 2022

Abstract
The heat content in the Indian Ocean has been increasing owing to anthropogenic greenhouse warming. Yet, where and how the anthropogenic heat is stored in the Indian Ocean have not been comprehended. Analysis of various observational and model-based datasets since the 1950s reveals a robust spatial pattern of the 0–700 m ocean heat content trend (ΔOHC), with enhanced warming in the subtropical southern Indian Ocean (SIO) but weak to minimal warming in the tropical Indian Ocean (TIO). The meridional temperature gradient between the TIO and SIO declined by 16.4% ± 7.5% during 1958–2014. The heat redistribution driven by time-varying surface winds plays a crucial role in shaping this ΔOHC pattern. Sensitivity experiments using a simplified ocean dynamical model suggest that changes in surface winds over the Indian Ocean, particularly those of the SIO, caused a convergence trend in the upper SIO and a divergence trend in the upper TIO. These wind changes primarily include the enhancements of westerlies in the Southern Ocean and the subtropical anticyclone in the SIO. Albeit with systematic biases, the ΔOHC pattern and surface wind changes simulated by phase 6 of the Coupled Model Intercomparison Project (CMIP6) models broadly resemble the observation and highlight the essence of external forcing in causing these changes. This heat storage pattern is projected to persist in the model-projected future, potentially impacting future climate.
Clinical outcomes of mild versus moderate hypothermic circulatory arrest with antegrade cerebral perfusion in adult aortic arch surgery: A systematic review and meta-analysis
Authors: Wang Lei , Zhong Guodong , Lv Xiaochai , Dong Yi , Hou Yanting , Chen Liangwan 
Published: December 2022

Objectives In adult aortic arch surgery, moderate hypothermic circulatory arrest (HCA) with selective antegrade cerebral perfusion (SACP) (MoHACP) is widely used, but the application of mild HCA with SACP (MiHACP) is still controversial. This meta-analysis aimed to compare clinical outcomes using MiHACP or MoHACP. Methods Studies comparing outcomes of MiHACP or MoHACP in adult aortic arch surgery were searched from four databases from inception through April 2022. Primary outcomes were postoperative permanent neurological deficit (PND), temporary neurological deficit (TND), and mortality. Secondary outcomes included other common complications. Meta-analysis was conducted using a random-effects model in all cases. Results Eleven comparative studies were included, with 1555 patients in MiHACP group and 1499 patients in MoHACP group, and the mean HCA temperature were 29.4°C and 24.8°C, respectively. Postoperative PND, TND, mortality, paraplegia, dialysis, tracheotomy, reexploration for bleeding, and chest tube drainage volume were comparable in the two groups ( p > 0.05). Ventilator time, intensive care unit and in-hospital length of stay were shorter in MiHACP group ( p < 0.05). Outcomes were also comparable or had some benefits in MiHACP group when subgroup analyses were conducted according to hemiarch or total arch replacement, unilateral or bilateral SACP, HCA time, emergency aortic dissection surgery, and concomitant procedure. Conclusion The present meta-analysis showed acceptability of MiHACP in adult aortic arch surgery. Results need to be taken with caution as moderate risk of bias and very low quality of evidence were observed in this meta-analysis. Randomized controlled trials are needed for further analysis.
Single-center experience of temporary-permanent pacemaker use in COVID-19 patients supported with veno-venous ECMO: A case series
Authors: Frederiks Pascal , Bianchi Paolo , Hunnybun Daniel , Behar Jonathan , Garfield Ben , Ledot Stéphane 
Published: December 2022

Introduction In the first year of the COVID-19 pandemic, nine out of 129 patients (7%) developed life-threatening bradycardia episodes ultimately requiring a TPPM, whilst being supported with VV-ECMO for severe COVID-19 ARDS in our tertiary cardio-pulmonary failure center. Analysis All subjects had asystole due to sinus node dysfunction and experienced at least one episode involving cardiopulmonary resuscitation. Most bradycardic events were seen in the context of vagal hypersensitivity. Mean time from general ICU admission to TPPM insertion was 20.6 ± 8.9 days. One patient developed a large chest wall hematoma weeks after TPPM implantation, no other TPPM-related issues were observed. No patient required a long-term pacing system. Six-months survival rate was high (89%). Conclusion These findings suggested that transient life-threatening sinus node disease is not uncommon in ECMO-dependent COVID-19 ARDS patients. TPPM with an active fixation lead is sometimes needed to facilitate ongoing ICU care, however, long-term permanent pacing was not required.
Healthcare professionals’ perceived barriers and facilitators of implementing clinical practice guidelines for stroke rehabilitation: A systematic review
Authors: Cormican Adrienne , Hirani Shashivadan P , McKeown Eamonn 
Published: December 2022

Objective To identify healthcare professionals’ perceived barriers and facilitators to clinical practice guideline implementation within stroke rehabilitation. Data sources CINAHL, MEDLINE, EMBASE, AMED, Cochrane library, Academic Search Complete and Scopus. Additional papers were identified through hand searching. Review methods The review followed the Preferred Reporting Item for Systematic Reviews and Meta-Analysis Protocols systematic review approach. Any empirical research that provided qualitative data on healthcare professionals’ perceived factors influencing clinical guideline implementation in stroke rehabilitation was included. One reviewer screened all titles and abstract reviews ( n = 669). Another two reviewers independently screened 30% of title and abstract reviews, followed by full-text reviews ( n = 61). Study quality was assessed using the mixed-method appraisal tool. Results Data from 10 qualitative, six quantitative and six mixed-method studies published between 2000 and 2022, involving 1576 participants in total, were analysed and synthesised using modified thematic synthesis approach. The majority of participants were therapists n = 1297 (occupational therapists, physiotherapists, speech and language therapists). Organisational factors (time constraints, resources) alongside healthcare professionals’ lack of knowledge and skills were the most cited barriers to guideline implementation. Contradictory attitudes and beliefs towards stroke guidelines applicability to real-life clinical practice and their evidence base were reported. Organisational support in the form of training, local protocols, performance monitoring and leadership were reported as perceived facilitators. Conclusion Barriers and facilitators are multifactorial and were identified at guideline, individual, team and organisational levels. There is a need to translate perceived barriers and facilitators into implementation interventions especially addressing organisational-level barriers.
Palliative and end-of-life care needs, experiences, and preferences of LGBTQ+ individuals with serious illness: A systematic mixed-methods review
Authors: Rosa William E , Roberts Kailey E , Braybrook Debbie , Harding Richard , Godwin Kendra , Mahoney Cassidy , Mathew Shiyon , Atkinson Thomas M , Banerjee Smita C , Haviland Kelly , Hughes Tonda L , Walters Chasity B , Parker Patricia A 
Published: December 2022

Background: Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals experience discrimination throughout the care continuum, including during serious illness and at end of life. High-quality palliative care requires that health professionals deliver individualized services that reflect the needs, experiences, and preferences of LGBTQ+ persons. Aim: To identify and appraise existing evidence related to the needs, experiences, and preferences for palliative and end of life care among LGBTQ+ individuals with serious illness. Design: Data-based convergent synthesis design reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources: PubMed, Embase, Cochrane CENTRAL, PsycINFO, CINAHL, and Scopus from January 1, 2010 to November 6, 2020. Results: Of 4875 results captured, 69 articles underwent full-text review and 13 were retained for analysis. Most studies were from North America with trans individuals represented in 10 of 13 studies. Needs ( n = 6) included increased social support, institutional safety, economic and legal supports, and advocacy to mitigate health barriers.Experiences ( n = 12) were driven by fear and worry associated with discrimination/stigma,providers’ hetero-/cisnormative assumptions, homophobia and transphobia, social isolation, and an undignified death. Preferences ( n = 6) pertained to inclusion of chosen families in decision-making, disclosure of LGBTQ+ identity based on safety of the clinical environment, and a desire to maintain autonomy. Conclusions: The robustness of the science has improved regarding the needs, experiences, and preferences of trans individuals. Actionable, inclusive policies coupled with sustained and integrated cultural sensitivity training for health workers are mandatory. Interventional research is critical to enhance tailored palliative care for LGBTQ+ people and their chosen families.
Motivations and experiences of patients with advanced cancer participating in Phase 1 clinical trials: A qualitative study
Authors: Yang Grace Meijuan , Ong Wah Ying , Tan Jasmine , Ding Jiayan , Ho Shirlynn , Tan Daniel , Neo Patricia 
Published: December 2022

Background: Persons with advanced cancer may participate in Phase 1 clinical trials – first-in-human trials that are conducted with the main objectives of safety and dosing. The motivations for participation are not well understood and may include hope for cure. Aim: To explore the perspectives of persons with advanced cancer in order to understand the motivations for participating in Phase 1 clinical trials, experiences while being on trial and views on palliative care provision. Design: Qualitative study with a constructivist stance, using thematic analysis based upon the grounded theory approach. Setting/participants: 20 persons with advanced cancer who were participating in a Phase 1 clinical trial. Results: Many participants described how Phase 1 clinical trial participation was their last hope, as they were cognisant of their advanced disease. Information-seeking needs differed – some needed comprehensive information while others relied on the doctor’s recommendation. Participants experienced varied negative and positive physical and psycho-emotional concerns, and needed to draw on multiple sources of support such as family, friends and healthcare professionals. Some could list potential benefits of palliative care but felt they did not require it yet. The overarching theme was hope and positive thinking as a way of coping. Conclusions: The concepts of hope as a way of coping and the supportive presence of healthcare professionals could be weaved into a future model of palliative care to improve the illness journey for patients considering Phase 1 clinical trial participation and other persons with advanced cancer.
Predicting roles of IL-27 and IL-32 in determining the severity and outcome of COVID-19
Authors: Zamani Batool , Najafizadeh Maedeh , Motedayyen Hossein , Arefnezhad Reza 
Published: December 2022

Objective Immune changes play fundamental roles in the pathogenesis and severity of coronavirus disease 2019 (COVID-19). Previous studies have revealed alterations in immune responses of patients with non-severe and severe COVID-19. Therefore, this study investigated whether interleukin-27 (IL-27) and interleukin-32 (IL-32) levels may be considered as predicting factors for determining the severity and outcome of COVID-19. Methods The blood samples were collected from 50 non-severe and severe patients infected with COVID-19 and 25 healthy subjects. The serum samples were isolated from the whole blood. The levels of IL-27 and IL-32 were measured by enzyme-linked immunosorbent assay and percentages of some immune cells were studied by cell counter. Results The levels of IL-27 and IL-32 were significantly higher in COVID-19 patients than healthy subjects ( p < 0.0001–0.01). IL-27 was significantly reduced in severe COVID-19 patients who needed to undergo ICU therapy ( p < 0.05). Disease severity was significantly associated with IL-27 level in patients with COVID-19 ( p < 0.05), unlike IL-32 level. There was a significant association between IL-27 and IL-32 in participants ( p < 0.0001, odds ratio (OR) = 0.9873; 95% confidence interval (CI) = 0.9998 to 1.000; p < 0.05, OR = 0.4462; 95% CI = 0.08,579 to 0.7802; p < 0.01, OR = 0.6640, 95% CI = 0.3007–0.8590). IL-27 level was significantly higher in the recovered subjects than dead cases ( p < 0.0001). IL-27 and IL-32 levels in patients who had fever were significantly higher than those who did not have ( p < 0.01–0.05), unlike patients who suffered from cough ( p < 0.001–0.01). The IL-27 level in patients with non-severe COVID-19 was directly correlated with CRP value ( p < 0.05, OR = 0.5,722,357, 95% CI = 0.06,807,176–0.8,435,928). IL-27 and IL-32 levels in non-severe patients were positively associated with NLR ( p < 0.01, OR = 0.7292; 95% CI = 0.2809 to 0.9163; p < 0.01, OR = 0.6537, 95% CI = 0.1425–0.8896). Patients with severe COVID-19 had a significant increase in NLR ( p < 0.0001–0.05). NLR was significantly correlated with the disease severity ( p < 0.0001–0.05). Survivors had a significant reduction in NLR compared with those who succumbed to COVID-19 ( p < 0.05). Conclusion Change in IL-27 level along with the frequencies of some immune cells may serve as a predictor of the severity and outcome of COVID-19.
Efficacy and Safety of Sacubitril/Valsartan Compared With ACEI/ARB on Health-Related Quality of Life in Heart Failure Patients: A Meta-Analysis
Authors: Yang Hua-rong , Xu Xiao-di , Shaikh Abdul Sami , Zhou Bo-ting 
Published: December 2022

Background: Data on the effects of sacubitril/valsartan compared with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) on health-related quality of life (HRQoL) are limited. Objective: To evaluate the comparative effects between sacubitril/valsartan and ACEI/ARB on HRQoL, a systematic review and meta-analysis were performed. Methods: PubMed, EMBASE, Web of Science, and ClinicalTrials.gov were searched from inception to March 2, 2022 for randomized controlled trials that compared the HRQoL scores, including Kansas City Cardiomyopathy Questionnaire (KCCQ), Minnesota Living with Heart Failure Questionnaire (MLHFQ), or Medical Outcomes Study Short-Form Health Survey 12 or 36 (SF-12/36), between sacubitril/valsartan and ACEI/ARB. After screening, studies that met the inclusion criteria were eventually included and analyzed. Results: A total of 8 studies with 17 390 patients (8693 patients used sacubitril/valsartan, and 8697 patients used ACEI/ARB) were included in this study. Five of these studies used KCCQ, 1 used SF-12/36, 1 used MLHFQ, and 1 used both KCCQ and SF-12/36. The KCCQ overall summary score and its subscales were significantly higher in sacubitril/valsartan compared with ACEI/ARB in heart failure patients with reduced ejection fraction, but were similar in heart failure patients with preserved ejection fraction. Sacubitril/valsartan conferred similar HRQoL scores in MLHFQ and SF-12/36 to ACEI/ARB. The most frequently reported adverse event for sacubitril/valsartan is hypotension and the risk is higher than for ACEI/ARB. Conclusions: Sacubitril/valsartan may have the potential to improve HRQoL in heart failure patients with reduced ejection fraction compared with ACEI/ARB. Hypotension is the most common adverse event with sacubitril/valsartan compared with ACEI/ARB. The results of this study may contribute to the rational use of sacubitril/valsartan.